Your Guide to Quitting Smoking

The information in this guide will help you understand the benefits of quitting smoking, identify the reasons you may want to quit smoking, and help you to quit safely and effectively.

This guide will also teach you practical skills to cope with urges to smoke, help you to find ways to deal with nicotine withdrawal, and help you get support from your friends and family. It also provides helpful hints on how to stay a nonsmoker once you’ve quit.

You may be able to quit just by using this guide, but most people benefit from cessation counseling and medications. The Tobacco Treatment Program at Memorial Sloan Kettering (MSK) is available to help you. Our program specializes in helping people with cancer, cancer survivors, and their family members. We understand the challenge of wanting to quit smoking while dealing with the stress of a cancer diagnosis, treatment, and the fear of recurrence. The program offers recommendations for cessation medications, counseling, and support to anyone who wants to quit or who is thinking about quitting. We can also recommend other support services here at MSK and in your community. For more information, call 212-610-0507.

Find Your Reasons to Quit

Research shows that there are risks if you continue to smoke and benefits if you quit no matter what kind of cancer you have or what stage it is. This is true from the time you get cancer all the way through your cancer treatment and follow-up care.

If you or someone you love is being treated for cancer, the changes in your priorities and outlook on life may help you quit. If you’re a cancer survivor, knowing you beat cancer may motivate you to live a healthier life. There are lots of good reasons to quit—we’re here to help you find yours. 

There is a lot of research about the negative effects of smoking on health that matter to people with cancer. Below are some reasons to quit smoking that are related to cancer care. Check off the reasons that matter most to you. Talk with your doctor about how smoking may affect your cancer treatment plan, and add any additional reasons to quit to your list.

Quitting smoking:

  • Reduces treatment complications.
  • Helps wounds heal after surgery.
  • Lowers the risk of infection after surgery.
  • Reduces symptoms related to chemotherapy toxicity, such as infection and heart or breathing problems.
  • Decreases the need for rehabilitation to improve breathing after surgery.
  • Can decrease the risk of a cancer coming back and of developing new cancers.
  • Helps the heart and lungs work better.
  • Improves sleep and helps people feel less tired and have more energy.
  • Can help people feel better emotionally, feel less stressed, and have a better quality of life.
  • Improves self-esteem.
  • Helps people feel more in control of their lives.
  • Can decrease the risk of dying from cancer and other diseases for people who have cancer or are cancer survivors.
  • Can improve people’s sense of smell, taste, and appetite.
  • Improves the effectiveness of cancer treatments.

Knowing the benefits quitting can have on their bodies is enough to help some people quit, but we find many people have their own reasons for wanting to quit. Below are some reasons people have shared with us. Do you have any of the same reasons to quit? If so, check them off, and use the blank spaces to write in your own reasons. The decision to quit smoking is a personal one, so the more meaningful this list is to you, the more helpful it will be.

  • To be more actively involved in my cancer care.
  • To have more energy.
  • To set a good example for family and friends.
  • Smoking is expensive.
  • Smoking smells bad.
  • Smoking causes yellow teeth and unhealthy gums.
  • I want freedom from tobacco addiction.
  • Most of my friends have already quit.
  • To see my children/grandchildren grow up.
  • To reduce my family’s worry about my health.
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Health Benefits of Quitting

The American Cancer Society suggests that everyone can benefit from quitting, starting…

  • 20 minutes after quitting smoking: your blood pressure decreases to your normal level. The temperature of your hands and feet increases to normal.
  • 8 hours after quitting smoking: the carbon monoxide level in your blood drops to normal.
  • 24 hours after quitting smoking: your chance of a heart attack decreases.
  • 2 weeks to 3 months after quitting smoking: your circulation improves and your lung function increases up to 30%.
  • 1 to 9 months after quitting smoking: coughing, sinus congestion, fatigue, and shortness of breath decrease. Cilia (tiny hair-like structures) work normally again, so they can clean your lungs and reduce infection.
  • 1 year after quitting smoking: the risk of coronary heart disease is one-half that of a smoker’s.
  • 5 years after quitting smoking: the risk of having a stroke is reduced to that of a nonsmoker’s.
  • 10 years after quitting smoking: the death rate from lung cancer is 50% lower than that of a person who continues to smoke. The risk of cancer of the mouth, throat, esophagus, bladder, kidney, and pancreas decreases.
  • 15 years after quitting smoking: the risk of heart disease is the same as a nonsmoker’s.
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Decide to Quit

Now that you’ve listed your reasons for quitting, it’s time to think about your quitting concerns. This is important so that you can find ways to handle them. Below on the left are some common concerns about quitting, and on the right are suggestions for dealing with these concerns. Check off those that are true for you, and add your own.

My Concerns about Quitting

How to Handle My Concerns

  • I will be irritable.


  • Medication for quitting will help.
  • Ask people to be patient with me.
  • Quitting will make me feel lousy.
  • Remind myself that within a few days, I’ll feel like myself again.
  • Medication for quitting will help.
  • I’m afraid I will fail.


  • Tell myself that if I slip, I’ll get back on track. Quitting takes practice and I’ll learn from my mistakes.
  • Get support from family, friends, or your healthcare provider.
  • Smoking relaxes me.




  • Try other relaxation methods, such as:
  • Take 3 deep breaths.
  • Listen to soft music.
  • Exercise or do light stretching.
  • Drink herbal decaffeinated tea.
  • Take a warm bath or shower.
  • Smoking is a difficult habit to break.
  • Tell myself that it may be tough at first, but my urges will lessen and I’ll learn to live without cigarettes.
  • I enjoy smoking.


  • Do more of the things that make me feel happy.
  • Distract myself with other activities. For example go for a walk, call a close friend, or go see a movie.
  • Smoking is comforting.


  • Get a massage.
  • Call a friend.
  • Soak in a bath.
  • I will gain weight.



  • Remind myself that using medication for quitting will make me less likely to gain weight.
  • Drink water.
  • Enjoy healthy snacks, such as low-fat yogurt, raw nuts, fresh fruits, and vegetables.
  • Increase my daily physical activity.
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START Quitting

The National Cancer Institute recommends the START approach to stop smoking. When you’re ready, use the strategies below to quit smoking.

S = Set a quit date (the actual day you will stop smoking)

T = Tell family, friends, and coworkers you plan to quit and when

A = Anticipate and plan for the challenges you may face while quitting

R = Remove cigarettes and other tobacco products from your home, car, and work

T = Talk with your doctor about quitting

Set a quit date

Choosing a quit date will motivate you and increase your chance of success. If you’re ready to set a quit date right now, the steps below will help you reach your goal.

If you’re not ready to set a quit date right now, that’s ok. Some people succeed by gradually cutting down on how much they smoke. Review your reasons for quitting often, and use the steps in this guide to help you feel more confident in setting a quit date later.

Tell your friends, family, and coworkers about your plans to quit

  • Tell them what they can do to help. If they smoke, consider asking them to try to quit along with you. You may find that you can give each other the best support since you know what the other is going through. If they aren’t ready to quit, ask them to promise not to smoke around you, your home, or your car, to keep cigarettes out of sight, and not to give you a cigarette, even if you ask for one. You don’t want their smoking to tempt you.
  • When you feel like smoking, ask them to help you focus on your reasons for quitting.
  • Suggest ways that they can encourage you without lecturing you. They should never focus on setbacks. They should focus on successes, no matter how small they may be. Every step toward quitting is a positive step.
  • Practice relaxing together using deep breathing, walking, or listening to music you like.
  • Ask them to help you plan how you will deal with urges to smoke.
  • Ask them to plan something special to celebrate your quit day, like a movie or dinner.
  • Ask them to be there for you if you want to talk. Just having someone to talk to can help.

Anticipate and plan for challenges

Expecting challenges is an important part of preparing to quit. If you’ve tried to quit smoking before, you’re one step closer to becoming tobacco free.

Know your triggers

If you’re like most people, you have triggers and habits that set you off or “tell” you to smoke. What are your triggers? Check them off below and add your own.

  • Drinking alcohol
  • Boredom
  • Coffee
  • Meals
  • Talking on the phone
  • Using a computer
  • Being around smokers
  • Stress

Prepare for nicotine withdrawal

When you stop smoking, your body has to get used to not having nicotine in your system. As your body adjusts to this, you’ll have signs of withdrawal. These usually last a week or 2, but some may last longer. Using NRT and other safe and effective medications for smoking cessation can reduce symptoms of nicotine withdrawal.

The first few days after quitting smoking are hard. Keep in mind that feeling irritable, upset, or down can be a normal part of early nicotine withdrawal. These feelings are temporary. Remind yourself why you want to quit. Keep using the strategies for coping with smoking urges that you came up with. Everyone experiences withdrawal differently, but below are the most common signs of withdrawal and helpful tips on managing them.

Signs of Withdrawal

What You Can Do







  • Cravings last only a minute or 2, so using the “4 Ds” can help you stay smoke free.

                  Delay—wait a few moments

                  Drink a glass of water

                  Distraction—do something else

                  Deep breathing

  • You can also use medications to help manage cravings and other signs of nicotine withdrawal. Common medications are listed later in this guide.



  • Take a warm bath.
  • Do deep breathing exercises.
  • Take an over-the-counter pain medication, such as acetaminophen (Tylenol®) or ibuprofen (Advil®).

Feeling down


  • Do things that make you happy and distract you, such as a hobby or spending time with friends.
  • Don’t drink alcohol. Alcohol causes more stress because of its effects on judgment, memory, health, and your ability to manage difficult situations.


  • Move slowly, especially when getting up.

Dry mouth/sore throat

  • Drink lots of water, suck on sugar-free candy, or chew sugar-free gum.
  • You may cough more as your lungs begin to recover, but the coughing will lessen after a short period of time.




  • Drink plenty of water.
  • Eat high-fiber foods, such as raw fruits and vegetables, bran, rice, and whole grains.
  • Be physically active. Exercises like walking or swimming can help your bowel movements become more regular.
  • Talk with your healthcare provider.

Feeling tired




  • Moderate physical activity and exercise are great ways to boost your energy. If possible, take a short walk and get some fresh air.
  • Get plenty of rest.
  • Schedule activities at times when you have the most energy.
  • Take breaks or naps. Don’t push yourself.
  • Ask for help rather than trying to do too much yourself.


  • Drink plenty of water.
  • Make healthy snack choices, such as fresh fruits and vegetables, low-fat yogurt, and raw nuts.

Irritability, tension and/or anxiety





  • Use short-acting nicotine replacement therapy (NRT). NRT and other safe and effective medications are explained later in this guide.
  • Do things that you enjoy and that distract you, such as a hobby.
  • Talk with friends or family members.
  • Do light stretching and deep breathing, which can reduce tension in your muscles and make you feel more relaxed.
  • Remind yourself that you will get through this.
  • Physical activity, such as going for a walk, can reduce stress and improve your mood. (Be sure to check with your doctor before starting any new exercise program.)

Trouble sleeping




  • Avoid caffeine in the evening and eating late at night.
  • Try a bedtime ritual, such as deep breathing, taking a warm bath or shower, reading, or listening to classical music.
  • Try drinking a glass of warm milk or a calming herbal tea before going to bed.
  • Don’t watch television or use a computer 1 to 2 hours before bedtime.
  • Ask your healthcare provider about whether a sleep medication may be right for you.

Trouble concentrating



  • Break down large projects into smaller tasks.
  • Allow time to prepare for a task and work up to it.
  • Simplify your schedule for a few days.
  • Take breaks often.
  • Make “to do” lists.

Quitting smoking while going through other stressful situations, such as cancer treatment, can be overwhelming. If these feelings are keeping you from doing your usual activities, you may be experiencing depression or anxiety. Talking with a healthcare provider who specializes in treating people who are quitting smoking can help. At MSK, our Tobacco Treatment Program can provide emotional support and treatment for you and your friends and family. Call 212-610-0507 for more information.

Learn to coach yourself

You can change your level of stress, mood, and even your behavior by learning to control your thoughts. Being very critical of yourself and having negative thoughts can make you feel more upset, worried, or depressed. Instead, try to reduce your stress by using positive, encouraging, and motivational thoughts. You can talk yourself into or out of smoking a cigarette.

Think about how you’ll coach yourself out of having a cigarette.

Instead of saying to yourself…

Try saying something like…

“This is just too hard. I can’t quit smoking.”

“I may have been hooked, but now I am learning how to live life without smoking. This is a challenge, and I’m making progress one step at a time.”

“Why bother? I don’t really see the point of quitting, anyway.”

“I made a commitment to quit for some good reasons. My doctor has described some benefits of quitting, and I want to do everything I can to fight this disease. I have come a long way, and I will make it.”

“Things will get better after I have a cigarette.”

“Cigarettes don’t make things better, they just provide a brief escape. Smoking will not solve this problem. I can find other ways to improve my situation.”

Before you try to quit, make a list of telephone numbers of people you can call for support, such as your family, friends, and the national toll-free Tobacco Quitline 1-800-QUIT NOW or 800-784-8669. Keep your telephone list handy for when you may need it.

Remove cigarettes and tobacco from your home, car, and workplace

Get rid of all the things that remind you of smoking such as:

  • Cigarettes
  • Matches
  • Lighters
  • Ashtrays

Remember to go through your pockets, kitchen drawers, and the glove compartment in your car. Making your home and car smoke free is an important first step toward quitting. If you no longer have reminders of your smoking in your home or car, you are improving your chances of success. Removing cigarettes from your workplace is also a great way to help reduce the chance that you will reach for a cigarette to deal with job-related stress.

Talk with your doctor about getting help to quit

Talk with your doctor about what challenges you expect and your concerns about quitting. Your doctor can provide you with advice and may give you a referral to a quit line or a tobacco treatment specialist to help you with your quitting efforts.


Addiction to nicotine is best treated with medications that have been proven to be safe and effective. These medications help by reducing cravings for cigarettes and decreasing the signs of withdrawal associated with quitting smoking, such as depression, anxiety, irritability or anger, increased appetite, restlessness, and problems concentrating. Using both medication and counseling will double your chances of successfully quitting and staying quit.

Below are frequently asked questions that people have about taking medication to help quit smoking.

Which types of medications are available to help me stop smoking?

  • Nicotine replacement therapy is one type of quitting medication that is approved by the Food and Drug Administration (FDA) and is safe and effective. These medications replace the nicotine your body gets from smoking cigarettes, helps manage nicotine withdrawal, and gradually reduces your dependence on nicotine. NRT products available include:
    • Nicotine gum (Nicorette®, Nicotrol®)
    • Nicotine inhaler (Nicotrol®)
    • Nicotine lozenge (Commit®)
    • Nicotine nasal spray (Nicotrol®)
    • Nicotine patch (NicodermCQ®, Nicotrol®, Habitrol®)
  • There are also 2 medications taken as a pill that are approved by the FDA to help you quit smoking. These medications do not contain nicotine but can reduce your urge to smoke, as well as the signs of nicotine withdrawal. These medications include:
    • Bupropion SR (Wellbutrin SR®, Zyban®)
    • Varenicline (Chantix®)  

Are these medications safe?

All of the available medications to help you quit smoking have been studied and are proven to be safe and effective. It is important to understand that these medications do not contain the harmful chemicals found in tobacco smoke, which are known to cause cancer. There is currently no evidence that shows that nicotine causes human cancer; however, it can be addictive and have other effects on your health.  

Can I use more than one medication at the same time?

Using more than 1 medication to stop smoking is both safe and effective. In fact, combining the nicotine patch with nicotine gum, lozenge, nasal spray, or inhaler, has been shown to be more effective than using either nicotine replacement therapy alone. Non-nicotine medications such as bupropion can also be safely combined with nicotine replacement therapy in order to increase your chances of quitting.

Can I use these medications if I am not ready to quit smoking?

If you’re not ready to set a quit date, using the smoking cessation medications can also help you to cut back or reduce the total number of cigarettes you smoke daily. This can help you quit smoking in the future. Talk with one of MSK’s tobacco treatment specialists or another healthcare provider about using these medications safely to cut down your use of cigarettes prior to quitting.

FDA-Approved Smoking Cessation Medications


How to Get it How it Works

Nicotine Patch

  • 21 mg
  • 14 mg
  • 7 mg

Over the counter (OTC)

  • Placed on the skin to deliver a small and steady dose of nicotine over a 24-hour period.
  • Can be used safely in combination with other nicotine replacement products and with bupropion.

Nicotine Gum

  • 2 mg
  • 4 mg


  • Chewed until a peppery flavor/tingling feeling is produced and then placed between cheek and gums in order to allow nicotine to be absorbed.
  • Can be used safely in combination with other NRT products and with bupropion.

Nicotine Lozenge

  • 2 mg
  • 4 mg


  • Similar to hard candies that dissolve in the mouth; they are moved side to side in the mouth to allow nicotine to be absorbed.
  • Can be used safely in combination with other NRT products and with bupropion.

Nicotine Inhaler

  • 10 mg/cartridge

By prescription only

  • Uses a mouthpiece that holds cartridges containing nicotine. As the user inhales the mouthpiece, a dose of nicotine is absorbed in the mouth and upper airway.
  • Can be used safely in combination with other NRT products and with bupropion.

Nicotine Nasal Spray

  • 1 mg/dose

By prescription only

  • Comes in a pump bottle that is placed in the nostril and sprayed to deliver a dose of nicotine that is absorbed in the nasal passage.
  • Can be used safely in combination with other NRT products and with bupropion.

Bupropion (Zyban®)

By prescription only

  • Pill that is taken by mouth.
  • Can be used safely in combination with nicotine replacement therapy

Varenicline (Chantix®)

By prescription only

  • Pill that is taken by mouth.
  • Makes smoking less enjoyable by blocking the effects of nicotine in people who continue to smoke.

What about electronic cigarettes (e-cigs or e-cigarettes)?

Electronic cigarettes are battery-operated devices that heat a liquid typically containing nicotine and flavorings. A vapor or mist is created, which is then inhaled.

The electronic cigarette is not an FDA-approved device to help people quit smoking, and therefore, we recommend that you use safe and proven methods to quit smoking.

We don’t yet know what the short and long-term health risks are related to using e-cigarettes. We also don’t know whether e-cigarettes help people quit smoking. At MSK, we examined the use of e-cigarettes among people with cancer and found no evidence that using e-cigarettes improved success in quitting smoking.

Some people are using the e-cigarette to help manage their nicotine withdrawal cravings, reduce their exposure to the harmful chemicals in traditional cigarettes, cut down or quit smoking, or prevent smoking relapse. If you have questions or thoughts about using an e-cigarette, talk with a tobacco treatment counselor.

On Your Quit Date

Congratulations! Here are 5 suggestions for your quit date.

  • Get rid of any reminders of smoking (cigarettes, lighters, ashtrays), if you haven’t done so already.
  • Avoid temptation—review and use the coping strategies you have selected from this guide.
  • Remind your friends and family that today is your quit date.
  • Reward yourself—treat yourself special during your first month off cigarettes.
  • Plan to celebrate the day you became a nonsmoker each month.

Staying a Nonsmoker

Now that you’ve quit, it’s time to think about how to stay smoke free.

  • A slip is when someone who has quit smoking has had a puff or a few cigarettes but doesn’t return back to their regular smoking habit.
  • Relapse is when someone who has quit smoking starts smoking one or more cigarettes a day for a week or more.
  • Slips put ex-smokers at risk for relapse.

Plan for situations

There are 8 common situations that can lead to a slip or relapse. Be aware of these and plan ways to avoid smoking if you are tempted.

  1. Stress or other negative feelings. People, situations, events, and emotions can trigger smoking. People often smoke to manage stress or deal with unpleasant feelings. Depression, anxiety, and anger can cause urges to smoke and result in relapse if you aren’t prepared to cope with these emotions in other ways.
  2. Positive feelings. Many smokers say they enjoy smoking, so when they quit, they lose a source of reward, pleasure, and comfort. Positive emotions can also trigger smoking. About 25% of people (1 out of 4) who relapse do so when they feel happy, calm, or relaxed.
  3. Withdrawal. Most nicotine withdrawal signs last a short time, but they can be unpleasant and lead to relapse. Smoking cessation medications can help lessen the signs of withdrawal and your body’s dependence on nicotine.
  4. Alcohol. When you drink alcohol, you’re more likely to give in to cravings to smoke. Avoid alcohol for the first month or so after your quit date.
  5. Relaxing after meals. For many people, relaxing after a meal is often paired with smoking. Make a list of alternate strategies you can use if finishing a meal is a smoking trigger for you.
  6. Social situations. Giving up cigarettes when you are with other smokers may feel like a loss, so be prepared. Celebrating with friends, especially those who smoke, may lead you to let your guard down. Either keep your time with other smokers limited, or ask if they can avoid smoking in your presence. Excusing yourself if you feel tempted is always a good way out.
  7. Recovery from cancer or treatment. Many people stop smoking after a cancer diagnosis, especially before surgery. Some people are tempted to smoke once they recover from treatment, start feeling better, and begin to go back to their usual routine. Use this time to change your routine, increase pleasant activities, and avoid your smoking triggers.
  8. Boredom. Some people, especially those who are tired, unable to work during their treatment, or both, find themselves feeling bored. Boredom can trigger smoking urges. Consider planning your day to include stimulating, engaging activities that bring you comfort, meaning, and satisfaction. Staying busy with hobbies or other enjoyable activities helps distract you from urges to smoke.

If you slip

If you have a slip, don’t panic! A slip is telling you something. Try to figure out what caused the slip. Ask yourself:

  • Was I in a high-risk situation, such as being with smoking friends at a social event or feeling overly stressed? Did I think about the high-risk situation ahead of time, and prepare or rehearse my coping strategies? What prevented me from identifying and preparing for the high-risk situation?
  • Was I having nicotine withdrawal? If using nicotine replacement, was I using it as directed?
  • Was my motivation to quit fading? If so, could I have boosted it by reviewing my reasons for quitting? Did I use positive coaching?

Get back on track by quitting smoking again. After thinking about what happened, make a plan to deal with it. Think about whether you find it best to avoid these situations altogether or face them using your best coping strategies. Remember to use coping strategies, such as positive self-coaching and engaging in a distracting activity, to increase your chances for future success.

If you relapse

If you relapse, don’t beat yourself up. Look out for negative self-statements, such as “I’ll never quit,” or “I’m a failure.” Think about these harsh statements—can you really predict the future? Can you really know it’s impossible for you to quit?

  • Throw away any cigarettes you still have.
  • Tell yourself that you have tried to quit and what you learned about yourself and the nicotine habit.
  • Think about times when you learned a new skill, such as riding a bicycle or using a computer. You didn’t just master these new skills in one try; you figured out what worked and what didn’t as you went along. So learning to live life without cigarettes also requires sticking with it and trying new ways to cope with the temptations to smoke.
  • If you slip or relapse, you may feel guilty or try to hide it. Instead, talk with your healthcare provider or others who are there to support you. Think about what led to the slip or relapse and figure out ways to deal with it next time.
  • It may be time to develop a stronger action plan. If you’re not sure why you relapsed or how to get back on track, call the Tobacco Treatment Program at MSK. We’re here to help.
  • Review the strategies in this guide.
  • Set a new quit date and start again. You are one step closer to achieving your goal.

Reviewing the strategies and suggestions in this guide from time to time can help you stay a nonsmoker. It’s never too late to enjoy the benefits of being a nonsmoker.

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American Cancer Society
1-800-ACS-2345 or 1-800-227-2345
Provides information and support to people with cancer and their caregivers. 
American Heart Association
Provides resources to help people quit smoking and stay quit.
American Lung Association
1-800-LUNG-USA or 1-800-586-4872
Provides resources to help people quit smoking.
Centers for Disease Control and Prevention
The Tips campaign features stories of former smokers living with smoking-related diseases and disabilities and the toll that smoking-related illnesses have taken on them. 
Memorial Sloan Kettering’s Tobacco Treatment Program
The Tobacco Treatment Program can help you stop using tobacco, whether or not you are a patient at MSK. We use a wide range of approaches to help you quit, including medications and behavioral techniques.
National Cancer Institute
Clearing the Air. Quit Smoking Today
This booklet is designed to help people quit smoking and prepare for the challenges that can come up after quitting.
National Smokers’ Quitline
1-800-QUIT NOW or 1-800-784-8669
Provides a variety of resources to help people quit smoking.
The EX Plan
A free quit smoking program.
US Department of Health and Human Services
A consumer guide to the Surgeon General’s report The Health Consequences of Smoking: 50 Years of Progress.
US Food and Drug Administration: Electronic Cigarettes (e-Cigarettes)
Information about regulations for e-cigarette use and to learn about and report adverse events.
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