Tuesday, July 1, 2008
The internet has long been rife with self-help sites for those who wish to give up smoking, but new technologies are emerging to give smokers a leg up in their struggle.
There are websites that offer interactive resources to motivate quitters and keep them on track, mini-computers that can help you track your progress, and software for hand-helds that makes it easier for doctors to pitch in.
"These technologies offer a lot of promise -- they are very intriguing," said Scott Strayer, a physician who developed software called the Handheld Computer Smoking Intervention Tool for the National Cancer Institute.
The software allows clinicians to access data about smoking cessation, drug interactions, addiction evaluations and other information to use in interviews as people begin the effort to quit.
The role of computers is evolving, said Strayer, a family practice physician who teaches at the University of Virginia. He hopes the next generation of hand-held medical devices will be able to track smokers' progress and link their quitting regime with their health records, to give doctors a portable and unobtrusive profile of their patients' efforts.
Though there has been little clinical research, Strayer said websites with interactive capabilities like social networking also can improve the chances of kicking the habit for good.
A study published last month in the New England Journal of Medicine found smokers tend to quit in groups and that real-life social networks add to the pressure to quit.
Researchers at the University of California-San Diego said they looked at 12,000 socially interconnected people over 32 years. They did not examine online communities, but some researchers believe that what works in the real world also would work online.
One of the best online communities is at a site run by a suburban Boston woman, Terry Miller (quitsmoking.about.com). It offers an environment of mutual encouragement and support among its thousands of members, who gather dots, stars, keys and wings as they progress.
Miller, a 51-year-old mother of two, logged on to the site after smoking for 26 years. That was six years ago and Miller now operates the site, which she says has helped thousands of people quit.
Miller says the online community actually may work better than a real-life social circle at helping people. For example, the support community online is far bigger, it's made up entirely of individuals on a shared journey, and it's available to quitters round-the-clock.
"In all of the years I've been participating at the ... forum, the idea of stepping outside of oneself to help another has been the foundation of the community. It's contagious and self-sustaining," Miller said. Though she has no firm evidence, Miller believes the success rate for people who join the site is much higher than the 7 percent who succeed in the general population.
Beth Bock, a professor in the Department of Psychiatry and Human Behavior at Brown University Medical School, has been studying online resources for aspiring quitters for years. Her latest research, due to be published shortly in the Journal of Medical Internet Research, found that while web-based resources are plentiful, it may be difficult to locate the best sites.
An analysis of the top results for search terms like "quit smoking" or "smoking cessation" found three of every four sites offering little or no quality resources; many merely sold smoking-cessation products or listing articles.
The best sites followed U.S. Public Health Service guidelines, which include assessing how ready smokers are to quit, assisting them with plans, providing practical counseling tips and suggestions, offering social support, recommending mediation and arranging follow-up.
Interaction is crucial, Bock said, and while some sites provide ways for smokers to interact with each other, they could be doing much more.
PRESSING THE BUTTON
The QuitKey mini computer helps quitters keep track of their progress.
Then there are devices like the QuitKey, a computer small enough to carry on your key chain, and which can prod you, step by step, along the path to nicotine freedom.
In step one, you smoke normally but press a button, to allow the device to track your tobacco habits. The little computer creates a profile of your addiction. Then, in stage two, it prompts you when to smoke, gradually reducing the number of cigarettes per day until it reaches zero.
If all else fails, there is a South American website called Build Your Own Death Project (irreal.cl/byodp) that offers a novel way of reminding smokers of the deadly consequences their habits can have.
The site allows smokers to download, print and assemble cigarette packaging with skeletons, ghosts and other ghoulish graphics on them and names like "Cancers," "Muerte" and "Suicide."
As a physician who has spent my professional career helping those with nicotine addiction, I would like to offer an alternative view. Using spit tobacco for smoking cessation is an area of controversy among anti-tobacco advocates. Many of us who have cared for patients with their tongues or half their jaws removed because of spit tobacco would not advocate its use. Moreover, UST, Philip Morris, RJ Reynolds and other producers of spit and smokeless tobacco are marketing flavored packets designed to attract and addict young people. And many spit tobacco products deliver more nicotine than cigarettes.
While I support using a variety of techniques for smoking cessation for my patients, I would suggest that a safer method than spit tobacco is using approved nicotine replacement such as patches, gum and lozenges. In fact, the most recent update of the CDC Guidelines for Smoking Cessation doesn't recommend use of spit tobacco but does recommend the use of combinations of nicotine replacements, such as patches plus gum, finding that the results were as good as using other pharmacologic therapy. And the cost is comparable to using spit tobacco. Moreover, all smokers have access to the national quit line (1-800-QUITNOW) and many states provide nicotine replacement therapy for those who can't afford it or whose insurance doesn't cover it.
I would urge all smokers trying to quit to use a proven approach which is safer than spit tobacco.
Think ahead. It often helps to set a date to quit and to spend some time preparing yourself for the challenges you'll encounter. The first ones are physiological. Tobacco smoke delivers nicotine, a powerful psychoactive drug, to the nervous system. Most smokers become irritable, restless, anxious or depressed when they try to go without it, and many have trouble concentrating and sleeping. Fortunately, these withdrawal symptoms are transient. They usually peak within two to three days and then wane steadily. So think beyond the discomfort of the moment. If you can make it to day four, life will get easier.
Use crutches. Medical treatment makes the transition easier. Nicotine administered through patches, gums, lozenges, inhalers or nasal sprays can alleviate withdrawal symptoms, and the prescription drug Zyban (bupropion) can help reduce craving. Studies suggest that quitters who use any of these aids double the chances of success. For best results, you should continue using them for two to three months.
Change your routine. Nicotine isn't the only reason quitting smoking is hard. Cigarettes become a part of a smoker's everyday routine. If you're accustomed to lighting up whenever you have a cup of coffee, finish a meal or encounter a stressful situation, you may need to recondition yourself. Simple tricks can help you sidestep temptation. Some people try switching from coffee to tea for a while, or using a toothpick as an after-dinner pacifier. New rituals are easy to adopt, and they quickly become old ones.
Seek support. Quitting is easier if you have people to lean on, so don't go it alone. Friends, co-workers and family members can provide much-needed moral support, especially if they've been through the process themselves. Physicians and psychotherapists can offer valuable counseling. And though smoking-cessation programs can't guarantee results, they can increase your chances of success. Free information and counseling are now available nationwide at 800-QUIT-NOW or through Web sites such as smokefree. gov, cdc.gov/tobacco and quitnet.com.
Smoking is a powerful addiction, but it can be beat. Former smokers now outnumber current ones in this country, and indoor-smoking bans are giving people new incentives to quit. Medicines now in development could soon make smoking cessation easier, but no one should wait for them. Today's treatments are effective, and too few smokers are benefiting from them.
RIGOTTI, AN ASSOCIATE PROFESSOR OF MEDICINE AT HARVARD MEDICAL SCHOOL, DIRECTS THE TOBACCO RESEARCH AND TREATMENT CENTER AT MASSACHUSETTS GENERAL HOSPITAL. FOR MORE INFORMATION ON SMOKING CESSATION, GO TO HEALTH.HARVARD.EDU/NEWSWEEK.
Friday, June 27, 2008
Learn how to get help to quit smoking and improve your chances of quitting. This document explains the best ways for you to quit as well as new treatments to help. It lists new medications that can double or triple your chances of quitting and quitting for good. It also tells about ways to avoid relapses and talks about concerns you may have about quitting, including weight gain.
All information is based on scientific research about what will give you the best chances of quitting.
Nicotine: A Powerful Addiction
If you have tried to quit smoking, you know how hard it can be. It is hard because nicotine is a very addictive drug. For some people, it can be as addictive as heroin or cocaine.
Quitting is hard. Usually people make 2 or 3 tries, or more, before finally being able to quit. Each time you try to quit, you can learn about what helps and what hurts.
Quitting takes hard work and a lot of effort, but you can quit smoking.
Good Reasons for Quitting
Quitting smoking is one of the most important things you will ever do:
- You will live longer and live better.
- Quitting will lower your chance of having a heart attack, stroke, or cancer.
- If you are pregnant, quitting smoking will improve your chances of having a healthy baby.
- The people you live with, especially your children, will be healthier.
- You will have extra money to spend on things other than cigarettes.
Five Keys for Quitting
Studies have shown that these five steps will help you quit and quit for good. You have the best chances of quitting if you use them together:
- Get ready.
- Get support.
- Learn new skills and behaviors.
- Get medication and use it correctly.
- Be prepared for relapse or difficult situations.
1. Get Ready
- Set a quit date.
- Change your environment.
- Get rid of ALL cigarettes and ashtrays in your home, car, and place of work.
- Don't let people smoke in your home.
- Review your past attempts to quit. Think about what worked and what did not.
- Once you quit, don't smoke—NOT EVEN A PUFF!
2. Get Support and Encouragement
Studies have shown that you have a better chance of being successful if you have help. You can get support in many ways:
- Tell your family, friends, and coworkers that you are going to quit and want their support. Ask them not to smoke around you or leave cigarettes out.
- Talk to your health care provider (for example, doctor, dentist, nurse, pharmacist, psychologist, or smoking counselor).
- Get individual, group, or telephone counseling. The more counseling you have, the better your chances are of quitting. Programs are given at local hospitals and health centers. Call your local health department for information about programs in your area.
3. Learn New Skills and Behaviors
- Try to distract yourself from urges to smoke. Talk to someone, go for a walk, or get busy with a task.
- When you first try to quit, change your routine. Use a different route to work. Drink tea instead of coffee. Eat breakfast in a different place.
- Do something to reduce your stress. Take a hot bath, exercise, or read a book.
- Plan something enjoyable to do every day.
- Drink a lot of water and other fluids.
4. Get Medication and Use It Correctly
Medications can help you stop smoking and lessen the urge to smoke.
- The U.S. Food and Drug Administration (FDA) has approved five medications to help you quit smoking:
- Bupropion SR—Available by prescription.
- Nicotine gum—Available over-the-counter.
- Nicotine inhaler—Available by prescription.
- Nicotine nasal spray—Available by prescription.
- Nicotine patch—Available by prescription and over-the-counter.
- Ask your health care provider for advice and carefully read the information on the package.
- All of these medications will more or less double your chances of quitting and quitting for good.
- Everyone who is trying to quit may benefit from using a medication. If you are pregnant or trying to become pregnant, nursing, under age 18, smoking fewer than 10 cigarettes per day, or have a medical condition, talk to your doctor or other health care provider before taking medications.
5. Be Prepared for Relapse or Difficult Situations
Most relapses occur within the first 3 months after quitting. Don't be discouraged if you start smoking again. Remember, most people try several times before they finally quit. Here are some difficult situations to watch for:
- Alcohol. Avoid drinking alcohol. Drinking lowers your chances of success.
- Other smokers. Being around smoking can make you want to smoke.
- Weight gain. Many smokers will gain weight when they quit, usually less than 10 pounds. Eat a healthy diet and stay active. Don't let weight gain distract you from your main goal—quitting smoking. Some quit-smoking medications may help delay weight gain.
- Bad mood or depression. There are a lot of ways to improve your mood other than smoking.
If you are having problems with any of these situations, talk to your doctor or other health care provider.
Special Situations or Conditions
Studies suggest that everyone can quit smoking. Your situation or condition can give you a special reason to quit.
- Pregnant women/new mothers: By quitting, you protect your baby's health and your own.
- Hospitalized patients: By quitting, you reduce health problems and help healing.
- Heart attack patients: By quitting, you reduce your risk of a second heart attack.
- Lung, head, and neck cancer patients: By quitting, you reduce your chance of a second cancer.
- Parents of children and adolescents: By quitting, you protect your children and adolescents from illnesses caused by second-hand smoke.
Questions to Think About
Think about the following questions before you try to stop smoking. You may want to talk about your answers with your health care provider.
1. Why do you want to quit?
2. When you tried to quit in the past, what helped and what didn't?
3. What will be the most difficult situations for you after you quit? How will you plan to handle them?
4. Who can help you through the tough times? Your family? Friends? Health care provider?
5. What pleasures do you get from smoking? What ways can you still get pleasure if you quit?
Here are some questions to ask your health care provider.
1. How can you help me to be successful at quitting?
2. What medication do you think would be best for me and how should I take it?
3. What should I do if I need more help?
4. What is smoking withdrawal like? How can I get information on withdrawal?
Quitting takes hard work and a lot of effort, but you can quit smoking.
You may want to contact these organizations for further information on smoking and how to quit.
For general information:
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
(800) AHA-USA1 (242-8721)
American Cancer Society
1599 Clifton Road, NE
Atlanta, GA 30329
American Lung Association
1740 Broadway, 14th Floor
New York, NY 10019
National Cancer Institute
Bethesda, MD 20892
(800) 4-CANCER (422-6237)
For pregnant women:
American College of Obstetricians and Gynecologists
409 12th Street, SW
Washington, DC 20024
For More Information
The information in this booklet was taken from Treating Tobacco Use and Dependence, a U.S. Public Health Service-sponsored Clinical Practice Guideline. This guideline was developed by a non-Federal panel of experts sponsored by a consortium consisting of Federal Government and nonprofit organizations:
- Agency for Healthcare Research and Quality (AHRQ).
- Centers for Disease Control and Prevention (CDC).
- National Cancer Institute (NCI).
- National Heart, Lung, and Blood Institute (NHLBI).
- National Institute on Drug Abuse (NIDA).
- Robert Wood Johnson Foundation (RWJF).
- University of Wisconsin Medical School's Center for Tobacco Research and Intervention (CTRI).
For information about the guideline or to get more copies of this booklet, call toll free: 800-358-9295, or write:
P.O. Box 8547
Silver Spring, MD 20907
U.S. Department of Health and Human Services
Public Health Service
Tomorrow (May 19th) has reached near "holiday" status here in the U.S., thanks to George Lucas. Yes, tomorrow is the U.S. opening of Star Wars Episode I: The Phantom Menace. I've got my tickets for opening night!
If you aren't familiar with the Star Wars movie series (http://www.starwars.com) you probably live on another planet. I've been a Star Wars nut ever since I saw the first movie in 1977 at the age of 9. I was blown away by the incredible special effects and story. The mythical story paints a clear picture of the battle of good versus evil, and touches people on many levels. Perhaps that explains at least part of the movie's popularity: Star Wars reflects the emotion and the fear and the excitement and the good and the evil inside each of us.
The Star Wars movies follow the Jedi Knights who possess amazing powers provided by "The Force". Ben Kenobi, one of the Jedi, tells Luke Skywalker what The Force is: "The Force is what gives a Jedi his power. It's an energy field created by all living things. It surrounds us and penetrates us. It binds the galaxy together." Ben goes on to tell Luke, "You must learn the ways of The Force..."
The wisdom of the Jedi and The Force found in the first three Star Wars movies can help you quit smoking if you'll apply that wisdom. You must learn the ways of The Force to quit smoking.
Ben taught Luke about The Force in the first movie, Star Wars. He tells Luke, "A Jedi can feel The Force flowing through him." Luke asks, "You mean it controls your actions?" Ben explains, "Partially. But it also obeys your commands."
The Force will obey your commands to "quit smoking." You are not destined to smoke for the rest of your life. You DO have control over your own destiny and the actions that you take. Use The Force now to take charge of whether or not you smoke or quit.
In the second movie, The Empire Strikes Back, Luke travels to a remote planet to receive training from Yoda, a Jedi master. During the course of Luke's training, Yoda provides many nuggets of wisdom that can help you become a non-smoking Jedi.
"A Jedi must have the deepest commitment. The most serious mind," Yoda tells Luke. The same holds true for you if you want to quit smoking. You must commit yourself fully to the task of quitting. You can't quit halfway. If you plan to quit, you must quit completely. Get serious about your commitment to quit.
Later, Yoda tells Luke "A Jedi's strength flows from The Force, but beware of the dark side." The dark side of The Force is the evil side of The Force. In many ways you might think of the dark side as your smoking addiction, or the cigarettes you smoke, or even the cigarette companies.
Luke asks Yoda, "Is the dark side stronger?"
"No," Yoda responds. "No. Quicker, easier, more seductive." Wow! Doesn't that just about sum up smoking? It's much easier to continue smoking rather than to quit, so seductive is the habit. No one said becoming a smoke-free Jedi would be easy!
Luke then asks Yoda, "But how am I to know the good side from the bad?" Yoda answers, "You will know when you are calm, at peace, passive."
A great way to begin beating your smoking habit it to practice relaxation techniques. If you find yourself giving in to your cravings when you are stressed, you are turning to the dark side! Relax! Breathe deeply. Clear your mind and sit quietly. Learn to control your stress with your mind, not with cigarettes.
One day, after Luke learns to move and float rocks using The Force, his X-Wing fighter spaceship sinks into the swamp near Yoda's home. Luke exclaims, "We'll never get it out now."
Disappointed, Yoda says to Luke, "So certain are you. Always with you what cannot be done."
Luke replies, "Master, moving stones around is one thing. But this is totally different."
Somewhat disgusted by now, Yoda shouts "No! No different. Only different in your mind. You must unlearn what you have learned."
Half-heartedly, Luke says "Alright, I'll give it a try."
"No! Try not. Do, or do not. There is not try," Yoda tells Luke.
How many times have you said I'll TRY to quit smoking, knowing full well that you don't really believe you can quit and don't really plan to quit? You must understand that quitting is not a game. Quitting is real life. If you are going to quit--QUIT! Don't just try. QUIT! If you stumble and start smoking again after quitting then quit again until you quit forever. Quit, or quit not. There is not try.
After Luke "tries" and fails to levitate his X-Wing out of the swamp, he tells Yoda "I can't. It's too big."
Yoda then gives Luke another lesson. "Size matters not. Look at me. Judge me by my size, do you? [Yoda is barely two feet tall]. And well you should not. For my ally is The Force, and a powerful ally it is."
The Force is a metaphor for God or religion or faith. Countless smokers have told me how their faith in God has helped them to quit smoking. By placing your faith in a higher power, you allow the infinite power of the universe (whatever you consider that to be--I'm not trying to advocate any particular religion here) to help you quit smoking. You remove the total burden from yourself. You'll gain strength from asking God to help you quit. You can move mountains with the help of your faith and prayer.
Luke didn't have the faith he needed to get his X-Wing out of the swamp. "You want the impossible," he tells Yoda.
Moments later, Yoda effortlessly raises the X-Wing out of the swamp and over to the side. In disbelief, Luke says, "I don't believe it!"
"That is why you fail," Yoda tells him.
Belief is absolutely critical to your success. Studies show that believing that you have the ability to quit is one of the most important indicators of future success. If you believe you have the ability to quit and believe that you will quit, you are much more likely to quit than someone who has no faith in themselves. Believe, and be free of cigarettes!
Later in the movie, Luke sees a vision of his friends, in which their lives are in danger. Luke feels that he needs to cut short his training and go to their aid. Yoda and Ben both encourage Luke to stay and continue with the training, fearing he will be at risk unless he completes his training.
Luke tries to assure them that he is ready. "I feel The Force," he tells them.
"But you cannot control it. This is a dangerous time for you, when you will be tempted by the dark side of The Force," Ben warns.
Similarly, when you are in the process of quitting, you must constantly guard against the dark side of temptation. Don't get sucked in by the notion that you can have "just one" cigarette. Remember, as Yoda says, "Once you start down the dark path, forever will it dominate your destiny." As time goes by, you will learn how to deal with your cravings and how to handle stress, without smoking. But it takes time. If you smoke just one cigarette, expecting to be able to control your urges, you're in for a real surprise. Just one puff can put you back at a pack-a-day habit in no time.
Luke finally leaves Ben and Yoda and goes to help his friends. He ends up fighting Darth Vader, a Jedi Knight who has turned to the dark side of The Force. Vader's plan is to turn Luke to the dark side and utilize his powers to further his own evil plans. "Join me and together we can rule the galaxy," Vader tempts Luke.
Cigarettes tempt you with inflated claims of looking cool, feeling relaxed and fulfilled. Unfortunately, cigarettes have an ominous dark side. Do I have to spell it out? You know cigarettes cause numerous health problems, cost a lot, and make you smell bad. Make sure you evaluate the temptation for what it really is: the desire for self-destruction.
If only our lives were as simple as buying a movie ticket! Good things in life take effort and work. Apply the lessons here to your own quit smoking program and I think you'll find you can make some of your own special effects!
May The Force be with you!
As you approach the date marked on your calendar, you'll need to prepare yourself for the actual quitting process. Since smoking has been part of your whole existence including your physical self, your emotional self, and part of your general surroundings, each of these areas needs preparation for the quitting process.
Preparation of Surroundings
Cigarette smoking has been part of your life and as such has probably left its mark all around you. In your efforts to quit smoking it is important for you to remove the evidence and reminders of your smoking habit. This will serve to decrease temptation from these reminders as well as to strengthen your commitment to the quitting process through visible reminders.
1. Two weeks prior to quit date, limit your smoking to one room in your home. This room should be the least comfortable place. For example, choose the laundry room, the basement, or the porch. Move all of your smoking paraphernalia, such as ashtray and lighter, to that room. Limiting where you smoke will help you to cut down on the quantity of cigarettes that you smoke by making the process more inconvenient. A pack of cigarettes that is next to the couch and in front of the television set will probably be smoked. Further, by limiting where you smoke you also eliminate many of the cues and triggers you identified in earlier chapters. If you tend to smoke when watching television or finishing a meal, you will begin to break that association by learning to smoke without engaging in either activity. Smoking should become merely an act of inhaling and putting out your cigarette and not a part of your daily routines.
2. Clean out your car. Remove all evidence that your car was that of a smoker. Vacuum out the carpet, remove the ashtray and lighter, and discard any remaining cigarettes. After your car is clean, make this a non-smoking area for yourself and other guests who ride in your car. By preparing your car, you will begin to break any associations that you may have between driving your car and smoking a cigarette. For example, if somebody cuts you off when you are driving and normally you would reach for a cigarette, you will now be forced to adopt an alternative strategy to manage this frustration. Also, as a non-smoking area your car will become a safe haven for you when you are tempted to smoke. Now you have eliminated one more trigger or cue for your smoking.
3. Clean and deodorize your home. Since you have now limited your smoking to only one room in your home, you can begin to clean and prepare the remaining rooms for your actual quit date. Get your carpets and draperies cleaned. Remove the odor of cigarettes from your furniture and clothing. Discover and remove those hidden cigarettes that may be lurking in the couch cushion, under the bed, or in the back of the refrigerator. During those initial days after your quit date, you may be tempted by any stray cigarette that you can find. Remove the temptation now before your quit date.
Preparation of Your Physical Self
Once your surroundings are prepared it is time to get yourself physically in shape for the quitting process. As you've seen in the preceding chapters, nicotine is a physically addicting chemical and as such your body may experience some withdrawal symptoms after you quit smoking. To make the process a little more comfortable, it is important to get yourself physically prepared for these changes.
1. Visit your dentist. Get your teeth cleaned. This will serve to remind you that you are about to begin life as a non-smoker. With the tar and nicotine removed from your teeth you are literally starting fresh without cigarettes.
2. Monitor your alcohol consumption prior to and immediately after quitting. The effects of alcohol are intensified when used in conjunction with cigarettes. That is, when alcohol and cigarettes are used together they each bring out the most harmful physical effects of the other. Further, when you drink alcohol your inhibitions are decreased and you are therefore more likely to relapse into smoking. For many smokers alcohol is also paired or associated with smoking. Therefore, when you have a drink you may automatically begin thinking about a cigarette, which puts you more at risk for relapsing into smoking. It maybe important for you to avoid alcohol during the first couple of months after quitting until you are beyond the most difficult phase of quitting. Then you can slowly reintroduce alcohol consumption back into your life.
3. Reduce your caffeine consumption prior to quitting. Nicotine acts on the body by changing your metabolism. If you are used to consuming a fair amount of caffeine as a smoker, your body may not be able to tolerate the same amount after you quit smoking. If this is the case, you may experience a jittery/nervous sensation which may not be related to tobacco withdrawal but rather caffeine intoxication. Several weeks before your quit date begin to reduce your caffeine consumption. Remember, caffeine is not just found in coffee but also in chocolate, soda pop, etc. Once you have quit smoking you will then be in a better position to re-establish an appropriate amount of caffeine for you.
4. Get plenty of rest. During your first smoke-free week it is important to get plenty of rest. You probably have been bombarding your body with the drug nicotine for many years. Once you stop the drug your body needs time to readjust without the drug. This healing process can be difficult and exhausting for the first couple of weeks. Plenty of rest will help move you physically through this process with greater ease. Think about this phase as a time for recovery.
5. Drink plenty of fluids. The healing process requires good nutrition and plenty of fluids. Try to drink fruit juices, which tend to cut down on the craving for nicotine for many people.
6. Use healthy oral substitutes. During the initial few weeks after quitting it is important to have healthy foods prepared for snacking. For example, keep celery, carrots, raisins, apples, pickles, sunflower seeds, etc. readily available for snacking. These snacks will help you when a craving strikes and you need something oral to satisfy you. However, make sure that the snacks you are choosing are low in calories and high in bulk. This will help with the craving but minimize the weight gain. [Note from QuitSmoking.com: Our E-Z Quit artificial cigarette is an excellent and healthy oral substitute.]
7. Chew sugarless gum and hard candy. During the first few weeks after you quit smoking your throat may feel dry or you may have a "tickle" cough; sucking on ice chips, hard candy, or chewing gum can help. Also, you can use the candy or gum as a substitute when you have a craving.
Preparation of Your Emotional Self
One of the biggest challenges to quitting smoking is preparing yourself emotionally. Many smokers talk about feeling a sense of loss when thinking about quitting smoking. You may find yourself thinking about quitting smoking as losing a friend or at the very least losing your coping strategy. Either way you describe it you may sense the loss of security and control when you quit smoking. To overcome these feelings you need to prepare yourself emotionally for the process of quitting smoking, and for life after cigarettes.
1. Repeat to yourself your reasons for needing to quit smoking. Although this has been stated many places throughout this book it bears repeating because it is so important. Your reasons for needing to quit smoking will provide you with the strength and willpower to get through the quitting process. Review these reasons. Reinforce them to yourself several times a day. Write them down and carry them with you. Place them in a visible area for yourself.
2. Plan activities for your first smoke-free week. The worst thing that can happen on your quit date or the weeks that follow is to find yourself in a situation where you are craving a cigarette and you have no alternative strategy available to you other than reaching for a cigarette. Plan activities that are inconsistent with smoking such as doing crossword puzzles, jogging, swimming, washing dishes, going to the grocery store, visiting the library or church, etc. Idle or empty time can be dangerous during the initial quitting process. Stay active and busy.
3. Occupy your hands with other objects. Use pencils, toothpicks, paper clips, rubber bands, etc. to occupy your hands when you feel something is missing without a cigarette.
4. Beware of cigarette advertisements. As a smoker you have probably been bombarded with literature on cigarettes, offered many coupons and rebates on cigarettes, and tempted by magazine and billboard ads. Don't be tempted. It may be helpful for you to analyze and seriously consider what these ads are really saying to you. For example, ask yourself how companies have been able to sell you a product that causes serious medical diseases that can lead to death. Why is it that the individuals who are portrayed in these ads always have smooth skin and white teeth? Nicotine alters the elasticity in the skin and yellows your teeth. Is your health really only worth that 50 cent coupon? Why do cigarette ads always show healthy, young, attractive individuals who are very happy? Most smokers tend to suffer from some effects of their smoking habit such as coughing and more frequent episodes of colds, bronchitis, and pneumonia. Many smokers continue to smoke as a way of dealing with depression and stress. What is so cool and refreshing about tar sticking to your lungs, and 4,000-plus substances being deposited in your lungs (including arsenic, formaldehyde, and carbon monoxide)? After years of smoking many smokers would not be able to participate in the vigorous activities that are shown in cigarette ads, nor are they able to breathe in and smell the fresh mountain air that is shown. Cigarette advertisements are successful in luring individuals into smoking and continuing to smoke by appealing to your perceived vulnerabilities. Everyone wants to be seen as attractive, successful, sexy, and fun. The reality is that by being pulled in by these ads you are risking your life to help the tobacco company make money. If you remind yourself of these realities you will be less likely to be tempted and intrigued by these ads. Rather you should be angry that they are making money at your expense.
5. Never allow yourself to think that one cigarette won't hurt. Many smokers relapse because they fall into the trap of believing that they can control their smoking and one cigarette won't hurt. This is harmful thinking because the majority of smokers may be able to have one for a while but eventually this will lead to two and before you realize it you will be back smoking the same quantity of cigarettes. Further, in order for your body to begin healing itself and to complete the withdrawal process you need to have all nicotine out of your system. By smoking one cigarette you re-introduce nicotine back into your system which delays healing.
6. "Smoking is no longer an option for me." Immediately after quitting you may find yourself looking for excuses to justify smoking. Excuses are easy to find when you are looking for them. However, if you have told yourself that smoking is not an option for you anymore you will need to find another option when your feel stressed or nervous, or when you are finishing a meal or waiting for a friend. On your quit date remind yourself that smoking is no longer an option for you and therefore you must handle whatever situation presents itself to you. This statement will empower you to find and use alternative coping strategies.
Fear of "Losing a Friend"
As your quit date approaches, you may find yourself feeling sad--as if you were about to lose a friend. Frequently, smokers will describe their cigarettes as a good "friend." Smoking may have helped them deal with periods of stress in their life, been a source of comfort when they felt lonely and depressed, and in some ways proved a companion when they felt socially awkward angry or isolated. If you share these feelings you may be fearful of what life will be like without this "friend." The following exercise is one developed in workshops. Smokers have reported that when they put this "friend" in a different context they could let go with a little more ease. By following the instructions below you, too, will be able to see your "friend" in a new way.
Close your eyes and picture your cigarette. Imagine that the cigarette is as tall as you are and you are standing side by side. Put your arm around the cigarette. You are now feeling comfort and support from your "friend." You believe that this "friend" will support you, will help you to feel in control, will take away your worry and stress, and will provide companionship for you when you are lonely. Imagine that the two of you are walking arm in arm. You believe in this "friend" and you trust this "friend." You are now approaching a grassy knoll. As you get closer to the hill, you see a hole in the ground with dirt piled around it. Your "friend" brings you closer to the hole. You feel the cold air and see that it is a grave site. Your name is on the gravestone. Arm in arm your "friend" walks you around the hole. You and your "friend" walk around and around the hole. You continue to get closer and closer to the edge of the hole. You begin to lose your footing and you reach for your "friend." You are afraid. You keep reaching and reaching and reaching for your "friend" but your friend keeps walking you closer and closer to the dark hole. Is this your "friend"?
The above exercise can be frightening and sobering. However, it is important for you to focus on the reality of your smoking. A friend would not want you to be in harm's way. A friend wants what is best for you. Although you may not find yourself using the word "friend" when you think about your cigarettes, you may be using and relying on them as such. Remember, a true friend does not just put a bandage on a situation but rather helps to guide you towards long-term coping. Cigarettes may make you feel better for the moment but in the end they lead you closer and closer to years of suffering. Cigarettes are not your friend.
Enlisting Social Support for Your Quit Date
1. Use your support systems. Remind your friends and family that you are going through the quitting process and that it is important to you that they support you. Smokers who have more social support have more success in quitting. Avoid friends or family members who may be jealous of your attempt and success at quitting smoking, particularly if they themselves have failed in the past to quit smoking. Rely on individuals who really want to see you succeed, including those who have successfully quit smoking or who are nonsmokers.
2. Be assertive and direct when asking for support. Be assertive when asking that others not smoke around you or place you in high risk situations. Be specific in your request for support or help. For example, you may ask that others be tolerant of irritable behavior during the first couple of weeks, suggest that others not smoke around you, and seek out rewards and praise from others for your efforts. Everyone needs encouragement and praise for persevering through the difficult process of quitting smoking. Don't view this as a sign of weakness.
3. Negotiating with a live-in smoker. Living with a smoker may make your efforts to quit smoking more difficult. Therefore, it is important to work out an agreement prior to your quit date that you can both feel comfortable with. For example, you may request that the smoker not leave cigarettes lying around the house. It may be a good idea to have the smoker smoke in only one room in the house or at least not smoke in your presence during the first couple of weeks after your quit date. Reinforce to the smoker how important quitting smoking is to you and how you value his or her support. Request that the smoker not do things or say things to undermine your efforts to quit smoking. If the smoker really cares about you and your health he or she will want to support your efforts in improving your overall well-being. Sometimes it is difficult for current smokers (even those with good intentions) to really support someone else's efforts to quit smoking. This can occur for several reasons. The smoker may be jealous that you are succeeding at quitting while he or she is not and therefore feel weak by comparison. The smoker may feel abandoned for having lost his or her "smoking partner." This may take some of the social pleasure of smoking away from him or her. Prior to your quit date, it will be helpful for you to discuss these feelings with the smoker in order to prevent any potential sabotage of your efforts and to increase all-around support of you.
4. Working with a smoker. What do you do if a co-worker smokes and is not interested in quitting? It is much easier to negotiate with a family member or friend than it is with a co-worker because loved ones presumably have your best interest at heart. However, this may not be the case with fellow employees. It is important to make a request for support or at the very least for respect of your efforts to quit smoking. Your co-workers may feel that you do not have a right to impose on them or they may share feelings such as jealousy. This is all right. You still have a right to make the request and to work out an equitable arrangement regarding smoking in the workplace. For example, you may ask for a transfer to a work area that is smoke-free. You may find your co-workers commenting on your attitude and saying, "You are so crabby you're driving us crazy--just smoke a cigarette." Remind yourself and them that part of your irritability is related to nicotine withdrawal and therefore it is short-term. This short-term irritability is probably related to physical changes in your body. However, it is important that you not use this as an opportunity to intentionally treat others poorly. Monitor your own behavior and mood. Get distance from a situation if you feel yourself getting irritated. This will help reduce any potential conflict in the workplace. Finally, you may also need to discuss the office smoking policy with your employer. Be aware of your rights.
How Family and Friends Can Provide Support
Friends and family members can play an important role in your efforts to quit smoking. It is important for them to stay supportive of you and your desire to quit and at the same time not to be confrontational or punitive. Many smokers report that the type of support they get from their family and friends ranges from nagging to encouraging them to smoke because their mood and behavior is "out of control." This can leave you feeling like a failure and this discouragement may lead to a return to smoking.
Answering the following questions will help you define specifically what role your family and friends play in your efforts to quit smoking.
What are some things that your family has said to you regarding your efforts to quit in the past?
What are they currently saying about your present efforts to quit smoking?
What have your family members done in the past when you have attempted to quit smoking? For example, have they offered you a cigarette when you got crabby?
What have your friends said to you in the past regarding your attempts to quit smoking?
What are your friends currently saying to you regarding your attempt to quit smoking?
Is there a difference between the support you receive from your smoking friends versus your non-smoking friends?
Ideas for Supportive Family and Friends
Your Quit Date and the Weeks That Follow
1. Visualize and reinterpret your physical symptoms as "symptoms of recovery." In chapter 14 on nicotine substitution you saw a list of physical withdrawal symptoms that you may experience during the initial phase of quitting. Keep in mind that these symptoms are short-term and necessary to the healing process. Try to think about them as "symptoms of recovery." This means that when you are feeling irritable and restless or are having a "craving" remind yourself that although these symptoms may not feel good they remind you that your body is healing. If your body were transparent you would be able to see positive changes occurring. However, since you cannot see the changes you need to use these "physical symptoms" as a reminder or cue that your body is healing. "The pain is healing pain." Each time you feel "uncomfortable" think about what is happening in your body. Use the following imagery exercise to guide you through this healing process.
Close your eyes and imagine your lungs. See the black tar sitting on the tiny little air sacs that makes it hard for you to breathe at times. Each time you feel "uncomfortable" imagine this tar gradually being lifted off your lungs. Each breath that you take feels easier. You feel the clean air healing the wounded lung tissue. You see the 4,000-plus particles that are floating in your bloodstream being washed away. You feel your arteries relaxing and allowing blood to pass more readily through, cutting your risk for strokes and heart attacks. With each passing day you see more and more healing occurring inside your body. With each "discomfort" that you feel you see healing occurring in your body. You remind yourself that these symptoms are short-term.
2. Pay attention to your "high risk" situations. In chapter 7 you filled out a chart that defined your own smoking patterns. Refer to this chart and focus on your "high risk" areas. These are times, such as when you are stressed at work or finishing a meal, when you are most likely to desire a cigarette. During the initial weeks after quitting smoking it is important that you pay close attention to these situations or feelings. Prepare for them and have alternative strategies available. You are most at risk for automatically falling back into your routine of smoking during the first couple of weeks after quitting smoking if you are not vigilant about these "high risk" areas. Try either to avoid these situations or at the very least to have alternative strategies available.
3. Use distraction techniques. When you find yourself tempted to smoke a cigarette get some distance from the thought or situation. Distraction is a wonderful technique for preventing impulsive smoking. Distraction could include physically removing yourself from the situation, shifting your thought to something other than smoking, or engaging in an activity that makes smoking difficult (such as washing dishes, exercising, or visiting a nonsmoking friend). It is important to remember that the "desire" to smoke is generally very brief, lasting only seconds. Initially after quitting you may find that the "desire" for a cigarette feels fairly strong and you may "desire" a cigarette quite frequently. However, with time you will notice that the strength and frequency of the desire will decrease. This is why distraction can be very helpful. If you distract yourself for a brief period of time, the "desire" will fade and over time you will not experience the desire as often. Say to yourself, "This desire will only last for a short period of time and if I give into it and smoke I will have to start the healing process all over again. If I can distract myself the desire will pass and I will be one step closer to reducing the frequency of this desire." Reward yourself each time you successfully distract yourself away from the "desire."
4. Reinforce your reasons for needing to quit smoking. During the initial weeks after quitting smoking you will need to continue to reinforce for yourself your reasons for needing to quit smoking. Remember, these reasons need to be specific and personal to you. These reasons will help get you through the periods of temptation.
5. Repeat to yourself the benefits of quitting smoking. You need to remind yourself that good will come of the discomfort, inconvenience, lifestyle changes, and general effort that you are making during this quitting process. Repeat the following list of benefits to yourself several times a day.
Benefits of Quitting Smoking
1. Circulation improves
2. Decreases or cures allergies (smokers have three times more allergies than nonsmokers)
3. Eliminates chronic bronchitis (which decreases energy level, resistance to infection, and predisposes one to emphysema) in a few months after cessation
4. Reduces number of cavities and increases chance of keeping your own teeth (smokers have three times more cavities and gum disease than non-smokers)
5. Decreases risk of esophageal cancer by 500 percent
6. Decreases risk of kidney cancer by 50 percent
7. Decreases frequency and intensity of headaches
8. Non-smoking women have less discomfort and less problems with menopause
9. Decreases risk of osteoporosis
10. Increases lung and breathing capacity
11. Increases female fertility by 50 percent
12. Significantly decreases your risk for lung cancer and emphysema
Thursday, June 26, 2008
Within hours of stopping, the level of carbon monoxide in your blood drops, enabling the blood to carry more oxygen.
Two days after quitting, nerve endings begin to recover and your sense of smell and taste begin to return.
Within 72 hours of quitting, your lungs’ bronchial tubes expand and lung volume increases.
Months after quitting, shortness of breath diminishes.
In the first year, the risk of heart attack attributed to smoking declines for both men and women.
Two to three years after quitting, the risk of heart attack attributed to smoking is virtually gone.After 10 years, the risk of developing cancer is about the same as for nonsmokers.
wouldn't be? It's so difficult to quit smoking, there can't
possible be a foolproof way to quit. Besides, if someone
invented a guaranteed way to quit the tobacco companies would
probably "buy them out."
Well, I'm here to tell you that there is one way to guarantee
that you quit smoking.
I was watching the comedy "City Slickers" the other day. In it
Billy Crystal plays a middle-aged man who has "lost his smile"
and can't seem to find happiness or meaning in his life. So he
sets off with some friends to go on a "fantasy vacation" where
they get to play cowboys on a real cattle drive. Jack Palance
plays a crusty old cowboy named Curly, guiding the "city folk"
on the drive.
Billy Crystal and Jack Palance are having a conversation along
the trail. Palance asks Crystal, "Do you know what the secret of
life is?" Crystal responds "No, what?" Palance holds up his
gloved index finger and says "This." Crystal wisecracks, "Your
finger?" Palance continues, "One thing. Just one thing. You
stick to that and everything else don't mean @#*$!" Crystal
asks, "That's great, but what's the one thing?" Then Palance
gives Crystal the nugget of wisdom I want you to pay attention
to: "That's what you've gotta figure out."
As long as there have been cigarettes there have been smokers.
And as long as there have been smokers there have been smokers
who wanted to quit. Consequently, there have also been people
and companies offering ideas, plans and products to help those
Because every smoker is different there is not a single "cure"
for smoking. If that were the case, I'd only have to write one
article and send it out over and over again. There would only be
one quit smoking product on QuitSmoking.com web site.
But guess what? What works to help you quit smoking doesn't work
for the next person who is quitting. Even the giant drug
manufacturers with all their millions of dollars available for
research can't seem to find a product that will help more than
20-50% (depending on which study you read) of their customers
So, do you just throw in the towel and give up this hopeless
cause? Absolutely not! You keep trying until you quit.
At the end of "City Slickers" after Billy Crystal and his
friends have tested their mettle and "found themselves" during
the difficult cattle drive, they are talking about the changes
they are going to make in their lives. Bruno Kirby plays one of
Crystal's friends on the trip. He asks Crystal, "You going to be
okay?" Crystal responds, "Yeah, 'cause I know what he meant."
"Who?" Kirby asks. "Curly...I know what this is," Crystal says,
holding up his index finger. Kirby is confused and asks "What?"
Crystal explains, "That's what you have to figure out."
Frustrated, Kirby threatens, "I'm gonna deck you, pal!" Then
Crystal tells him the final truth that I want you to understand:
"No, that's what it is-it's something different for everybody.
It's whatever is most important for you."
I'm often asked what's the best way to quit smoking. The answer
is simple: THE WAY THAT WORKS FOR **YOU**.
Why am I writing an article for this ezine twice per month? I
want you to have many different thoughts and approaches for
quitting. If you try one method and don't succeed, try again.
Keep looking until you find the solution that's right for YOU.
That's the "one thing" absolutely guaranteed to help you quit
It's a common problem: You are trying your best to quit smoking but everyone around you still smokes. If you have a spouse or other family member who smokes, you are exposed to smoking every day. If your co-workers smoke, you probably have smokers around you at least five days per week. If your friends smoke, you'll be exposed to smoking whenever you get together to have some fun.
So how do you maintain your resolve to quit when everywhere you look you see someone lighting up? How do you deal with the personal conflicts that can develop when you quit but your family, friends and co-workers don't?
First, you must acknowledge the fact that you may be all alone in your efforts to quit smoking. This solitude may be frustrating and counter-productive but you must accept the fact that the people around you are not going to quit smoking just because you are. In fact, they may try to coerce or encourage you to start smoking again. When you quit you may be placing pressure to quit smoking, however unintentional, on the people in your life . They may resent it or be frightened by your quitting. Their natural, perhaps unconscious, response may be to make quitting more difficult for you.
So prepare yourself for the loneliness you may feel when you quit. Prepare yourself for the backlash that you may receive from the smokers around you. Be prepared to forgive and forget.
Next, take time to talk to the smokers in your life. Ask them for a few minutes to discuss the fact that you are quitting smoking. Sit down and let them know how very important quitting is to you. Tell them that you need their support and ask them to be considerate whenever they want to smoke. Make sure they understand that you are quitting for you, not for anyone else. Make sure they understand that you do not expect them to quit because you are quitting. Invite them to quit with you but make it clear that quitting must be their own decision.
Lay out some ground rules that everyone can live with, regarding where and when they will smoke. Make it clear that you don't expect them to totally change their smoking habits, but that you need cooperation to help you quit. Set clear times and locations for them to smoke, or make sure you have someplace you can comfortably retreat to, should the smoker in your life need to light up. Make sure you have something to distract your attention, in another room, if someone is smoking near you. Start a new hobby or have a book on-hand, whenever you have to get away from the smoke.
When you get together with friends, you may find that the activities you participate in naturally involve smoking. Try going to a bar or bowling alley without having smoke all around you (unless you live in an area where smoking is banned indoors)! You may find it necessary to adjust the types of things you do with your friends, to help you avoid being placed in a smoking situation. Try activities that are outdoors, or that involve exercise. Go places where smoking isn't allowed. If your friends are truly your friends, they'll understand and want to accommodate your needs.
Avoiding smoke at work may be difficult if your workplace allows smoking indoors. If necessary, request that your work area be moved to a non-smoking portion of your office. You may also ask to have your entire office declared "smoke-free." Consider getting an air filter to help remove the smell of smoke where you work.
If you have grown accustomed to your smoking breaks and the smoking buddies at your workplace, you face another type of withdrawal besides nicotine withdrawal: friendship withdrawal. Chances are, if you've worked someplace with a designated smoking area for any length of time, that you have made quite a number of friends or smoking buddies. If you're going to quit smoking successfully, you're going to have remove yourself from the smoking area. Naturally, this means removing yourself from the friends you've made. Realize, however, that just because you don't smoke with these people, you don't have to stop being friendly. Let your smoking buddies know that you are quitting, and that you won't be joining them any longer. But also let them know you wish to continue your friendship. Exchange phone numbers if necessary, and try to get together for lunch or other times convenient to both of you.
Quitting smoking even when other people around you are smoking doesn't have to be difficult and a strain on interpersonal relations. Take some time to create an atmosphere where everyone knows that you are quitting and that you need their cooperation to succeed. At the same time, be considerate of the other smokers, giving them their own freedom to smoke when they so choose. Working together with family, friends and co-workers, you can quit!
people truly love to smoke. There's no denying that smoking
provides real benefits such as relaxation or feelings of
So, how do you quit when you love to smoke?
YOU GOTTA WANNA
First and foremost, you have to have the desire to quit. If you
love smoking and don't want or plan to quit, then there's almost
no point in reading further. But if you honestly do want to
quit, then you have the first and most important ingredient for
Is it possible to love smoking while simultaneously wanting to
quit? Of course! Think about any destructive behavior you or
other people engage in. For example, you may love to speed when
you drive around town, yet you know it is dangerous and you want
to quit doing it. Alcoholics have a love-hate relationship with
their drink. You smoke and enjoy it, but you know it is bad for
DEVELOP THE DESIRE TO QUIT
"I love smoking too much to develop the desire to quit," you may
be saying. However, there are some simple steps you can take to
create the will to quit.
1. Make a list of the benefits you receive from smoking. Write
down as many benefits as you can think of.
2. Make a list of the bad things that have resulted or may
result from continuing to smoke.
3. Make a list of the reasons YOU want to quit. For example,
your list might include "live longer", "set a good example for
my children", "save money", etc. Everyone needs a purpose or a
reason to do anything before he or she is truly motivated to do
it. Make sure you know why you want to quit.
Read each of your lists at least once per day. These lists will
provide you with concrete motivation for quitting.
4. Make an appointment with your doctor and ask him or her to be
very frank with you about the destructiveness of smoking. Ask to
see pictures of lungs taken out of smokers' bodies. Have your
doctor explain what good things will happen after you quit.
Hearing and seeing these things from your doctor may influence
you more than anything else. After all, this person has devoted
their life to understanding the human body. They know the
truth, and most likely you'll believe what they have to say.
EXAMINE THE "BENEFITS"
Once you have a definite desire to quit smoking, it's time to
examine the so-called "benefits" of smoking. By now you should
have the "benefits of smoking" list that you made in step 1
You must become very objective when you analyze your list. Is
each list item truly a benefit or just a "fix". If you smoke to
relax, ask yourself "how does a non-smoker deal with stress
without smoking?" If you smoke to relieve boredom are you
benefiting yourself temporarily by smoking, while paying for it
with reduced health and expensive cigarettes?
Look at each item in your list from the perspective of a non-
smoker. What would a non-smoker have to say about your list? How
does a non-smoker deal with the world without smoking? Can you
obtain the same or similar benefits without a cigarette?
Remember that much of the "positive" benefit of smoking is
temporary. The long-term effects of smoking are nearly all
After examining the benefits you get from smoking, you need to
develop replacements for your cigarettes (and their effects) so
that you can continue to receive the benefits that smoking
provides you, but without the downside.
First, you need to understand that some of the so-called
benefits of smoking are really just a cruel lie. As your body
has grown accustomed to smoking and the accompanying physical
and chemical effects on your body, you have developed a need to
smoke to achieve these "benefits." You feel that the only way
you can relax is to smoke, and you do find that smoking calms
your nerves. But how long has it been since you relaxed on your
own, without the aid of a cigarette? Again, how does a non-
smoker relax? Smoking has become your crutch, when your ankle
really isn't broken.
So, on your list of "benefits of smoking" next to each benefit,
write down something you can do, other than smoking, that will
replicate the benefit.
For example, if the benefit you wrote down was that smoking
helps you sleep, you might write down that you would exercise
regularly. Exercise can aid your body in so many ways, including
better sleep. If you wrote that smoking helps you to get moving
in the morning, you might write down that you will listen to
your favorite high-energy music while you get dressed.
Be creative! This is the fun part. You get to re-invent your
TURN LOVE TO DISGUST
If you love to smoke, you need to begin to despise it.
Switch to a different brand of cigarettes--one that you don't
Look at yourself in the mirror when you smoke. Looks stupid,
doesn't it? No other animal in the world, even the lowliest,
purposefully inhales smoke. Why do you?
Look at your hands and teeth. They're disgusting, aren't they?
You're not going to get a date looking like that!
And you stink too! Yuck!
The cigarette companies are robbing you of $1,000 per year. Are
you going to let them get away with that? And your car smells
terrible. You won't be able to get as much for it when you sell
You're a social outcast at restaurants. Nobody likes to smell
your stinky smoke.
Get the idea?
NOW GO OUT AND DO IT
You can read this and do nothing or you can follow the steps and
take ACTION! Nothing in your life worth doing happens magically.
You have to create your own magic by taking action. Action.
You're hearing it from all directions: "Quit smoking!" But the
heck with that! You're going to smoke until the day you die,
right? Here's how to "fight back" against the tyrants and
authority establishment that is trying to make you quit.
First, you must never believe that quitting smoking is possible.
On the contrary, no one has ever quit smoking. Once you've had
one puff, you're hooked for life. Might as well just start
smoking even if you only inhale some second-hand smoke. You see,
if you believe you can quit smoking, then you might actually try
to do something about it. Believing is the first, most important
step to becoming an evil "non-smoker". So don't believe what you
hear from anyone else. Don't believe your own gut-instinct that
tells you that you do have the ability to quit. You don't! It's
impossible! Forget it!
Second, don't set a date for quitting. The winners in life are
the people who never plan their life. They just get lucky. Money
falls from the sky whenever they need it. They get around to
doing things "someday."
The losers in life spend time planning their day, planning their
goals and dreams; planning, planning, planning. Don't do that!
It's a waste of your time. You don't need to know when you are
going to do anything. You'll be just fine letting life "happen"
to you. Free love, man! Peace!
Don't set a date for quitting smoking. That way you'll never
know when you should put the cigarettes down for the last time.
That way you can just smoke one right after the other, with no
thought of when you want to become smoke-free.
Third, to guarantee you'll never quit smoking, don't talk to
your doctor about quitting. He or she will just give you a load
of hogwash. They think they know everything, those doctors. They
say smoking will shorten your life, make you sicker more often,
cause sexual dysfunction, give you heart and lung disease, plus
a whole bunch of other unsubstantiated claims. Everyone knows
that smoking never hurt anyone.
Your doctor would try to offer you his professional advice, and
maybe even try to prescribe some "helpful" medications for
quitting. They go to school for a million years and all of a
sudden these doctors think they can help heal people! Imagine.
Oh sure, studies may show that smokers who consult with their
physician are more likely to quit, but then everybody knows that
no one every quit smoking, right? (See the first method, above.)
Fourth, don't exercise. Exercise is hard. You have to burn
calories. You have to discipline yourself to move your muscles
three or four times per week. You have to stop watching TV for
30 minutes. No way!
Stay seated and smoke another pack. Or two.
Exercise is good for you, they say. It can help you take your
mind off smoking. It can relieve stress. But you have cigarettes
to relieve stress, right?
Who wants to exercise when it gives you bulging muscles and a
tone body? The "experts" will try to tell you that you might
feel pretty good about yourself when you start to get in shape.
You just might want to take better care of yourself and quit
smoking. Your self-esteem will improve, your sleep will improve,
your stamina will increase, your sense of purpose will rise,
your weight will drop, your performance at work will improve.
That's what the "experts" say. Nonsense. You're doing just fine
right now, smoking your cigarettes on the couch, in front of the
Finally, the fifth way to guarantee that you'll never quit
smoking is to just give up trying to quit. Don't take any action
toward quitting. It's not necessary. Oh sure, you've tried to
quit before. Did it work? Of course not. So forget it. It's just
not worth the effort. You're a slave to cigarettes.
You don't want to live five or ten years longer anyway, do you?
No, quitting isn't possible. Quitting requires that you actually
try. So don't try. Don't make plans to quit. Don't read about
how to quit. Don't talk with your doctor. Don't learn from other
smokers who quit. Don't try to quit cold turkey or to gradually
reduce the number of cigarettes you smoke. Don't do any of that
weird deep breathing stuff. Don't drink plenty of water. Don't
exercise. Don't eat healthier foods. Don't try to find a
quitting buddy. Don't remove all the ash trays and lighters and
matches and cigarettes from your home and office and vehicle.
Don't talk to strangers!
Face it, you're a smoker. You love smoking. You love the
coughing and hacking. You love freezing to death when you have
to smoke in the designated smoking area outside. You love being
stared at every time you light a cigarette in public. You love
spending hundreds or even thousands of dollars each year on your
habit. You love smelling terrible. You love having bad breath.
You love paying more for your insurance. You love spending time
in the hospital.
Remaining a smoker is easy, now that you know the five simple
ways to guarantee that you never quit smoking. Get started today
(or whenever you feel like it--or never--see step 5)
Brought to you by the Good-For-You-And-Your-Children Tobacco
If you are a smoker who is trying to stop smoking after years of puffing on cigarettes, you can make stopping easier by following some simple tips:
Throw out all cigarettes, ashtrays, lighters, etc. Remove the implements of your smoking habit so the temptation is reduced, and to make it more difficult to smoke again.
Plan some distractions for yourself. When you stop smoking, you are dramatically altering your normal daily activities. You’ll have extra time that you used to spend smoking. Make sure you have something to occupy the former smoking periods. If you normally smoke after meals, plan to do something else like work on a puzzle, walk for 10 minutes, read a book, etc.
Stay away from other smokers. Your smoking buddies at work probably don’t want you to stop smoking because they may miss your company, and they will probably feel guilty about their own smoking weakness. They’ll try to pull you back in to smoking, if you give them a chance. Don’t. Make a clean break from other smokers. Stay away from bars, smoking sections in restaurants, and other places you could be exposed to smoke and other smokers.
Get plenty of rest. You may feel tired after you stop. That’s normal for many people who stop smoking. Don’t fight it. Get extra sleep and allow your body to do the work it needs to begin rebuilding itself.
Drink lots of water. Water is essential to life. Water flushes and cleans the body. Make sure your body has plenty of water to get the nicotine and toxins flushed from your system. Drinking water can also help satisfy oral cravings you may have after you cut out the cigarettes.Pick a stop smoking aid that will help make the smoking cessation process easier.
This book guides you from thinking about stopping smoking through actually doing it-from the day you quit to quitting for keeps. It gives tips on fighting temptation-and what to do if you give in-and on avoiding weight gain (a handy Snack Calorie Chart is included). By telling you what to expect, it can help you through the day-by-day process of becoming a nonsmoker.
In this booklet, you'll find a variety of tips and helpful hints on kicking your smoking habit. Take a few moments to look at each suggestion carefully. Pick those you feel comfortable with and decide today that you're going to use them to quit. It may take a while to find the combination that's right for you, but you can quit for good, even if you've tried to quit before.
Many smokers have successfully given up cigarettes by replacing them with new habits without quitting "cold turkey," planning a special program, or seeking professional help.
The following approaches include many of those most popular with ex-smokers. Remember that successful methods are as different as the people who use them. What may seem silly to others may be just what you need to quit. So don't be embarrassed to try something new. These methods can make your own personal efforts a little easier.
Pick the ideas that make sense to you. And then follow through. You'll have a much better chance of success.
PREPARING YOURSELF FOR QUITTING
* Decide positively that you want to quit. Try to avoid negative thoughts about how difficult it might be.
* List all the reasons you want to quit. Every night before going to bed, repeat one of those reasons 10 times.
* Develop strong personal reasons in addition to your health and obligations to others. For example, think of all the time you waste taking cigarette breaks, rushing out to buy a pack, hunting for a light, etc.
* Begin to condition yourself physically: Start a modest exercise program; drink more fluids; get plenty of rest; and avoid fatigue.
* Set a target date for quitting-perhaps a special day such as your birthday, your anniversary, or the Great American Smokeout. If you smoke heavily at work, quit during your vacation so that you're already committed to quitting when you return. Make the date sacred and don't let anything change it. This will make it easy for you to keep track of the day you became a nonsmoker and to celebrate that date every year.
KNOWING WHAT TO EXPECT
* Have realistic expectations-quitting isn't easy, but it's not impossible either. More than 3 million Americans quit every year.
* Understand that withdrawal symptoms are temporary. They usually last only 1-2 weeks.
* Know that most relapses occur in the first week after quitting, when withdrawal symptoms are strongest, and your body is still dependent on nicotine. Be aware that this will be your hardest time and use all your personal resources, willpower, family, friends, and the tips in this booklet-to get you through this critical period successfully.
* Know that most other relapses occur in the first 3 months after quitting, when situational triggers, such as a particularly stressful event, occur unexpectedly. These are the times when people reach for cigarettes automatically, because they associate smoking with relaxing. This is the kind of situation that's hard to prepare yourself for until it happens, so it's especially important to recognize it if it does happen. Remember that smoking is a habit, but a habit you can break.
* Realize that most successful ex-smokers quit for good only after several attempts. You may be one of those who can quit on your first try. But if you're not, don't give up. Try again.
INVOLVING SOMEONE ELSE
* Bet a friend you can quit on your target date. Put your cigarette money aside for every day you don't smoke and forfeit it if you smoke. (But if you do smoke, don't give up. Simply strengthen your resolve and try again.)
* Ask your friend or spouse to quit with you.
* Tell your family and friends that you're quitting and when. They can be an important source of support both before and after you quit.
WAYS OF QUITTING
* Switch to a brand you find distasteful.
* Change to a brand that is low in tar and nicotine a couple of weeks before your target date. This will help change your smoking behavior. However, do not smoke more cigarettes, inhale them more often or more deeply, or place your fingertips over the holes in the filters. These actions will increase your nicotine intake, and the idea is to get your body used to functioning without nicotine.
Cut Down the Number of Cigarettes You Smoke
* Smoke only half of each cigarette.
* Each day, postpone the lighting of your first cigarette 1 hour.
* Decide you'll only smoke during odd or even hours of the day.
* Decide beforehand how many cigarettes you'll smoke during the day. For each additional cigarette, give a dollar to your favorite charity.
* Change your eating habits to help you cut down. For example, drink milk, which many people consider incompatible with smoking. End meals or snacks with something that won't lead to a cigarette.
* Reach for a glass of juice instead of a cigarette for a "pick-me-up."
* Remember: Cutting down can help you quit, but it's not a substitute for quitting. If you're down to about seven cigarettes a day, it's time to set your target date to quit and get ready to stick to it.
Don't Smoke "Automatically"
* Smoke only those cigarettes you really want. Catch yourself before you light up a cigarette out of pure habit.
* Don't empty your ashtrays. This will remind you of how many cigarettes you've smoked each day, and the sight and the smell of stale cigarettes butts will be very unpleasant.
* Make yourself aware of each cigarette by using the opposite hand or putting cigarettes in an unfamiliar location or a different pocket to break the automatic reach.
* If you light up many times during the day without even thinking about it, try to look into a mirror each time you put a match to your cigarette-you may decide you don't need it.
Make Smoking Inconvenient
* Stop buying cigarettes by the carton. Wait until one pack is empty before you buy another.
* Stop carrying cigarettes with you at home or at work. Make them difficult to get.
Make Smoking Unpleasant
* Smoke only under circumstances that aren't especially pleasurable for you. If you like to smoke with others, smoke alone. Turn your chair to an empty corner and focus only on the cigarette you are smoking and all its many negative effects.
* Collect all your cigarette butts in one large glass container as a visual reminder of the filth made by smoking.
JUST BEFORE QUITTING
* Practice going without cigarettes.
* Don't think of never smoking again. Think of quitting in terms of 1 day at a time.
* Tell yourself you won't smoke today and then, don't.
* Clean your clothes to rid them of the cigarette smell, which can linger for a long time.
ON THE DAY YOU QUIT
* Throw away all your cigarettes and matches. Hide your lighters and ashtrays.
* Visit the dentist and have your teeth cleaned to get rid of tobacco stains. Notice how nice they look and resolve to keep them that way.
* Make a list of things you'd like to buy for yourself or someone else. Estimate the cost in terms of packs of cigarettes and put the money aside to buy these presents.
* Keep very busy on the big day. Go to the movies, exercise, take long walks, go bike riding.
* Remind your family and friends that this is your quit date and ask them to help you over the rough spots of the first couple of days and weeks.
* Buy yourself a treat or do something special to celebrate.
IMMEDIATELY AFTER QUITTING
* Develop a clean, fresh, nonsmoking environment around yourself, at work and at home. Buy yourself flowers. You may be surprised how much you can enjoy their scent now.
* The first few days after you quit, spend as much free time as possible in places where smoking isn't allowed, such as libraries, museums, theaters, department stores, and churches.
* Drink large quantities of water and fruit juice (but avoid sodas that contain caffeine).
* Try to avoid alcohol, coffee, and other beverages that you associate with cigarette smoking.
* Strike up conversation instead of a match for a cigarette.
* If you miss the sensation of having a cigarette in your hand, play with something else, such as a pencil, a paper clip, a marble.
* If you miss having something in your mouth, try toothpicks or a fake cigarette.
* Instead of smoking after meals, get up from the table and brush your teeth or go for a walk.
* If you always smoke while driving, listen to a particularly interesting radio program or your favorite music, or take public transportation for a while, if you can.
* For the first 1-3 weeks, avoid situations you strongly associate with the pleasurable aspects of smoking, such as watching your favorite TV program, sitting in your favorite chair, or having a cocktail before dinner.
* Until you are confident of your ability to stay off cigarettes, limit your socializing to healthful, outdoor activities or situations where smoking is not allowed.
* If you must be in a situation where you'll be tempted to smoke, such as a cocktail or dinner party, try to associate with the nonsmokers there.
* Try to analyze cigarette ads to understand how they attempt to "sell" you on individual brands.
When You Get the Crazies
* Keep oral substitutes handy. Try carrots, pickles, sunflower seeds, apples, celery, raisins, or sugarless gum instead of a cigarette.
* Take 10 deep breaths and hold the last one while lighting a match. Exhale slowly and blow out the match. Pretend it's a cigarette and crush it out in an ashtray.
* Take a shower or bath if possible.
* Learn to relax quickly and deeply. Make yourself limp, visualize a soothing, pleasing situation and get away from it all for a moment. Concentrate on that peaceful image and nothing else.
* Light incense or a candle instead of a cigarette.
* Never allow yourself to think that "one won't hurt" -it will.
Find New Habits
* Change your habits to make smoking difficult, impossible, or unnecessary. For example, it's hard to smoke while you're swimming, jogging, or playing tennis or handball. When your desire for a cigarette is intense, wash your hands or the dishes, or try new recipes.
* Do things that require you to use your hands. Try crossword puzzles, needlework, gardening, or household chores. Go bike riding or take the dog for a walk; give yourself a manicure; write letters.
* Enjoy having a clean-mouth taste and maintain it by brushing your teeth frequently and using a mouthwash.
* Stretch a lot.
* Get plenty of rest.
* Pay attention to your appearance. Look and feel sharp.
* Try to find time for the activities that are the most meaningful, satisfying, and important to you.
About Gaining Weight
Many people who are considering quitting are very concerned about gaining weight. If you are concerned about weight gain, keep these points in mind:
* Quitting doesn't mean you'll automatically gain weight. When people gain, it's because they often eat more once they quit.
* The benefits of giving up cigarettes far outweigh the drawbacks of adding a few pounds. You'd have to gain a very large amount of weight to offset the many substantial health benefits that a normal smoker gains by quitting. Watch what you eat, and if you are concerned about gaining weight, consider the tips that follow.
Tips To Help You Avoid Weight Gain
* Make sure you have a well balanced diet, with the proper amounts of protein, carbohydrates, and fat.
* Don't set a target date for a holiday, when the temptation of high-calorie food and drinks may be too hard to resist.
* Drink a glass of water before your meals.
* Weigh yourself weekly.
* Chew sugarless gum when you want sweet foods.
* Plan menus carefully and count calories. Don't try to lose weight; just try to maintain your prequitting weight.
* Have low-calorie foods on hand for nibbling. Use the Snack Calorie Chart to choose foods that are both nutritious and low in calories. Some good choices are fresh fruits and vegetables, fruit and vegetable juices, low-fat cottage cheese, and air-popped popcorn without butter.
* Take time for daily exercise or join an organized exercise group.
SNACK CALORIE CHART
BEVERAGES Carbonated (per 8-ounce glass)
Fruit flavors (10-13% sugar) 115
Ginger ale 75
Fruit drinks (per 1/2 cup)
Apricot nectar 70
Cranberry juice 80
Grape drink 70
Lemonade (frozen) 55
Fruit juices (per 1/2 cup)
Apple juice, canned 60
Grape juice, bottled 80
Grapefruit juice, canned, unsweetened 50
Orange juice, canned, unsweetened 55
Pineapple juice, canned, unsweetened 70
Prune juice, canned 100
Vegetable juices (per 1/2 cup)
Tomato juice 25
Vegetable juice cocktail 20
Coffee and tea
Coffee, black 3-5
with 1 tsp. sugar 18-20
with 1 tsp. cream 13-15
Tea, plain 0-1
with 1 tsp. sugar 15-16
CANDY, CHIPS, Candy (per ounce)
AND Hard candy 110
PRETZELS Jelly beans 105
Chips (per cup)
Corn chips 230
Potato chips 115
Popcorn (air-popped, without butter) 25
Dutch, 1 twisted 60
Stick, 5 regular 10
CHEESE American, processed 105
(per ounce) Cottage, creamed 30
Cottage, low-fat (2%) 25
Swiss, natural 105
Butter, 2-inch diameter 15
Graham, 2 1/2 inches square, 2 55
Matzoh, 6-inch diameter 80
FRUITS (raw) Apple, 1 medium 80
Apricots, fresh, 3 medium 50
Apricots, dried, 5 halves 40
Banana, 1 medium 105
Blackberries, 1/2 cup 35
Blueberries, 1/2 cup 40
Cantaloupe, 1/4 melon 50
Cherries, 10 50
Dates, dried, 3 70
Fig, dried, 1 medium 50
Grapefruit, 1/2 40
Grapes, 20 30
Orange, 1 medium 60
Peach, 1 medium 35
Pear, 1 medium 100
Pineapple, 1/2 cup 40
Prunes, dried, 3 60
Raisins, 1/4 cup 110
Strawberries, 1 cup 45
Watermelon, 1 cup 50
NUTS (per 2 Almonds 105
tablespoons) Brazil nuts 115
Pecans, halves 95
VEGETABLES Carrots, 1/2 cup grated 35
(raw) Celery, 5-inch stalks, 3 10
Pickle, 1 15-20
WHAT HAPPENS AFTER YOU QUIT SMOKING
Within 12 hours after you have your last cigarette, your body will begin to heal itself. The levels of carbon monoxide and nicotine in your system will decline rapidly, and your heart and lungs will begin to repair the damage caused by cigarette smoke
Within a few days you will probably begin to notice some remarkable changes in your body. Your sense of smell and taste may improve. You will breathe easier, and your smoker's hack will begin to disappear, although you may notice that you will continue to cough for a while. And you will be free of the mess, smell, inconvenience, expense, and dependence of cigarette smoking.
As your body begins to repair itself, instead of feeling better right away, you may feel worse for a while. It's important to understand that healing is a process-it begins immediately, but it continues over time. These "withdrawal pangs" are really symptoms of the recovery process (See "Withdrawal Symptoms and Activities That Might Help".)
Immediately after quitting, many ex-smokers experience "symptoms of recovery" such as temporary weight gain caused by fluid retention, irregularity and dry, sore gums or tongue. You may feel edgy, hungry, more tired, or more short-tempered than usual; you may have trouble sleeping or notice that you are coughing a lot. These symptoms are the result of your body clearing itself of nicotine, a powerful addictive chemical. Most nicotine is gone from the body in 2-3 days.
It is important to understand that the after-effects of quitting are only temporary and signal the beginning of a healthier life. Now that you've quit, you've added a number of healthy, productive days to each year of your life. Most important, you've greatly improved your chances for a longer life. You have significantly reduced your risk of death from heart disease, stroke, chronic bronchitis, emphysema, and several kinds of cancer-not just lung cancer. More than 400,000 deaths in the United States each year are from smoking-related illnesses.
WITHDRAWAL SYMPTOMS AND ACTIVITIES THAT MIGHT HELP*
Dry mouth; sore throat, gums, or
tongue Sip ice-cold water or fruit juice, or chew gum.
Headaches Take a warm bath or shower. Try relaxation or meditation techniques.
Trouble sleeping Don't drink coffee, tea, or soda with caffeine after 6:00 p.m. Again, try relaxation or meditation techniques.
Irregularity Add roughage to your diet, such as raw fruit, vegetables, and whole-grain cereals. Drink 6-8 glasses of water a day.
Fatigue Take a nap. Try not to push yourself during this time; don't expect too much of your body until it's had a chance to begin to heal itself over a couple of weeks.
Hunger Drink water or low-calorie liquids. Eat low-fat, low calorie snacks. (See "Snack Calorie Chart".)
Tenseness, irritability Take a walk, soak in a hot bath, try relaxation or meditation tech piques.
Coughing Sip warm herbal tea. Suck on cough drops or sugarless hard candy.
*Adapted from Quitting Times: A Magazine for Women Who Smoke, funded by the Pennsylvania Department of Health; prepared by Fox Chase Cancer Center, Philadelphia.
QUITTING FOR KEEPS
Now you are ready to develop a new habit-not smoking. Like any other habit, it takes time to become a part of you; unlike most other habits, though, not smoking will take some conscious effort and practice. This section of the booklet can be a big help. You will find many techniques to use for developing the nonsmoking habit and holding on to it.
By reading this section of the booklet carefully and reviewing it often, you'll become more aware of the places and situations that prompt the desire for a cigarette. You will also learn about many nonsmoking ways to deal with the urge to smoke. These are called coping skills. Finally, you will learn what to do in case you do slip and give in to the smoking urge.
Keep Your Guard Up
The key to living as a nonsmoker is to avoid letting your urges or cravings for a cigarette lead you to smoke. Don't kid yourself-even though you have made a commitment not to smoke, you will sometimes be tempted. But instead of giving in to the urge, you can use it as a learning experience.
First, remind yourself that you have quit and you are a nonsmoker. Then look closely at your urge to smoke and ask yourself:
* Where was I when I got the urge?
* What was I doing at the time?
* Who was with me?
* What was I thinking?
The urge to smoke after you've quit often hits at predictable times. The trick is to anticipate those times and find ways to cope with them-without smoking. Naturally, it won't be easy at first. In fact, you may continue to want a cigarette at times. But remember, even if you slip, it doesn't mean an end to the nonsmoking you. It does mean that you should try to identify what triggered your slip, strengthen your commitment to quitting, and try again.
Look at the following list of typical triggers. Do many of them ring a bell with you? Check off those that might trigger an urge to smoke, and add any others you can think of:
* Working under pressure
* Feeling blue
* Talking on the telephone
* Having a drink
* Watching television
* Driving your car
* Finishing a meal
* Playing cards
* Drinking coffee
* Watching someone else smoke
If you are like many new nonsmokers, the most difficult place to resist the urge to smoke is the most familiar-home. The activities most closely associated with smoking urges are eating, partying, and drinking. And, not surprisingly, most urges occur when a smoker is present
How to Dampen That Urge
There are seven major coping skills to help you fight the urge to smoke. These tips are designed for you, the new nonsmoker, to help you nurture the nonsmoking habit.
1. Think about why you quit.
Go back to your list of reasons for quitting. Look at this list several times a day, especially when you are hit with the urge to smoke. The best reasons you could have for quitting are very personally yours, and these are also the best reasons to stay a nonsmoker.
2. Know when you are rationalizing.
It is easy to rationalize yourself back into smoking. (See "Common Rationalizations".) Don't talk yourself into smoking again. A new nonsmoker in a tense situation may think, "I'll just have one cigarette to calm myself down." If thoughts like this pop into your head, stop and think again! You know better ways to relax, nonsmokers' ways, such as taking a walk or doing breathing exercises.
Concern about gaining weight may also lead to rationalizations. Learn to counter thoughts, such as "I'd rather be thin, even if it means smoking." Remember that a slight weight gain is not likely to endanger your health as much as smoking would. (Cigarette smokers have about a 70-percent higher rate of premature death than nonsmokers.) And review the list of healthy, low-calorie snacks that you used when quitting.
3. Anticipate triggers and prepare to avoid them.
By now you know which situations, people, and feelings are likely to tempt you to smoke. Be prepared to meet these triggers head-on and counteract them. Keep using the skills that helped you cope in cutting down and quitting:
* Keep your hands busy-doodle, knit, type a letter.
* Avoid people who smoke; spend more time with nonsmoking friends.
* Find activities that make smoking difficult (gardening, washing the car, taking a shower). Exercise to help knock out the smoking urge; it will help you to feel and look good as well.
* Put something other than a cigarette in your mouth. Chew sugarless gum or nibble on a carrot or celery stick.
* Avoid places where smoking is permitted. Sit in the nonsmoking section of restaurants, trains, and planes.
* Reduce your consumption of alcohol, which often stimulates the desire to smoke. Try to have no more than one or two drinks at a party. Better yet, have a glass of juice, soda, or mineral water.
4. Reward yourself for not smoking.
Congratulations are in order each time you get through a day without smoking. After a week, give yourself a pat on the back and a reward of some kind. Buy a new tape or compact disc. Treat yourself to a movie or concert. No matter how you do it, make sure you reward yourself in some way. It helps to remind yourself that what you are doing is important.
5. Use positive thoughts.
If self-defeating thoughts start to creep in, remind yourself again that you are a nonsmoker, that you do not want to smoke, and that you have good reasons for quitting. Putting yourself down and trying to hold out using willpower alone are not effective coping techniques. Mobilize the power of positive thinking!
6. Use relaxation techniques.
Breathing exercises help to reduce tension. Instead of having a cigarette, take a long deep breath, count to 10, and release it. Repeat this five times. See how much more relaxed you feel?
7. Get social support.
The commitment to remain a nonsmoker can be made easier by talking about it with friends and relatives. They can congratulate you as you check off another day, week, and month as a nonsmoker. Tell the people close to you that you might be tense for a while, so they know what to expect. They'll be sympathetic when you have an urge to smoke and can be counted on to help you resist it. Remember to call on your friends when you are lonely, or you feel an urge to smoke. A buddy system is a great technique.
Not Smoking Is Habit-Forming
Good for you! You have made a commitment not to smoke, and by using this booklet, you know what to do if you are tempted to forget that commitment. It is difficult to stay a nonsmoker once you have had a cigarette so do everything possible to avoid it.
If you follow the advice in this booklet and use at least one coping skill whenever you have an urge to smoke, you will have quit for keeps!
Relapse: If You Do Smoke Again
If you slip and smoke, don't be discouraged. Many former smokers tried to stop several times before they finally succeeded. Here's what you should do:
* Recognize that you have had a slip. A slip means that you have had a small setback and smoked a cigarette or two. But your first cigarette did not make you a smoker to start with, and a small setback does not make you a smoker again.
* Don't be too hard on yourself. One slip doesn't mean you're a failure or that you can't be a nonsmoker, but it is important to get yourself back on the nonsmoking track immediately.
* Identify the trigger: Exactly what was it that prompted you to smoke? Be aware of the trigger and decide now how you will cope with it when it comes up again.
* Know and use the coping skills described above. People who know at least one coping skill are more likely to remain nonsmokers than those who do not know any.
* Sign a contract with yourself to remain a nonsmoker.
* If you think you need professional help, see your doctor. He or she can provide extra motivation for you to stop smoking. Your doctor may also prescribe nicotine gum or a nicotine patch as an alternative source of nicotine while you break the habit of smoking.
* Each month, on the anniversary of your quit date, plan a special celebration.
* Periodically, write down new reasons you are glad you quit and post these reasons where you will be sure to see them.
* Make up a calendar for the first 90 days. Cross off each day and indicate the money you saved by not smoking.
* Set other intermediate target dates and do something special with the money you have saved.
I'm under a lot of stress, and smoking relaxes me. Your body is used to nicotine, so you naturally feel more relaxed when you give your body a substance upon which it has grown dependent. But nicotine really is a stimulant; it raises your heart rate, blood pressure, and adrenaline level. Most ex-smokers feel much less nervous just a few weeks after quitting.
Smoking makes me more effective in my work. Trouble concentrating can be a short-term symptom of quitting, but smoking actually deprives your brain of oxygen
I've already cut down to a safe level. Cutting down is a good first step, but there's a big difference in the benefits to you between smoking a little and not smoking at all. Besides, smokers who cut back open inhale more open and more deeply, negating many of the benefits of cutting back. After you've cut back to about seven cigarettes a day, it's time to set a quit date.
I smoke only safe, low-tar/low-nicotine cigarettes. These cigarettes still contain harmful substances, and many smokers who use them inhale more open and more deeply to maintain their nicotine intake. Also, carbon monoxide intake often increases with a switch to low-tar cigarettes.
It's too hard to quit. I don't have the willpower. Quitting and staying away from cigarettes is hard, but it's not impossible. More than 3 million Americans quit every year. It's important for you to remember that many people have had to try more than once, and try more than one method, before they became ex-smokers, but they have done it, and so can you.
I'm worried about gaining weight. Most smokers who gain more than 5-10 pounds are eating more. Gaining weight isn't inevitable. There are certain things you can do to help keep your weight stable. (See Tips To Help You Avoid Weight Gain.)
I don't know what to do with my hands. That's a common complaint among ax-smokers. You can keep your hands busy in other ways; it's just a matter of getting used to the change of not holding a cigarette. Try holding something else, such as a pencil, paper clip, or marble. Practice simply keeping your hands clasped together. If you're at home, think of all the things you wish you had time to do, make a list, and consult the list for alternatives to smoking whenever your hands feel restless.
Sometimes I have an a/most irresistible urge to have a cigarette. This is a common feeling, especially within the first 1-3 weeks. The longer you're off cigarettes, the more your urges probably will come at times when you smoked before, such as when you're drinking coffee or alcohol or are at a cocktail party where other people are smoking. These are high risk situations, and you can help yourself by avoiding them whenever possible. If you can't avoid them, you can try to visualize in advance how you'll handle the desire for a cigarette if it arises in those situations.
I blew it. I smoked a cigarette. Smoking one or a few cigarettes doesn't mean you've "blown it." It does mean that you have to strengthen your determination to quit and try again-harder. Don't forget that you got through several days, perhaps even weeks or months, without a cigarette. This shows that you don't need cigarettes and that you can be a successful quitter.
*Adapted from Clinical Opportunities for Smoking Intervention-A Guide for the Busy Physician. National Heart, Lung, and Blood Institute. NIH Pub. No. 86-2178. August 1986.
FOR FURTHER INFORMATION
The Cancer Information Service, a program of the National Cancer Institute, is a nationwide telephone service for cancer patients and their families and friends, the public, and health care professionals. The staff can answer questions (in English or Spanish) and can send free National Cancer Institute materials about cancer. They also know about support groups and other resources and services. One toll-free number, 1-800-4-CANCER (1-800-422-6237), connects callers with the office that serves their area.
The following organizations also can help you. Contact them to learn more about quitting for keeps.
American Cancer Society
1599 Clifton Road, NE
Atlanta, GA 30329
The American Cancer Society (ACS) is a voluntary organization composed of 58 divisions and 3,100 local units. Through "The Great American Smokeout" in November, the annual Cancer Crusade in April, and the numerous educational materials, ACS helps people learn about the health hazards of smoking and become successful ex-smokers.
American Heart Association
7272 Greenville Avenue
Dallas, TX 75231
The American Heart Association (AMA) is a voluntary organization with 130,000 members (physicians, scientists, and laypersons) in 55 state and regional groups. AHA produces a variety of publications and audiovisual materials about the effects of smoking on the heart. AHA also has developed a guidebook for incorporating a weight-control component into smoking cessation programs.
American Lung Association
New York, NY 10019-4374
The oldest voluntary health agency with 57 state associations and 60 affiliates throughout the United States, the American Lung Association (ALA) provides help for smokers who wish to quit through their Freedom From Smoking self-help smoking cessation program. The organization actively supports legislation and information campaigns for nonsmokers' rights and conducts public information programs about the health effects of smoking.
Consult your local telephone directory for listings of local chapters.
Office on Smoking and Health
Centers for Disease Control
Mail Stop K-50
4770 Buford Highway, NE
Atlanta, GA 30341-3724
The Office on Smoking and Health (OSH) is the Department of Health and Human Services' lead agency in smoking control. OSH sponsors distribution of publications on smoking-related topics, such as free flyers on relapse after initial quitting, helping a friend or family member quit smoking, the health hazards of smoking, and the effects of parental smoking on teenagers.