Kathryn Jean Lucas, MD |
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Kathryn Jean Lucas, MD |
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| inside health |
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| Smokeless in Carolina |
| By: K. Jean Lucas, M.D. |
In high school, smoking set Laura apart from the others. Smoking made her feel like an adult, gave her a way to rebel against parental controls, and best of all, it helped her to control her weight which had begun to increase with starting her menstrual periods. By the time she turned twenty, she realized that she still needed the cigarettes. If she missed even a fraction of the two packs per day she smoked, she would be irritable and shaky. Her co-workers would beg her to smoke if she were acting this way. As time went on, she found herself unable to climb up stairs without her heart racing and breathing hard. When she went to her family doctor with these complaints, she was told to stop smoking. How could she?
John had always been described as "high-strung" and "hyper". Smoking as a teenager helped him concentrate on his school work and calmed him down so he could stay out of trouble. Whenever, crises or stresses would arise, the cigarettes would increase in importance as a way of coping. After his two recent sinus infections, which he thought would never go away, he wanted to quit smoking. He was afraid that he would feel worse not smoking and be unable to handle stress. What could he do?
Cynthia always felt like she needed something in her hands. As a child, she was always dragging her stuffed bear around. As a adult, she found that the procedures involved in smoking: the retrieval of a cigarette, the lighting of one, the holding and puffing, and the disposal of the cigarette satisfied those needs. At least, smoking unlike eating, caused her to maintain or even lose weight. Her physician had told her that her smoking was causing her daughter’s asthma to get worse. She knew she had to quit, but what could replace the enjoyment she felt watching that curl of smoke drift into the air?
WHAT TYPE OF SMOKER ARE YOU?
Prior to deciding to quit smoking, you must ask yourself why do you smoke. Does it stimulate you? Relax you? Does it feel good? Do you need something in your hand? Is physical addiction the only reason? Or is it just a habit? Take the test below to see what category you fall in. Your stop smoking strategy needs to be individualized to take into consideration what you get by smoking. If the plan does not include a healthy substitute for what you use cigarettes for, then it is apt to fail. It may be that lack of awareness and planning is why over 60% of smokers do not quit permanently the first time they try.
UNDER WHAT CIRCUMSTANCES DO YOU SMOKE?
Like all habits, you are unconsciously lighting up at times. At other times, a specific trigger prompts you to smoke. To be aware of why and when you smoke and the triggering events that start it up, it is useful to write down for several days, the circumstances surrounding the smoking of the cigarette. It helps to make a chart showing the time of the cigarette, the event surrounding the smoking, the people with whom you smoke, the feelings you have or the reason you are smoking. List whether a physical or psychological need prompted the smoking. Examples of events precipitating lighting up are as follows: stressful events, eating, taking a break at work, getting in your car to commute, irritability, physical craving, waiting, having an alcoholic drink, being at a party, being with smokers, or getting up in the morning.
WHY DO YOU WANT TO QUIT SMOKING?
Remember that unless you convince yourself of the need for quitting, you are unlikely to stay smoke-free. Doing it to please your spouse or boss or doing it as a part of a bet will not make you avoid cigarettes over the long term. If you are convinced that smoking is helping you with your weight, you will restart smoking if you gain any weight at all by quitting. Therefore, you must come up with your own list of reasons. Do not accept a list that your family or doctor made up for you because these reasons may not be important to you. Below are examples of why some people quit smoking. You may use these and come up with more for you. It is helpful to write or type these reasons in large print and put them where you will see them every day (such as on your bathroom mirror).
Reasons to quit smoking:
I will stop coughing in the morning.
Rank your own reasons for quitting from first to last. Read and study your list every day for at least two weeks until you are convinced that stopping smoking is what you need to do.
WHEN DO YOU WANT TO QUIT SMOKING?
After you are convinced that you need to quit, you should set a date for stopping. Leave yourself enough time in order to plan the behavior changes that will be required when you quit. Do not set the date on a holiday when you tend to overeat. Do not set the date during a very stressful period in your life. A special date for you such as your anniversary or birthday may be appropriate. During a vacation when your usual routine is disrupted and you are more relaxed is often an ideal time. Moving into a new house or buying a new car is often a good time; keeping the house or the car smoke-free is often a good incentive.
HOW DO YOU PLAN FOR THE STOP DATE?
Make cigarettes less accessible: Try to make it harder to smoke. Only buy one pack of cigarettes at a time. Put them in a jar that is hard to get open or in another less accessible place so that you have to go out of your way to get them. Switch to a brand that you dislike. Smoke only half of each cigarette. Cut down on the number of puffs per cigarette. Don’t smoke until you feel a craving. Smoke only in unpleasurable situations (if you like to smoke with people, then make yourself smoke alone). Each day postpone by one hour the time you will light your first cigarette.
Know your triggers for smoking: If possible, avoid your usual triggers for smoking. For example, if you smoke at parties, do not attend any parties for awhile. If you smoke while on the telephone, have something else in your hand while talking or remove the cigarettes from your reach, so you will be unable to get them when you are talking. If you smoke after eating, get up from the table and take a walk away from where the cigarettes are immediately after you finish. You can think of other ways of avoiding triggers.
Learn stress reduction techniques: Practice deep-breathing exercises for relaxation. Visualize yourself in a pleasant environment. Do progressive muscle relaxation.
Exercise: Now is the time to gradually start increasing your exercise. Start walking and gradually increase the time you walk by at least five minutes per day. A good time to walk would be during the situations which trigger smoking such as breaks at work, after eating, or when you are under stress. New habits will help break old ones. Exercise will give you many of the supposed benefits without smoking plus make you feel better and healthier.
Set up alternatives to smoking: What else could you do without a cigarette in your hand? Work on a hobby, sew, read, play sports, work on crossword puzzles. What could replace cigarettes in your hand? A pen, carrot sticks, a small rubber ball to squeeze, and small furry object. What can replace cigarettes in your mouth? Sugarless gum, carrot sticks, celery, water, popsicles, lollypops. What can you do with your hands while on the phone? Doodle, take notes on the conversation, address envelopes, play with a small toy near the phone. Be creative and think of other replacements.
Make a diet plan for stopping: Plan for buying only healthy and nutritious foods. Eat small snacks in-between meals to satisfy the increase in food craving especially for sugar and fat which may accompany stopping smoking.
Avoid high smoking areas and people: If you have other smokers at home, it will very difficult for you to stop on your own. It may be helpful to ban all smoking in the house so that your environment after stopping will be smoke-free. The best way to deal with a spouse smoking is for both of you to work together to stop at the same time. Many workplaces already ban smoking. Avoid break rooms and loading docks where smokers congregate. Go to lunch with non-smokers.
Develop a friendship with ex-smokers and non-smokers. If you play cards with smokers, ban smoking during games or play with those who do not smoke.
Plan rewards for a day without cigarettes: Rewards such be non-food items or activities which you enjoy. They should be easy to obtain. If they involve another person, be sure to enlist that person’s involvement in the plan. The rewards should be in proportion to the effort expended in changing a habit. Reward yourself as soon as possible after the task is accomplished. For example, rewards can be bestowed for exercising at least three times in one week. After you stop smoking, the days without cigarettes may be counted for points leading to prizes. Examples of prizes include: buying new clothes, books, tapes. You may want to reward yourself with a long bubble bath, sleeping late, going to a movie or play, or getting a massage. Larger rewards may be a weekend or weeklong trip.
Talk to your doctor about preventing physical withdrawal symptoms: If you have tried to quit smoking in the past and experienced symptoms of withdrawal: hot and cold flushes, fast heart rate, anxiety, and cravings for cigarettes, your success at quitting can be improved by alleviating these unpleasant symptoms. Using nicotine patches will prevent your craving nicotine. The patches give a low dose sustained amount to your body all the time. They do not give the high levels that a cigarette does but they also do not have the level of nicotine drop precipitously after the cigarette is finished. Before using the patches, all of the other planning and thinking about quitting should be done. The nicotine patches do not make anyone quit. They are merely an aid to quitting.
HOW DO YOU STAY SMOKE-FREE?
Habits, to be completely gone and forgotten, may take months of constant effort to eradicate. The smoking habit may have been with you for decades; why do you think yourself a failure if you restart to smoke after not smoking for only a few months. If you are trying to learn a new skill, do you give up after trying it once. Think of stopping as a continuous self-improvement process by which you learn a little more about yourself each time you try to quit permanently. If you have quit in the past, analyze why you failed. Did lack of prior planning doom your plan to failure? Did you quit because of external pressures to quit and not for yourself? Did you gain a few pounds and panic? Did you fail to start an exercise program and practice relaxation techniques prior to quitting? Did you try to stop during a stressful period in your life? Did you continue to be around people who smoke? Did your spouse not quit with you and continue to smoke? Did you fail to think of yourself as a nonsmoker? Did you not find a substitute for smoking in your life?
Becoming a nonsmoker is another habit you will develop over time. The longer you go without smoking, the easier it is to never pick up another cigarette. Over time, you will feel healthier and happier not smoking. Keep trying! Your body will thank you and repay you in many ways you would never have predicted. Good luck!.
MORE REASONS TO STOP SMOKING
By now, everyone has surely gotten the message that smoking causes emphysema, lung cancer, head and neck cancer, and heart disease. However, if you are one of those people who are still smoking, we would like to take this opportunity to list less well-known reasons to stop.
Reasons to Stop Smoking
If you get the idea that we really want you to quit smoking, you are right. Stopping smoking will provide healthy benefits for your whole body. If you are worried about troublesome withdrawal symptoms, nicotine patches will help. However, the patches will not prevent you from restarting. Only an analysis of why you smoke (stress, boredom, etc.) will enable you to think of alternatives and change your habits to create a new you.
For more information, contact our office or the American Lung Association.
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