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Mark Twain once said, “It’s easy to stop smoking. I’ve done it a thousand times.” He’s right. Quitting is easy. Staying quit is the hard part. We’ve all heard of a smoker who threw his cigarettes away and never wanted another one. Those are the rare cases. Less than 5 smokers in 100 can do that. Most people struggle many times before they finally overcome their tobacco addiction, and, unfortunately, some never succeed.

However, while stopping tobacco is a challenge, it is achievable when you follow effective strategies. I’ve helped thousands of smokers to quit, and you can join the winner’s circle. In this article I’ll share with you some of the important steps that have helped my patients to reach their goal of a tobacco-free life.

Before You Begin

In order to get into a positive, success-oriented frame of mind, begin by setting your personal goal. Do not simply make a promise on an impulse to yourself or anyone else to quit and then toss the cigarettes (or other tobacco product) without a plan. It’s better to set a quit date sometime in the near future, and then take steps to prepare ahead of time. (The rest of this article refers to smoking cigarettes, but most of the suggestions will work for any form of tobacco use, chew, spit, cigars, or pipes.)

Find out why you smoke. A good first step is to identify the reasons why you smoke: to relax from stress, to satisfy a craving, to keep your hands busy—or just because it’s a habit. Then try to think of creative alternatives to meet those needs without resorting to tobacco. If you smoke when you feel stressed, read a book on relaxation techniques and practice them for 10 to 15 minutes instead of smoking.

Monitor your use of tobacco. Record on a calendar or chart the amount you smoke or chew each day. Use the chart below to calculate how much money your smoking is costing you, then make plans to use this money after you stop smoking in ways you especially enjoy.

Reduce easy access. Keep your tobacco materials out of reach and sight, including lighters and matches. Make yourself get up and find them when you really want to smoke. This makes your use of tobacco more of a conscious, deliberate act and disrupts your automatic habits.

Create smoke-free zones. Quit smoking in your car or in one room in the house. Better yet, set aside one room or an outdoor patio as the only place you’ll smoke.

Think of yourself as a nonuser.Consciously imagine yourself turning down an offer of a cigarette. Visualize how you’ll respond when someone offers you a cigarette.

Celebrate your quit date. Choose the most stress-free day of the week to declare your “Freedom From Smoking Day,” then make a big event out of it. Go out with family and/or friends for breakfast at your favorite nonsmoking restaurant. Decorate your house with flowers, potpourri, and balloons. And plan the day carefully to protect yourself from contact with any reminders of tobacco. Go places where smoking isn’t allowed.

Build a team to help you quit. This strategy is so important I’ve made it the next major section of the article. Isolation is the companion of addictions, so don’t go at it alone!

Don’t Go It Alone

The majority of tobacco addicts who try to stop on their own end up failing. You’ll be more successful if you build a team to help you through the process.

Your doctor. Consult your doctor before your quit date. He or she can prescribe medication to help you through the initial withdrawal phase, which usually lasts from seven to ten days. Success rates are much higher when these medications are used properly. The following three effective medications are approved as aids to quitting smoking: Bupropion (Zyban®, Wellbutrin®), Varenicline (Chantix®), and Nicotine Replacement Therapy.

Bupropion will moderate the highs and lows you experience from nicotine withdrawal and craving, making it easier to get through the first few weeks without nicotine.

Varenicline is a molecule that looks like nicotine to the brain and it blocks the receptors that respond to a hit of nicotine, thereby reducing the positive “high” of smoking. The desire for a cigarette is reduced by each of these two pills but in different locations in the pathway of nicotine addiction in the brain.

Nicotine Replacement Therapy will deliver a pure dose of nicotine to your brain, but without the 4,000 toxic chemicals in tobacco smoke. Then you will slowly reduce the amount of nicotine dose you’re replacing until your brain no longer needs it.

Your doctor can prescribe any of these treatment options, and some are now available over the counter. Make sure you discuss the best option for you and any possible side effects that may be relevant in your condition.

Consider that you may need to stay on medications for up to two to six months, depending on the strength of your craving cycle and withdrawal symptoms.

A support person. When the going gets tough, you’ll find it extremely helpful to have a person you can call to discuss your feelings. This person should be able to help you through a slipup without being judging or condemning. It will be especially helpful if you can find someone who’s already succeeded in overcoming a tobacco addiction. And if you’re spiritually inclined, it will help to find someone who can pray with you and give spiritual guidance.

Family and friends. Being tobacco free will be easier if you have the cooperation of your family and friends. If any of them smoke, you can ask them to help you by not smoking in your presence or offering you cigarettes during the first few weeks of withdrawal.

Also, ask them to be patient if you seem a bit irritable for a few days. The feelings are a result of your brain breaking free from the control of nicotine and readjusting its chemistry, tempo, and rhythms. Finally, avoid being around people who make fun of your efforts to stop using tobacco. Such people are not really friends who care about your well-being.

Coping With Cravings

Addiction is based on chemical reactions in your brain that distort the way it works, and this is especially true of nicotine addiction. Almost 95 percent of regular tobacco users become addicted. So one of your most important strategies will be to learn to handle the cravings that brain chemistry changes cause, but without rushing back to a hit from your tobacco. The following six Ds will help you to deal with the desire for tobacco.

Delay. If you wait long enough, the craving will begin to weaken by itself. So tell yourself, “I can hang on for three minutes.” Then during those three minutes, instead of enduring the pain, practice one of the other Ds below to pass the time.

Deep breathing. Take in a deep breath slowly through your nose, then exhale through your mouth. Do this ten times. This will produce a calming effect and begin to reverse some of the irritable brain chemistry sensations. Close your eyes and try to relax.

Discuss with a friend. Call the friend on your support team and talk about the withdrawal, craving, or negative feelings you’re experiencing.

Distract yourself. Find something to do that will get your mind off of tobacco. It will be particularly helpful to find a task that needs completion and/or that you especially enjoy. Begin an activity that you normally would not do while smoking, like washing dishes or brushing your teeth.

Drink water. Drink an ice-cold glass of water through a straw. It’s good for you, it will keep your hands busy, and it will give you the sense of something in your mouth besides a cigarette. Water will also release some “good feeling” chemicals in your brain, and it will flush the nicotine from your system.

Divine power. The Creator God is available 24/7 to help you, and He already knows what you are going through. Try the following ways to access His power:

Say a simple prayer, such as “God, I need Your help right now to cope with this craving. Thank You for empowering my choice to achieve victory!”

Carry a small pocket Bible in the place where you’ve been keeping cigarettes. Underline special verses and read them during your three-minute time-out. Some helpful examples are 1 Corinthians 6:19, 20; John 15:5; Philippians 4:13; and Jude 1:24.

Go for a short walk in nature and enjoy the sunshine and singing birds.

Count your blessings and focus on the positive aspects of why you are choosing new behaviors rather than just lighting up another cigarette.

Call your support person and ask him or her to pray with or for you.

Meditate quietly on a positive theme that assures you that God is in control.

About Slips

Slipping up and smoking one cigarette doesn’t mean you’ve lost the battle with tobacco. Guilty feelings and shame are normal, but prolonged guilt will hinder your progress. Learn to forgive yourself and continue to move toward health. It probably took you several years to develop your addiction. It isn’t realistic to expect it to disappear overnight.

So when you slip, figure out what led up to it and repeat out loud your determination to quit. Then think through how to avoid the slip next time and restart your recovery process with a strategy to correct that issue.

During a struggle with craving or after you happen to slip up is when your team members can be especially helpful.

Be sure to keep your appointments with your doctor, call your support person, and stay tuned to the power from on High.

Be patient with yourself. Give yourself time. If you persist, you will win! You can move tobacco out of your life, if you stick to your game plan and use all the tools that are available now.

This article is based on the booklet Tobacco: You Can Be Free that outlines a plan for recovery from addiction to nicotine. It was written by specialists in the treatment of addiction at Loma Linda University in California.

Tobacco: You Can Be Free!

by Linda Hyder Ferry, MD, MPH
From the July 2008 Signs  

Get Some Air . . .

One of the most common ailments resulting from smoking is emphysema. About 80 percent of sufferers are smokers.

Emphysema is a chronic, progressive disorder of reduced lung function. It can’t be reversed, but it can be halted—if the sufferer gives up smoking. Surgery is another option.

Inhalation of toxic substances such as cigarette smoke can damage the tiny air sacs in the lungs. The sacs enlarge progressively, losing their natural elasticity, and don’t empty completely before a sufferer inhales again. The trapped air and damaged lung lining interferes with the normal exchange of oxygen for carbon dioxide. It is this that makes you feel short of breath.

Tobacco smoke has many components, including cancer-causing agents. Tobacco smoke stuns the airways, literally paralyzing the microscopic hairs lining the bronchial tubes. This interferes with the usual sweeping away of irritants and germs from the airways.

Unfortunately emphysema may not reveal itself until long-term lung damage has already occurred, with shortness of breath one of the first symptoms. There may be some difficulty recovering from mild upper-respiratory infections, a chronic mild cough, loss of appetite and weight, and fatigue due to an oxygen lack.

There is no cure for emphysema, but prompt treatment along with walking or bike riding and upper-body exercises can reduce the impact of emphysema and slow its progression. But the single most effective change is to stop smoking, so do it now!

Are You Hooked?

Tobacco: You Can Be Free! contains strategies for recovery as well as basic self-tests, such as the Fagerstrom test for nicotine dependence, below. Take time to complete it now, and determine how hooked—and in need of help—you are.

  1. How many minutes after you wake up do you first smoke?
    • more than 60—0 points
    • 31-60—1 points
    • 5-30—2 points
    • less than 5—3 points
  2. Do you find it hard not to smoke in places you shouldn’t?
    • No—0 points
    • Yes—1 point
  3. Which cigarette would you find hardest to give up?
    • first in the morning?—1 point
    • any other than the first—0 points
  4. Do you smoke more in the first few hours after waking than during the rest of the day?
    • No—0 points
    • Yes—1 point
  5. How many cigarettes do you smoke each day?
    • 10 or less—0 points
    • 11-20—1 point
    • 21-30—2 points
    • 31 or more—3 points
  6. Do you smoke even if you’re sick in bed most of the day, or have the flu or a bad cough?
    • No—0 points
    • Yes—1 point

    Total: ________ points

    1–2 points: low
    3–6 points: moderate
    7–10 points: high