Question

THE EVER EFFECTIVE APPROACH TO QUIT SMOKING

Dr.R.Manoj Raghavan · Accepted Answer

A good percentage of people who smoke want to quit the habit, few who understand the physical and psychological damage it can do to them and many because they feel that the they are losing control over the habit and its going well beyond the levels at which they want to maintain it and some because it eats into their pocket. They even express the wish to quit which only follows their version of inability to do so and a feeling helplessness. A considerable number of people make plans to quit and even fix up the dates to quit only to find, some excuses to postpone it. Few even take some measures to quit such gradual reduction in the number of cigarettes they use everyday only to see that they lose control very soon. Few even quit complete only to get back in to the habit within a few days at the slightest provocation.
Smoking is more of a habitual behaviour than the physical need for nicotine for whatever the purpose it may serve. The habituation is consistently maintained by the various factors such as the cost involved in each smoke, the ease at which it can be possessed, carried and used, the absence of social stigma associated with it and its lack of impact on the functional capacity of an individual, rather a irrational belief that it helps in improving the alertness and functional ability.
The commencement of the habit can be mostly traced to the mid or late adolescence or early adulthood, usually with a social smoke, either under peer pressure or as crowd behaviour with the intention to be an integral part of the young energetic risk taking community rather than being an odd man out who sticks to his principles. In some cases it is just done which the intention to mimic the machismo appearance and personality of some film actor whom they adore. Tobacco companies working all out to increase their profits by issuing subtle attractive ads and sponsoring events which have mass following where their ads about their products just coerce anyone to give a try has its own role in people taking up the habit.
Later this practice becomes a widely used method for having short breaks from continuing activities or as mechanism for distracting from preoccupations associated with stress, fear, anxiety, depression or even boredom. Associating this habit with regular activities of day to day life such as having a smoke after every coffee or tea, every meal, every snack and even as a positive reinforcement when some immediate goals are achieved, making it an automatic response to such activity is another factor that helps in maintaining is consistency. Availability of a smokers around who would willing offer a cigarette even without you asking for it, and many a times force you to take one, just for the sake of giving them a company and lack of assertiveness on the part of most of the smokers to say a no to such offer is another important factor.
The consistent maintenance of the habit gradually leads to status where it seems as natural as eating and sleeping and cigarettes becomes an essential ingredient of everyday life such as water and air.
How to quit smoking
Step 1: Prepare
Level 1: make the indispensable plans
Most of people who smoke fail to quit because of the false belief that the habit of smoking is well within their control and they can quit smoking whenever they want. The first thing anyone has to do is to get over this belief. Realize that smoking is a very difficult habit to quit and it cannot be done unless and otherwise you are willing to go through a tough initial period of abstinence.
• Plan for complete exit not a partial one or gradual reduction
• List down the merits and demerits of the habit. Analyze the details to confirm whether you should really quit. While analyzing the details, if at any point of time you feel that there are some benefits of continuing the habit, be clear that its going to be vey difficult for you to quit and you really need to take some extra burden on yourself if you really want to quit
• List down all the stimulus triggers the intention of smoking. It may well be anything from having tea, coffee, meals to whenever you feel down, stressed or bored. Sometime it may be a planned one like having a fag every hour or whenever your friend or colleague offers one. Maintaining a journal to record of each time you smoke and the antecedent incident will help in having the complete details of the instigators.
• Highlight the situations in which you have intense craving to smoke
• List down the names of all your friends who smoke and highlight the ones who offer you a cigarette whenever you meet with special reference to people who start discussions only after they light a cigarette
• If you are preparing a journal also list down whether having a smoke had just helped you to distract yourself from and unpleasant feeling which you have been preoccupied with or whether it has provided a relief. If so identify the problem or the feeling and list it down
• Also list down the alternative activities which can provide you the same level of distraction or the methods in which you can really get over the overwhelming negative feelings
• If you have tried being abstinent earlier, list down the negative feelings and any specific physical symptoms you had while you had been maintaining abstinence. Also note down the incident which resulted in your failure to continue the same.
Level 2:prepare yourself
• Get the knowledge about the various withdrawal symptoms that you may experience and the time period it may be present when you quit smoking
• Develop the belief that all the physical and psychological distress you undergo will cease to exist in a few days and you need to go through these short term sufferings for long term befits
• Develop assertiveness altleast to say” NO” to anyone who offers you cigarettes and “NO” to yourself whenever you have an intense craving to smoke
• Get trained in a few relaxations techniques, the most suitable one being the Jacobson’s progressive relaxation technique
• Decide a date and time to quit. Always remember that today is the best day. You can even do the level one preparation after you have decided that you are quitting.
• Discard any cigarettes in your possession, without worrying about wastage of resources because sometimes your intention to quit after exhausting all the available recourses may become a never ending process
• Remove all the products associated with smoking such as ash trays, mouth fresheners, lighters etc in your vicinity that may remind you of your habit
• Take a short break from any professional demand such as working long hours in the night or stressful deadlines which can increase the intensity of craving
• List out a number of activities of your interest and start doing it
• Prepare yourself to counter the de-motivating comments or intentions from people around you or the smoking populations intensions to isolate you for your decision. Have the clarity that they are exhibiting these behaviours just to cover up their own helplessness and failure related to quitting
Level 3: prepare your environment
• Inform everyone around about your plans to quit and once you have quit and ask for their support to maintain it
• Tell your friends and other social contact assertively that they should not offer cigarettes whenever you meet
• Ask your friends and loved ones to remind you of gaol of total abstinence frequently and to restrain you whenever you exhibit any symptoms of relapse
Step 2 sustaining abstinence
• Don’t have cigarettes or tobacco related products or any products which remind you of smoking in your vicinity
• Don’t have any doubts about you decision or your capacity to quit because self doubts are slippery and it may gradually break down your confidence and efforts to quit.
• Remind yourself about the antecedent activities such a having a meal, coffee etc, which trigger your intention to smoke to avoid doing it whenever you involve in the activity
• Find a healthy alternative such as having a fruit or nuts or mouth freshening spices such a cardamom
• If there is any antecedent activity that you can avoid, avoid it
• Keep yourself engaged with activities of interest and entertainment
• Start maintaining a consistent schedule for sleeping. This will help in overcoming any sleep disturbances that may arise after you quit.
• Also develop the practice of consistent schedule for eating and having a healthy balanced diet.
• Start practicing some physical exercises or yoga in the morning to make your body and mind active which will help you to overcome the withdrawal symptoms such as depression, fatigue and constipation
• Practice some relaxation exercises preferably Jacobson’s progressive relaxation to overcome the withdrawal symptoms of restlessness, anxiety , irritability etc. This can also help in improving the concentration. Controlled breathing or pranayma can also be very effective.
• Remind yourself the reasons based on which you decided to quit and the possible benefits from your decision
• Remind yourself that you are not a loner by being a non-smoker, there is a good percentage of people who are non-smokers with whom you can have sociable and friendly relationships.
• Avoid tempting situations such as being in the company of smokers, who me even compel you to smoke
• Challenge the irrational thoughts associated with smoking that arise time and again such as “smoking relaxes you”, “making you function effectively” with rational thoughts that there are safe activities which can help you to achieve the same. Support these rational thought with various benefits you enjoy being a non smoker.
• Avoid places which is associated with your smoking habit
• Be assertive and say an emphatic “NO” to anybody who offer you a smoke, irrespective of who they are and what consequences you may have to face by doing so. Understand that accepting it will harm you more than anything else
• Whenever there is intense craving to smoke try to distract yourself from the thought by involving yourself in any activity that can really be interesting or that can keep you mind occupied. Activities such as listening to music, solving puzzles, reading stories or novels etc can be very helpful
• Overcome your oral carving by taking water or healthy fluids such as fresh fruit juices or snacks frequently
• Overcome your psychomotor craving associated with your fingers by drawing or just scribbling on paper or even squeezing a ball, whenever you have a sense of restlessness in your fingers. Even playing games on mobile can also be useful. But be careful not to get addicted to that habit.
• Avoid stressful situations if possible, but the better way is to learn stress management techniques and use them to overcome your stress and anxiety
• Avoid being awake in the night for long time. Better to avoid even professional demands of staying awake in the night. If you cant avoid it try some other methods such a frequent short walk, having water frequently etc to keep yourself alert and awake.
• Avoid all alcoholic beverages because it may bring down your capacity to control psychological cravings
• Save the money you spend every day for cigarettes on a day to day basis. Use the money to buy yourself or your loved ones a gift periodically
• Provide positive reinforcement to yourself in the form of rewards periodically. But be careful that that your reward is not a smoke.
• Make a list of the situations in which you wanted to smoke and how you overcame your intensions on a day to day basis. Appreciate yourself for doing the same. As days go by you can see that the numbers decrease which by itself will keep you motivated.
• If there are any specific alternative activities which you feel as easy and effective try doing it frequently whenever the intensions arise
• Preferably don’t use any substitutes such as nicotine coated gums, or nicotine replacement therapy using nasal sprays or patches because it may only sustain the nicotine addiction. if you really feel that you need a substitute you may use normal gums, nuts etc
• Get feedback from your loved ones and non-smoking friends on how it has helped them.
• Start advocating the harmful effects of smoking among your friends who smoke and others. This will help in reminding you of the need to quit completely and at the same time help you in having a social control, because after advocating a cause you know that you can never smoke in their presence again at any point of time.
• Have the clarity of thought that now you are a non-smoker and you have a healthy life like every other non-smokers.
• Always remember that you are only one cigarette away from being a smoker. By taking even one puff you have lost the fight to quit and to achieve your goal you need to take extra efforts and self control
• Even if you slip don’t give up, try to learn from your experience about what triggered your slip, evolve methods of handling it effectively and get back with more vigour to fight the habit

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