Dear Dr. Peg,
I want to quit smoking but I am having a really hard time. Can you help?
Dear Smoker:
Addictions are very tough to break, and nicotine addiction is one of the hardest. So first let me congratulate you for even getting to the point where you want to quit. It’s a big first step.
Before you take any action, I recommend you do some thinking. Thorough mental preparation is helpful for any challenging task. Ask yourself the following questions:
What do you enjoy and appreciate about smoking? How are cigarettes a positive force in your life? Do they calm you down, give you social time with friends? There must be something positive about our addictions, or we wouldn’t have them. It’s important to recognize the good stuff because you need that information to make your best decisions.
Often our best chance of beating an addiction is to be able to replace some of what the addiction is giving us with a healthy substitute. The more you understand yourself and your behaviors and motivations, the more successful you’ll be when you try to change. A patient once told me that cigarettes were her best friend. Imagine how hard it was for her to let that go. In her case, a healthy substitute would be for her to either engage in social activities that provide her with a set of generic friends or to seek and establish a few close friendships that can replace the friendship awarded her by cigs.
People often don’t let go of a habit until the negative outweighs the positive — sometimes not until the negative drowns the positive. So the next step, naturally, is to ask yourself about the negative. What are the downsides to smoking? Nasty cough? Hassle from your girlfriend? Hazards to your bank account? Stinky car? Everyone is different, and each quitter has his own reasons.
Clarify yours.
As a doctor, I could provide you with plenty of medical reasons to quit smoking if you need them. From colds to cancers, with heart disease and stroke in between. Smoking hazards are well known.
There are two basic ways to quit smoking: suddenly or gradually. Cold turkey is from all to nothing in one swift move: Do it and be done. Tapering, on the other hand, is cutting down a little at a time until you have quit. This prolongs the process, but softens it as well.
Which way sounds good to you: swift and sure, or slow and steady? Both ways can be successful. It’s just a matter of which works best for you.
To help you quit, you might try substitution. For example, instead of putting a cigarette in your mouth, you might pop in a toothpick or a carrot stick. Hit the floor with a few pushups when you get a craving. Chew gum instead of a plug of tobacco. Brush your teeth after eating instead of smoking. Friends close enough to smell your breath will thank you for that last one.
Get content from The Daily Lobo delivered to your inbox
Addiction has two main facets. The first is the physical dependence that your body has on the substance regardless of your will. This is the biochemical reaction that happens inside you, making you feel better when you have your drug of choice and lousy when you don’t.
The second is the behavior or the habit. For example, the way you reach for your smokes after you put down your fork or when you get in your car. You can control your behavior. It’s important to acknowledge and address both parts of a tobacco addiction.
Nicotine replacement products like gum and patches give you nicotine so you can work with the behavior without the distraction of nicotine withdrawal. You change the behavior first then take away the nicotine. Of course, you eventually have to quit the patch or the gum or the electronic cigarette too, in order to really quit.
There is also a number of medications that help people quit nicotine products and decrease withdrawal symptoms. You start the medication several days before your chosen quit date and when the day comes you quit cold turkey. These medications require a doctor’s prescription.
Whatever method you choose, pick a good time to quit. You want to maximize your chance of success, so don’t try to quit smoking during finals week or the day before you defend your thesis. Most people who quit smoking or chewing have tried multiple times. They may have even succeeded for a short time, but many may ride the cycle of addiction before they jump off for good. If you have quit before, that means you have had practice, and everyone knows that practice makes perfect. Acknowledge that you are attempting something very difficult. Be gentle with yourself. If you slip up and have a cigarette, try to forgive yourself and go back to your plan.
Good luck to you. If you need help, come see our health educators in the classy glassy office just outside the SHAC front door. You can call 1-800-QUIT-NOW, a free service provided in part by the U.S. Department of Health and Human Services, or visit one of the many online quit communities.
For additional help, visit:
nicotine-anonymous.org
becomeanex.org
quitnet.com
ffsonline.org
Peggy Spencer has been a UNM Student Health physician for 20 years. E-mail your questions to her directly at pspencer@unm.edu. All questions will be considered, and all questioners will remain anonymous. This column has general health information only and cannot replace a visit to a health provider.
