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General : Question posed by email to  
 Message 1 of 1 in Discussion 
From: Joel  (Original Message)Sent: 12/5/2005 10:06 PM
Question posed in an email to
I'm looking for a rehabilitation / detox type setting.  Kinda like drug rehab.  So far, I'm thinking about xxxx in xxxxxxx.  It's the whole package; quit smoking, learn about weight control & nutrition, behavior therapy, physical exercising, etc.  This is more my husband's preferance.  He doesn't think he can quit unless he gets locked up somewhere.  The reason I like the xxxxxxxxxx  process is because it's all encompassing.  He's worried about weight gain, so we can keep him occupied learning all about life for a week.  All he's done all his life is work.  His kids are handling more, therefore, he's handling less.  So, not only does he have to quit smoking, he needs to learn how to live . . . major behavior modification is going to be involved.


There are some clinics out there that do basically lock up people to quit smoking. But I wouldn’t put much stock in the technique. When I worked in a hospital setting for over 20 years, we would lock up people all the time and not let people smoke. It was not in our smoking clinic; it was in our intensive care unit. If the conditions were serious enough, we would have people locked up for days and weeks enough.
Technically, these people were detoxed from nicotine. Heck, some of them were comatose and never even experienced withdrawal. In theory, this sounds appealing to some smokers. But the reality of the situation is often, in fact maybe more often than not; the first thing these patients would do upon release from the hospital is grab for a cigarette. You see these people never quit smoking. They were smokers who were just not allowed to smoke.

They didn't learn anything about survival in the real world without smoking. They knew how to be fed intravenously, they knew how to use a remote on a television, but that is about it. The urge for a cigarette upon being released was normally incredible. It’s interesting though, there is a real easy way to stop that urge. Just throw them on a gurney, stick an IV in their arm and all of a sudden they don’t need a cigarette. They are doing the one thing they learned to do as an ex-smoker, being a connected patient.

People need to face the real world as quickly as they can to start to break the associations of day to day rituals. Only then will they prove to themselves that there is life after smoking.

There actually was a hospital in the Chicago area that used to have an inpatient unit for smoking cessation. It went under in less than a year of operation. I had three of their patient’s come to my program to quit. Two of them made it while in my clinic. All of them said that they were basically doped up during the hospitalization. I think they were using a drug called clonidine at the time. Powerful antihypertensive that at one time was thought to be helpful. Never met anyone who actually got off smoking using it though. So if you find a program, check out what they do before assuming it’s a good plan.

My basic feeling though is that no one needs to be locked up to quit smoking. People looking to get locked up are looking for an easy way out of a drug addiction. Bottom line is that there is not an easy way out--but there is a way out. It is simply to quit smoking.

Everything you did as a smoker you can still do as an ex-smoker. The problem is that you have to prove this point to yourself. The way to continue to prove this premise is to go on facing your day to day life while making and continuing to stick to a personal commitment to never take another puff!


Here are a few articles that address the issue of waiting for the right time or looking for an easy method to quit.  

How does your program compare to...

"How does your program compare to hypnosis or acupuncture?" "Do you know anything about the single session treatment program advertised on the radio?"  "I hear they have in patient treatment program at another hospital, what do you think of that for quitting smoking?"  "My doctor said I should try nicotine gum, do you agree?"  "I hear there are programs which promise no withdrawal or weight gain." "How about the shock treatments with money back guarantees?"   "Why should I choose you over the free program offered at...?"  Almost daily we will receive calls asking at least one of these questions.  It seems everyone wants us to compare what we do with that of other "treatment" strategies.  While the specific questions vary, my advice is inevitably the same.  If you are considering us or another program, go to them first.

People seem to be surprised at this advice.  I think some wonder whether or not I am receiving a kickback from the other organization.  But money is not the factor influencing the advice to seek help elsewhere before attempting us.  Or maybe they think I can't defend our program over the other "proven" method.  This assumption is also incorrect.  Why then, am I willingly turning away potential customers to the local competition?

Anyone who has gone through our clinic will attest that participation in our program requires a 100% effort and commitment to attempt quitting.  That is not to say that every participant must know before hand that he is going to stop.  The person must be resolved to the fact that he will try as hard as he can to stop for just two weeks, a day at a time.  Then, once past the initial withdrawal syndrome, he can decide whether or not he truly wishes to smoke.  We want him reach the point where he has a free choice.  But he must base his decision on his true options, smoke nothing or everything, there is no in-between.

Anyone coming into our program with a backup method in mind, is not normally willing to give the 100% necessary to break the initial grip.  When things start getting tough, which they almost inevitable do, the person just throws in the towel and takes a puff with the idea that it is no big loss, he will just try the other program next time.  But his assessment is grossly mistaken--taking that first puff may very well be the biggest mistakes he ever made in his life--one that may in fact cost him his life.  He may never again have the desire, strength, or opportunity to quit again. 

What of his hypothesis that the other program will probably work better for him.  Well, let it suffice to say, that when I suggest that a smoker goes to another program to quit before coming to ours, I am not really worried about losing potential income.   I am just postponing when I may actually meet and work with the individual.  In fact, the odds are, our price will increase significantly by that time and they are usually willing to pay.  In the interim, they spent hundreds to thousands of dollars trying all these magical programs or feeding their addiction. 

But money is not the major factor which needs to be considered.  Smoking an extra five years, 10 months, or even a few weeks carries a potential risk.  You just don't know which cigarette may be the one to initiate an irreversible process, such as cancer or a fatal heart attack or stroke.  Every day you puff these risks remain high.  But the day you stop, you begin to reduce your risks, and eventually, they can drop to that of a person who never smoked a day in his life.  Then, to keep your risk as low as possible and to never again have to go through the quitting process, simply NEVER TAKE ANOTHER PUFF!

 Avoiding Triggers 

Many years ago I had a man named Mark (not his real name) join one of my smoking clinics. Mark came to me on the first day of the clinic and told me how he had recently added an addition on to his house and one of the rooms he added was a home office. Mark lived in a suburb about 20 miles from his office in downtown Chicago. Mark had the luxury that he didn't really need to go to his downtown office much and could do most of his work from home. He was nervous though because his home office was more than just his office--it was also his smoking sanctuary. Mark had small kids who were allergic to smoke and his wife didn't want Mark smoking around the kids. Since the kids were never allowed in the office anyway, Mark agreed only to smoke in that one room of the house. The office had in essence become his smoking room. He had only had the home office a short period of time now but the relationship seemed deeply ingrained.

When Mark was telling me about the new home office smoking room he confided in me that he was really scared to go into the room for he was sure it would be too powerful of a trigger and cause him to smoke. I told him he should go into the room quickly to overcome the fear but he said he just wanted to give it a few days before he attempted it. I figured I would let it go, thinking it would actually be good for Mark to get the additional experiences of driving to the city and working with other people proving to himself that he could deal with the outside world and still maintain his quit.

Mark never brought up the home office smoking room again during the clinic and I had basically forgotten about it too. Mark completed the clinic and sounded great at graduation. I figured he was on his way to a complete smoke free life.

A couple of months after the clinic was over I was following up Mark's group on a Saturday morning. Actually I had talked to him numerous times over the two month period but this conversation took an interesting twist. While on the phone Mark had said something about his office downtown and for the first time since I met Mark I remembered his concerns about his home office. I asked him if he was still going downtown much or mostly working out of his home office now. All of a sudden there was an awkward silence on the phone. Mark kind of hemmed and hawed for a while and said, "Well, this is kind of embarrassing to admit be I actually haven't gone into the home office yet."

I quickly said, "Mark, are you telling me that you have been driving 20 miles to and from work every day for two months because you are afraid that if you go into your home office you are going to smoke." He said yes, but it was worth it. He loved not smoking. Not smoking was great. So while driving 40 miles a day was a tad inconvenient, it was worth the effort since it was helping him to save his life.

I agreed it would be worth driving 40 miles every day if it were necessary in order to sustain a quit and thus saving his health and his life. The problem was that it was not necessary--Mark could work in his home office and just not smoke. To that Mark replied that the association was just too strong and his quit was just to valuable.

I asked Mark if he had a phone in the room in question to which he replied, "Of course I have a phone, it's my office." I said, "Mark, I want you to go into that room and call me back at this number." Now it took some real effort for me to persuade Mark to go into the room and to call me back. He was scared for he was totally convinced that being in that room was going to undercut his quit but Mark eventually goes into his office and places the call.

So I start a conversation of small talk with Mark, making a point of checking the clock at the beginning of the call. I knew some of Mark's family members and friends, and I started asking him questions about these people and making a real concerted effort of never broaching the topic of smoking once. Now I know most of you reader here have only gotten to know me from my writings and have never seen me live and talking but I can assure you that if you talk to any of my family members or friends, or especially to my clinic graduates, they will all attest that I can talk for hours on end even though I have nothing really important to say. I purposely engaged Mark into a half hour conversation consisting of absolutely nothing important--just small talk.

A half an hour into the conversation of small talk I abruptly blurted out, "Hey Mark, you have been in your home office now for 30 minutes. Have you thought about a cigarette once." Mark started laughing. He realized what I had done, getting him into the room and talking his ear off just to show him that he could be in the room and on the phone and not need to smoke. I think Mark instantly realized that his fears were unfounded.

I saw Mark last year, for the first time in probably fifteen or twenty years. He had now been smoke free for over a quarter of a century. We didn't really talk about smoking issues much either. It was no longer an issue in Mark's life. I just did my obligatory warning about never getting overly complacent, pointing out to him that over the past four years I had two people who were once 35 year ex-smokers who lost their quits. He was still well aware of what we taught in the clinic and was still totally committed to never take another puff.

As most people who read here have probably noticed, they have started saving lots of money since they have quit smoking. I suspect Mark had also saved a small fortune. This may not have been the case if we had not had our little conversation that Saturday morning. For if we had not talked that day Mark may have been driving an extra 200 miles a week, plus paying for parking for a quarter of a century. I don't even want to try to do the math of what these additional expenses would have cost. The fact is that they would have been totally unnecessary. When a person goes 25 years smoke free he proves beyond a shadow of a doubt that everything he was able to do as a smoker he can now do as an ex-smoker. This is a crucial lesson for all to learn.

Putting off facing certain activities triggers will likely prolong the stress, anxieties and fears that you will not be able to overcome the specific situation without relapse. All people who quit must realize that all you did as a smoker you can do as an ex-smoker too. All it takes is proving it to yourself one situation at a time. You can continue to live your life and get through all events with your quit intact as long as you always remember to stick with your personal commitment to never take another puff!


The Easy Way Out! 

Did you hear about the lady who went on two diets simultaneously to lose weight?  Doing both at once she ate enough food to satisfy her appetite and figured she would lose weight twice as fast.

This humorous story illustrates a very serious point.  Human nature dictates that we look for the easiest and least painful route to make necessary changes.  Unfortunately, what often appears to be the easiest technique may not always be the best.  If this lady really relied on this twisted logic, she would not only fail in losing weight, but would probably end up weighing more than before she started her diets.  And while this story may seem farfetched, many people who try to follow medically unproven and controversial weight control programs often end up with this very dilemma.

But weight control is not the only situation where people rely on unsuccessful techniques.  Cigarette smoking is another problem for which people try to find different solutions.  People are always looking for new and easy ways to quit smoking.  Many behavioral scientists believed that smoking is only a learned pattern.  If this were so, there would be many different approaches available to quit.  Behavior modification techniques such as reducing the amount of or exposure to a substance or situation, aversion therapy, hypnosis, acupuncture, record keeping, desensitization and countless other approaches have been used for years to help people unlearn unwanted behavior patterns.

But cigarette smoking is not simply a learned behavior or bad habit.  It is more complex, more powerful, and worst of all more deadly than most bad habits.  Cigarette smoking is an addiction.  This fact becomes quite evident the first day of every smoking clinic.  Just about every person in the group can relate some story which demonstrates that to some degree he or she is controlled by cigarettes.  Some have gone so far as to rummage garbage cans in the middle of the night in search of cigarettes.  Others take butts out of dirty ashtrays.  Still others sneak cigarettes while hospitalized from smoking-related illnesses even though smoking was expressly forbidden by their physician.  After hearing of these dramatic experiences, few people argue the point that the addiction to cigarettes exerts tremendous control over the smoker.

Addiction does not respond to cut-down approaches.  Addiction does not lend itself to controlled use of the substance.  If a person tries to treat an addiction as a bad habit, they will lose to the addiction.  If, on the other hand, the treats an addiction as an addiction, they stand a good chance of beating it.  Once a person is addicted to a substance, they must totally avoid any use of that substance or else relapse into a full- fledged drug dependency.  This holds true for alcohol, heroin, nicotine, and a host of other drugs.

As far as nicotine is concerned, if the smoker quits cold he will overcome the strongest stages of withdrawal within 72 hours.   After two weeks, physical withdrawal ceases.  Then, once it is understood that any amount of nicotine administered in any manner will reinforce his dependence, they have all the ammunition they need to overcome the occasional desire.  They must always base the decision of whether or not they should smoke a cigarette on their true options.  They have the choice of smoking none or smoking everything.  There is no in between.  Based on that, their choice is clear - NEVER TAKE ANOTHER PUFF!

I Will Quit When...  

"I will quit when my doctor tells me I have to."  "I can't quit now it's tax season."  "Maybe I will quit on vacation."  "School is starting and I'm too nervous to quit."  "I will quit in the summer when I can exercise more."  "When conditions improve at work, I will stop."  "Quit now, during midterm, you must be nuts!"  "Maybe after my daughters wedding."  "My father is in the hospital. I can't quit now."  "If I quit now, it will spoil the whole trip."  "The doctor says I need surgery.  I'm too nervous to try now."  "When I lose 15 pounds, I will stop."  "I am making too many other changes to stop now."  "I have smoked for years and feel fine, why should I stop smoking now?"  "I'm in the process of moving, and it's a real headache.  I can't stop now."  "It is too soon after my new promotion, when things settle down I will stop."  "When we have a verifiable bilateral disarmament agreement, I will consider quitting."  "It is too late.  I'm as good as dead now."

Amazing, isn't it, how so many people can come up with so many excuses not to stop smoking?  If any of these were valid reasons why now is not a good time to quit, when did 47,000,000 ex-smokers in our country stop?  They must have been experiencing at least one of these situations during the initial quitting process.  The only difference between successful ex-smokers and the smokers making these statements is that the ex-smokers were bright enough to recognize that smoking was not really necessary to deal with any of these situations.

The best time to quit is NOW.  No matter when now is.  In fact, many of the times specifically stated as bad times to quit may be the best.  I actually prefer that people quit when experiencing some degree of emotional stress.  In most cases, the more stress the better.  This may sound harsh, but in the long run it will vastly improve the chances of long term success in abstaining from cigarettes.

When people quit at an easy time in their lives, they begin to feel comfortable as ex-smokers as long as no problems surface.  But there is always the fear that when things get difficult they will not be able to cope without cigarettes.  Many, when facing their first real catastrophe, return to smoking because they were not equipped to deal with real stress as ex-smokers.

If, on the other hand, they had quit during a difficult time, they would have realized that even under severe emotional stress life goes on without smoking.  They will be secure in the knowledge that they can deal with crisis, any crisis, as non-smokers.  Once they overcame the initial quitting process they found they were able to deal with stress better.  They were able to meet the physical and emotional demands in their lives more efficiently than when they were smokers.  They were truly better equipped for survival in our complicated world without the "help" of cigarettes.

So, no matter what is going on in your life, quit smoking.  When things get tough - show yourself how tough you are.  And once off smoking, deal with all future problems in as constructive a manner as you possibly can, always keeping one essential stress management technique foremost in your mind - NEVER TAKE ANOTHER PUFF!


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