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General : Email from a person planning on quitting December 15  
     
Reply
 Message 1 of 7 in Discussion 
From: Joel  (Original Message)Sent: 12/6/2005 9:14 PM
Joel
I have made the decision to get out from under the smokes. I am 46 years old and have smoked since early teens. I am currently a 30 cigarette a day smoker. I have chosen a quit date of December the 15th 2005. The date was selected because I have scheduled to be off work that Thursday and Friday. That along with the weekend, I will have four days to start my Quit without being in the normal routine. Will this be a good way to start, or should one start just any ole day?
Thanks
Bill
 
 

Setting quit dates

Conventional wisdom in smoking cessation circles says that people should make plans and preparations for some unspecified future time to quit. Most people think that when others quit smoking that they must have put a lot of time into preparations and planning, setting quit dates and following stringent protocols until the magic day arrives.

When it comes down to it, this kind of action plan is rarely seen in real world quitters. I emphasize the term real world quitters as opposed to people quitting in the virtual world of the Internet. People who seek out and participate in Internet sites do at times spend an inordinate amount of time reading and planning about their quits before taking the plunge. Even at our site we see people say they were reading here for weeks or months before finally quitting and joining up. Although I suspect there are a fair number of people who had already decided to quit right away and searched us out after their quit had begun, and some people who may not have actually decided to quit but who when finding WhyQuit.com and seeing cigarettes for what they are decided then and there to start their quits.

Getting back to real world experience though, the best people to talk to when it comes to quitting smoking is those who have successfully quit and have successfully stayed off for a significant period of time. These are people who have proven that their technique in quitting was viable considering they have quit and they are still smoke free. Talk to everyone you know who is off all nicotine for a year or longer and find out how they initially quit smoking. You will be amazed at the consistency of the answer you get if you perform that little survey.

People are going to pretty much fall into one of three categories of stories. They are:

  1. People who woke up one day and were suddenly sick and tired of smoking. They tossed them that day and never looked back.
  2. People who get sick. Not smoking sick, meaning some kind of catastrophic smoking induced illness. Just people who get a cold or a flu and feel miserable. The feel too sick to smoke, they may feel too sick to eat. They are down with the infection for two or three days, start to get better and then realize that they have a few days down without smoking and decide to try to keep it going. Again, they never look back and stuck with their new commitment.
  3. People who leave a doctors office given an ultimatum. Quit smoking or drop dead--it's your choice. These are people who some sort of problem has been identified by their doctors who lays out in no uncertain terms that the person's life is at risk now if they do not quit smoking.

All of these story share one thing in common--the technique that people use to quit. They simply quit smoking one day. The reason they quit had varied but the technique they used was basically the same. If you examine each of the three scenarios you will also see that none of them lend themselves to long-term planning--they are spur of the moment decisions elicited by some external circumstance.

I really do encourage all people to talk to do this survey, talking to long-term ex-smokers in their real world. People who they knew when they were smokers, who they knew when they quit and who they still know as ex-smokers. The more people do this the more obvious it will become how people quit smoking and how people stay off of smoking. Again, people quit smoking by simply quitting smoking and people stay off of smoking by simply knowing that to stay smoke free that they must never take another puff!

Joel



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Reply
 Message 2 of 7 in Discussion 
From: MSN NicknameRickrob53_GoldSent: 12/6/2005 10:23 PM
Bill, the following was written by one of WhyQuits founding members.  Understanding what I was up against (nicotine addiction) and knowing what to expect when I quit was one of the keys to my successfully ending my smoking 22 months ago (after 33+ years of smoking).
Richard
 
Are you ready to take back your life?
Have you tried all the quit smoking magic cures and yet still find yourself hooked? Is it possible that you skipped the most important step of all? When did you take the time to read the instructions that came with your addiction?
 
Was the stroke of midnight on New Year's Eve 2002-2003 once again supposed to be the exact moment in time when you quit smoking forever and permanently broke nicotine's powerful grip upon your life?   Did it really need to be?
 
In truth, quitting on January 2,  February 3, March 4, April 5, in the middle of any day, tomorrow, or even before that next puff are all perfect times to begin the up to 72 hours needed to purge your body of all nicotine so that chemical withdrawal can peak in intensity and then begin to gradually decline.  In truth, any moment that you choose to reclaim your life is a glorious moment indeed.
 
Contrary to what you'll read, it doesn't take massive planning, truckloads of motivation, spending your hard earned money on the lastest and greatest magic cure, a certain number of attempts (usually said to be 5), or you making major changes in your life, in order to quit. It requires only genuine desire and you taking the time -- at long last -- to read the instructions that came with your addiction.
 
More than 90% of all successful quitters alive today - an estimated 1.2 billion - quit smoking cold turkey. Most of them discovered the power of nicotine - just one puff - through repeated failures (usually said to be 5) and the school of hard-quit-knocks. Could education have served as a shortcut?   Absolutely!
 
Nicotine Addiction -  In 1988 the U.S. Surgeon General declared that nicotine is chemically addictive and likened the pharmacologic and behavioral processes responsible for "tobacco addiction" to those responsible for addiction to heroin and cocaine (ACSH). Since then science discovered that  the brains of nicotine smokers on autopsy were found to have grown millions of extra neurons in the cortex, striatum, and cerebellum regions (1995, 1999).  There is a growing sense that this visual "up-regulation" of brain cells may play a role in the addiction process itself (NIDA, 2002). 
 
Between 1988 and today science has clearly presented neuro-chemical evidence that nicotine enslaves the brain's dopamine reward pathways in a manner strikingly similar to other drugs of addiction (HealthCanada, WhyFiles).  Today the National Institute of Drug Abuse is trying to get the states to look at  treating nicotine dependency as the true chemical addiction that it is.  It has openly declared that withdrawal from chronic nicotine use rivals the magnitude and duration of similar changes observed during withdrawal from other drugs such as cocaine, opiates, amphetamines, and alcohol.   
 
In comparison studies with heroin, cocaine and alcohol, experts are consistently concluding that nicotine ranks highest when it comes to chemical dependency - defined as how difficult it is for the user to quit, the relapse rate, the percentage of people who eventually become dependent, the rating users give their own need for the substance and the degree to which the substance will be used in the face of evidence that it causes harm (Henningfield Study and Benowitz StudyB.Y.U. Drug Comparison Study).  Only last year (March 2002) did we begin to fully appreciate how nicotine is so much more captivating than other drugs of addiction.  It some articles its now being  called the most perfectly designed substance of addiction.
 
Although U.S. cigarettes still do not carry any addiction warning label, since 2000 the Canadian government's cigarette pack warning label has declared "WARNING:  CIGARETTES ARE HIGHLY ADDICTIVE - Studies have shown that tobacco can be harder to quit than heroin or cocaine."
 
Even the web sites of the tobacco companies are now admitting that nicotine is addictive.  At the Philip Morris web site it states  "we agree with the overwhelming medical and scientific consensus that cigarette smoking is addictive."
 
From England (Royal College of Physicians) to America's heartland (Illinois) and on to the West coast (Washington), youth and smokers are being taught that nicotine dependency is a true chemical addiction, on a par with all other drugs of addiction. 
 
The Law of Addiction - The law of addiction is simple and its understanding crucial. If a former nicotine addict uses any nicotine, even one puff, they are all but assured of full and complete relapse back to their old level of nicotine intake or higher. Whether you quit for a day, a month, a year or a decade, just one puff of new nicotine and your period of healing and freedom are over.
 
Chemical Withdrawal - Nicotine's half-life in the human body is two hours. Within 72 hours the quitter's body is nicotine free and chemical withdrawal peaks in intensity as the brain begins sensing the arrival of, and adjusting to, nicotine free blood serum. But, just one puff and the early quitter must again endure the anxieties associated with another 72 hours of nicotine cleansing. Few of us are strong enough to go toe-to-toe with nicotine but then we don't need to be as nicotine’s I.Q. is zero. Don't try to out-muscle your addiction, outsmart it !
 
When it comes to true chemical addiction, there is no such thing as having "just one." It's a destructive illusion that kills. Instead of picturing that one "perfect" smoke, picture all the others that come with it. Instead of trying to cheat or reward yourself by bumming just one cigarette, grab the entire pack and run because you’re going to need every single one of them, and the thousands more that follow. There is only one rule to staying free - Never Take Another Puff!
 
Quitting smoking is a temporary period of adjustment during which a nicotine dependent person develops the patience needed to allow themselves to once again become 100% comfortable functioning with natural levels of dopamine and adrenaline. Peak chemical withdrawal occurs within 72 hours and within 10 days to two weeks the brain has chemically adjusted to functioning without nicotine.
 
Crave Episodes - Psychological recovery also normally peaks at about day three, when an "average" of six crave episodes occur. A crave episode is triggered by encountering a time, place, location, emotion, event, or activity that acted as a conditioned cue for your subconscious mind to begin to expect the arrival of new nicotine. It's the ingrained nicotine feeding patterns that you selected to fulfill your chemical addiction's endless need for more.
 
The good news is that most triggers are reconditioned and discarded by the mind with a single encounter. The good news is that no crave episode will last longer than three minutes but be sure and look at a clock as your mind may try and convince you that the minutes are hours. The good news is that the "average" quitter experiences just eighteen minutes of craves on the most challenging day - day three. The good news is that by day ten the "average" quitter is experiencing just 1.4 craves per day.
 
You may have established more feeding cues than the "average" quitter but even if you are compelled to meet, greet and defeat ten triggers on your most challenging day, that's still no more than thirty minutes of crave episode anxiety on the worst day of all. Can you handle 30 minutes of substantial anxiety? Sure you can, we all can.
 
Within a few weeks you'll begin experiencing entire days without encountering an un-reconditioned crave trigger, but remain alert. After going a few days without a crave episode it's normal to let your guard down, and when a trigger is eventually encountered it is likely to feel like you've been caught off-guard and sucker-punched. The crave was no more intense than others. It's just that you were no longer in battle mode, awaiting its arrival.
 
Thoughts & Memories As the number of craves continue to dwindle, your focus will turn to a phase where you'll find yourself sorting through and dealing with thousands or even millions of independent memories associated with years of lighting, puffing, tasting, smelling, inhaling, sensing, ashing, butting, needing, craving, feeding, buying and sharing your addiction.
 
At times, a sea of thoughts can seem to flood your mind. Unlike crave episodes, thoughts can linger on as long as you allow them. The good news is that to a great extent we can control our thoughts. The good news is that with each passing day you'll experience fewer and fewer thoughts of wanting to smoke. The good news is that within just a few months you'll begin to experience entire days where you never once think about wanting to smoke.
 
Measuring Victory  - An important initial expectations tip is to abandon all thought of quitting forever - a mighty big bite to chew upon - and instead view each day of freedom as the full and complete victory that it truly is -  "Take it ONE DAY AT A TIME."  If you insist upon measuring success in terms of quitting forever, when will you be entitled to celebrate? What good is celebrating once you're dead?
 
Below are a dozen solid quitting tips to help take the "cold" out of cold turkey quitting. For additional information, motivation enhancement, group support, free counseling, and hundreds of additional pointers  you're in the right place as 150,000 archieved Freedom posts address almost every cessation topic imaginable!
 
1) Blood Sugar Changes When Quitting -  Drink plenty of fruit juices the first three days to help avoid symptoms associated with wild blood sugar swings - headaches, an inability to concentrate, dizziness, time perception distortions and the ubiquitous sweet tooth. Cranberry juice is excellent.
 
Nicotine fed you by indirectly pumping stored fats and sugars into your blood via adrenaline releases. It allowed us to skip meals and yet not feel hungry because nicotine was feeding us. Normal people must eat. It isn't a matter of consuming more calories but of learning to spread our daily intake out more evenly over the entire day.
 
2) Caffeine - Blood studies have shown that nicotine accelerates the rate at which caffeine is metabolized by 203%. This means that nicotine smokers may need twice the caffeine as non-smokers in order to feel the same effects from caffeine.
 
If you are a heavy caffeine drinker (over 750 mg) and you failed to reduce your caffeine intake by roughly half during prior quitting attempts then it's likely that you found yourself climbing every wall in sight. Don't give up your caffeine but do understand why you may need less.
 
3) Quit for yourself  - Quit for yourself not others. If you quit for others, what will happen the first time they disappoint you? We call it "junkie thinking" and it is a "quit" killer. Don't entrust your cessation motivation to anyone but you. It may be fun to have a quitting buddy along but do not lean upon them as a primary source of motivation. Also don't expect your family to appreciate what it's like for a drug addict during withdrawal and recovery unless they've ever been chemically dependent themselves. It just isn't fair.
 
4) Crutches - Although you may need to reduce your caffeine intake or take great care in using alcohol during the first week, don't give up anything in your life when quitting except for nicotine. Also, don't pick-up any new crutches either, good or bad. Food can be a crutch but so can any abrupt or major lifestyle change, even exercise programs. A crutch is any new activity that you are relying and depending upon to help you quit. You don't need any crutches.
 
5) Record Your Reasons - Write down all of your reasons for quitting, keep them close at hand, and use them as a powerful crave coping tool during challenging moments. Also, take a few notes or keep a diary during the first few days so that you can document what withdrawal was like. The mind quickly suppresses life's negative memories. Preserve them as both a yardstick to measure your healing and a tool to renew and invigorate your motivation to stay quit.
 
6)  Crave Episode Coping - What will you do to get though a craving that lasts up to three minutes? Have both a primary plan and at least one back-up and use them all if need be. Three approaches during crave episodes are to briefly distract your mind, to relax it, or to confront the crave head-on.
 
Distraction can be any activity that works for you including walking away from the relapse threat, a brief period of exercise, or even screaming into a pillow. Try reciting your ABCs while associating each letter with a food (A is for Grandma's hot apple pie).
 
Relaxation can range form of a five minute shower to a few slow deep breaths while clearing your mind of all chatter and focusing on your favorite color, object, person or place.
 
Crave confrontation can be empowering. In your mind relax while reaching out and embracing your crave. It can not hurt you, cut you or make you bleed. Wrap your arms around it. Sense its power peak in intensity and then slowly begin to subside. Victory is yours!
 
In that a crave episode is always less than three minutes, delay is your friend. Get rid of all your cigarettes and build-in a bit of delay. With tobacco having a 50% kill rate - each dying an average of more than 5,000 days early - chemical withdrawal is not a time for mind games. You have nothing to prove.
 
7)  Quitting Aids  - On September 11, 2002, a new California study was published in the Journal of the American Medical Association (JAMA) which concluded that "NRT appears no longer effective in increasing long-term successful cessation in California smokers." Here is a link to the JAMA study - http://jama.ama-assn.org/issues/v288n10/abs/joc11973.html
 
NRT is the nicotine patch, gum, spray, inhaler and lozenge. Nicotine is nicotine, as it all comes from the same plant. In the "real-world" those using NRT are not part of some highly structured medical study whose education program focused exclusively on successful nicotine delivery device transfer (from tobacco to NRT device), while ignoring the abrupt nicotine cessation education needs of those in the control or placebo group - like "Tips" one and two above.
 
Not only does NRT needlessly prolong nicotine withdrawal, the fact that it does so is being used in many studies in order to claim success. For example, in the new nicotine lozenge studies the authors declare successful "cessation" at three months while study participants continue using the nicotine lozenge for six months.
 
The slight of hand is in defining "quitting" as quitting smoking and not in breaking nicotine's powerful grip upon the brain's dopamine reward pathways. Under definitions used in most medical studies a nicotine smoker who gets hooked on nicotine gum or chewing tobacco has successfully quit. Keep your eye on the nicotine!
 
8) The smoking dream  - Your body's healing is likely to trigger one of the most vivid dreams in your entire life. Don't be afraid as it's perfectly normal. You'll awake convinced that you have actually smoked, when what your improved senses of smell and taste have sampled are the odors being given off during the breakdown of tars inside horizontal healing lungs.
 
9) Minimizing weight gain - Although metabolism changes can account for a pound or two of weight gain, within just ninety days of quitting you can expect an almost one-third increase in overall lung function. The ability to build cardiovascular endurance is a powerful tool for change. Quitting smoking does not cause major weight gain - eating does.
 
Two quick points. Smoking was your old cue that a meal had ended and you may need to find a healthy new cue (walk, dishes, tooth-pic, brushing your teeth). Also, with nicotine feeding us, many smokers are not used to encountering and dealing with true hunger. Whether you eat with a shovel or a teaspoon it still takes roughly 25 minutes for your body to digest those first few bites so that the brain's hunger switch can be turned off. When hunger arrives eat as slowly as possible.
 
10)  Lingering Symptoms - In dealing with symptoms it's pretty safe to blame quitting for almost everything you feel during the first three days, but after that you need to listen more closely to your body and contact your doctor should you have any lingering concerns.
 
Each puff of smoke introduced over 500 gases and 3,500 chemical particles into your body. Some of those chemicals could have been hiding or masking a serious underlying condition (for example asthma or thyroid conditions) or even interacting with medications that you were already taking (like depression meds). It is not unusual for medications to need adjusting.
 
11) Understanding the emotional loss  Even though you are leaving an extremely abusive and destructive relationship, the endless cycle of using nicotine to briefly satisfy your dependency created a powerful bond. During this temporary journey of adjustment from active smoker to comfortable ex-smoker, the emotional sense of loss and the phases you'll go through can be similar to those experienced during the death of a loved one - denial, anger, bargaining, depression and acceptance.
 
Although it is normal to feel a short term sense of loss when quitting, chronic organic depression is also real and for some smokers nicotine became a deadly means of medicating it. If you become at all concerned about lingering depression then seek medical assistance not nicotine!
 
12)  Patience is your friend - While quitting, the next few minutes will always be doable. One of the greatest challenges faced by the new quitter is in developing quitting patience after a lifetime of sensing new nicotine arrive in their brain within 10 seconds of a new puff. Give yourself a couple of minutes and the worst will pass. Someday soon you'll look back upon your biggest challenge of all as your greatest moment of glory.
 
Just one day at a time, baby steps and never forget the golden rule - no nicotine - Never Take Another Puff!   
 
Breathe deep, hug hard, live long!    John : )
 

Reply
 Message 3 of 7 in Discussion 
From: JohnSent: 12/6/2005 10:27 PM
 
 

 
 
Hello Bill and welcome to Ask Joel.  In my own quitting history I too often thought the triggerless weekend looked mighty inviting.   I think almost all would agree that getting started and getting those first hours and first day under our belt is oh so important.   But I'd like to get you thinking about the interesting data reflected in the above chart from a crave episode study.   
 
In that nicotine's half-life of two-hours is pretty much beyond our ability to control, we can be fairly confident that physical withdrawal is going to peak on day three.  But even then if we keep our blood sugar level stable and learn to again properly fuel our body every few hours (as each puff of nicotine is no longer our spoon feeding us stored fats and sugars),  trying to abandon needless fears as you're leaving nothing behind, keep your core motivations on your mind's center state, and follow some of the other advice you'll find at www.WhyQuit.com, peak withdrawal may actually be far more comfortable than you ever imagined possible  
 
But contrary to the above chart, not necessarily so for when we begin to meet, greet and defeat our subconscious mind's conditioned expectations of the times, places, events and emotions that it should expect to receive a new supply of nicotine.   Although totally unproven, I've always had this theory that the primary reason that the number of crave triggers encountered in the above study peaks on day three is that's when the average quitter comes out of the weekend closet and begins to encounter the bulk of their normal conditioned nicotine feeding cues (weekly paper, getting ready for work, driving or traveling to work, stress, breaks, lunch, breaks, leaving work, arriving home, pre-dinner nicotine,  after dinner nicotine,  after clean-up nicotine,  preparing for tomorrow's work.
 
I've often wondered how the above chart would look if we made all quitters commence nicotine dependency recovery on Monday morning as they headed off to work.  My gut tells me it's a mixed bag,  Bill.  It's good to gain some momentum and confidence but I wonder how smart we were for timing peak nicotine detox and our peak encounter with our nomal daily triggers to both occur at roughly the same time.
 
Although time distortion is a very real recovery symptom, if you actually time any crave episode I'm confident you'll find that it's over within 3 minutes.  By the above chart that would mean 18 minutes of anxiety on your most challenging day.   But what if you're not like the "average" quitter from the above study.   What if somehow have established twice as many smoking cues.   That would be about 36 minutes of significant challenge on your most challenging day.   Could you handle that, Bill?   Absolutely!
 
Whenever you're ready we invited you to jump in the pool, Bill.  The water is great.  Do your best not to be afraid.  A crave cannot hurt, cut or kill you.   Much of the anxiety is self-induced by a mind that has convinced itself that enduring a less than 3 minute crave episode is horrible.  It's healing, Bill, and means one more extinguished trigger and one more aspect of life reclaimed.   This is an amazing jourey of re-adjustment and everything you think and feel is a required part of reclaiming your physical, subconscious and conscious mind.  Celebrate the process as you're going home to a wonderful sense of mental quit and calm that you have not known since nicotine took control
 
Once started there's just one guiding principle that guarantees success to all who follow it ... no nicotine just one hour, challenge and day at a time,  Never Take Another Puff!  
 
John  -   Free and healing for six years, six months & 22 days

Reply
 Message 4 of 7 in Discussion 
From: MSN NicknameJoeJFree-Gold-Sent: 12/6/2005 10:32 PM
Hi Bill,
 
I see Joel has given you very sound advice. The best time is when it is YOUR time to quit.  Sounds like you're there.
 
I can only speak credibly to my own experience. 
 
Almost 11 months ago I was like you - late 40's, a long time smoker (since age 9) and wanting to quit soon.  Just didn't know how.
 
I did not have time to set a day.  I began reading at WhyQuit.com and then FreedomFromTobaccoQuitSmokingNow on January 9th.  I read for hours.  I read until I understood about why I smoked, why I was addicted, how I could break free in 72 hours and how I could learn to live & stay free by Never allowing nicotine into my body again. 
 
I wrote this message about a week ago at Freedom about that particular 'fork in the road'.  Maybe it will help. Message 7
 
All I know Bill is that if I could so can you.  Anbody can.  It's a wonderful journey and it begins with a single step in the right direction.  Yes YOU can!
 
Joe

Reply
 Message 5 of 7 in Discussion 
From: JohnSent: 12/6/2005 10:48 PM
It's pretty neat to think that all three of us were working the same question at the same time.  That's pretty special seeing how the doors were just opened.   We'll have to remember where this question of Bill's is so that we can make quick reference of it in the future. I imagine we'lll hear from a few planners. This is message #62.    

Reply
 Message 6 of 7 in Discussion 
From: JoelSent: 1/27/2006 9:40 PM
One of our first posts at AskJoel was on the important issue of setting quit dates.
 
This was in the news today at I felt worthy of bringing up this string:

Snap Decision to Quit Smoking Called Effective
1/27/2006

Some smokers may need a "quit plan" to stop smoking, but researchers say that those who spontaneously decide to quit may have more success, Reuters reported Jan. 26.

"Contrary to what experts had previously believed, the idea that you have to plan your quit attempts ahead of time isn't necessarily true," said researcher Robert West of University College London, who along with colleague Taj Sohal queried 1,900 smokers and former smokers about their attempts to quit.

West and Sohal found that about half of all quit attempts were spontaneous, and that those who chose to quit on the spot were 50-60 percent more likely to succeed than those who planned their attempt in advance.

The researchers stressed that the findings should not be used to discourage quit plans, but rather reinforce the importance of the smoker being in the right frame of mind and motivated when they decide to quit.

The study was published in the January 2006 issue of the British Medical Journal.

This article is online at http://www.jointogether.org/y/0,2521,578951,00.html


Normally when I see a news headline with "New Study" attached to a smoking cessation report I cringe. Somehow most studies reported are some sort of laboratory study, where conclusions are being drawn from rodents or people in experimental settings. Somehow lab settings seem to always show what we teach here at Freedom is wrong.

Every now and then though a different kind of study is released. Not research done in a lab where the researchers control the variables--but rather real world surveys where researchers are simply trying to find out what has worked for people in real world settings.
 
Those kind of studies are a whole lot more credible to me, and I believe to be a whole lot more replicable by any average person trying to see if the the reports hold true to their own experiences and to the experiences of those around them. These kind of studies often result in the the smoking cessation experts of the world having to tap dance around the new findings.
 
Here is a comment I put up earlier today regarding real world studies involving NRT's. I am going to change a few words in that commentary, replacing the phrase "NRT" with a variation of the phrase "plan your quit" or "planned their quit." I think all who read here will realize that the same concepts apply:

 

I really do encourage all people to take this survey, talking to long-term ex-smokers in their real world. People who you knew when they were smokers, who you knew when they were quitting and who you still know as being successful long-term ex-smokers. The more people you talk to the more obvious it will become how people quit smoking and how people stay off of smoking. Again, people quit smoking by simply quitting smoking and people stay off of smoking by simply knowing that to stay smoke free that they must never take another puff!

Again, go talk to as many long-term successful ex-smokers (people off all forms of nicotine for at least a year or longer) in your real world that you can find and find out how they quit. I don't believe that there is a single professional smoking cessation "plan your quit" advocate who will suggest to their patients that they take a similar survey. For if they did their credibility would be called into question almost immediately when the patient starting seeing the results of their real life survey. They will end up having to spend quite a bit of time trying to explain away the discrepancy, using excuses like the people who "Planned their quit" didn't do it right or didn't "plan" long enough or were more addicted smokers.

We don't need to spend time trying to explain away the results of the surveys that people will do in there real world settings. All we have to say is the results make it more and more obvious that the way to quit smoking and to stay successfully free is no more complicated than just making and sticking to a personal commitment to never take another puff.

Joel


Reply
 Message 7 of 7 in Discussion 
From: JoelSent: 5/22/2007 11:34 PM
From: Joel  (Original Message) Sent: 3/8/2006 6:19 AM

Joel's Reinforcement Library

Never Take Another Puff animated gif



Setting Quit Dates



Conventional wisdom in smoking cessation circles says that people should make plans and preparations for some unspecified future time to quit. Most people think that when others quit smoking that they must have put a lot of time into preparations and planning, setting quit dates and following stringent protocols until the magic day arrives.

When it comes down to it, this kind of action plan is rarely seen in real world quitters. I emphasize the term real world quitters as opposed to people quitting in the virtual world of the Internet. People who seek out and participate in Internet sites do at times spend an inordinate amount of time reading and planning about their quits before taking the plunge. Even at our site we see people say they were reading here for weeks or months before finally quitting and joining up. Although I suspect there are a fair number of people who had already decided to quit right away and searched us out after their quit had begun, and some people who may not have actually decided to quit but who when finding WhyQuit.com and seeing cigarettes for what they are decided then and there to start their quits.

Getting back to real world experience though, the best people to talk to when it comes to quitting smoking are those who have successfully quit and have successfully stayed off for a significant period of time. These are people who have proven that their technique in quitting was viable considering they have quit and they are still smoke free. Talk to everyone you know who is off all nicotine for a year or longer and find out how they initially quit smoking. You will be amazed at the consistency of the answer you get if you perform that little survey.

People are going to pretty much fall into one of three categories of stories. They are:

  • People who awoke one day and were suddenly sick and tired of smoking. They tossed them that day and never looked back.

  • People who get sick. Not smoking sick, meaning some kind of catastrophic smoking induced illness. Just people who get a cold or a flu and feel miserable. They feel too sick to smoke, they may feel too sick to eat. They are down with the infection for two or three days, start to get better and then realize that they have a few days down without smoking and decide to try to keep it going. Again, they never look back and stuck with their new commitment.

  • People who leave a doctors office who have been given an ultimatum. Quit smoking or drop dead--it's your choice. These are people for whom some sort of problem has been identified by their doctors, who lay out in no uncertain terms that the person's life is at risk now if they do not quit smoking.

All of these stories share one thing in common--the technique that people use to quit. They simply quit smoking one day. The reasons they quit varied but the technique they used was basically the same. If you examine each of the three scenarios you will also see that none of them lend themselves to long-term planning--they are spur of the moment decisions elicited by some external circumstance.

I really do encourage all people to do this survey, talking to long- term ex-smokers in their real world, people who they knew when they were smokers, who they knew when they quit and who they still know as ex- smokers. The more people do this the more obvious it will become how people quit smoking and how people stay off of smoking. Again, people quit smoking by simply quitting smoking and people stay off of smoking by simply knowing that to stay smoke free that they must never take another puff!

Joel

© Joel Spitzer 2006
Page created February 19, 2006 and last updated by Joel Spitzer on February 19, 2006

The British Medical Journal reported an interesting study that tied into this article very well. Here is a link to the abstract of that study:

http://bmj.bmjjournals.com/cgi/content/abstract/bmj.38723.573866.AEv1

I wrote a reply to the journal that got posted on their response website. Here is a link to that reply:

http://bmj.bmjjournals.com/cgi/eletters/bmj.38723.573866.AEv1#127706

That commentary elicited a reply from another person, who was basically trying to give the impression that serious scientists shouldn't put too much emphasis on real world experiences. I wrote a reply to this editorial but it somehow did not seem to get past the editorial review board at the British Medical Journal. I think the reply is still valid so I am attaching it below:




Re: Flawed reasoning  
Joel Spitzer,
Health Educator
Conduct Stop Smoking Clinics for the Evanston and the Skokie Illinois Health Departments 60201,60076

Send response to journal:
Re: Re: Flawed reasoning
 

 

 

"...because something commonly happens in a particular way 'in the real world' then this should be considered the best way."

Smoking cessation experts often seem to have to be telling people to dismiss real world experiences. Usually I see a little different variation of the comment above. Common statements I have seen are something to the effects that while it is likely that a person may at times encounter real world quitters who succeeded by using non-recommended techniques, usually meaning no pharmaceutical intervention or in what this study is showing, people who used no set quitting date, that these people are just the exceptional cases. What the experts are trying to do in effect is discredit observations made by people, making them think that the occurrence of such experiences are really rare.

The author above was at least accurate enough to say, "While it is true that most smokers who quit do so without any specific behavioral support or pharmacological treatment..." The rest of the comment was going on to try to give the impression that there would have been even more successful quitters if people would just do what smoking cessation experts say should work as opposed to doing what actual quitters continually say has worked for them.

The tactic being employed here is to leave the impression that we could just have a whole lot more successful quitters if people would just utilize the miraculous effective products out there that actually help people to quit. There is also the perception being portrayed that there really are very few ex-smokers out there because most who have tried to quit have done so unaided and everyone just knows how improbable it is for people to be able to quit in an unaided attempt.

Medical professionals and the general public are being misled to believe that quitting smoking is just too plain difficult for people to do on their own and that the odds of a person actually quitting on their own is really pretty dismal.

This would all make perfect sense if not for the fact that we have so many successful ex-smokers in the real world. In America, we have more former smokers than current smokers. Over half of the people who used to smoke have now quit smoking. From the comment made above it should be clear to all that most of the people who have quit either did not know of professional recommendations for quitting or chose to ignore professional intervention techniques. Yet these people successfully quit anyway. I think that this is an important point to hit home with all medical professionals. The medical profession has got to start to help people to realize the real potential of success that individuals do have to quit smoking instead of perpetuating the idea that quitting is just too hard for an individual smoker to expect to actually succeed without help.

While this article should have been about planning techniques, the original author and a few experts weighing in on the discussion have tried to turn it into a referendum on selling pharmaceutical interventions. Nicotine replacement products have been around for over two decades now-- and a significant percentage of smokers have used them to try to quit smoking. If a product has been around for decades, used by millions of people worldwide, AND, has been truly effective, it should be easy for most health care practitioners to come up with lots and lots of successful patients, colleagues, family members and friends who have quit with these products.

As I said in my original commentary above:

" I don't believe that there is a single professional smoking cessation "plan your quit" advocate who will suggest other medical professionals should take a similar survey. For if they did their study results would almost certainly be called into question when the health care professional starts seeing the results of his or her real life survey. The experts will end up having to spend quite a bit of time trying to explain away the discrepancy, using rationalizations like the people who planned their quit "didn't do it right" or didn't "plan" long enough or were "just more addicted smokers."

In all honesty, I don't expect my encouraging of real world observations by health care professionals to have much impact with smoking cessation experts. They are going to profess to believe whatever other experts keep telling them to believe or, what the funders of their studies believe.

I do however believe that health care workers who are on the front line and actually deal with patients who smoke are going to be a bit more critical and analytical about this. If they spend any time talking with patients they are going to see through the rhetoric and the rationalizations of the experts.

I have always tried to disseminate the message that just because something works in the lab or in study conditions doesn't necessarily translate to the fact that the process will work in the real world. The smoking cessation experts seem to have to work on the basis that just because something works in the real world doesn't mean that it is a good approach if it doesn't seem to work in a lab.

I have high hopes that medical professionals really wanting to help their patients are going to be more influenced by what they see is successful than by being told by the experts what should be successful, but somehow not replicable in their own practices.

 


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