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I have tried numerous times to quit smoking via various aids and on my own without substitution aka.... the patch, hypnosis, cold turkey, sheer motivation... etc. The biggest issue for me is the withdrawl period. I work full time and of course have the common stress issues as most people today, and within hours of quitting find myself disoriented and unable to concentrate. This in turn causes me to get frustrated and looking for a good reason to quit "quitting." Any advice on how to overcome the initial physical withdraw period and to get a mindset that is more powerful in the journey to freedom from addiction? |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:25 PM |
"Minimizing the Most Common Side Effects to Quitting Smoking"
Blood sugar plummets in many people when first quitting. The most common side effects felt during the first three days can often be traced back to blood sugar issues. Symptoms such as headache, inability to concentrate, dizziness, time perception distortions, and the ubiquitous sweet tooth encountered by many, are often associated with this blood sugar drop. The symptoms of low blood sugar are basically the same symptoms as not having enough oxygen, similar to reactions experienced at high altitudes. The reason being the inadequate supply of sugar and/or oxygen means the brain is getting an incomplete fuel. If you have plenty of one and not enough of the other, your brain can not function at any form of optimal level. When you quit smoking, oxygen levels are often better than they have been in years, but with a limited supply of sugar it can't properly fuel your brain.
It is not that cigarettes put sugar into your blood stream; it is more of a drug interaction of the stimulant effect of nicotine that affects the blood sugar levels. Cigarettes cause the body to release its own stores of sugar and fat by a drug type of interaction. That is how it basically operated as an appetite suppressant, affecting the satiety centers of your hypothalamus. As far as for the sugar levels, nicotine in fact works much more efficiently than food. If you use food to elevate blood sugar levels, it literally takes up to 20 minutes from the time you chew and swallow the food before it is released to the blood, and thus the brain, for its desired effect of fueling your brain. Cigarettes, by working through a drug interaction causes the body to release it's own stores of sugar, but not in 20 minutes but usually in a matter of seconds. In a sense, your body has not had to release sugar on its own in years, you have done it by using nicotine's drug effect !
This is where many people really gorge themselves on food upon cessation. They start to experience a drop in blood sugar and instinctively reach for something sweet. Upon finishing the food, they still feel symptomatic. Of course they do, it takes them a minute or two to eat, but the blood sugar isn't boosted for another 18 minutes. Since they are not feeling immediately better, they eat a little more. They continue to consume more and more food, minute after minute until they finally they start to feel better. Again if they are waiting for the blood sugar to go up we are talking about 20 minutes after the first swallow. People can eat a lot of food in 20 minutes. But they begin to believe that this was the amount needed before feeling better. This can be repeated numerous times throughout the day thus causing a lot of calories being consumed and causing weight gain to become a real risk.
When you abruptly quit smoking, the body is in kind of a state of loss, not knowing how to work normally since it has not worked normally in such a long time. Usually by the third day, though, your body will readjust and release sugar as it is needed. Without eating any more your body will just figure out how to regulate blood sugar more efficiently.
You may find though that you do have to change dietary patterns to one that is more normal for you. Normal is not what it was as a smoker, but more what it was before you took up smoking with aging thrown in. Some people go until evening without eating while they are smokers. If they try the same routine as ex-smokers they will suffer side effects of low blood sugar. It is not that there is something wrong with them now, they were abnormal before for all practical purposes. This doesn't mean they should eat more food, but it may mean they need to redistribute the food eaten to a more spread out pattern so they are getting blood sugar doses throughout the day as nature really had always intended.
To minimize some of the real low blood sugar effects of the first few days it really can help to keep drinking juice throughout the day. After the fourth day though, this should no longer be necessary as your body should be able to release sugar stores if your diet is normalized. If you are having problems that are indicative of blood sugar issues beyond day three, it wouldn't hurt talking to your doctor and maybe getting some nutritional counseling. In order to allow your body to maintain permanent control over the amount of glucose (sugar) in your brain ... NEVER TAKE ANOTHER PUFF! |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:26 PM |
For people who are a bit concerned that it is impossible for you to quit because you tried “all the other ways�?before, don’t sweat it. It is usually that you tried a bunch of other ways that by their own limitations had a lousy chance of success. Even the cold-turkey you tried, if it was without a true understanding of the addiction and what you were fighting had severe limitations. It wasn’t that your ability to quit didn’t exist, your techniques or preparation were just not methods that a true drug addiction was going to be respond to. If you follow our advice and everybody’s lead here, this quit will be different.
Here is an article you will find of particular interest on that issue:
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 to 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 |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:27 PM |
Quitting Smoking:
A Fate Worse than Death?
People sitting in at smoking clinics are amazed at how resistant smokers are to giving up cigarettes. Even smokers will sit and listen to horror stories of other participants in sheer disbelief. Some smokers have had multiple heart attacks, circulatory conditions resulting in amputations, cancers, emphysema and a host of other disabling and deadly diseases. How in the world could these people have continued smoking after all that? Some of these smokers are fully aware that smoking is crippling and killing them, but continue to smoke anyway. A legitimate question asked by any sane smoker or nonsmoker is, “why?�?BR>
The answer to such a complex issue is really quite simple. The smoker often has cigarettes so tied into his lifestyle that he feels when he gives up smoking he will give up all activities associated with cigarettes. Considering these activities include almost everything he does from the time he awakes to the time he goes to sleep, life seems like it will not be worth living as an ex-smoker. The smoker is also afraid he will experience the painful withdrawal symptoms from not smoking as long as he deprives himself of cigarettes. Considering all this, quitting smoking creates a greater fear than dying from smoking.
If the smoker were correct in all his assumptions of what life as an ex-smoker were like, then maybe it would not be worth it to quit. But all these assumptions are wrong. There is life after smoking, and withdrawal does not last forever. Trying to convince the smoker of this, though, is quite an uphill battle. These beliefs are deeply ingrained and are conditioned from the false positive effects experienced from cigarettes.
The smoker often feels that he needs a cigarette in order to get out of bed in the morning. Typically, when he awakes he feels a slight headache, tired, irritable, depressed and disoriented. He is under the belief that all people awake feeling this way. He is fortunate though, because he has a way to stop these horrible feelings. He smokes a cigarette or two. Then he begins waking up and feels human again. Once he is awake, he feels he needs cigarettes to give him energy to make it through the day. When he is under stress and nervous, the cigarettes calm him down. Giving up this wonder drug seems ludicrous to him.
But if he quits smoking he will be pleasantly surprised to find out that he will feel better and be able to cope with life more efficiently than when he was a smoker. When he wakes up in the morning, he will feel tremendously better than when he awoke as a smoker. No longer will he drag out of bed feeling horrible. Now he will wake up feeling well rested and refreshed. In general, he will be calmer than when he smoked. Even when under stress, he normally will not experience the panic reactions he used to feel whenever his nicotine level fell below acceptable levels. The belief that cigarettes were needed for energy is one of the most deceptive of all. Almost any ex-smoker will attest that he has more strength, endurance, and energy than he ever did as a smoker. And the fear of prolonged withdrawal also had no merit, for withdrawal symptoms would peak within three days, and totally subside within two weeks.
If any smoker just gives himself the chance to really feel how nice not smoking is, he will no longer have the irrational fears which keeps him maintaining his deadly addiction. He will find life will become simpler, happier, cleaner, and most importantly healthier, than when he was a smoker. His only fear will now be in relapsing to smoking and all he has to do to prevent this is - NEVER TAKE ANOTHER PUFF! |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:29 PM |
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 33,000,000 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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Reply
| | | From: Joel | Sent: 4/25/2006 12:29 PM |
How would you deal with the following situations?
Your 2-year-old is having a temper tantrum because he wants a new toy. Would you;
1. Leave him alone until he calmed down
2. Give into his demands
3. Give him a tranquilizer
Your 7-year-old is anxious about next weeks' Little League tryouts. Would you;
1. Assure him that he can do it
2. Practice with him and tell him to try his best
3. Give him a valium every three hours until the game
Your 14-year-old is crushed when she is not asked to the sophomore dance. Would you;
1. Fix her up with one of your friend's children
2. Tell her to go anyway
3. Give her cocaine to pick up her spirits
Your 15-year-old is self-conscious about being 5 pounds overweight. Would you;
1. Cook lower calorie meals
2. Enroll her in a diet or exercise program
3. Put her on appetite suppressants
All of these young people are experiencing what adults would consider "growing pains." A little time, patience and positive reassuring will help them overcome all of these difficult situations.
The fact is, as long as anyone continues to develop physically, emotionally, intellectually, professionally or spiritually, they too will experience growing pains. Adults are prone to hurt, pain, sadness, depression and anxiety just as children are. These feelings are all necessary if we wish to continue to develop our minds and bodies. Without such growth, we would not experience happiness, satisfaction, contentment or purpose to their full extent.
The third choice in each of the above situations was, of course, ridiculous. We would not subject our children to chemical hazards to overcome such trivial problems. However, as adults we are fully capable of practicing such dangerous behaviors for our own relief. Take cigarette smoking as an example.
When you were still a smoker, how many times would you say you had to smoke because you were lonely and sad without your friendly cigarettes? How many times did you say that you had to smoke because of all the stress in your life? How many times did you tell yourself that many social activities were just not fun without your cigarettes? How many times did you say that you would gain too much weight if you quit smoking? All you were saying was that you needed nicotine, a drug, to overcome everyday life problems.
It was not until you were off cigarettes that you realized you could overcome such problems without smoking, and in most cases more effectively than when you were a smoker. Once you had quit you realized just how much a source of stress the habit was to you. You were caught by a socially unacceptable and physically deadly addiction and were quite often aware of it. This is when you had the desire to give them up, but thought the pain of quitting too great to even attempt it.
Even today, you probably still desire an occasional cigarette. It may be in a stressful situation, at a party after a few drinks, or at a time when you find yourself alone with nothing better to do. The fact is, there is nothing worse you can do than take a cigarette. One cigarette will not help you over the problem. In reality, it will create a new problem, a disastrous situation of a reinforced addiction, with all the physical dangers and associated dirty habits.
So, next time you have the desire for a cigarette, sit back and take a few moments to reflect upon what you are setting yourself up for. Do you need that drug? Do you want that addiction? If not, simply remember - NEVER TAKE ANOTHER PUFF!
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Reply
| | | From: Joel | Sent: 4/25/2006 12:30 PM |
I Have to Smoke Because of All My Stress!
Stress is considered a cause for smoking by many people. Actually, smoking is a cause of stress. Recent correspondence dealt with reasons people give for going back to smoking: social situations, parties, alcohol consumption and stress. This month I wish to amplify on stress.
In January of 1979, Chicago and vicinity was devastated by a major blizzard. Heavy snows fell just after the New Year crippling the area. Additional snowfall continued throughout the week. During this time period I was barraged with phone calls from participants of the November, 1978 clinic claiming to be terribly nervous, upset and anxious from "not smoking." Curiously, most of them were feeling well during the month of December. They had occasional urges which lasted only seconds and were quite easy to overcome. What they were experiencing in January was different. Many felt that they were on the verge of cracking up. To them life was "just no good" without their cigarettes. Was the anxiety they were now experiencing really a side effect from giving up smoking?
To any outside observer the answer to the mysterious intensification of perceived withdrawal was obvious. In fact, if our ex-smokers listened to radio or television or read the front page of any newspaper, they would have encountered a story on cabin fever. By simply comparing their symptoms with those accompanying cabin fever they would understand what was happening.
Attributing the anxiety to smoking cessation was transference of blame. In fact, they were having a normal reaction to an abnormal situation - confinement due to the blizzard. They would have had the same anxiety whether or not they had given up cigarettes.
The above story illustrates an atypical time period in which numerous people experience similar complaints. In everyday life inherent problems exist. Work, family, friends, and money can all contribute to daily distress. Ex-smokers often think that if they just take a cigarette during a stressful episode the situation will be solved. For example, consider a person who finds he has a flat tire in a parking lot during a freezing rain. When encountering this kind of misfortune, the ex-smoker's first reaction often is, "I need a cigarette." What will actually solve this problem is changing the tire, and driving off in a warm car. What would a cigarette do to help this situation? It only makes the person see the flat tire longer and freeze more. This adds up to greater frustration. The first puff will probably reinforce the addiction to cigarettes which is a much greater crisis than the flat tire ever was. In fact, taking the first puff almost always results in a bigger problem than the crisis that "caused" them to take the puff. Even in a real catastrophe, such as a death in the family, injuries, illnesses, flooding resulting in major property loss, bankruptcy and so on, a cigarette will not solve the problem. It will just add another major problem to the originally bad situation.
Remember, smoking cannot solve problems of daily living. No matter what the problem, there is a more effective way of solving it than smoking. In fact, a smoker's health risks are a real problem that can only be solved if they - NEVER TAKE ANOTHER PUFF! |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:31 PM |
While most smokers actually believe that smoking was an effective stress treatment strategy (a drug that calmed them down), when it really comes down to it, smoking never truly calmed them down. All it did was administered nicotine alleviated nicotine withdrawal that was induced by stress. The illustration and text below covers this point. The one true step that people are doing here to control their stress is getting rid of a product that should cause any thinking person a lot of worry and to stop the vicious cycle of drug feeding and drug withdrawal by always knowing now to never take another puff! Joel 
In the illustration above you can see on the left how a non-smokers reacts to stress. Without it they are happy and comfortable, when encountering stress they lose this comfort and depending on its severity they can get either mildly annoyed or really upset. The resolution of the stress will normally bring the non-smoker back to the original state of comfort, after a little time of cooling down of course. Smokers are much more complex. Stress has an affect on all people--it makes the urine acidic. Both smokers and non-smokers experience this phenomena. In non-smoker smokers, the urine acidity has no real visible or perceivable effects--smokers are much more complicated. After the initial stress a smoker will feel like a non-smoker encountering stress, for a few seconds. But then the delineation occurs, the smoker's nicotine level depletes because of the urine acidity induced by the stress, and the smoker is kicked into a drug withdrawal state. The smoker has four ways to deal with the situation now. First, the smoker can just smoke a cigarette. Well low and behold if the smoker does this he or she will feel "better." He or she will not feel good; he or she just won't be feeling withdrawal for the moment but still be feeling the initial stress. In essence, he or she will feel like a non-smoker under stress, not great, but not in withdrawal either. The second way a smoker can handle the stress is to solve it and also smoke a cigarette. This results in one happy smoker. No stress now and no withdrawal, life is good at the moment. The feeling of bliss is basically the same feeling a non-smoker has who resolves his or her stress. But then there are the other two scenarios. The smoker can solve the problem but not smoke. Here is the kicker here, the problem is resolved but the smoker is still in withdrawal, the nicotine level has dropped and problem resolution has no way to stop the nicotine depletion, only a cigarette can do that. The worst of all situations is the smoker who cannot solve the problem and also cannot smoke a cigarette. This is a miserable situation to ever be in. You normally don't want to be around a smoker in this situation let alone being one yourself. Many smokers find themselves facing this dilemma daily since many jobs and social settings do not allow smoking yet constantly force the smoker to face stresses. When you quit smoking these last four reactions to stress become a thing of the past. You still face stress, but you no longer have to face drug withdrawals induced by it. In essence you deal with stress in a totally different way when you don't have chronic drug withdrawals exaggerating it. To stay in the position of being able to handle stresses with greater clarity and minimal discomfort always know that no matter what the stress, to avoid it having any long lasting and life threatening complications always remember to never take another puff! Joel |
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Reply
| | | From: Joel | Sent: 4/25/2006 12:34 PM |
In the first few days of a quit the question is often asked, "will this get better." If the concept that the physical and psychological reactions occuring are short-term and temporary is not understood, the person often gives up on the effort and ends the quit. They try to stop, get some big time physical discomfort, think this is what life is like as an ex-smoker, and go back to smoking. It is a cycle repeated over and over throughout the world throughout the history of tobacco use. I always advise people that if the way they felt the first day or two or three was the way they were going to feel the rest of their life by quitting, they should just smoke and die prematurely. To quit smoking only to live 20 extra years in chronic pain wouldn't be worth it. But when quitting smoking, the way symptoms and reactions that mayt be experienced don't feel like this forever. What they are experiencing when the quit is not what it is like to be an ex-smoker, it is what it is like to be a smoker in drug withdrawal. This is a very temporary state. Once they get through the third day the physical withdrawal will ease up. For those in your first few hours or days of your quit, understand the reactions this far are temporary, it is quitting running a normal course, and it will end and you will feel better. When you get flu symptoms from the flu you accept this method of accepting the temporary state of the feelings because you have had the flu before and know they improve and basically, you don't have a choice. With withdrawal, you don't believe it will end and you know you have a choice to stop it. You can smoke. But smoking does not stop withdrawal. It just delays it off for 20 to 30 minutes. Then it starts again. Then you smoke another one. That holds you for 20 to 30 minutes. Then you need another. Get the picture. This is your life now, constantly smoking to put off withdrawal again another half hour or so. All the time poisoning your body with hundreds of poisons. By stopping you withdrawal for a few days, and then get better the rest of your life. Soon you will recognize that your life will go on without smoking. You will be able to face miserable tasks, celebrate life happy events and even just do nothing without smoking--basically live without cigarettes and without the preoccupation of smoking. The longer you are now off and the more life circumstances that you successfully overcome smoke free,the sooner this concept is believed and the the fear of life without smoking will be conquered. Hang in there during this time of uncertainty just know that it will improve and get continually better and better as long as you maintain your focus and never take another puff! Joel |
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Joel, Thanks for your quick response! You have given me so much food for thought that is extremely helpful. I actually found that while I was reading your responses I did not have a craving to smoke. I love the mantra.... never take another puff. I am not there just yet......... but I truly believe that education about the effects of smoking and what to expect are very useful in building up my confidence in myself and determination to set a quit date I can commit to.. one hour at a time! A friend sent me a link to your site and I find myself reading it often.... maybe this is a turning stone. Never too late to NEVER TAKE ANOTHER PUFF!!!!!!!!!!! Thank YOU! |
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Reply
| | | From: Joel | Sent: 4/26/2006 5:56 PM |
Joel's Reinforcement Library
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:
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| | 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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| | | From: Joel | Sent: 4/26/2006 5:57 PM |
Below another issue I thought would be important to attach to this string. Setting a future quit date--especially and extended future date, carries the risks of something going wrong before the date actually arrives: Many years ago I had a man in my clinic named John. John was a pretty high profile public figure, in his early 40's who had many great accomplishments in his life. He came to my clinic, lasted a few days and lost the quit. He was in the middle of a high profile media situation and just decided he needed his focus and the stakes of what he was involved with at the time were just too high to deal with withdrawal. John explained this to me, and promised he would return again one day when things would be better. Well, I have heard this hundreds of times before, and while occasionally people do return, it is not the majority and probably not even a significantly high percentage. Being that I was having 50 or more people at a time in these clinics, I couldn't spend much time dealing with those who were not quitting. Three year later John does return to the clinic and does quit smoking. He did great his second time around. Not only did he quit, but he became a regular volunteer for me, coming to many clinics as a panelist to help people first quitting. He also sent in lots of people, probably 15 to 20 over the next couple of years. About three years after John's quit, he was going in for a physical and to his surprise there was a small spot on his chest x-ray. When it was biopsied they found out John had cancer. He was about 48 at the time, in the peak of his career, still had children of school age and now was facing this terrible diagnosis. It was a horrible shock to many people. As is often the case with lung cancer, it was a fast deterioration. Within a year and a half John had succumbed to the disease. I went to John's funeral--it was huge. There were hundreds and hundreds of people there. Many I knew, some because of their high public profile, but more because John had sent in so many people to the clinic in the time period that he was off smoking. Even after the diagnosis he was still sending people in. One of the men there was from one of the recent clinics and had told me how tragic this was that John had lost his life and how his lost quit was probably the reason. To be realistic I told him that it is possible that if John had quit the first time in the clinic it may not have made a difference. He basically found out he had lung cancer three years after he quit, and that lung cancer could be present for 5 years or even 10 years without presenting symptoms or even showing up on the x-ray. Being that the day I met him was about 6 years before the diagnosis, it was not totally improbable that at that time the cancer had already been initiated and was silently growing. The man then proceeded to tell me that my clinic was not the first clinic John had tried. That in fact, 10 years before joining that first group with me, he and John had gone to another local clinic together to quit and both in a matter of days wrote it off as a bad time to quit--but knew they would both quit again one day. Well John was right, he did eventually quit again one day. But it turned out to be over 16 years later. Now the odds were quite different--if he had quit that first time around he probably would never had developed the disease that ultimately cost him his life. The lesson here needs to be once you have a quit going, do everything in your power to make it last. While you are seeing people come back who just seem to be quitting again, if you relapse you just don't know you will ever get the strength or desire to quit again, and that even if you do, you don't know whether something won't go wrong in the interim period before the next quit. John is not the only person I know who fits this profile--I know lots of them--people who could have had extra years and extra decades who lost them by minimizing the implications of not quitting or of relapsing. Once you have a quit smoking, understand your very life is contingent on understanding the importance of knowing to never take another puff! Joel |
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| | | From: Joel | Sent: 4/26/2006 6:06 PM |
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 33,000,000 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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Reply
| | | From: Joel | Sent: 4/26/2006 6:09 PM |
Actions speak louder than words—or thought.
A thought for a cigarette will never cause a person to go back to smoking—only an action can do that. The action is a puff on a cigarette or any administration of nicotine from any source for that matter.
Thoughts or words are not decisive factors of anything. Lets say you never quit smoking, and are eventually diagnosed with emphysema, and then knowing that every puff you took was destroying more and more lung tissue, basically crippling you a little bit more every smoking moment.
Should you then feel solace for saying as you are lighting up a cigarette, "Yes, I know I am destroying more lung tissue and I am likely going to be on oxygen soon and gasping for air at some point until my heart finally gives out from the overload, but at least I thought about quitting today.�?BR>
I don't think you or your family, friends, or doctor will look at this statement as a major accomplishment as you are lighting up one cigarette off the one that is about to burn out. Especially if you have said the comment earlier that same day, and have been saying it day after day for decades now.
If you think back to when you were first quitting, the odds were you had numerous thoughts for days and maybe weeks and still, here you are smoke free. It is because you never gave into those thoughts.
Today still your actions are speaking louder than your words or your thoughts. The action is you didn't take a puff yesterday and I strongly suspect if you are here reading now you are not planning on taking one puff today either. As long as you continue this practice, it does not matter if you never think of a puff again or if you think of it daily. You will never relapse as long as you never take another puff!
Joel |
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