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| | | From: Joel (Original Message) | Sent: 5/9/2006 1:03 PM |
Hi,
I am a 43 year old female ex-smoker wannabe. I have quit cold turkey so many times that I have lost count; varying rates of success or failure depending on your perspective (anywhere from 3 months to 3 years). Usually, my downfall is a very stressful event (most recently), or the absolutely ill-conceived notion that I can be a social smoker, only smoking when I drink. I am quite familiar with quitting cold turkey, I find that I can make it through the worst phases of withdrawal: crankiness, tiredness, the mind-numbing fog for a couple of weeks, etc.) but I can't seem to fight off the inevitable weight gain (THAT really bothers me, but ultimately, I'd rather be fat than stinky). The other problem I have is that "like a true addict" I am attracted to cigarettes for the rush of energy that they provide, knowing full well that if I continue smoking, that "rush" turns into a complete sapping of my energy...it seems as though I am unable to resist...
That said, I am wondering if you would advise some sort of drug or natural remedy to assist with increasing dopamine levels for someone like me?
Also, I am considering (specified kind of treatment). I have two friends who did the latter with good results, so far (it has been 9 months).
Sorry this is so lengthy. I have perused your site and respect what you do and would appreciate your opinion.
Thank you.
Octavia
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Reply
| | | From: Joel | Sent: 5/9/2006 1:09 PM |
My standard reply to people
writing me about clinics in other areas: I am generally unhappy with most programs I find on smoking cessation throughout the country. The vast majority of programs follow recommendations and guidelines that are considered the state of the art in smoking cessation, and unfortunately, the state of the art in smoking cessation generally produces dismal results. It is the reason I have tried to put everything I can out in the Internet, free of charge for all people to have no matter where they live. Here is one article that I use describing what I though of programs that were used in the past on treating smoking: “I Liked My Other Smoking Clinic More!�?
Almost 30 years ago when I was conducting one of my first Stop Smoking Clinics, one of the successful participants, a lady named Barbara, told me that she had once attended another clinic and liked it more than ours. I asked her how long she had quit for in that program and she said, "Oh, I didn't quit at all." I then asked her how many of the other people quit. She replied, "I don't know if anybody quit." I then asked, if nobody quit, why did she like the program more? She answered, "When I completed the program, I didn't feel bad about smoking!" The task of any smoking clinic should be to help the participant break free from the powerful grip of the nicotine addiction. To do this, each participant needs to have a thorough understanding of both why he or she smokes and the consequences associated with maintaining use of cigarettes. Cigarettes are addictive, expensive, socially unacceptable, and deadly. How in the world can any individual or clinic realize these effects and minimize the significance to the point where a smoker doesn't feel bad smoking? The natural impulse of most smokers is to deny the health and social implications of smoking. When he picks up a newspaper and sees a headline with "Surgeon General", he will read no further. When he hears a broadcast on radio or television about the dangers, he either totally disregards the message or maintains the false belief that the problem doesn't apply to him. But eventually, even his own body complains. He may experience physical symptoms such as coughing, wheezing, pains in chest, numbness in extremities, headaches, stomachaches, hoarseness, and a variety of other complaints. He will generally pass the blame to the weather, his diet, to his stress, to a cold or flu, to allergies or any other excuse he can muster up to protect his cigarettes. Our clinic was designed to permanently destroy all rationalizations of smoking by the smoker. He may make up lots of excuses for smoking, but he knows that they all are lies. Our clinic will accomplish one of two goals. Either the smoker will quit smoking, or the clinic will screw up his smoking for the rest of his life. No longer will he be able to sit back at the end of a day and think to himself in ignorant bliss how much he enjoyed his cigarettes. To the contrary, if any thought of smoking is allowed to creep into consciousness, it will be anger over how stupid it was to inhale 20, 40, 60 or even more cigarettes that day, and how sad it is that he is probably going to do the same again tomorrow. Why do we want to make the smoker miserable about smoking? Because maybe if he gets mad enough about smoking he will stop it. Sooner or later logic may motivate him to stop. Maybe he will do it on his own, or maybe he will come back to us for help. How he does it is not important; what is important is that he does quit. For, while the concepts we instill in him may make him miserable, not understanding them can cause more significant long-term suffering. If our clinic did what Barbara's first clinic accomplished - alleviating negative feelings toward smoking - it could result in the ammunition necessary to maintain smoking. Since cigarettes are responsible for over 400,000 premature deaths per year and the crippling of literally millions of others, alleviating the anxiety of smoking is not in the best interest of the smoker. Consider the physical, psychological, social, economic and any other personal consequences of smoking. Consider them all and - NEVER TAKE ANOTHER PUFF!
As I said above, most of the programs out there now rely on the state of the art quitting aids. Below are a series of articles discussing my views as to why I see real limitations in all of these aids and thus, most of the programs that rely on these aids.
I usually get a steady stream of one or two emails a month from people inquiring why I personally have such a critical view on the use of nicotine replacement products. Being that it takes time to personally answer all of these emails, I have assembled links to the series of articles that I have written to address the different issues involving the use of nicotine replacement products for smoking cessation. Pharmacological Aids to Smoking Cessation Pharmacological Aids Part II 40 Years of Progress? Quitting Methods: Who Should You Believe? So How Did Most Successful Ex-Smokers Actually Quit? Most expert say "Don't quit cold turkey" Hooked on the Cure Is Cold Turkey the Only Way to Quit? I originally wrote this to a member asking if we knew of a program that would lock her up so she would have to quit smoking:
Being Locked Up to Quit Smoking I do think there are some clinics out there that do basically lock up people to quit smoking. But I wouldn’t put much stock in the technique. We lock up people all the time in our hospital and don’t let people smoke. It’s not in our smoking clinic; it’s in our intensive care unit. You can lock people up for days and weeks if the condition is serious enough. Technically, these people are detoxed from nicotine. Heck, some of them were comatose and never even experienced withdrawal. In theory, this sounds appealing to some smokers. But the reality of the situation is often, in fact maybe more often than not; the first thing these patients do upon release from the hospital is grab for a cigarette. You see these people never quit smoking. They were smokers who were just not allowed to smoke. They don’t learn anything about survival in the real world without smoking. They know how to be fed intravenously, they know how to use a remote on a television, but that is about it. The urge for a cigarette upon being released is incredible. It’s interesting though, there is a real easy way to stop the urge. Throw them on a gurney, stick an IV in their arm and all of a sudden they don’t need a cigarette. They are doing the one thing they learned, being a connected patient. People need to face the real world as quickly as they can to start to break the associations of day to day rituals. Only then will they prove to themselves that there is life after smoking. Joel P.S. There actually was a hospital in the Chicago area that used to have an inpatient unit for smoking cessation. It went under in less than a year of operation. I had three of their patient’s come to my program to quit. Two of them made it. All of them said that they were basically doped up during the hospitalization. I think they were using a drug called clonidine at the time. Powerful antihypertensive that at one time was thought to be helpful. Never met anyone who actually got off smoking using it though. So if you find a program, check out what they do before assuming it’s a good plan.
Take advantage of the information we have at the Freedom board, www.whyquit.com, and download the free e-book from www.whyquit.com/joel/ntap.pdf. I really have tried to put all of the material and information out on the Internet to help people no matter where they are from and at absolutely no cost. Most people who have successfully quit smoking have done it with almost no understanding and information. Quitting is possible and with all of the information provided between these online resources, you will have a real edge. Hope you find this material helpful. Joel Here is one more that your email made me think of: I've tried everything to quit smoking and nothing works 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?�?nbsp; "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 and The Easy Way Out!
Did you hear about the lady who went on two diets simultaneously to lose weight? Doing both at once she ate enough food to satisfy her appetite and figured she would lose weight twice as fast. This humorous story illustrates a very serious point. Human nature dictates that we look for the easiest and least painful route to make necessary changes. Unfortunately, what often appears to be the easiest technique may not always be the best. If this lady really relied on this twisted logic, she would not only fail in losing weight, but would probably end up weighing more than before she started her diets. And while this story may seem farfetched, many people who try to follow medically unproven and controversial weight control programs often end up with this very dilemma. But weight control is not the only situation where people rely on unsuccessful techniques. Cigarette smoking is another problem for which people try to find different solutions. People are always looking for new and easy ways to quit smoking. Many behavioral scientists believed that smoking is only a learned pattern. If this were so, there would be many different approaches available to quit. Behavior modification techniques such as reducing the amount of or exposure to a substance or situation, aversion therapy, hypnosis, acupuncture, record keeping, desensitization and countless other approaches have been used for years to help people unlearn unwanted behavior patterns. But cigarette smoking is not simply a learned behavior or bad habit. It is more complex, more powerful, and worst of all more deadly than most bad habits. Cigarette smoking is an addiction. This fact becomes quite evident the first day of every smoking clinic. Just about every person in the group can relate some story which demonstrates that to some degree he or she is controlled by cigarettes. Some have gone so far as to rummage garbage cans in the middle of the night in search of cigarettes. Others take butts out of dirty ashtrays. Still others sneak cigarettes while hospitalized from smoking-related illnesses even though smoking is expressly forbidden by their physician. After hearing of these dramatic experiences, few people argue the point that the addiction to cigarettes exerts tremendous control over the smoker. Addiction does not respond to cut-down approaches. Addiction does not lend itself to controlled use of the substance. If people try to treat an addiction as a bad habit, they will lose to the addiction. If, on the other hand, they treat an addiction as an addiction, they stand a good chance of beating it. Once a person is addicted to a substance, he must totally avoid any use of that substance or else relapse into a full- fledged drug dependency. This holds true for alcohol, heroin, nicotine, and a host of other drugs. As far as nicotine is concerned, if the smoker quits cold he will overcome the strongest stages of withdrawal within 72 hours. After two weeks, physical withdrawal ceases. Then, once it is understood that any amount of nicotine administered in any manner will reinforce his dependence, he has all the ammunition he needs to overcome the occasional desire. He must always base the decision of whether or not he should smoke a cigarette on his true options. He has the choice of smoking none or smoking everything. There is no in between. Based on that, his choice is clear - NEVER TAKE ANOTHER PUFF! |
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Reply
| | | From: Joel | Sent: 5/9/2006 1:10 PM |
“I’ve tried everything to lose weight but nothing works!�?BR>
Recently a lady called our department inquiring about our recommendations concerning a liquid protein diet program for weight control. We explained that for any kind of permanent weight control program to be successful, a sensible approach which can be maintained after reaching an ideal weight is required. Otherwise, the person is likely to adopt their old pattern which resulted in being overweight in the first place. Liquid protein diets are potentially dangerous and are not conducive to permanent weight loss . We suggested that she enroll in a sensible weight control program. She replied, "I tried them all, they are a rip-off and a fraud! I didn't lose any weight at all!" She proceeded to ask what approach we recommend. We suggested a sensible diet and exercise program. "Exercise," she expressed with disgust, "who has time to exercise?" It was becoming apparent why her past attempts at weight control had failed so miserably. It was not a weakness in the program, but rather in her own conviction in losing weight. She wanted to be thinner, but heaven forbid she should have to work at it.
In order to be successful in any lifestyle change, a person must first decide how important benefits from the change are to them. If the benefits are important enough, the individual can make a sincere commitment and have a good chance of being successful. Weight control is an important topic because so many ex-smokers do gain weight after first giving up cigarettes.
Upon cessation of smoking, food may smell and taste better and many ex-smokers find they do have an increased appetite. Many feel a real need to substitute food for the oral gratification they claim to have derived from cigarette smoking. Some feel that since they quit smoking, they ought to be able to treat themselves as a reward for their great accomplishment. While it may seem like a rational idea at the time, there may be severe ramifications. Even after the initial quitting process is over and the urge for cigarettes diminishes, a new eating pattern is now being established. This pattern includes consuming more calories than are burned off in normal daily activities. The end result is extra fat and extra weight.
Giving up cigarettes is a great accomplishment, but it does not necessitate consuming vast quantities of extra calories. Eating cakes, cookies, ice cream, extra main courses, or drinking extra alcohol all causes real weight gain. Calories add up quickly. While many people may get discouraged by this added weight, they do not always take positive steps to correct the situation. They persist with their new habit of continuous gluttony. What does it take to encourage these people to initiate a positive change?
When they get sick and tired enough of being overweight, they can do something about it. That is how they first quit smoking. It came to a point where they knew it was time to quit. In the beginning it was not easy to give up cigarettes. Not only did they have to break a strongly ingrained habit but also a potent addiction. They experienced real drug withdrawals. But their conviction was strong. In a short time they were nicotine free. It became relatively easy not to smoke. Food can take a similar route. At first it may be hard to refuse the extra dessert. It may not be easy to go out for that first walk around the block. But soon, smaller portions of food become sufficient to quench culinary desires. You may even begin to look forward to your walk. And you will begin to look and feel better. That's the real pay-off.
If you are concerned about your weight, do something about it. Start to modify your diet. Take up exercise. Some past participants find it helpful to attend our smoking clinic when they first start their diet. Listening to the great difficulty that the participants are experiencing giving up cigarettes and remembering how they overcame the same problem, can establish a strong sense of confidence. They begin to realize that if they could quit smoking, they could do anything. Some people not only lose the extra weight they gained since they quit smoking, but continue to make positive changes in diet and exercise, even to the point of weighing less than when they were smokers.
Work on staying healthier and happier. Be sensible with your diet. Push yourself to keep active. Most important, always keep in practice - NEVER TAKE ANOTHER PUFF!
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Reply
| | | From: Joel | Sent: 5/9/2006 1:11 PM |
Patience in weight control issues
Be patient with weight control efforts. Quitting smoking is harder than losing weight, initially. But weight control is a harder process in the long term. For once you quit smoking, not smoking eventually becomes a habit. And the battle line for successfully not smoking is clear and simple to understand. You are fighting a puff. You can't administer any nicotine. There is no gray area here.
Eating is more complicated. You will have to eat the rest of your life. When are you eating a little more than you should? A little more is a difficult concept. If you eat a little more once, it is no big deal. If you eat a little more every day, there is a problem. An example, let's say as a "reward" for not smoking, you have one extra cookie, say about 100 calories. Weight yourself at the end of that day and nothing would have happened. Now lets say you do this every day for a week. Weigh yourself at the end of the week and you probably still won't notice any difference. You would have consumed 700 calories, but basically it's not noticeable. If you do it for a month, you may have increased the scale weight by almost a pound. Now you would have consumed about 3,000 calories, and 3,500 calories is about a pound of fat. But think about this too, if you step on a scale one-month to the next and had altered a pound, that would be no grounds for panic. A pound, that can be scale error. Heck, you can step on a scale a couple of times a day and seem to vary a pound. So the pattern of the extra cookie still seems unimportant.
Now the catch. If you continue this pattern of one seemingly harmless cookie for a year, 10.4 pounds of fat will be the result and if you don’t catch on after that and do it for 10 years, 104 pounds of fat is the outcome! 104 pounds from the addition of one cookie a day!
Here is where substituting food becomes treacherous. You do it with the idea that it is only for the early days of quitting but it often is extended to it’s own pattern. One cookie or 100 calories is probably minimal compared to the number of actual calories substituted by many people.
If you eat a little more, you can exercise to offset the difference. But you must be realistic about how much exercise is needed to offset caloric intake. You have to exercise quite a bit to burn off a relatively small amount of food.
An example, let’s say you sit down at a feast. You start out with a drink before dinner. Next you have a dinner roll or two with a little butter. Followed by a salad, with croutons and a teaspoon of salad dressing. Now the main course, meats, potatoes, vegetable with cheese sauces, another helping of meat to top it off. You’re pretty full now, better stop. Oh, but wait, dessert is being served. You have a pie ala mode. Boy you are stuffed now. Almost sick to your stomach in fact. You know what you decide to do? You are going out for a walk. You actually drag yourself outside and walk for 20 minutes. Your hope may be to burn off the meal. In fact, you will burn off the teaspoon salad dressing. You won’t touch the calories of the appetizers, drinks, main course or dessert. You will burn the equivalent of the salad dressing. I am not saying don’t go for the walk. I am saying don’t eat food with a shovel, go for a short walk and expect to rectify the meal.
OK, now what’s the upside here. Basically, making a little change can cause a significant weight alteration. But this process works in reverse too. If you "deprive" yourself of a cookie daily, and go for a walk, weigh your self at the end of a week and see no change, you get discouraged. If you are patient and weigh yourself at the end of the month and lose a couple of pounds, you can be furious. A couple of pounds after all that deprivation and work, what’s the point? Again, even a couple of pounds could be scale error. But if you stick with it even though it seems initially futile, over the year you could lose 20 pounds and likely keep it off. Again, a little change adds up to a big difference over a lifetime. Patience is crucial. You are not starving yourself or working yourself to exhaustion, just not taking one food item and a simple 20-minute walk. Slow, but constant. By making a small modification to daily eating patterns and sticking with it over the long term, you can lose significant weight.
Take simple steps here to alter the daily patterns. A little less food, a little more activity. The reward is not immediately obvious but will be with time. Improved health, self-esteem, just overall feeling of well being. You can do this as an ex-smoker, but you must prove it to yourself. But again be patient. Quitting smoking had great benefits that are often immediately felt. Weight control efforts are a little harder to see and feel initially, but the rewards will be forth coming with time. So start today off right, watch what you eat and Never Take Another Puff!
Joel
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Reply
| | | From: Joel | Sent: 5/9/2006 1:11 PM |
Minimizing the Weight Gained After Quitting Smoking
You may have heard that you can’t deal with weight control issues at the same time as quitting smoking. It may be fine for some people to gorge themselves while quitting smoking and deal with the weight at a later time. The health implication of a minor weight gain is negligible in comparison to the health risks posed by smoking. The average smoker would have to gain about 75 pounds to put the additional workload on the heart that is experienced by smoking, and this is not saying anything about the smoking cancer risk.
But for esthetic and emotional reasons, allowing uncontrolled eating and the inevitable weight gain is a mistake that will often undermine the quitting process. Discouragement over appearance can cause some to return to smoking. Then the smoker has the additional problem of the extra weight combined with smoking. Sometimes the weight does not automatically disappear by simply relapsing back to smoking.
Weight gain following smoking cessation can be due to several factors. Smoking can have an effect on a person’s metabolism and thus quitting can account for a small weight gain in some individuals. Gains of 5 to 10 pounds over a number of months can be attributed to metabolic alterations in some individuals. But once weight gain exceeds 10 pounds, other factors are more probably responsible.
Snacking between meals or increasing the overall size of meals, can easily result in the consuming of several hundred extra calories per day. Eating just an additional 100 calories a day will result in a one pound fat gain in just over a month, 10.4 pounds in one year, and an extra 104 pounds in ten years. 104 pounds of fat from drinking the equivalent of one extra soft drink per day. This is why you often hear, "I didn’t eat that much more but gained excessive amounts of weight!" True, they may not have eaten that much more daily, but they did it everyday, and the cumulative effect can easily account for the "mysterious" weight gain.
Some ex-smokers eat more because they are just hungrier. They find themselves snacking between meals or needing to eat at times that were never necessary before. If they wait to eat too late in the day or there is too much time between meals, they may start to experience symptoms such as headaches, sleepiness or lack of energy. This can be a real side effect of smoking cessation.
The reason for the new sense of hunger is due to the fact that nicotine is an appetite suppressant. Smoking between meals seems to eradicate the need for the snacking behaviors experienced by many ex-smokers. Nicotine does this by elevating the blood sugar and blood fat levels, basically tricking the body into thinking that it has eaten more than it actually has. While that may help to control weight, it does so at a risk. Cigarettes used as an appetite suppressant can cause cancer, heart disease, strokes and a host of other illnesses.
The ex-smoker is no longer constantly administering an appetite suppressant. This does not mean he or she needs to increase caloric intake. It may be a matter of redistributing food normally eaten at single sittings at large meals into numerous smaller meals spaced throughout the day. This can allow for the snacking between meals ex-smokers are notorious for without increasing overall caloric intake. As an example, if breakfast consists of cereal, muffin, eggs, and a glass of juice, instead of eating all that food in one sitting, it can be dispersed over two or three times keeping a more even distribution of blood sugar throughout the morning hours. The same rule can apply to lunch and dinner, allowing for numerous snacking times throughout the day.
A more insidious mechanism of increased caloric intake can be experienced by unwittingly eating more at the end of meals. The smoking of a cigarette used to signify the end of a meal. With no cigarette to serve as a cue, the ex-smoker may continue to consume extra food after every meal whether or not he or she is hungry. The ex-smoker may not even know that they have eaten more in the process.
One solution to this behavior can be planning the meal out in advance. Calculate and prepare the amount of food you used to consume while smoking and acknowledge to yourself that you have finished. Another way is leave the table immediately upon completion of the meal. If you must stay at the table have a glass of cold water or a non-caloric beverage present. Don’t leave a plate with scraps or desserts in easy reach.
Another very good solution is getting up and brushing your teeth. This can become the new cue for the end of the meal as well as improve dental hygiene. The clean feeling in your mouth may be a new pleasurable experience for an ex-smoker. While smoking, brushing of the teeth was often followed by a cigarette, compromising the overall cleansing process.
Besides controlling consumption, exercise is another tool to help with weight control efforts after quitting smoking. Twenty to thirty minutes of exercise done every other day can offset the metabolic alteration accompanied by smoking cessation. If you are eating "a little more," then more exercise can help offset that, too. But be realistic. You have to do a lot of activity to burn off a relatively small amount of food. That is not to say it is a waste of time to exercise to lose weight; just don’t eat food with a shovel and go for a short walk and expect to work off the difference.
Successful weight control while quitting smoking can be accomplished with a little extra effort and planning. If weight gain is experienced during smoking cessation, steps should be implemented as soon as possible to reverse the process. Then to maintain a healthy lifestyle, watch your food consumption, exercise regularly, and most importantly - NEVER TAKE ANOTHER PUFF! |
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Reply
| | | From: Joel | Sent: 5/9/2006 1:12 PM |
“I would rather be a little overweight and not smoking than underweight and dead.�?BR>
This thought provoking sentiment was one panelist's opinion of the 10 pounds she gained when giving up cigarettes. While it is not inevitable, many people do gain weight when quitting smoking. The reason is quite easy to explain - they eat more.
People eat more when quitting smoking for a variety of reasons. Food is often enjoyed more since the improved senses in ex-smokers make it smell and taste better. For some, cigarettes decrease the appetite. Others use cigarettes as their cue that the meal has ended. Take away the cigarette and they don't know it is time to stop eating. Social situations with food used to be easy as a smoker. When a smoker is done with their food, they can sit and smoke while conversing with others at the table. Without cigarettes, they feel awkward just sitting, so they often order extra coffee and dessert to last the duration of the conversation. All of these different behaviors add up to one result, extra calories eaten which result in gaining weight.
Weight gain can be extremely dangerous to an ex-smoker. But this is not because of the strain on the heart. An average ex-smoker would have to gain 75 to 100 pounds to put a strain on their heart equal to the extra risk associated with smoking a pack a day. And then, the extra weight would not cause the lung destruction, cancer risk and many other conditions caused by smoking. The real danger of the extra weight is that many ex-smokers use it as an excuse to go back to smoking. They think that if they smoke again they will automatically lose weight. To their unpleasant surprise, many return to smoking and keep on the added pounds.
One clinic participant told how after three months without smoking she gained 15 pounds. Her doctor told her that she must lose the weight. He said that if she had to, just smoke one or two cigarettes a day to help. If her doctor understood the addictive potential of cigarettes he would never have given her such advice. For, as soon as she took her first few cigarettes, she started smoking in excess of 3 packs per day. Her weight gain did not go away. When her doctor realized that she had returned to smoking, he warned her that it was imperative that she quit. In her condition smoking was extremely dangerous. So not only did she still have to lose 15 pounds, but once again she had to go through the withdrawal process of stopping smoking.
Smokers, ex-smokers or never-smokers can all lose weight the same way. The three ways to lose weight are to decrease the amount of calories one eats, increase ones activities to burn extra calories, or, a combination of both techniques. While dieting may be more difficult for some after smoking cessation, it is possible, and in many ways ex-smokers have major advantages over smokers for controlling their weight.
The most obvious advantage is that not smoking allows a person to do more physical activities, burning off fat in the process. When smoking, exercise is tiresome, painful and for some, impossible. But with the improvement in breathing and cardiovascular fitness accompanying smoking cessation, exercise can become a regular routine in the ex-smokers lifestyle. And while dieting may be difficult at first, ex-smokers should realize that if they had the capability of breaking free from cigarettes, they could also decrease the amount they eat. It is simply a matter of using the same determination initially used to quit smoking.
So, the next time you look in the mirror or step on a scale and feel that you are unhappy with your weight, start taking some sensible steps to deal with it. Become active, eat lower calorie, nutritious foods, and pat yourself on the back for once again taking control of your life. Not only will you lose weight, look and feel better, but you would have done it all without smoking. With that knowledge you should be extra proud. Diet, exercise and - NEVER TAKE ANOTHER PUFF!
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Reply
| | | From: Joel | Sent: 5/9/2006 1:13 PM |
Can people quit smoking and still drink alcohol?
There are different groups of people that must be taken into consideration when addressing alcohol and quitting: people who have never taken a drink in their lives, people who are truly social drinkers, drinkers who consider themselves to be social drinkers but who may in fact have a drinking problem, people who know that they are alcoholics and who have quit drinking, and people who are actively drinking alcoholics. There are different considerations involving quitting for each of these groups.
Never Drinkers
The easiest group of course is people who have never been drinkers and don't plan on ever drinking. There is nothing they need to worry about regarding alcohol consumption when quitting smoking.
Social Drinkers
Truly social drinkers can still drink alcohol without risk of smoking relapse--but being mentally prepared can be crucially important for them. They must go into ALL drinking situations reminding themselves that they are recovering nicotine addicts and that they are going to be recovering nicotine addicts for the rest of their lives.
While that may not sound great in concept--being a recovering nicotine addict--it sure beats being an actively using nicotine addict, hands down. For over time, being a recovering nicotine addict has no real signs or symptoms and no real adverse health or even social effects associated with it. Being an active user would actively be destroying tissue with every puff, depositing cancer-producing chemicals with every puff, assaulting your heart and circulatory system with every puff, costing you money with every puff, and making you reek with every puff.
It is important for these people to know that know that everything that they could do as smokers, they can also do as ex-smokers. They just have to teach themselves how. There are some things that new quitters are forced to learn early on like how to eat, sleep, use the washroom, breathe, etc. These are things that are required from day one for survival. So even though they may resist doing one of them, they can't resist for long and will thereby be forced to start to break the association to smoking early on.
Other things are sometimes put off and seen as unimportant to face early on. Tasks like doing housework, laundry, cleaning, brushing teeth, combing hair, or maybe even going to work and doing their jobs. While it is true that people won't die if they stop doing one or more of these activities for a day or two, putting off doing them too long will create a set of problems that can be quite annoying to those around them.
Besides threatening their livelihood and making them look like slobs in general, if carried on too long, it can really start to make them feel intimidated that they may never again be able to do these activities. Again, it must be repeated, everything a person did as a smoker they can also do as an ex-smoker--but they have to teach themselves how.
Now when it comes to areas of less importance like watching television, sports, playing cards, being a couch potato, and yes, even drinking with friends--things that are not necessary for survival and in fact, things that may not even be good for a person--well, the truth is people can do these things too as ex-smokers.
The same process is necessary though. They have to teach themselves how. Holding off too long can create a sense of intimidation, the feeling that they can never do the specific activity again. This simply is not the case. They will be able to get themselves back to their pre-quitting existence if they choose to.
Drinking is a special case because the association is so strong and by its very nature lowers their inhibitions. It can cause people to do some very irrational behaviors. Smoking can be one of them. Because of the drug's influence, it is best that people take it on gradually, in the beginning in a safe environment.
These people should probably limit themselves to one drink the first time out just to show themselves that they can have a drink without smoking. Also, they should do it with people who are non-smokers and who really are supportive of their quitting. This is a much safer situation in the beginning than going out with drinking buddies who smoke cigarettes and who may be a tad envious of their quitting, and who, while drinking themselves also have their inhibitions lowered. It may manifest in behaviors of encouragement of smoking at a time when the person is more vulnerable.
Soon ex-smokers will be able to face these environments too. Again it is best that they do it gradually, breaking some of the association and intimidation factors in the safer controlled environments. The fact is, though, for the rest of their lives they will need to keep their guard up, in a sense reminding themselves of their reasons for having quit and the importance to stay off smoking, every time before they go drinking. It prepares them to face the situation in a much safer state of readiness.
These people need to use timetables that they are comfortable with, but the sooner they take on activities like drinking the sooner that they will prove to themselves that life goes on without smoking.
Problem Drinkers
The next group is people who define themselves as social drinkers but who do in fact have a drinking problem. These are people who cannot drink in a controlled manner, or people whose drinking at one time has adversely affected their health or caused them any economic, professional, legal, or personal problems.
These people need to think long and hard about whether they are in fact problem drinkers or possibly dealing with alcoholism issues. If a person says that they know that their drinking will cause them to take a cigarette and relapse back to smoking, and then they take a drink and relapse, they are in effect problem drinkers for they have now put their health on the line in order to drink.
Recovering Alcoholics
A person who has acknowledged that he or she is an alcoholic and has successfully quit drinking probably has a rather thorough understanding of addiction. If he or she didn't, he or she would not be successfully off drinking but more likely rather still is an active drinker. People who are successfully recovering from alcoholism probably understand the relapse implications of just one drink, or just one sip.
All a person who has quit drinking needs to do to quit smoking is to just transfer his or her experience and knowledge with alcohol, while aiming it straight at nicotine. The same problem -- drug addiction. The same solution -- stop delivering nicotine into his or her system.
The recovering alcoholic will probably be scared about quitting, feeling that life will never be the same without smoking. �?The odds are pretty good that he or she probably had those exact same fears when quitting drinking. The recovering alcoholic was right when he or she thought his or her life would be different. It in all likelihood became immeasurably better. The same will hold true with quitting smoking.
I always state it this way. Treat an addiction as an addiction and a person will learn to control it. Treat an addiction like a bad habit and the person won't have a prayer. Nicotine use is an addiction. If a recovering alcoholic takes his or her understanding of addiction and aims it at nicotine he or she will do fine.
I should point out that whenever I have a person who quits smoking after quitting another substance, he or she often has a harder time quitting than the average smoker. Smoking may have been a crutch used to help them get off of the other substance. Now, when quitting cigarettes, not only is the person trying to break free from a primary addiction, but he or she is also trying to remove the crutch that he or she feels supported recovery from the other addiction.
While it may be harder up front, people recovering from alcoholism or any other addiction can be more prepped for success than the average quitter, for once again, they understand addiction. If the quitter aims their alcohol recovery program at treating this addiction, they will do fine with nicotine dependency recovery, too.
Drinking Alcoholics
The last group is people who are actively drinking alcoholics who want to quit smoking. When it comes to nicotine addiction, the only thing these people need to do to successfully quit smoking is to stop delivering nicotine. Are there other things that some people may also have to get rid of after they quit smoking? Sure there are.
If a person were a diabetic while smoking and not watching his or her diet, he or she would likely have to get his or her sugar intake under control when quitting smoking. The fact is, though, he or she probably needed to get his or her sugar under control when he or she was still smoking. Quitting didn't change that variable. Alcohol is no different. If a person has a drinking problem before quitting, he or she will still have a drinking problem after quitting. Still, all the problem-drinker needs to do to get off nicotine is just to get off nicotine. The drinking problem still exists and still needs to be dealt with.
A person first realizing he or she has an alcoholism problem and who also wants to quit smoking either has to quit both substances at the same time or get drinking under control first. The only reason I say that some people probably need to quit drinking first is because of the limitation of how the person's alcohol treatment program will advise him or her when they find out that he or she is a recent quitter of cigarettes.
Many if not most alcohol recovery programs will inadvertently or very purposely push a new ex-smoker entering the program to smoke. Over the years I have in fact had actively drinking alcoholics in smoking clinics--people who made it abundantly clear that they knew they had drinking problems and smoking problems but wanted to treat the smoking first.
I really do try to get them into alcohol treatment concurrently but cannot force them to do it. On more than one occasion I have seen the person successfully quit smoking, stay off for months and sometime longer, and finally get into AA, only to be assigned a smoking sponsor who tells the person that he or she can't "get off smoking and drinking at once," and who actually encourages the person to smoke again.
Note the sequence here--the ex-smoker has been off of nicotine for an extended time period but the smoking sponsor says that the person can't quit both at once. It is unfortunate that most alcohol and drug treatment programs just don't recognize smoking as another drug addiction.
You will not often see an AA sponsor say that you can't give up drinking and heroin at once, so if you have been off heroin for six months and now want to quit drinking, you should probably take heroin for a while until you get alcohol out of your system.
The bottom line is that there are other things that ex-smokers may need to address but not in order to sustain their quits, but to sustain their health or control other problems. To successfully overcome smoking and arrest a dependency upon nicotine requires only that a smoker make and stick to a personal commitment to Never Take Another Puff. |
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| | | From: Joel | Sent: 5/9/2006 1:15 PM |
I Smoke Because I Like Smoking!
Ask almost any current smoker why she continues to indulge in such a dangerous habit and she will normally reply, "Because I like smoking." While she may say this in all honesty, it is a very misleading statement, both to the listener and to the smoker herself. She does not smoke because she enjoys smoking, rather she smokes because she does not enjoy not smoking.
Nicotine is a powerfully addictive drug. The smoker is in a constant battle to maintain a narrow range of nicotine in her blood stream (serum nicotine level). Every time the smoker's serum nicotine level falls below the minimum limit, she experiences drug withdrawal. She becomes tense, irritable, anxious and, in some cases, even shows physical symptoms. She does not enjoy feeling these withdrawals. The only thing that will alleviate these acute symptoms will be a cigarette. The nicotine loss is then replenished and, hence, the smoker feels better. She enjoyed smoking.
A smoker must also be cautious not to exceed his upper limit of tolerance for nicotine or else suffer varying degrees of nicotine poisoning. Many smokers can attest to this condition. It usually occurs after parties or extremely tense situations when the smoker finds themselves exceeding their normal level of consumption. They feels sick, nauseous, dizzy and generally miserable.
Being a successful smoker is like being an accomplished tight rope walker. The smoker must constantly maintain a balance between these two painful extremes of too much or too little nicotine. The fear which accompanies initial smoking cessation is that the rest of the ex-smoker's entire life will be as horrible as the first few days without cigarettes. What ex-smokers will learn is that within a short period of time, the physical withdrawal will start to diminish. First, the urges will weaken in intensity and then become shorter in duration. There will be longer time intervals between urges. It will eventually reach the point where the ex-smoker will desire a cigarette very infrequently, if ever. Those who continue to smoke will continue to be in a constant battle of maintaining their serum nicotine level.
Included in this battle is the great expense of buying pack after pack and the dangerous assault on the smoker's body of inhaling the poison nicotine along with over 4,000 other toxic chemicals which comprise the tars and gasses produced from the combustion of tobacco. These chemicals are deadly by themselves and even more so in combination.
So the next time you think of how much you once seemed to enjoy cigarettes, sit back and take a serious, objective look at why you have such an idealization of this dangerous product. Consider all the consequences. You will probably realize that you feel physically and mentally better now than you ever did as a smoker. Consider all of this and - NEVER TAKE ANOTHER PUFF!
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| | | From: Joel | Sent: 5/9/2006 1:15 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!
© Joel Spitzer 1982, 2000
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| | | From: Joel | Sent: 5/9/2006 2:03 PM |
Is cold turkey the only way to quit?
I have seen it written that we have said that the ONLY way to quit smoking is to quit cold turkey. This is not a totally accurate statement. It is not that cold turkey is the only way to quit,; it is just that cold turkey is the method which gives people the best chance of success. It is the method that all but a small percentage of long-term ex-smokers in the world used to successfully quit smoking.
There are people who have quit using alternative approaches. There are some who cut down gradually and actually succeeded at quitting. For every person who did it like this and succeeded, there are many many many many others who tried it and failed. The individual who used the method will think it is great because it worked for him or her, but since it works for so few people it will generally be recognized as a pretty ineffective technique by most people who do "real world" research into how to quit.
By "real world" research I mean by going to long-term ex-nicotine users who you know personally and finding out how they all got off nicotine. Again, you will very rarely find any who did it by gradual withdrawal. If you find a person like this who is now off years, you should never minimize the person's success. He or she quit smoking, likely doing it in a way that made it much more difficult than it needed to be, but still he or she did pull off the quit. The only advice that I would encourage that you share with the person is that now to stay off he or she must understand the bottom line method of sustaining his or her quit. That message is staying cognizant of the addiction and that the only true guaranteed method to stay off now is knowing never to administer nicotine again.
The same principle here applies to people who use NRT products. There are people who have quit this way. Again, it is a small percentage of the long-term ex-users out there, but they do exist. An individual who pulled it off this way will also feel that it is a great method for quitting. But again, this method works for a small percentage of people who try it and if you look into real world long-term quits you will have a very hard time finding many people who actually successfully got off nicotine this way.
I feel it necessary to use that phrase, "got off nicotine," as opposed to saying, "got off smoking." There are some major experts coming out and advocating that people should be given nicotine supplements forever to stay off of smoking. Can this work? Of course it can. If you can give people enough nicotine via supplements it will satisfy their need for nicotine. After all, this is the primary reason they were smoking at the end--to feed a nicotine addiction. If the smoker can just get nicotine for the rest of his or her life via another route, he or she will avoid going through the three days of nicotine withdrawal.
The question needs to be, why should anyone have to pay what is likely to be tens of thousands of dollars to avoid a few days of withdrawal.? On top of this, these people will never be totally free of the moderate withdrawals that such usage is likely to keep going. These people will in fact tout the use of the product as a great aid, but when compared to what people who are totally nicotine free are experiencing, this victory over cigarettes is just a bit hollow.
There are a few people though whom you may encounter over your lifetime that did quit using NRT's as intended, weaning down for week after week and eventually quitting. If the person is now off for years, he or she is pretty much in the same state as a person who had quit cold turkey. He or she is nicotine free, and he or she should be thrilled by that fact. In some ways I look at people like this with a bit of awe, for they in all likelihood stuck with a process that was pretty much a gradual and prolonged withdrawal and yet they succeeded.
Again, debating the merits of their method with them is pretty much a moot point. It worked for them and you are going to have a pretty hard time convincing them that it is an ineffective method. But you do have a message that you can share with them that they do need to know. That message is that even though they are off nicotine for years, they still need to recognize that they are not cured of nicotine addiction and never will be. No matter how they had stopped, they must still understand the bottom line message, that the only way to stay free now is staying totally committed to never administer nicotine again via any nicotine replacement source and to never administer nicotine again from the original source that likely started the whole process by knowing to never take another puff!
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| | | From: Joel | Sent: 5/9/2006 2:11 PM |
So how did most successful ex-smokers actually quit?
If you look around the Internet or even request information from professional health organizations on how to quit smoking you are likely to find that the standard advice given is to use a pharmacological approach, i.e., nicotine replacement products and or Zyban. Each time you see this advice you will also be told that these approaches double your chances of quitting. Some sites and groups come out and almost say, point-blank, do not go cold turkey--basically leaving the reader with the impression that nobody could possibly quit this way.  The American Cancer Society's Cancer Facts & Figures 2003 report contains the chart to the right which shows the percentage of current smokers who have tried different routes at quitting smoking and also indicates the percentage of current ex-smokers who quit by different techniques.
The numbers that are highly telling are the percentages that indicate how former smokers had actually quit. Keep in mind that this chart is limited. It does not tell us how long they had quit or other key pieces of information, such as, did the people who used quitting aids such as NRT ever actually get off the NRT. But I am not concerned about that at this moment. According to the American Cancer Society report, how did former smokers actually quit? Those using drug therapies and counseling had a 6.8% quitting rate while those using other methods 2.1%. The remainder quit cold-turkey or cut down. In that it is generally accepted that cutting down techniques do not work, we can safely assume that they had an extremely limited impact upon the overall number. So, approximately 90% of the people who are successfully classified as former smokers quit cold turkey. On the same page as Table 3 is located you will find the following recommendation: "All patients attempting to quit should be encouraged to use effective pharmacotherapies except in the presence of specific contraindications." You have to ask yourself how many of the successful ex-smokers in the world today would have actually succeeded if they sought out and listened to "professional" advice such as this. If you are trying to determine what is the best way to quit, you have a choice. You can go with the "experts" or you can go with what 90% of successful quitters have done. Take Your Own Survey So how do most people really quit smoking? Don't take our word for it, or the American Cancer Society's, but instead talk to every long-term ex-smoker you personally know. See how many of them fall into one of the following three categories: 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; or 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 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 used was basically the same. For the most part they are clear examples of spur of the moment decisions elicited by some external, and sometimes unknown circumstance. I really do encourage all people to take their own 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!
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