Stop Smoking Otherwise

There are many different ways to stop smoking and I'll describe a sampling of the most effective ones below. But remember that there are many different approaches and the best method for one person may not be the best method for another. Also, it's common for people to make several "quit attempts" before they finally succeed. So if you try one approach and it doesn't work for you -- don't give up! Try again using another approach instead of, or in addition to, the one you tried.

Cigarette smoking involves both a physical addiction to nicotine and a psychosocial habit, so effective interventions typically include components that address BOTH of these factors.

Physical addiction: Many people can successfully quit by going "cold turkey." But those who are more physically dependent on nicotine (generally those who smoke within 30 minutes of waking up and/or who smoke more than 20 cigarettes per day) are more likely to succeed if they gradually "wean" themselves off of nicotine before trying to quit altogether. This makes it easier by decreasing their experience of unpleasant withdrawal symptoms when they quit.

One effective way to wean yourself is by using nicotine replacement products, such as nicotine patches or nicotine gum. There are advantages and disadvantages to each of these methods (e.g., the patches are much easier to use, but the gum can provide a nicotine "hit" on demand), but a full discussion of these is beyond the scope of this column -- talk to a professional about this further if you are interested in using nicotine replacement (see the resources section below).

Both nicotine gum and nicotine patches are now available "over-the-counter,". But remember that they are a little pricey and they are not "magic pills" -- studies have found that quit rates are much higher when nicotine replacement products are used in combination with "cognitive-behavioral" approaches that also address your smoking habit.

Another effective approach for weaning yourself off of nicotine is called "nicotine fading." It involves progressively switching to cigarette brands with lower and lower nicotine levels before quitting altogether -- a typical schedule is to switch once a week for 3 weeks to brands with 30%, 60%, and then 90% less nicotine than you started with.

One potential problem with this approach is that some smokers "compensate" for lower nicotine levels by smoking more cigarettes, taking more puffs off of each cigarette, and/or puffing more deeply and this can lessen the effectiveness of nicotine fading.

But there are things you can do to decrease the compensation problem -- you can be aware of it and minimize these behaviors, and you can delay a brand switch for a few days if you notice that you're compensating (some people's bodies take a little longer to adjust and they will naturally stop compensating after a few extra days). Besides being inexpensive, this approach to "weaning" can also help you develop confidence in your ability to exercise some control over your smoking habit before you stop smoking altogether.

Smoking habit: One effective approach for addressing your smoking habit is called "relapse prevention." This involves identifying your personal "triggers," "cues," or "high-risk situations" for smoking, and then developing "tools" or "coping skills" for dealing with them. Triggers can be a wide variety of things -- people, places, events, emotions. Do you smoke after meals, at parties, when you're angry or anxious or bored, or in your car?

Once you've identified the situations that are likely to put you at risk for relapsing after you've quit, you can develop ways to cope with them. If you smoke when you're anxious, learn a deep breathing skill or work on some calming thoughts you can say to yourself when you're nervous (e.g., "Calm," "Relax").

If you smoke, when you're bored, make a list of 10 things you can do instead of smoke and keep it handy for after you've quit. If you smoke after dinner, plan to go for a walk each night after dinner instead. In other words, plan ahead and develop ways to avoid, escape from, or cope with the things that might trigger you to return to smoking after you've quit.

Continue to identify difficult situations after you quit and continue to work on improving your coping skills so that you can stay smoke free. If you slip, don't give up! -- examine the situation to identify hidden or new triggers, develop some new coping skills or strengthen your existing ones, then set another quit date, and try again.

Another effective approach for addressing your smoking habit is to develop a quit smoking contract with yourself -- plan to give yourself small rewards for each day, and progressively larger rewards for increasingly longer periods of time, that you stay smoke free.

Yet another effective approach is to develop a support system for quitting -- ask a non-smoking friend or family member to be your "buddy," someone you can call to help you through tough times and someone who can help reward you for time smoke free (by doing one of your household chores for you for a full day smoke free, by taking you to lunch for being smoke free for a whole week).

Remember, combining approaches that address both your physical addiction and your smoking habit is most likely to be effective...and, as the old adage says, "If at first you don't succeed -- Try, Try again!"

Resources:

Luckily, there are many excellent resources available to help you quit smoking. Nonprofit groups can be found in communities throughout the country: