December 30 , 2005
iranian.com

About Shokooh

Quit for good

QUESTION

Dear Shokooh,

Every year on New Year’s Eve, I promise myself that this will be the year I stop smoking. Despite my good intentions, by the first week in January, I am back to my two-pack a day habit. My wife is very supportive and doesn’t nag me, but I have two children who are very afraid for my health and get more vocal about it every year. What can I do to quit for good? I have been smoking for over thirty years and I am addicted. I would describe my addiction as very, very strong. Is there any chance I can succeed?

Thank you,

REPLY

Dear Reader,

Congratulations on your efforts!  I am impressed that, despite the incredible difficulty of quitting, you are motivated enough to try year after year. It is especially moving to hear that your love for your children is so strong that you are willing to continue trying to quit in the face of a strong addiction.

Nearly 45 million American adults are smokers. Of these, an estimated 70 percent actively want to quit. You are far from alone. Any habit that has been practiced and perfected for thirty years will be hard to break. Your goal is not impossible, but will require motivation and commitment. Your repeated attempts are not failures. They are necessary steps towards freeing yourself from addiction. Research shows that most ex-smokers had multiple quitting trials before saying goodbye to cigarettes for good. Everything you have tried and done—regardless of outcome—has brought you to this moment, to this attempt. Success is absolutely possible.

Nicotine is a highly addictive product and many ex-smokers say that breaking free of it is the hardest thing they have ever done. In addition to the physical addiction, there is the reality that smoking is probably a big part of your life, one that you may enjoy and find pleasurable. Cigarettes have accompanied you for thirty years—they have been there when you were happy, upset, bored, or stressed. Smoking may have facilitated social interactions, been a part of adolescent rebellious memories, or been a habit you shared with close friends. As you begin contemplating quitting, remember to take some time to acknowledge the role that smoking has played in your life. It is a habit that is unhealthy and harmful—but has also given you pleasure and enjoyment. Acknowledge that, mourn the loss and change, and begin thinking about all the reasons why you want to quit. It is perfectly normal to have mixed feelings about quitting. Just don’t let that stop you!

Take the time to truly think about what is driving your desire to quit smoking. Literally write the reasons down on paper and keep the list with you. One of my patients wrote his list on the back of a photograph of his family. He keeps this in his wallet and pulls it out when he is tempted to reach for a cigarette. We have all heard the public service announcements on television and know why smoking is bad. What I want you to do is come up with your own personal list—why do YOU want to quit? The longer the list and the more ground you cover, the better. There will be times everyday when you don’t feel like quitting, when you want to smoke. The longer and more detailed this list of reasons, the more helpful it will be.

Your second task is to think about, and write down, a list of your smoking habits and triggers. Observe your smoking behaviors. When do you smoke? What situations make you crave a cigarette? What are your smoking habits?  Do you smoke with others or by yourself? Do you smoke after meals? While watching the news? When you are upset or stressed? Be specific—you cannot change a behavior until you first are aware of it and understand it.

The next step is active preparation. Talk to your medical doctor about your desire to quit and ask for his/her assistance and shared ideas. Ask your doctor about nicotine replacement therapy (NRT).  Many studies have concluded that NRT such as the patch or inhaler (available by prescription) can dramatically assist in quitting. Your physician can be an amazing ally in your fight to quit.

There are many different behavior modification programs that target smoking cessation. A psychologist can help guide you during this process. Support groups may also be of assistance. If you decide to embark on your own, try to find some resources for information and help. The government’s website (www.smokefree.gov) is an excellent site that promotes the START approach:

S = Set a quit date.

T = Tell family, friends, and co-workers that you plan to quit.

A = Anticipate and plan for the challenges you'll face while quitting.

R = Remove cigarettes and other tobacco products from your home, car, and work.

T = Talk to your doctor about getting help to quit.

As you know, quitting isn't easy. You have tried many times and it may take several more tries before you are free of this addiction. Remember that you learn something with each attempt. Be gentle and try not to judge yourself too harshly. Millions of people have quit smoking for good. You can be one of them.

Best wishes for a healthy New Year.

Shokooh

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This column is for general educational purposes only-- it is not a substitute for medical attention, counseling, or therapy of any kind. The Couch and the staff of this website urge you to seek immediate medical attention if you are in an urgent, harmful, or potentially dangerous situation. Psychiatric emergencies or urgent matters should be handled by calling 9-1-1 or going to the nearest emergency room.   Please note that your emails will not be answered on an individual basis and your confidentiality cannot be guaranteed. Top

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