By Gibran Rodriguez de los Reyes, M.A.
So, smoking is harmful. And it can also kill you. Groundbreaking, right? Not really. In my professional practice and personal life, I have yet to come across a smoker who is not aware of the detrimental effects of commercial tobacco on their health. It is common knowledge that smoking is one of the leading causes of preventable death around the globe. And although the world continues to see greater bans on tobacco products and restrictions on their use in public spaces, smoking continues to be a (somewhat) accepted practice in many societies. Cigarettes and other tobacco products continue to be sold around the world in convenience stores and other easy-access venues. The implicit acceptance of such a deleterious practice further complicates the scenario for many a smoker who wishes to quit.
Science has been very clear about nicotine, one of the main components of tobacco products; it is highly addictive. Quitting smoking can be as challenging as recovering from addiction to heroin or cocaine. The path toward quitting can become a taxing one when we realize that, for many individuals, smoking has been reinforced throughout their lives, as it is paired with a plethora of everyday situations and emotional cues. Nonetheless, several strategies and skills may prove useful to those who wish to slay this dragon; such strategies stem from dialectical behaviour therapy or DBT. Below, I’ve compiled a list of tools to help you quit smoking. When I was quitting smoking (yes, therapists may struggle with problem behaviours, too!), I found these to be among the most helpful.
- Accept the challenge. Quitting is hard and may bring about intense discomfort. Also, realizing that a substance has such a powerful effect on our minds and behaviour can summon intense shame. If we accept this as a formidable challenge, we can relate to it differently, as quitting smoking is oftentimes not a one-time affair. Recognizing that the urge to smoke may come and go even after months or years of quitting, and that effectively facing such an adversary requires conscious effort, can help bring about self-compassion and kindness towards oneself. When we are kind to ourselves, we are less prone to be paralyzed by shame.
- Define why you want to quit. Write down a list of the pros and cons of smoking. Yes, they may be quite clear in your mind, but putting them down on paper makes them more tangible. Visualize yourself doing the things you wish you could do, but cannot because of the adverse effects of smoking on your health. Be honest with yourself if you still see more pros than cons to your cigarette use; this realization may imply that more personal work is needed to discover what’s underneath the addiction. Make sure you feel ready to take on this quest. Connect with former smokers through social media or online communities and inquire about their experience to increase your motivation.
- Know your enemy. Nicotine is an incredibly addictive substance because of its powerful rewarding effects on human neural pathways. This makes it a daunting enemy. Moreover, the use of cigarettes or other tobacco products is commonly involved in regulating one’s emotions. Have you ever wondered why many people smoke more when they’re stressed or anxious? Have you noticed how smoking is often associated with social interaction? Given that it is easily accessible and mostly socially acceptable, smoking can become a quintessential means to intensify pleasant emotions or counteract uncomfortable ones. Therefore, it is useful to write down the times when you tend to smoke more; if possible, create a log and track your cigarette consumption for a couple of weeks. Note when, where, and in what situations you tend to smoke. Were you experiencing a particular set of emotions? Do you experience difficulties coping with these emotions regularly? These questions will help you draft a personalized quitting plan.
- There is no one size fits all. Quitting cold turkey, systematically reducing the number of cigarettes you smoke, turning to medication, using patches, chewing gum, using quitting apps, or changing to e-cigarettes are all strategies that some people swear by. There is no one way to quit, and each person will find some strategies more effective than others. Ask yourself: which strategy would work for me best at this very moment? And, why? Talk with your physician or psychotherapist about your thoughts. Draft a plan to follow up on your chosen strategy until you actually stop smoking or relying on nicotine through other means. Balance the fact that you may have to switch or combine strategies, and that the quitting process may take you a bit longer than expected. Create a cope ahead plan in case one strategy doesn’t work so you can shift gears and use a different approach. Be specific about your time frame to achieve your goal, but also remain flexible; rewiring our brain and behaviour takes time.
- Put together a toolbox. Regardless of the approach that you follow in quitting smoking, there will be moments when you will deal with withdrawal symptoms. Be ready for this, as successfully resisting strong cravings requires great fortitude. Many coping skills and strategies can come in handy to help you resist cravings. For example, you can engage in physical activity for 20 minutes, call a loved one, tip your body temperature, improve the moment with mental imagery, distract yourself, or use progressive muscle relaxation to resist the urge. Keep the list of the pros and cons you wrote to remind yourself why you’re doing this. Remember that cravings will pass and that your irritability or mood swings will subdue over time. If you feel like it, track your cravings and notice how they start becoming less frequent over time. There are some great apps out there which help you monitor your cravings and your progress!
- Change your environment. It isn’t a surprise that environmental cues matter when it comes to helping you quit smoking. Get rid of any cigarette packs, lighters, or even ashtrays that may lie around your household. Avoid places where people smoke for a few weeks. Use a DEAR MAN (in other words, Describe and Explain the situation, Ask for what you need, and Reinforce the change, and do it Mindfully, Assertively and with openness to Negotiation) to ask your smoker friends not to smoke in front of you.
- Enlist the help of others. Telling loved ones about your desire to quit can provide you with extra support and motivation. Loved ones can also help keep you accountable to your goal of quitting. Enlist someone whom you can reach out to in case you feel like you’re about to light up. Call a support line if necessary. Commit to relying on their support before actually buying that pack.
- Reward yourself. Acknowledging small victories along the way will reinforce your will to quit. Set milestones that you’d like to reach and reward yourself for reaching them. Share your success with people who care about you. Write down what changes you’re noticing in your body and overall health. Count the money you’ve saved on cigarettes! This information will surely make you feel good about yourself and give you a sense of personal mastery.
- Follow your wise mind. It is common for ex-smokers to give in to the idea that one last puff or drag from a cigarette won’t do any harm after weeks, months, or even years of abstinence. Nonetheless, this practice usually leads to more frequent slip-ups, and before you know it, the nicotine monster is back with a vengeance. When you feel like having a puff, and you notice that you’re justifying it as “harmless” or “meaningless”, ask yourself if you’re in Wise mind. Observe and describe the situation; what is going on inside me? What is happening around me or in my environment? Most likely, whatever it is that you’re trying to regulate with that puff could be attended to through different means without compromising your goal to quit.
- Self-compassion and self-care. While navigating the rough waters of nicotine withdrawal, put your PLEASE skills into practice (in other words, treat physical illnesses, balance eating, avoid mood-altering substances, balance sleep and get exercise). Taking care of yourself and strengthening your emotional immune system will make you less vulnerable to your cravings and more in charge of your emotion-driven behaviours. Also, remember that slipping up does not mean that you’ve failed; we’re only human, and nicotine has the potential of rewiring your brain, making it especially hard to quit. But giving up tobacco is not impossible! If you slip up, accept it, analyze what contributed to it and move forward with your plan. Don’t let shame and guilt make you give up; choose to act opposite to these emotions.
Image
Siimon, A. (2019). Cigarette. UnSplash. https://unsplash.com/photos/ryBnRg4c3L0.