A Hard Habit
For all the intense efforts to reduce smoking in America over the past two decades, the progress has not been stellar. Today one in four men and one in five women still smoke. For those who never smoked, this is a befuddling fact. Don't smokers understand that cigarettes are the number one killer in America, that they dramatically increase risk for heart disease, stroke, cancer, high blood pressure, and almost every other health concern, small or large? How could any habit be worth this?
Truth is, most smokers do understand. They also understand the huge financial toll of smoking, with a pack of 20 cigarettes costing $7 in some areas (imagine: $2,500 spent a year on cigarettes by pack-a-day smokers -- often people of only modest resources). Then why do millions still smoke? In good part, because the nicotine in cigarettes is highly addictive. In good part, because smoking provides psychological comfort to some people. Perhaps most of all, because quitting smoking is so hard. Researchers and businesses have responded strongly to the last point. Never have there been so many tools, systems, and programs available for quitting smoking. And with every month that passes, there is more research showing the benefits of quitting, and the drawbacks of not quitting. So if you smoke, consider again whether it is time, finally, to quit. If yes, you'll need to think through the best approach, perhaps working with your doctor or an expert. But the following 25 tips will help you succeed.
1. Make an honest list of all the things you like about smoking. Draw a line down the center of a piece of paper and write them on one side; on the other side make a list of all the things you dislike, such as how it can interfere with your health, work, family, etc., suggests Daniel Z. Lieberman, M.D., director of the Clinical Psychiatric Research Center at George Washington University Medical Center in Washington, D.C. Think about the list over time, and make changes. If you are brave enough, get feedback from family and friends about things they don't like about your use of cigarettes. When the negative side outweighs the positive side, you are ready to quit.
2. Then make another list of why quitting won't be easy. Be thorough, even if the list gets long and discouraging. Here's the important part: Next to each entry, list one or more options for overcoming that challenge. For instance, one item might be: "Nicotine is an addictive drug." Your option might be: "Try a nicotine replacement alternative." Another reason might be: "Smoking helps me deal with stress." Your option might be: "Take five-minute walks instead." The more you anticipate the challenges to quitting, and their solutions, the better your chance of success.
3. Set a quit date and write a "quit date contract" that includes your signature and that of a supportive witness.
4. Write all your reasons for quitting on an index card. And keep it near you at all times. Here are some to get you started: "My daughter, my granddaughter, my husband, my wife..." You get the idea.
5. As you're getting ready to quit, stop buying cartons of cigarettes. Instead, only buy a pack at a time, and only carry two or three with you at a time (try putting them in an Altoids tin). Eventually you'll find that when you want a smoke, you won't have any immediately available. That will slowly wean you down to fewer cigarettes.
6. Keep a list of when you smoke, what you're doing at the time, and how bad the craving is for a week before quitting to see if specific times of the day or activities increase your cravings, suggests Gaylene Mooney, chair of the American Association for Respiratory Care's Subcommittee on Smoking and Tobacco-Related Issues. Then arrange fun, unique things to do during those times, like some of the ones we recommend here.
7. Prepare a list of things to do when a craving hits. Suggestions include: take a walk, drink a glass of water, kiss your partner or child, throw the ball for the dog, wash the car, clean out a cupboard or closet, have sex, chew a piece of gum, wash your face, brush your teeth, take a nap, get a cup of coffee or tea, practice your deep breathing, light a candle. Make copies of the list and keep one with you at all times so when the craving hits, you can whip out the list and quickly do something from it.
Reduce and Replace
8. When your quit date arrives, throw out anything that reminds you of smoking. That includes all smoking paraphernalia -- leftover cigarettes, matches, lighters, ashtrays, cigarette holders, even the lighter in your car.
9. Instead of a cigarette break at work, play a game of solitaire on your computer. It takes about the same time and is much more fun (although, like cigarettes, it can get addictive). If your company prohibits games like that, find another five-minute diversion: a phone call, a stroll, or eating a piece of fruit outdoors (but not where smokers congregate).
10. Switch to a cup of herbal tea whenever you usually have a cigarette. That might be at breakfast, midmorning, or after meals. The act of brewing the tea and slowly sipping it as it cools will provide the same stress relief as a hit of nicotine.
11. Switch your cigarette habit for a nut habit -- four nuts in their shell for every cigarette you want to smoke. This way, you're using your hands and your mouth, getting the same physical and oral sensations you get from smoking.
12. Carry some cinnamon-flavored toothpicks with you. Suck on one whenever a cig craving hits.
13. Make an appointment with an acupuncturist.
There's some evidence that auricular acupuncture (i.e., needles in the ears) curbs cigarette cravings quite successfully, says Ather Ali, N.D., a naturopathic physician completing a National Institutes of Health-sponsored postdoctoral research fellowship at the Yale-Griffin Prevention Research Center in Derby, Connecticut. You can even do it yourself by taping "seeds" (small beads) onto the acupuncture points and squeezing them whenever cravings arise.
14. Swing by the health food store for some Avena sativa (oat) extract. One study found that, taken at 1 milliliters four times daily, it helped habitual tobacco smokers significantly decrease the number of cigarettes they smoked.
15. Think of difficult things you have done in the past. Ask people who know you well to remind you of challenges you have successfully overcome, says Dr. Lieberman. This will give you the necessary self-confidence to stick with your pledge not to smoke.
16. To minimize cravings, change your routine. Sit in a different chair at breakfast or take a different route to work. If you usually have a drink and cigarette after work, change that to a walk. If you're used to a smoke with your morning coffee, switch to tea, or stop at Starbucks for a cup of java -- the chain is smoke-free.
17. Tell your friends, coworkers, boss, partner, kids, etc., how you feel about situations instead of bottling up your emotions. If something makes you angry, express it instead of smothering it with cigarette smoke. If you're bored, admit to yourself that you're bored and find something energetic to do instead of lighting up.
State of Mind
18. If you relapse, just start again. You haven't failed. Some people have to quit as many as eight times before they are successful.
19. Put all the money you're saving on cigarettes in a large glass jar. You want to physically see how much you've been spending. Earmark that money for something you've always dreamed of doing, but never thought you could afford, be it a cruise to Alaska or a first-class ticket to visit an old college friend.
20. Switch to decaf until you've been cigarette-free for two months. Too much caffeine while quitting can cause the jitters.
21. Create a smoke-free zone. Don't allow anyone to use tobacco in your home, car, or even while sitting next to you in a restaurant. Make actual "No Smoking" signs and hang them around your house and in your car.
22. Find a healthy snack food you can keep with you and use in place of cigarettes to quench that urge for oral gratification. For instance, try pistachio nuts, sunflower seeds, sugarless lollipops or gum, carrot or celery sticks. The last ones are best if you are concerned about weight gain.
23. Picture yourself playing tennis. Or go play tennis. British researchers found volunteers trying to quit smoking were better able to ignore their urges to smoke when they were told to visualize a tennis match.
24. Quit when you're in a good mood. Studies find that you're less likely to be a successful quitter if you quit when you're depressed or under a great deal of stress.
25. Post this list in a visible location in your house. Whenever you're tempted to light up, take a look at all the ways smoking can damage your health:
- Increases risk of lung, bladder, pancreatic, mouth, esophageal, and other cancers, including leukemia
- Reduces fertility
- Contributes to thin bones
- Affects mental capacity and memory
- Reduces levels of folate, low levels of which can increase the risk of heart disease, depression, and Alzheimer's disease
- Increases likelihood of impotence
- Affects ability to smell and taste
- Results in low-birth-weight, premature babies
- Increases risk of depression in adolescents
- Increases risk of heart disease, stroke, high blood pressure
- Increases risk of diabetes
- Increases your child's risk of obesity and diabetes later in life if you smoked while pregnant
