Stop smoking

psi.bmp (21826 bytes) William W. Lee, Ed.D.

Licensed Clinical Psychologist

STOP SMOKING

This past November 15th the Great American Smokeout celebrated its 25th anniversary. In the past this event resulted in millions stopping smoking for a day and many of these people successfully quit for good. Quitting smoking will improve your general health. You'll breathe easier, feel better and reduce your risk of developing various cancers and having a heart attack or stroke. But quitting isn't easy and for most people, it's "try and try again". They try to quit, then pick up the habit again. Multiple attempts are the norm because nicotine is so addictive. Organizations like the American Cancer Society, the American Heart Association, American Lung Association and the American Legacy Foundation offer assistance to help smokers quit as well as preventing people from starting in the first place. Of every 10 smokers, eight begin before age 18. This has resulted in a vigorous campaign to prevent the next generation from lighting up.

Recognize that quitting is a process and few smokers accomplish it the first time. Due to the addictive nature of nicotine, most people make four or more attempts before they quit for good. The National Institutes of Health estimates that 85 percent of smokers have either tried to quit or would like to quit.

A few tips for beginning the road to quitting smoking from the American Cancer Society:

	spend as much time as possible in places where smoking is prohibited
	drink large quantities of water and fruit juice. Avoid alcohol, coffee and other beverages associated with smoking
	take deep rhythmic breaths similar to smoking to relax
	eat several small meals. This maintains constant blood sugar levels and helps prevent the urge to smoke
	keep you goal in mind. Don't think that one cigarette won't hurt, it will

Scientists have identified the physical, psychological and behavioral factors that affect a person's ability to quit and likelihood of relapse. Research has shown that individualized approaches are helpful. The Smoking Cessation Program of the Society of Memorial Sloan-Kettering Cancer Prevention and Wellness Program utilizes clinical psychologists to review the participant's medical and smoking history, past attempts to quit, lifestyle and motivation. Identification of their pattern of smoking helps smokers plan alternative activities so that they won't light up. Stress is a major trigger as many smokers use tobacco as a way of coping with anger, conflict and time pressures. These psychologists help smokers learn to cope with stress in a productive way such as exercising or managing their time more efficiently. Lifestyle and environmental factors play a role in determining the likelihood that the smoker will be able to quit and avoid relapse. For example, it is difficult for smokers to quit if they live and work with other smokers. Ways of dealing with these factors also become the focus of intervention.

To increase the chances of quitting there are a host of nicotine replacement products that can help smokers reduce their craving and withdrawal symptoms. Some products like the nicotine patch and nicotine gum are available in over-the-counter forms while others like nicotine nasal spray and nicotine inhalers are available by prescription only. Medication that doesn't replace nicotine but instead reduces craving is another option. Be sure to check with your physician before using any of these products to make sure that it is safe and appropriate for you.

Quitting smoking does not necessarily lead to weight gain. Here's what the American Heart Association recommends:

	Longer mealtimes - put away extra food so it is hard to have second helpings; eat slower (smaller bites, put fork down after each mouthful, swallow before filling fork again, sip water, extend time, slow down and savor the taste and texture of your food, and set the goal to be the last one to finish eating); get up from table as soon as you're finished; and start a new habit like walking, having coffee away from the table; save dessert for a late-evening snack.
	Control oral craving - to substitute for having something in your mouth carry sugarless gum and artificially sweetened mints; eat only one peice of candy at a time; make it last as long as you can by letting it melt in your mouth instead of chewing it; find things to keep your hands busy such as crafts or crossword puzzles; choose foods to nibble on that require some work such as fruits that need to be peeled.
	Control the evening snack - store high calorie snacks out of sight, in inconvenient places or where they're harder to see; remove food from living areas; delay your snack by increasing the amount of time between your urge to eat and having a snack; substitute another activity when the urge to snack strikes; divide your snack into portions; create situations in which you are aware of eating instead of snacking without being aware of eating.
	Manage social events - coffe breaks, cocktail parties and sporting events cause many to overeat to avoid smoking. Instead of a coffee break, take a walk or read. Instead of watching a sport, exercise. Modify or avoid situations that tempt you. Beware of alcohol since consumption of alcohol adds calories and may also reduce your resolve to avoid smoking.

Not all ideas work for everyone. Keeping a journal to record your progress helps identify what works, what situations are triggers for craving a cigarette and your sources of stress. Seek professional help if you are experiencing frustration in your efforts to quit smoking.

For more information contact:

	American Cancer Society (www.cancer.org)
	American Heart Association (www.americanheart.org)
	American Legacy Foundation (www.americanlegacy.org)
	American Lung Association (www.lungusa.org)
	Office on Smoking and Health/Centers for Disease Control and Prevention (www.cdc.gov/tobacco)
	The Society for Memeorial Sloan-Kettering Center for Cancer Prevention and Wellness Center (www.mskcc.org)