Part 2: Techniques, Troubleshooting, and Tips

Last Updated: June 12, 2007

The urge will pass whether you smoke or not.
- Unknown

The urge will pass whether you kill or not.
- Graham King

23. Why is quitting smoking so difficult?

You have probably quit smoking (or using tobacco in another form) before,
and you have probably gone back to the habit. Whether your "smobriety" (to
use a term from the addiction recovery program Nicotine Anonymous) lasted an
hour or a year, you no doubt learned a basic truth: breaking away from
tobacco products can be, at best, unpleasant, and at worst, a living hell.
And the memory of that unpleasant experience may have left you with a fear
of trying again.

Understanding the source of your physical and emotion reactions can help get
you through those difficult early days. Quitting smoking will be one of the
hardest things that you will ever do. This is because smoking is actually a
three-fold problem: you have developed psychological, social, and physical
needs for the drug nicotine.

As a smoker, all your emotions were medicated with a nicotine packed
cigarette: you relaxed with nicotine; you laughed with nicotine, wept with
nicotine, digested with nicotine. You used smoking to pass the time, ready
yourself for a crisis, calm yourself after one, even (ironically) to catch
your breath during a difficult task. You began your day by dosing with
nicotine, your drug of choice (perhaps one among others), and ended it the
same way. No wonder that, suddenly deprived of all that, your mind and body
go wonky for a little while.

Nicotine attaches itself to you physically. From the American Heart
Association:

Nicotine Addiction

When a person smokes a cigarette, the body responds immediately to
thechemical nicotine in the smoke. Nicotine causes a short-term increase in
blood pressure, heart rate, and the flow of blood from the heart. It also
causes the arteries to narrow. Carbon monoxide reduces the amount of oxygen
the blood can carry. This, combined with the effects produced by nicotine,
creates an imbalance in the demand for oxygen by the cells and the amount of
oxygen the blood is able to supply. Smoking further increases the amount of
fatty acids, glucose, and various hormones in the blood. There are several
ways that cigarette smoking may increase the risk of developing hardening of
the arteries and heart attacks.
First, carbon monoxide may damage the inner walls of the arteries that
encourages the buildup of fat on these walls. Over time, this causes the
vessels to narrow and harden.

Nicotine may also contribute to this process. Smoking also causes several
changes in the blood. They include increased adhesiveness and clustering of
platelets in the blood, shortened platelet survival, decreased clotting
time, and increased thickness of the blood. These effects can lead to a
heart attack.

The 1988 Surgeon General's Report, 'Nicotine Addiction,' concluded that:

        * Cigarettes and other forms of tobacco are addicting.
        * Nicotine is the drug that causes addiction.
        * Pharmacologic and behavioral characteristics that determine
tobacco addiction are similar to those  that determine addiction to drugs
such as heroin and cocaine.

For additional information on this subject, contact your local American
Heart Association office or call 1-800-242-8721.

The social attraction of smoking is perhaps the most insidious prong of the
nicotine addiction. Until recently, even after the dangers of smoking were
well known, smoking was widely seen as essentially harmless; though this
opinion is now held by fewer people (and I'll wager that most of them are
still smoking), it has not disappeared. We still often hear smoking defended
with the argument that the sale, purchase, promotion and use of tobacco
products are legal activities nearly everywhere in the world.

While true, this statement obscures the question of the safety of smoking
and fails to raise other explanations for its legitimate status, such as the
financial contribution which the tobacco industry makes to the world
economy.

And, greater public awareness of the harm that smoking does has not greatly
altered its image as sexy, cool, adult, fashionable. Books such as
Christopher Buckley's Thank You For Smoking and movies like Reality Bites
(where the sole non-smoker is Ben Stiller's dorky outsider character)
override those public service announcements and notices on
the sides of cigarette packages in the minds of the tobacco industry's most
important consumers: adolescents and teens. (Incidentally, we have it from a
very reliable source that the people who make a certain brand of popular
cigarettes featuring a certain dromedary on the package paid for the actors
in Reality Bites to smoke their cigarettes. And for more
proof of this common industry practice, here's an interesting letter
http://tinyurl.com/yup3u ( from one of America's top action stars.)  Give it
a minute's thought: do you really like smoking, or do you just like your
smoker image and the props associated with it (the cigarette, the nifty
smoke rings, the ash; the holes in your clothing, yellow stains on your
teeth, nasty taste on your breath)?

The minute you quit smoking your life changes drastically. Your identity as
a smoker is gone; the crutch which helped you handle situations is kicked
out from under you; your body and mind begin to play quite clever tricks on
you to get their drug. All these changes can be nearly overwhelming, but the
important thing to remember is that things will
get better as you learn new and better ways to live your life. And everyone
can learn; a few hundred of us at AS3 alone will testify to that!

(Paraphrased from 'The Cigarette Papers' by Dr. Stanton Glantz)

  According to researchers, nicotine stimulates the Hypothalmus to produce
the same chemicals it does in stressful situations: corticosteroids.  This
makes one feel less anxious, and yet possibly more focused.  Add nicotine to
a stressful stiatuion, and you get more than a regular dose.

  Over time (and number of cigarettes), the hypothalmus adjusts.  Now,
"without" a cigarette, you're getting less than average corticosteroids, but
smoking brings you back up to a normal level, maybe not even surpassing what
a non-smoker gets, but compared to a lowered baseline it feels good.

  After quitting, over time the hypothalmus adjusts back.  The research
doesn't say how fast. (AS3 may be able to add some estimates to that).

24. I smoke lights. Aren't they safer?

(Excerpted from New York Times News Service, May 2, 1994)

Quote:
WASHINGTON--Smokers of cigarettes low in tar and nicotine may be getting
more of those substances than they think, Federal Trade Commission officials
and experts on smoking say. ...

     National polls conducted by the Gallup organization have found that
smokers believe that cigarettes labelled "light" are less hazardous and will
deliver less tar and nicotine. But evidence has accumulated that the
measurements, which are carried out by tobacco company laboratories under
the supervision of the FTC, bear little or no relation to how much nicotine
and tar smokers actually get from smoking.

 "The commission has been aware for a while that the test has problems
regarding the actual intake that consumers will get," Judith D. Wilkenfeld,
assistant director in the FTC's Division of Advertising Practices, said in a
telephone interview.

     The FTC cigarette tests are carried out by machines that hold the
cigarette and draw air through them in 2-second puffs once every minute
until the cigarette is burned down to the filter.

     But cigarettes now include several features that make the machine tests
meaningless, according to Dr. Jack Henningfield, chief of clinical
pharmacology research at the National Institute on Drug Abuse.

     For example, a majority of cigarettes now have tiny, nearly invisible
hole in their filter paper or in the cigarette paper near the filter. When
the smoking machine draws on a cigarette, a large amount of air is drawn in,
and this dilutes the smoke getting to the measuring device, making today's
cigarettes appear to contain less tar and nicotine.

     But smokers do not handle the cigarettes the same way machines do.
They find the diluted smoke milder, and to make up for the "lighter" taste,
or less satisfying amount of nicotine, they puff more or draw deeper,
pulling in more total smoke, so that the result is the same amount, or more,
of nicotine and tar.

     In addition, the tiny filtration holes are often blocked by smokers
with their lips or hands, thus cutting off the air that would have diluted
the smoke....

     Scientific studies over recent years have shown that smokers get about
the same amount of nicotine and tar no matter what kind of cigarette they
use.

25. Are cigars any better?

[From the on-line page "Ask Dr. Weil," Copyright =A9 1994, 1995, 1996, 1997
HotWired, Inc. All rights reserved. Used without permission]

Quote:
Cigar consumption is climbing rapidly in the United States, where people
smoked 3 billion cigars last year, compared to 2.1 billion in 1993. Around
the world, cigar makers are especially trying to target women by promoting
their wares as a sign of affluence and sophistication. There are cigar
magazines, cigar bars, and even instructional cigar dinners.

Donald Shopland, coordinator of the smoking and tobacco control program at
the National Cancer Institute, calls the increase in cigar consumption
"astounding" - particularly since it has been in decline for many decades.
Alarmed, the institute plans to issue a report on safety, chemical
composition, advertising, health policies, and other cigar issues in the
fall.

I'm not impressed by the sophistication of rolled brown tobacco leaves lit
up in anybody's mouth. If you smoke cigars, you're tripling your risk of
lung cancer compared to not smoking at all. True, cigarette smokers have
nine times the risk of developing lung cancer, so I suppose that's one good
point. Cigar smoke is harsher than cigarette smoke, so most people can't
inhale it deeply enough or often enough to establish the pattern of chemical
dependence on nicotine that makes cigarette smoking so risky.

But if you inhale regularly, the risk is the same as with cigarettes. You
are also increasing the possibility of head and neck cancers, cancer of the
esophagus, and cancer in the oral cavity. If you compare cigars and
cigarettes smoked in equal amounts, the risk of mouth and throat cancer are
the same.

Cancer of the oral cavity is one of the nastiest cancers that can occur, in
many cases causing disfigurement and death. Sigmund Freud smoked 20 cigars a
day and died of tobacco-related oral cancer. Ulysses S. Grant, the 18th US
president, also smoked about that much and died of throat cancer. He dropped
70 pounds and became addicted to cocaine in his efforts to escape the pain.

Also, cigar smoke is at least as hazardous to the people around you as
cigarette smoke. In a recent study published in the New England Journal of
Medicine, tobacco use - including cigar smoking - by spouses increased the
risk of lung cancer by 30 percent in people who didn't smoke at all
themselves. Exposure in the workplace and social settings bumped up the risk
even more. Eating fruits and vegetables, or taking supplemental vitamins,
didn't improve matters for the spouses.

A new California Environmental Protection Agency report released after years
of peer review and government scrutiny (and some would say suppression),
blames secondhand tobacco smoke for the deaths of at least 4,700 nonsmoking
Californians a year. The report says California smokers cause between 4,200
and 7,440 deaths from heart attacks and stroke each year among the people
around them, and 360 deaths from lung cancer. Their secondhand smoke is
responsible for up to 3,000 new cases of childhood asthma annually. Cigar
smoke billows out in greater volume and contains high quantities of
unhealthy substances, so it's not an improvement.

There are plenty of healthier ways to satisfy an oral fixation. Try carrots.

Disclaimer: All material provided in the Ask Dr.Weil program is provided for
educational purposes only. Consult your own physician regarding the
applicability of any opinions or recommendations with respect to your
symptoms or medical condition.

26. Should I switch from smoking to smokeless (chewing) tobacco?

It would be a very poor trade-off to use smokeless tobacco as a replacement
for smoking. For one thing, it's pretty disgusting to watch someone
chewing - and spitting out the tobacco juice. And though the risk of
developing lung cancer and emphysema may be lowered, chewing has its own set
of horrors.

"I have been asked to explain why smokeless tobacco is not a safe substitute
for smokers who want to quit.

"First of all my wife works for an oral surgeon, and she is my main drive,
along with my 2 young sons, to quit this nasty habit.

"She has told me of this one guy who had to have his entire jawbone removed
and had hip bone taken to replace it. This was a direct result of smokeless
tobacco wreaking havoc and causing cancer that had gotten to the bone. This
guy, early 30s (who I would love to meet myself) has to wear a face shield
with pins in his neck area to hold the hip bone replacement in place until
it bonds and starts to grow. If that isn't bad enough to not start this
habit then what is. This is not the only case they had on smokeless tobacco
users -I can only imagine how many people have it and don't know. I am one
of the lucky ones who had access to the warning signs but most don't. I
started when I was 15 years old playing baseball and am now 29 years old
married almost 10 years with 2 kids. I am damn lucky I didn't have anything
happen to me. The absolute clincher was when a 24 year old came in to have a
biopsy on his lip and found out he had cancer. 24 years old - think about
it!!!

"For those who must chew - please do not put the chew in the same place
every time you chew. This is what causes the breakdown of the lip. It first
turns white - leukoplakia is the term - which is a pre-cancerous sign. Then
is may get hardened and change color - IF you have any of these signs - GO
GET CHECKED!!

"I never put it in the same spot twice and had as many as 6 areas I used so
I wouldn't get the bad spots on my lips. I am not condoning chewing but IF
you must and are reading this - move it around until you have the courage to
quit."

27. How can I prepare to quit smoking or chewing tobacco?

It is generally agreed around here that preparation is the single most
important factor in successfully overcoming nicotine addiction. Getting
yourself to a state of psychological readiness starts with the thought that
you may be about ready to stop smoking, and when that thought occurs, IMHO
you've begun the process of becoming a non-/ex-smoker.
Then, if you read the posts in alt.support.stop-smoking, soon you may find,
as many have, that you've begun to think that you are ready to stop. Before
you know it, you'll be setting a quit date! Once you've reached that stage,
here are some suggestions to aid in your preparation:

  a. Set a quit date, preferably around a relatively stress-free time,
although you shouldn't wait until the perfect time, because it doesn't
exist! If you like, announce your intended quit date to the group and ask
for quit buddies, or join in a group which has already formed.
Belonging to a club usually gives you extra support, and makes you extra
accountable!

  b. Until your quit day, smoke without guilt, but do keep planning. Think
about what provisions you will have on hand to comfort you, what (brainless)
projects to keep you busy, what comfy quiet spaces if you find you just want
to sleep, and whether you'll have access to AS3 and to e-mail. If the people
you spend time with have not had the pleasure of seeing you go insane
before, consider apologizing in advance for any bad behaviour you may
exhibit. :) (After you quit, the statement, "I just quit smoking" will
excuse much. Milk it for all it's worth!) As you read other people's posts
and the info available on the web, you'll get some ideas that will help you.

  c. Make any appointments, join any classes, lay in any provisions (herbal
teas, cinnamon sticks, licorice root, comfort foods, Valium, etc.), and buy
your patches, spray or Nicorette if you decide to use nicotine replacement
therapy.

  d. Start emptying your ashtrays into one or more clear glass jars which
you'll save as long as needed - I kept one for a few months after I quit.
(ed.) This 'revulsion therapy' will be of help after the initial motivation
begins to leave you and you start thinking that smoking wasn't so bad after
all. And each time you open the jar to add more butts and ashes, you'll get
a whiff of negative reinforcement. Some people add a bit of water to their
'butt jars' to make them that much more nauseating - not recommended for
those with sensitive stomachs!

  e. Keep a running list of reasons you want to quit. Especially as your
date gets closer, really study the list; pick one of the most compelling
reasons and repeat it to yourself over the course of the day. It's best to
keep the reasons positive, upbeat; e.g., instead of saying "I want to quit
so that I don't die a horrible ravaging death by lung cancer" you might say
"I want to take a proactive role in my good health."

  f. [Hot off the cyberpress! From Ask Dr. Weil, downloaded 21 Nov. 96]:

Quote:
If you smoke, do breathing exercises. They will help motivate you to quit
and help you with your cravings for cigarettes. Here's how to start. Sit
with your back straight. Place the tip of your tongue against the ridge of
tissue behind your upper front teeth, and keep it there
throughout the exercise.

   * First, exhale completely though your mouth, making a whoosh sound.
   * Next, close your mouth and inhale quietly through your nose to a mental
count of four.
   * Next, hold your breath for a count of seven.
   * Then exhale through your mouth, making a whoosh sound, to a count of
eight.

This is one breath. Now inhale again and repeat the cycle three more times.

Endquote.

  g. [From the same Ask Dr. Weil column; see above.]

"If you smoke, you should take antioxidant vitamins and minerals, which to
some extent can reverse the changes in respiratory tissue caused by smoking,
and so help protect against lung cancer. Also, increase your intake of
dietary sources of carotene (carrots, sweet potatoes, yellow squash, and
leafy green vegetables)."

  h. Visualize: Start looking at people functioning normally without
smoking. People who don't smoke are capable of having an argument, talking
on the phone, waiting for a bus, playing pool, and basking in the afterglow
just as well as people who smoke. Picture yourself getting through moments
you normally associate with smoking, without doing so.
Don't overwhelm yourself, i.e., you don't need to picture yourself getting
through life or even the day without smoking; just one activity at a time.
Watch someone enjoying a cafe latte without smoking. You can be in that
picture!

  i. Keep reading alt.support.stop-smoking daily (hourly, if necessary!), so
that you'll start to get a sense of what to expect (good and bad), and post
whenever you like, as often as you like, and as nonsensically as you like!
Try not to loosen your withdrawal temper on another AS3 poster though.

Most important, keep in mind that quitting smoking is a journey, not an
event. You will run into many obstacles on that journey, and meet many false
friends. The more you can feel good about the place you're heading (the
smober life) and unsentimental about the place you're leaving (life chained
to nicotine), the more strength you will have to complete that
journey.

Joe Jaquez contributed the following observations to the group:

When you decide to quit, it has to be for you, not for your wife, kids, or
anyone else. Find a supportive friend(s) that you can call anytime of the
day or night, someone who's shoulder you can cry on...because it's the
hardest thing you will ever do, it's harder to quit smoking that to quit
abusing heroin or alcohol....The desire to live has to overpower the desire
to smoke....Your primary relationship has to change from the cigarette to
you...to have a relationship with yourself and to continue living for years
to come

28. How long will the physical withdrawal last?

Physical withdrawal symptoms last anywhere from between 48 hours to two
weeks. This can vary from person to person depending on the amount that you
smoked and your physical and psychological make up. Many in the group have
found the physical effects typically last between 3 to 7 days.
Unfortunately, you will probably not arise on the 15th day after stubbing
out your last fag to find yourself completely disinterested in nicotine.
Even once the drug is out of your system, you will have desires to smoke
which will feel very much like withdrawal symptoms. They are not. Know that
your mind is playing tricks, and fight the urge!

29. Can't I have just one last one?

And then what? You don't want just one more, you want every one. The
nicotine addiction is a very clever animal which is capable of putting
strange thoughts into your head, such as: It's been three months since I
quit; let me smoke one just to make certain I'm not addicted anymore. Or: I
haven't smoked in six months; let me remind myself how much I hate it.
Or: Now that I have a decade of smobriety behind me, I can be a social
smoker.

There is simply no reason to smoke 'just one more' cigarette. You prove that
you're not addicted by not taking the drug. And you know you'll never be a
social smoker. And if you really listen to yourself, you also know that 9.99
times out of 10, a social smoker is an addict in the making.

It is not safe to smoke even a single cigarette as this could send you right
back to smoking as much or even more than you did prior to quitting.
Furthermore, it's not sensible. There is no reason to consume tobacco, and
very reason not to. Remember: You're only a puff away from a pack a day. And
if you don't believe this FAQ, read AS3; you'll see stories of people who
found that just one cigarette was enough to send them back into smoking even
after years of not smoking. Here's Mona's experience:

"My experience during the nine years I was smober was that I almost never
thought about cigs in any way remotely like I wanted one. In fact, that
quit, after even the first couple months, I was so damned proud of myself
that even if the junkie old part of myself momentarily thought it wanted a
cig, I was clear that I was very happy to be a non-smoker, and that 'urge'
just went away, nearly instantly.

"Of course, the fact I'm here, quitting again, the 13th time in my life, is
proof that, on some days nearly anyone can be unconscious or stupid or
downhearted enough that the cig devil sees his opportunity -- the old junkie
(me) who used the cig as emotional comfort encourages one to have one, don't
worry, you've quit all these years, you don't have to smoke tomorrow, just
let yourself have one now, when you 'need it'. HAH!

"I hope I'll never be that unsuspecting again! I hate quitting, and love
being smober."

Thoughts to close the Alt.Support.Stop-Smoking FAQ, Part 2:

"One cigarette is too many, and a thousand are not enough."- unknown

"What lies behind us and what lies before us are tiny matters compared to
what lies within us."- Ralph W. Emerson

"Hang tough, don't puff!"- Barry Pekilis

Please go on to Part 3.