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(Information from the QUITNET website)

GETTING THROUGH THE FIRST FEW WEEKS

Why Quitting is Hard

Quitting is difficult for two major reasons:

physical addiction

psychological addiction or "habit"

Dependency on cigarettes is due to both of these factors. In fact they intertwine to make quitting much more difficult than just a bad habit or some other physical addictions. The combination of the two is what makes cigarettes one of the most addictive drugs used today. In order to quit smoking it is necessary to break both the "habit" and the nicotine addiction.

Some people have more of a problem with one side of smoking than the other. It may be that you smoke more for the nicotine, or for the pleasure of holding a cigarette. It is important to think about why you smoke each time you have a cigarette. This will let you identify your triggers, things you do that always make you light up. Once you have identified your reasons for smoking and your triggers you can go about breaking them.

Smoking is deeply ingrained in almost all smokers. Quitting takes time and effort; most smokers who quit on their own don't succeed for good until the seventh or eighth time (even though they may claim it was on their first try!). Don't get discouraged if something happens -- the key to quitting is not letting little setbacks become big failures in your mind. Remember that a slip is just a slip and it doesn't mean you can't stay quit!

Smoking is a behavior that you learned over a very long period. Even if you have only been smoking for a few years you have probably smoked well over 20,000 cigarettes! Eventually, after smoking so many cigarettes, they become associated with other things you do: drinking coffee, talking on the phone, or driving in the car. These other events become triggers, events that have tight connections to the urge to smoke. By breaking or changing these connections you can manage your smoking.

There are three basic ways to manage your triggers:

Avoid the situation:

If you smoke with your coffee then don't drink coffee; have water or cut down on the amount of coffee or caffeine that you drink.

If you smoke in the car avoid unnecessary driving or have a soda or juice bottle to occupy your hands (there is also the steering wheel!).

Change the situation

Drink your coffee standing up and with your other hand. Try drinking it with a straw if that works.

Sit in the nonsmoking section at the restaurant or café and avoid situations that will require you to be around with someone smoking.

Substitute for the cigarette

Keep something in your free hand when you're on the phone: a pen, a small toy, a photo.

Chew gum or hard candy, or try carrot sticks.

Sucking on a straw can help.

Managing Your Triggers

By keeping a record of your triggers and how you deal with them, you identify possible difficult situations before they occur, in fact, before you even quit!

One way to monitor your smoking patterns before quitting is to use "Track Sheets" to keep track of your cigarettes. On your sheet, you should write down the situation you are in (just enough so you remember: phone, work, on break, public transportation, etc.), how badly you feel you need that cigarette (on a scale of 1 to 5), and check under the face that most closely approximates your mood.

If you are going to be tapering your smoking before quitting you can use this information to eliminate low-need cigarettes.

Look over your Track Sheets and write down your most important triggers:

Deep Breathing – inhaling and exhaling slowly helps you to relax

Drink Water – drink plenty of water throughout the day, esp. during a craving

Do Something Else – change activity (call a friend, go for a walk)

Delay – the urge for a cigarette will pass if you hold on for a few minutes

Withdrawal and Recovery Symptoms (Are different for everyone!)

Understanding the changes your body undergoes when you are quitting is the first step towards dealing with them. We can group them into two categories:

Withdrawal Symptoms: these are feelings that are due to your body's need for nicotine and your mind's need for cigarettes. They are natural and almost all smokers go through them.

Recovery Symptoms: these are the manifestations of your body healing itself from the damage from nicotine and tar. The overall feeling is often a bit like having a cold. These symptoms generally last only a few days. This is your body getting better!

Recovery Symptoms

Headaches, dizziness, tingling in the hands and feet:

When you quit, blood vessels all over your body open back up. Increased blood flow to the cerebellum can cause headaches; increased blood flow to the fingers and toes can give a feeling of tingling (like after your leg falls asleep.) Dizziness can result from both lower blood pressure and an increase in oxygen to nerves and tissue as carbon monoxide is eliminated from your blood system.

Sore throat, coughing:

Nicotine paralyzes the cilia responsible for keeping your respiratory system clean. Many people have a morning cough as these defenses come back "online" after not smoking all night. In the same way, when some people quit, they will cough as their lungs begin to clean themselves out. A sore throat may result from development of new tissue and the clearing of tar and nicotine from old tissue.

Hunger

To pay for all of this recovery your body needs energy and materials to rebuild. Glucose, or sugar, primarily so you may feel a craving for snacks, especially sweets. Sticking to fruits and fruit juices is not only better for energy but will help you avoid weight gain.

Withdrawal Symptoms

Craving

The most familiar and the most common. This your body's physical addiction calling out. Just keep in mind that this usually passes within a week.

Difficulty Concentrating

Nicotine is used by many people to help focus their attention. Common examples are chain-smoking writers or baseball pitchers with a big wad of chew in their cheek. After a while this becomes a crutch, it may take a couple of weeks for you to become accustomed to working without nicotine. Additionally the increased blood flow and oxygen can lead to a feeling of mental fogginess.

Some people report feeling that sounds are louder, or external stimuli are somehow more palpable. Nicotine actually seems to affect people's concentration by decreasing peripheral vision and hearing. If the baby seems to cry louder, or people seem to walk by your office more often, it's probably just that you notice it more without the numbing effect of nicotine.

Fatigue

Nicotine increases your metabolism to an abnormally high rate. When you stop smoking your metabolism drops back to normal and you may find that your energy level drops. Also, you aren't regularly receiving a stimulant (nicotine) that you had become accustomed to. This will go away. It just takes time.

Oops...

Feelings of failure after slipping are so common that there is even a term for them: the Abstinence Violation Effect. This refers to the very powerful feelings of guilt, depression and failure that often come when a new ex-smoker slips and has a cigarette.

If you slip, remember:

A slip is just a mistake, not a lifestyle change or a national referendum on your willpower. Think about what happened and how to prevent it from ever happening again.

One cigarette does not make you a smoker again. One cigarette didn't make you a smoker in the first place, and one slip now doesn't mean you aren't a non smoker.

Remember all your reasons for quitting and how far you've come.

Remember not to smoke the next cigarette. You don't have to smoke another cigarette just because you had one.

 

This is not, in any way, an excuse to smoke. Don't ever let yourself think that just one won't hurt -- it will. It will put you in the very uncomfortable situation we just discussed/covered.

Developing new ways to relax and deal with stress is often critical to ensuring a permanent quit. Although ex-smokers often don't realize it, they are already quite familiar with the principle of 'relaxation through deep-breathing'. Smokers do it all the time, only not with clean air! 'Inhale- Hold- Exhale' is the same process that we now use to relax or meditate.

10 Steps to Relaxation

1. Choose a time of day when you're comfortable with turning off the telephone/cellphone, TV, radio, etc. Eventually, you'll want to perform this exercise each morning and evening, but for now, just develop the habit of doing it daily.

2. Choose a chair that allows you to sit comfortably upright. Slouching actually increases tension in some parts of the body, and lying down may cause you to drift into sleep. Some people prefer to sit cross-legged on the floor; be sure that you're not in any physical discomfort if you do so.

3. Find a timer that you can set for at least five minutes; do so and keep it next to the chair.

4. Sit quietly erect with your hands in your lap. Your eyes may be opened or closed (whichever is more comfortable). Just let yourself sit for a few moments.

5. Slowly INHALE through your nose; HOLD for a second or two, and, as you EXHALE say, "Relax".

6. Try to focus on each part of your body, from top to bottom or randomly, as you tell yourself to relax. You may actually FEEL your muscles letting go.

7. Let your thoughts wander where they will. Any attempt by you to 'clear your mind' will likely cause tension. "Relax". You can bring yourself back to the moment at any time by simply focusing on your breath and the word, "Relax".

8. Let the timer worry about how long you've been relaxing. All you need to do is just breathe in and out and say, "Relax".

9. When your time is up, sit for another minute and check out how your body feels. The more you're aware of the good benefit of relaxing, the more motivation you'll have to continue doing it.

10. Remember that you can do this exercise any time you like. Five minutes each morning and night is a very good beginning, but relaxing for as little as one minute is preferable to not relaxing at all (and a 'quickie' is often crucial when in crisis). Do what you CAN do, and increase that when you can.

What About Weight Gain?

Some weight gain while quitting is normal, about 5-8 pounds. One of the effects of nicotine is to speed up your metabolism; essentially your body runs at a faster than normal speed, making you burn more calories. When you stop using nicotine, your metabolism slows down, and you will probably gain a few pounds. Also, nicotine affects both hunger, sense of smell and taste, and the digestive system. All of these factors make weight gain more likely, but are they are manageable. Your metabolism will increase overtime with proper nutrition and exercise.

Most weight gain results from increased snacking. Not only does food seem more appealing due to your re-awakened sense of smell and taste, but it also provides an alternative to smoking. There is no reason to avoid snacking -- what has to go are the twinkies. Keep celery and carrot sticks or other low-calorie snacks around to help prevent splurging on junk food. They also provide a nice substitute for a cigarette.

It is estimated that you would have to gain 75 pounds to in order to equal the serious disease risks from smoking. The keys to controlling your weight are the same when you quit smoking as during any other time: exercise, eat healthy meals, and fruits and vegetables, and avoid fats and high calorie sweets. Most weight gain when quitting comes from snacking so eat several small meals instead of a large ones. This will curb the feeling of between-meal hunger.

Recognizing that it is possible that you will gain some weight can help in quitting. Let yourself wait until you are a secure non-smoker to start to take it back off.

All of this said -- remember one thing: the surest way to make quitting difficult is to go on a diet at the same time. As all smokers know, a cigarette can help make you less hungry. This works strongly in reverse -- if you are hungry you are going to want a cigarette. Much as with other drugs, food deprivation leads to increased desire for and use of nicotine. Lab rats who are given access to nicotine and are then put on a "diet" will increase their consumption of the drug dramatically. People react in much the same way; however, we are able to plan ahead.

In other words -- if you are concerned about weight gain, eat sensibly but don't overdo it.

The Wellness Center of Maine Coast Memorial Hospital, Ellsworth

667-2474

Blue Hill Memorial Hospital, Blue Hill

374-2836 ext. 2131

Healthy Acadia

Mount Desert Island Hospital, Bar Harbor

288-5081 ext. 319