Smokers often say, “Don’t tell me why to quit, tell me how.” There is no one right way to quit, but there are some key elements in quitting with success. These 4 factors are key:
- making the decision to quit
- setting a quit date and choosing a quit plan
- dealing with withdrawal
- staying quit (maintenance)
Making the decision to quit: How do people change?
The decision to quit smoking is one that only you can make. Others may want you to quit, but the real commitment must come from you.
Researchers have looked into how and why people stop smoking. They have some ideas, or models, of how this happens.
The Health Belief Model of behavior change
The Health Belief Model says that you will be more likely to stop smoking if you:
- believe that you could get a smoking-related disease and this worries you
- believe that you can make an honest attempt at quitting smoking
- believe that the benefits of quitting outweigh the benefits of continuing to smoke
- know of someone who has had health problems as a result of their smoking
Do any of these apply to you?
Stages of Change Model of behavior change
The Stages of Change Model identifies the stages that a person goes through in making a change in behavior. Here are the stages as they apply to quitting smoking:
Pre-contemplation: At this stage, the smoker is not seriously thinking about quitting.
Contemplation: The smoker is actively thinking about quitting but is not quite ready to make a serious attempt. This person may say, “Yes, I’m ready to quit, but the stress at work is too much,” or “I don’t want to gain weight,” or “I’m not sure if I can do it.”
Preparation: Smokers in the preparation stage seriously intend to quit in the next month and often have tried to quit in the past 12 months. They usually have a plan.
Action: This is the first 6 months when the smoker is actively quitting.
Maintenance: This is the period of 6 months to 5 years after quitting when the ex-smoker is aware of the danger of relapse and takes steps to avoid it.
Where do you fit in this model? If you are thinking about quitting, setting a date and deciding on a plan will move you into the preparation stage, the best place to start.
Setting a quit date and making a plan
Pick a Quit Day
Once you’ve decided to quit, you’re ready to pick a quit date. This is a very important step. Pick a specific day within the next month as your Quit Day. Picking a date too far in the future can allow you time to rationalize and change your mind. But do give yourself enough time to prepare and come up with a plan. You might choose a date with a special meaning like a birthday or anniversary, or the date of the Great American Smokeout (the third Thursday in November each year). Or you may want to just pick a random date. Circle the date on your calendar. Make a strong, personal commitment to quit on that day.
Plan for your prescriptions: Remember that if you are planning to use a prescription drug, you will need to talk with your doctor about getting it in time for your Quit Day. If you plan to use bupropion (Zyban) or varenicline (Chantix), you must start taking the drug a full week before your Quit Day. If you are using one of these medicines, add a note on your calendar for the week before your Quit Day to remind you to start taking the drug.
Prepare for your Quit Day
There is no one right way to quit. Most smokers prefer to quit cold turkey — they stop completely, all at once. They smoke until their Quit Day and then quit. Or they may smoke fewer cigarettes for 1 or 2 weeks before their Quit Day. Another way involves cutting down on the number of cigarettes you smoke each day. With this method, you slowly reduce the amount of nicotine in your body. You might cut out cigarettes smoked with a cup of coffee, or you might decide to smoke only at certain times of the day. While it sounds logical to cut down in order to reduce withdrawal symptoms, in practice this can be hard to do.
Quitting smoking is a lot like losing weight: it takes a strong commitment over a long time. Smokers may wish there was a magic bullet — a pill or method that would make quitting painless and easy. But there is nothing like that. Nicotine substitutes can help reduce withdrawal symptoms, but they work best when they are used as part of a stop-smoking plan that addresses both the physical and psychological components of quitting smoking.
Here are some steps to help you prepare for your Quit Day:
- Pick the date and mark it on your calendar.
- Tell friends and family about your Quit Day.
- Get rid of all the cigarettes and ashtrays in your home, car, and place of work.
- Stock up on oral substitutes — sugarless gum, carrot sticks, hard candy, cinnamon sticks, coffee stirrers, straws, and/or toothpicks.
- Decide on a plan. Will you use NRT or other medicines? Will you attend a stop-smoking class? If so, sign up now.
- Practice saying, “No thank you, I don’t smoke.”
- Set up a support system. This could be a group class, Nicotine Anonymous, or a friend or family member who has successfully quit and is willing to help you. Ask family and friends who still smoke not to smoke around you or leave cigarettes out where you can see them.
- If you are using bupropion or varenicline, take your dose each day of the week leading up to your Quit Day.
- Think back to your past attempts to quit. Try to figure out what worked and what did not work for you.
Successful quitting is a matter of planning and commitment, not luck. Decide now on your own plan. Some options include using nicotine replacement or other medicines, joining a stop-smoking class, going to Nicotine Anonymous meetings, using self-help materials such as books and pamphlets, or some combination of these methods. For the best chance at success, your plan should include 2 or more of these options.
Your Quit Day
On your Quit Day, follow these suggestions:
- Do not smoke. This means none at all — not even one puff!
- Keep active — try walking, exercising, or doing other activities or hobbies.
- Drink lots of water and juices.
- Begin using nicotine replacement if that is your choice.
- Attend stop-smoking class or follow your self-help plan.
- Avoid situations where the urge to smoke is strong.
- Reduce or avoid alcohol.
- Think about changing your routine. Use a different route to go to work, drink tea instead of coffee. Eat breakfast in a different place or eat different foods.
- Read on to find out more about the kinds of thoughts and temptations that come up when you try to quit, and ideas for strategies to deal with or avoid them.
Dealing with withdrawal
Withdrawal from nicotine has 2 parts — the physical and the mental. The physical symptoms, while annoying, are not life-threatening. Nicotine replacement and other medicines can help reduce many of these physical symptoms. But most smokers find that the bigger challenge is the mental part of quitting.
If you have been smoking for any length of time, smoking has become linked with nearly everything you do — waking up in the morning, eating, reading, watching TV, and drinking coffee, for example. It will take time to “un-link” smoking from these activities. This is why, even if you are using a nicotine replacement, you may still have strong urges to smoke.
Rationalizations are sneaky
One way to overcome these urges or cravings is to notice and identify rationalizations as they come up. A rationalization is a mistaken thought that seems to make sense to you at the time, but the thought is not based on reality. If you choose to believe in such a thought, it can serve as a way to justify smoking. If you have tried to quit before, you will probably recognize many of these common rationalizations:
- I’ll just have one to get through this rough spot.
- Today is not a good day. I’ll quit tomorrow.
- It’s my only vice.
- How bad is smoking, really? Uncle Harry smoked all his life and he lived to be over 90.
- Air pollution is probably just as bad.
- You’ve got to die of something.
- Life is no fun without smoking.
You probably can add more to the list. As you go through the first few days without smoking, write down any rationalizations as they come up and recognize them for what they are: messages that can trick you into going back to smoking. Look out for them, because they always show up when you’re trying to quit. After you write down the idea, let it go from your mind. Be ready with a distraction, a plan of action, and other ways to re-direct your thoughts to something else.
Use the ideas below to help you keep your commitment to quitting.
Stay away from people and places where you are tempted to smoke. Later on you will be able to handle these with more confidence.
Change your habits
Switch to juices or water instead of alcohol or coffee. Take a different route to work. Take a brisk walk instead of a coffee break.
Alternatives: Use substitutes you can put in your mouth such as sugarless gum or hard candy, raw vegetables such as carrot sticks, or sunflower seeds. Some people chew on a coffee stirrer or a straw.
Activities: Do something to reduce your stress. Exercise or do hobbies that keep your hands busy, such as needlework or woodworking, which can help distract you from the urge to smoke. Take a hot bath, exercise, or read a book.
Deep breathing: When you were smoking, you breathed deeply as you inhaled the smoke. When the urge strikes now, breathe deeply and picture your lungs filling with fresh, clean air. Remind yourself of your reasons for quitting and the benefits you’ll gain as an ex-smoker.
Delay: If you feel that you are about to light up, delay. Tell yourself you must wait at least 10 minutes. Often this simple trick will allow you to move beyond the strong urge to smoke.
What you’re doing is not easy, so you deserve a reward. Put the money you would have spent on tobacco in a jar every day and then buy yourself a weekly treat. Buy a magazine or book, go out to eat, develop a new hobby, or take a yoga class. Or save the money for a major purchase. You can also reward yourself in ways that don’t cost money: visit a park, go to the library, and check local news listings for museums, community centers, and colleges that have free exhibits, films, and other things to do.
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