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By Tina Pavane
If you have ever tried to quit smoking, most likely more than once, you may find preventing a relapse feels like you are constantly pushing a boulder uphill. You may have heard that voice in your head — if I could have a cigarette right now I would be able to control things better, or if I have one puff I’ll be in a better mood, or a smoke right now would help me concentrate. If you give in, you blame yourself for having no willpower or being a weak person for not being able to rope in that urge to smoke. In short, quitting smoking can be tough!
What’s Behind the Urge to Smoke?
As soon as nicotine makes its way from the lungs to the brain, it docks onto certain receptors on the surface of cells through the body that is meant for other chemicals.1 It is essentially an imposter. When it locks onto neurons in the brain it causes the cells to release certain brain chemicals called neurotransmitters. One of these neurotransmitters is dopamine, sometimes referred to as the chemical of desire and reward. It is a feel-good chemical, which is why people like to smoke, especially during times of stress. However, nicotine is eliminated from the body rather fast and this causes dopamine to run low. This drop can cause a person to become irritable, depressed, anxious or stressed. It may be difficult to concentrate or remember things. Nicotine basically hijacks this reward system and smokers are at its mercy.
The urge to smoke is a powerful force to resist, especially early on as nicotine leaves the body. You crave the next puff because your body has become accustomed to getting it. But even long after a person stops, smoking urges can still derail efforts to stay smoke-free months, even years, after quitting. It’s as if the brain is forever branded with smoking memories making non-smokers urge managers for life.
What helps quitters succeed is an arsenal of smoking cessation tactics that fortify attempts to quit. While some people can quit “cold turkey,” most people will need help. Here are some ways former smokers deal with challenges and temptations.
Master High-Risk Situations
Smoking-related cues are problematic for former smokers (quitters) because they remind them about smoking. Resisting the urge to light up in situations previously associated with smoking can be ruinous.2 Seeing a pack of cigarettes or socializing with others who smoke is among the many cues that quitters work hard to ignore.
Before you set a quit date, write your cigarette’s memoir — who, what, where, with whom, when, and why. Take an inventory of when you smoke and make a list of all triggering behaviors, places, paraphernalia, people, and routines that are associated with smoking. Purge the house of visual reminders such as ashtrays and lighters, and clean smoke-saturated cars, carpets, curtains, and clothes. Turn your surroundings into a smoke-free zone.
Make plans to deal with smoking triggers beforehand — replace potential threats with something else, move them to a new location or out of view, or rearrange activities to sidestep reminders such as avoiding stores where you would normally buy cigarettes. Even a can of soda, certain types of music, the sight of a smoking partner at work, or favorite smoking chair can be triggering. If you walk into the house, throw your keys down and grab a smoke, dash to take a shower instead. Be creative.
Cognitive Behavioral Therapy (CBT) may help quitters cope with situations that trigger urges to smoke by revising your thoughts.3 A CBT therapist uses exercises that change the way you think and feel when facing stressful situations and smoking triggers.
Reorganize, reframe, and remove smoking reminders.
Move Attention Away From the Urge to Smoke
Distraction techniques used to treat substance abuses or mental health conditions may also work for people trying to quit smoking. The goal is to divert your attention away from the urge long enough to take your mind off smoking. Engage your mind, be social, or do something physical. It’s a good idea to select some distractions in advance so you aren’t fishing around during the height of an urge, especially if you are out and about. In a pinch, count backward from 100 by 7s.
The easiest distraction is drinking a glass of water. Other distractions can be playing a game, reading a book, doing a puzzle, watching something, or perusing social media. Call a friend, do your nails, clean the fridge, take a walk, bake a cake, or eat a lemon.
Some quitters have found mobile apps, including the Quitter’s Circle app developed by Pfizer and the American Lung Association, helpful. For distractions on the go, download apps that provide a scrollable list of instant distractions.4
Don't forget about exercise. Exercise is the perfect distractor because it is not only a great promoter of overall health, can help curb withdrawal symptoms experienced early in the stop smoking process. 5 6 It also increases more feel-good brain chemicals.
Simple yoga-style breathing and other mind-body practices can help reduce stress and help quitters ride out the desire to smoke by reducing tension.
Lean Into the Urge to Smoke
Mindfulness meditation for smoking cessation is a very new approach to dealing with smoking urges and borrows from the experience treating other forms of addictions.7 Put simply, it brings intentional awareness and acceptance of the smoking urge. Unlike diversion, which asks you to actively move away from negative thoughts, mindfulness training for smoking cessation involves recognizing the desire to smoke, getting close to it, feeling the physical sensations happening in the body, accepting it, and riding it out until the urge to smoke is gone.8 Some call it “surfing the urge.”
There is no one profile of a successful quitter and no best method. Whether it takes one, or a hundred attempts, combatting smoking is often hard but it can be done.
1 National Institute on Drug Abuse. “Is Nicotine Addictive?” NIDA, www.drugabuse.gov/publications/tobacco-nicotine-e-cigarettes/nicotine-addictive.
2 “Know Your Smoking Triggers.” Smokefree.gov, smokefree.gov/challenges-when-quitting/cravings-triggers/know-your-smoking-triggers.
3 National Institute on Drug Abuse. “Cognitive-Behavioral Therapy (Alcohol, Marijuana, Cocaine, Methamphetamine, Nicotine).” NIDA, www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/evidence-based-approaches-to-drug-addiction-treatment/behavioral.
4 Ploderer, Bernd, et al. Advances in Pediatrics., U.S. National Library of Medicine, 2014, www.ncbi.nlm.nih.gov/pmc/articles/PMC4114415/.
5 “Fight Cravings with Exercise.” Smokefree.gov, smokefree.gov/challenges-when-quitting/cravings-triggers/fight-cravings-exercise.
6 Allen, AM, et al. Effect of brief exercise on urges to smoke in men and women smokers. U.S. National Library of Medicine, 2018, https://www.ncbi.nlm.nih.gov/pubmed/28950116.
7 Brewer, Jusdon A., et al. Mindfulness Training for smoking cessation: results from a
randomized controlled trial, National Institute of Health, 2011, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3191261/pdf/nihms305149.pdf.
8 Davis, James M., et al. Advances in Pediatrics., U.S. National Library of Medicine, Dec. 2017, www.ncbi.nlm.nih.gov/pmc/articles/PMC5863924/.