Some Quit Smoking Techniques (methods.html)

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[A] Introduction

You don't need to read this (methods.html) web page in order to understand and apply card therapy. This page is just a generalized description of the various programs and methods that helped me.

This page and web site describes a wide variety of methods, techniques, books, and online resources, many of which are not even remotely part of the NicA program nor its membership either formally or informally.

Much of what follows is from my experience, and impressions I got from reading more than 2000 postings by several other people in the alt.support.stop-smoking newsgroup and other online quit-smoking forums. Plus some material from the Freedom From Smoking class (American Lung Association). I am not in the medical or health fields. Nor does any of the below represent the opinions of Nicotine Anonymous (often abbreviated as 'NicA' in this document), of which I am an active member. NicA does not endorse nor recommend any programs, products, or methods other than its own 12-step program. The below is strictly my viewpoint and experience.

The 12-step program, meetings, mutual support and fellowship of the NicA program was an important part of my quit-smoking success. But I also used many other resources and methods, some of which are from programs and books that are critical of 12-step programs. I found these latter non-12-step programs/books to have techniques that were very helpful to me in resisting cravings to smoke. In particular, I owe the 'card therapy' idea to these books. These cards were crucial to me in resisting cravings during the first month or so.

During the first month, I found the mutual support of the NicA meetings to also be very helpful. But for me, the real value of the NicA program came later, in learning to adjust to life as a non-smoker on a long term basis.

I found that for me, one or two methods or programs were not enough to quit or stay quit. It was only when I simultaneously used several resources and programs that I succeeded in staying quit.

The combination of methods I used to quit smoking were:

The most important part for me was the card therapy. I wrote on 3 X 5 cards things I needed to tell myself when the cravings hit. Such as all the reasons why having 'just one' cigarette wasn't a good idea. Eventually I created 22 cards filled with tiny writing, some of them to handle particular trigger situations like anger or frustration.

I begin by describing the wide variation between nicotine users. Almost all nicotine users are addicts in the sense that they can't just have a few cigarettes now and then, on a 'take it or leave it' basis. But some are able to quit without too much difficulty, while others are emotionally attached at several levels to the drug and find it very difficult to quit for long.

[B] The Many Different Types Of Smokers

Quitting smoking is a long and difficult project for most people. And unfortunately, most people require several attempts to quit. Mark Twain once said 'quitting smoking is easy, I've quit a hundred times'.

There are a lot of variations among smokers as to the severity of their habit, and to the difficulty of their quit. Just like people vary greatly in their relationship to alcohol. Some people are take - it - or - leave - it social drinkers, while some are hopeless alcoholics, and others are in various places in between. Well, with regard to smoking, some people quit and quit for good fairly easily. At the opposite extreme are some who are so addicted that they make an unsuccessful life-long project of quitting and relapsing and quitting and relapsing. And there are people in all categories in between.

The luckiest ones are those who just decide to quit smoking and do it. Its tough for about the first week, and then after that, its not all that difficult. And they stay quit for good.

Less fortunate, but still very fortunate, are those that quit, and like the previous category, don't find it particularly tough after the first week. But they relapse back into smoking, because they tried to have their cake and eat it too. They tried limited smoking and found they couldn't keep it limited. So eventually they had to quit again. Having learned their lesson about the impossibility of limited smoking, they stay quit permanently.

Less fortunate, but still fortunate, are those who had to quit once or twice more than the previous category, before they learned the lesson of the futility of limited smoking.

Finally we get to the category of real slow learners that have numerous quit smoking attempts over many years. They are the ones that take several years to learn the futility of limited smoking. (I have learned that I am in this category.) Smoking and quitting smoking and smoking again become a pattern, a way of life. It seems that these people have a perverse need to make themselves miserable. These people seem to have more than a nicotine habit. They seem to have developed a complex around it that affects all aspects of their personality and their lives. Their mind, personality, and daily life is about as adversely affected by nicotine as if they were smoking crack - cocaine rather than tobacco.

All categories of people quitting tobacco can benefit from the support and experience of others in a program like NicA. But the last category of nicotine addict needs a program like NicA -- a program that deals with aspects of personality and ways of thinking in general, not just on quit - smoking tips.

There are probably several other categories of smokers. For example, there is the category consisting of the fortunate (?) few who do succeed in returning to very limited smoking and staying limited. My guess is that most of them make themselves somewhat miserable anticipating that one cigar at the end of the week or month.

[C] Two Phases To Quitting Smoking Permanently

In my mind, there are two phases to quitting smoking permanently:

[C1] Initial quit smoking phase

This phase is the first days and weeks after one has quit smoking. This is a very intense and difficult time, where one is feeling cravings for nicotine several times an hour. This period lasts for maybe a month. Days 2, 3, and 4 of the quit are the worst for most people. (There seemed to be a strong consensus about days 2, 3, or 4 being the worst in alt.support.stop-smoking). But throughout the month, cravings are intense and frequent enough for most people that they are constantly on - guard against slips. This is one fortunate aspect of this phase -- people are very vigilant about slips and try very hard not to smoke even one cigarette.

[C2] Relapse prevention phase

This period begins about 1 month after the quit. After a month, people begin to feel secure about their quit. Cravings are fewer and less intense. People seldom feel such intense urges that they feel driven to smoke again. However, people start feeling too secure, and start imagining that one cigarette won't hurt, or how about 2 cigarettes a week, or perhaps a cigar once a month, or something like that. I call this relapse prevention phase the 'don't be stupid phase'. In contrast to phase 1 (the first month) where someone may be driven back to smoking by long and intense cravings, phase 2 (the 2nd month and beyond) is one where many people relapse by being over-confident and 'stupid'. Stupid in that they try experimenting with 'just one cigarette' or with limited smoking.

Most people who occasionally have just one cigarette soon relapse into a pattern of smoking one or two cigarettes a week. They then begin to eagerly anticipate that special day and time of the week that they have given themselves permission to smoke. Soon it gets to be something like smoking two cigarettes twice a week. Then every other day. This slide down the slippery slope of limited smoking continues until pretty soon they relapse to regular full time smoking at the same level as before the quit. Or, perhaps having experienced this slippery slide process from previous quit attempts, they thus realize that they are headed towards a complete relapse. So they quit completely again before this happens. But they find that that this new 'just - in - time' quit is almost as tough as the original quit.

I found in a couple of my last quit attempts that I could successfully restrict myself to having 2 or 3 cigarettes once or twice in a month. But I found that I was continually suffering my habit, and was keeping mild cravings alive indefinitely. And that I was making myself vulnerable to suffering intense cravings when an especially stressful event or two occurred in my life. Which could have resulted in me relapsing into full time smoking.

I then learned not to smoke on any kind of regular basis, not even as few as a couple cigarettes once or twice a month. But I found that even after a month or two of not smoking anything at all, I would then suffer some especially stressful event and succumb to having just one or two cigarettes. I then learned that even one lousy cigarette sets up (mostly) mild cravings for at least a couple of weeks. And it makes me more sensitive to stress -- i.e. in a stressful situation, my cravings greatly increase.

Because I found myself perpetually so sensitive to stress, I found that I was procrastinating and putting off a lot of stressful tasks that I needed to do. (In some cases when I attempted the task, I suffered a torrent of cravings). That led to lots of important things not getting done or getting done late. This caused me to feel guilt, shame, and more misery. Just because of one lousy cigarette.

So after much of this stupid silly self-experimentation, I have learned that while I can have one or two cigarettes without relapsing, I pay a very heavy price in terms of cravings for the next 2 weeks at least. Now whenever I think of smoking a cigarette, I think of this experience, and realize that the one cigarette I am contemplating smoking will lead to weeks of misery. Whenever I think of smoking a cigarette, I tell myself that that I will be 'smoking weeks of pure misery'. This true (for me) statement immediately quashes the urge to smoke.

The above description of the quit smoking phases and process is pretty depressing. I think that most people who quit smoking go through much of the same silly self-experimentation that I did. How unfortunate.

The good news is that there is one guaranteed way to quit smoking successfully and permanently. The guaranteed way is to never, ever, under any circumstances, take a single puff! It will be tough to do during phase 1, because of the intense and frequent cravings. But most who make it to phase 2 will be able to stay quit if they refuse to do limited smoking experiments on themselves (silly self-experimentation).

[C3] In Either Phase, Your Cravings Might Be Less Than When You Smoked

This might be a little off-topic in this section, but it was a powerful realization for me. I found that after the first week of my quit, my cravings were less than what they were in my smoking days! When I was smoking, I regulated myself somewhat to keep from increasing my smoking. Also, there were many places and occasions where it was very difficult or impossible to smoke, and I just had to suffer. Others have said the same thing -- that cravings after a week or two after quitting smoking were less than what they normally endured in their smoking days. I don't know if it is true in your situation, but I mention it in case it is true. Thinking about it and reminding myself of it was a big factor in getting through the first days and weeks. Particularly if you haven't quit smoking yet, or recently have, its a good idea to write down 'what it is (or was) like to be a smoker'. Particularly concentrate on writing about all the times and places as a smoker that you were dying to break away and get outside to smoke. Then, several days after you've quit, contrast the cravings you are experiencing with your description of the cravings you experienced in your smoking days. You may conclude that your cravings now are less than in your smoking days. If this is true, what sense would it make to go back to smoking?

[D] Some of my suggested resources for help in quitting smoking

[D1] Nicotine Anonymous (NicA)

Nicotine Anonymous (NicA) is an organization that supports people who wish to quit tobacco and nicotine use. It uses a 12 step program very similar to the 12 step program of Alcoholics Anonymous (AA).

NicA consists primarily of weekly support group meetings. There are approximately 450 meetings in the world -- about 400 in the U.S. and Canada, and about 50 in the rest of the world.

To find out more about Nicotine Anonymous, see the the web site at http://nicotine-anonymous.org. In particular, note these two links: 'Meetings - United States Directory' and 'Meetings - International'. The former is of course a list of all U.S. meetings. The latter is a list of all meetings outside of the U.S. In addition, there is a list of new meetings (that are not yet in either directory) in the middle of the Nicotine Anonymous home page.

If you have a desire to quit nicotine use, and if there are no convenient NicA meeting(s) near you (see above paragraph on how to find NicA meetings), then you are invited to start a NicA meeting. To find out how to do so, please send email to info@nicotine-anonymous.org, and PLEASE INCLUDE A REGULAR POSTAL MAILING ADDRESS, so that NicA can send you our meeting starter kit.

A common question is 'how do I 'join' Nicotine Anonymous?' The only requirement for Nicotine Anonymous membership is a desire to quit nicotine use. There are no forms to fill out, no approvals to obtain, no dues to send in, no religious or other beliefs to subscribe to, no nothing but a desire to quit. You are a Nicotine Anonymous member when you say you are.

[D2] Online Resources (internet)

The alt.support.stop-smoking newsgroup and the Compuserve Recovery forum, Nicotine Addiction section, was very helpful to me. I have since accumulated a large number of internet quit-smoking newsgroups, message boards, chat rooms, and web sites at groupsa.html and groupsb.html.

[D3] Freedom From Smoking Class (Once a Week for 8 Weeks)

The American Lung Association puts on several Freedom from Smoking classes. These meet for 1 1/2 - 2 hours each week for 8 weeks, and cost $125 (August 1997). The classes taught about the hazards of smoking, reasons to quit smoking, and mostly a wide variety of techniques to quit smoking. The most important part of the class for me was the peer group support -- that we all quit together at about the same time, and had quit buddies we talked to on the phone. And saw each week at class. Also, making the commitment of the time and money to attend the class was a big incentive to stay quit.

While it was helpful, it was not enough for me and some others. The main drawback was that most of us quit on the 3rd week of class, when we were scheduled to do so. That left only 5 weeks to adjust to being a non-smoker before the class ended. What I did for ongoing support after the class ended, (and because I had some slips), was to attend Nicotine Anonymous meetings. I also participated in some on line (Internet) news groups.

[D4] American Cancer Society and American Heart Association programs

The American Cancer Society also offers a program similar to the Freedom From Smoking class, and I think so does the American Heart Association.

[D5] Mental Conditioning, Rational Thinking, Card Therapy, Journaling

This set of recommendations is a very personal one, in that I know of noone else who has used these techniques to quit smoking to anywhere near the extent that I did.

I found that even with the NicA program, and with the gum or the patch, that I simply could not fight some cravings for nicotine. I had many quits lasting only a day or two each. I also blew a few one or two month quits because of urges I couldn't overcome. Finally, in desperation, I went to the bookstore and looked at some of the quit-smoking books. I didn't find any books that told me anything useful to me that I didn't already know, so I looked at books in the alcohol and drug - addiction section. I found and read two books that helped me a lot:

(1) 'When AA Doesn't Work For You -- Rational Steps To Quitting Alcohol', by Albert Ellis and Emmett Velten, 1992, Barracade Books Inc. The general class of therapy presented in this book is known as Rational Emotive Therapy (RET). It is written for alcohol and drug users, but I found it perfectly applicable to nicotine users as well.

(2) 'Rational Recovery, The New Cure For Substance Addiction', by Jack Trimpey, 1996, Pocket Books

The idea for the cards came from these two books. Both books focus on 'rational self-talk' -- what to say to oneself when the cravings hit. My description of the contents of the books may seem dry, theoretical, and terse, because I try to give an idea of what they are about in a short amount of space. In contrast, my description of the cards are more conversational. And finally, the cards themselves are the product of all of this effort.

Both books encouraged me to recognize each craving to smoke, and to list reasons why I shouldn't smoke. I kept 3 X 5 index cards with me. As I was suffering through withdrawal, I would write on the cards reasons not to smoke, reasons why 'just one' was a foolish idea, things to calm my mind down, and whatever other thoughts I came up with to cope with the situation. As I came up with new thoughts and ideas, I wrote them down. When I got hit with strong urges, I would read some of the cards that I had previously written. I found that whenever I took the time to read a few of the cards, the urge to smoke ALWAYS went away, and I never slipped. The only times that I slipped were when I didn't have the cards with me, or when I said to heck with reading the cards. (Duh). But though I slipped, I fortunately never completely relapsed back into regular smoking.

The cards were the most crucial part of my last and so far successful quit.

In previous quits, I followed the old standard quit - smoking advice by coming up with a list of about 20 reasons why I wanted to stop smoking. But I found that this list of reasons was not powerful enough to quell the cravings. I remember reading through the reasons again and again, and then still giving in and smoking. The point is that the cards that I used on my last quit are more than just a list of reasons to stop smoking. Yes, some of the cards were just a list of reasons to stop smoking. But other cards dealt with specific trigger situations, and the consequences of giving in to an urge to have 'just one' cigarette. I also had cards that listed affirmations and things to calm me down. Other cards reminded me what it was like before when I was smoking and repeatedly trying to quit.

One reason why the "reasons to quit" list did not have much power to help were because too many of the reasons were far in the future and uncertain, such as "I might get cancer in 20 years" or "I might need dentures in 10 years". So I tried to think of more nearer-term reasons to quit -- benefits to enjoy within days or a few months of quitting. These I found to be much more powerful.

For more on the books and the cards that helped in my mental conditioning to resist cravings, see mental.html

[E] Patches, Gums, Zyban

Based on my discussions with other smokers, what I've read and heard, and from people's experiences in the alt.support.stop-smoking newsgroup, is that for most people, these products are quite helpful, but that quitting smoking is still a difficult ordeal. I personally recommend talking to your doctor, or an organization like the American Lung Association, the American Cancer Society, or the American Heart Association about the effectiveness of these products.

Some people ask me if Nicotine Anonymous is against medications or against nicotine replacement products such as the patch or gum. NicA has no position regarding the use of patches, gum, Zyban, or any other medications. NicA doesn't endorse or oppose any outside programs or medications or causes or issues. This decision is strictly up to the individual, although consultation with a trusted doctor is recommended before arriving at the decision.

For some guidance in making an individual decision, you might read AA's position on medications, as contained in the AA pamphlet, 'The AA Member - Medications and Other Drugs'. This pamphlet is online at: http://www.aa.org/catalog.cfm?category=4&product=33 . Boiled down to its essence, it is ultimately you and your doctor who decide. "No A.A. Member Plays Doctor".

NicA doesn't have any equivalent pamphlet.

At least at the two NicA meeting locations that I have attended, I've heard people talk about using these things (patches, gums, etc.) after the meeting. Frankly, I've occasionally heard people mention these things during their turn during the meeting, though hopefully very very briefly, as NicA members are bound by NicA Traditions (its groundrules) from talking about outside programs and products. At meetings, NicA members concentrate on the 12 steps of recovery and other mental attitudes, at which NicA is experienced, rather than discussions of different products and programs, at which it is not.

I've been to NicA meetings where I see people visibly wearing the patch, and someone chawing away at 'the gum', with the next piece of gum on the table.

It is also my personal observation that most people who are NicA members who have quit recently have done so with the help of one of these products.

On the other hand, there are some forms of addictive personalities where, by taking medication, particularly addictive medications, people substitute one addiction for another. I have heard of people who are hooked on the patch or gum for years. Again, one should read the above 'The AA Member - Medications and Other Drugs' on the problems that some addicts have in taking medications.

[F] Acupuncture, Hypnosis

A few in the alt.support.stop-smoking newsgroup have said these techniques have been very helpful. I personally have no experience with them.

[G] Using A Days & Hours Wall Calendar Or Meter

I had several numbered 2 X 3 slips of papers. One set of 31 slips was numbered from 0 to 30. This set was used to count the days. Another set of 24 slips of papers were numbered from 0 to 23 -- to count the hours.

I then put two nails side by side in a wall. On the left - side nail I hung a slip of paper indicating the number of days that I had quit. On the right - side nail I hung a slip of paper indicating the number of hours that I had quit. The below is an example of the 2 slips indicating that I had quit for 2 days and 15 hours:

        +--------+    +--------+
        |   *    |    |    *   |
        |        |    |        |
        |   2    |    |   15   |
        |        |    |        |
        +--------+    +--------+ 

(The *'s indicate the holes in the slips from which they hung from nails in the wall).

During the first few days of my quit, replacing the 'hours' slip every hour with the next higher numbered slip gave me a big sense of affirmation of my accomplishment (getting through another hour smoke - free). And it was always a very big moment when it came time to replace the day with the next higher numbered day.

When I had reached a month smoke - free, I started using the left - side set of slips to indicate the number of months, and the right - side set of slips to indicate the number of days.

[H] Do Whatever It Takes

Some people say they really want to quit, that its a life or death matter. They also say that nicotine addiction is as strong as heroin addiction, and so they know it is going to be extremely tough to quit. But then, paradoxically, they expect to simply be able to quit. Without attending any quit-smoking classes or support groups, without taking time off from work or significantly lightening domestic responsibilities, without reading any quit-smoking books or literature, without journaling or any other mode of writing therapy. In other words, even though they give lip service to the idea that nicotine is as addicting as heroin, they then expect to quit smoking without putting much time and effort, other than willpower and maybe the patch, into the quit effort.

I was like that. Many failed quits. But with each quit, I learned to try some additional things, like gum, patches, classes, and books. And most of all, in my last (so far successful quit) I put in tons of time reading addiction books and writing up my quit-smoking cards and reading them over and over until the urge to smoke passed.

In general, I learned to pour into my quit effort whatever amount of time and money it took to quit, or at least more time and money than I spent on the preceding failed quit attempt.


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