Smokers are addicted to more than just nicotine. Research shows that people are just as hooked on the self-medicating uses of cigarettes for stress relief and weight control.
Make 2018 the year you quit smoking for good.
Amy Gettler stubbed out her last cigarette three weeks ago after 20 years of lighting up.
“I quit after a long discussion with my partner, who wanted me to want better for my health,” Gettler, 34, told Moneyish. “It’s what killed my dad, and to keep going with it – especially turning 35 this year – would just be dumb.”
She called the New York State Smokers’ Quitline (1-866-NY-QUITS), where an operator asked about her smoking history and triggers, and set her up with a two-week supply of 21 milligram nicotine patches (which run $40-$50) that are worn for 24 hours, plus three canisters of nicotine lozenges that have helped with her cigarette cravings. She also gets texts from SmokeFree.gov with daily tips and advice.
But like most smokers, the real hump has been getting over the daily cigarette rituals. Gettler has been in the habit of smoking with her morning coffee, or anytime she drinks alcohol, as well as after she gets her nails done. “I get irritated, but I focus on breathing until it passes,” she said. “I daydream about running upstairs and not being out of breath.”
Gene Caballero, 38, from Nashville also quit with the support of his significant other last year.
“I asked her what she wanted for Valentine’s Day, and that was it,” said Caballero. “I was like, are you sure you don’t want anything from Tiffany’s instead?”
He had been smoking a pack a day for five years to ease the nerves and anxiety that came with starting GreenPal, his Uber-like lawn care service. So when he quit smoking last February, he suffered weeks of shakes, semi-panic attacks and sleepless nights – and nicotine gum and patches could only do so much to curb those cravings when he woke up or got stressed at work.
“My plan of attack was trading it for other things; instead of waking up and smoking, I would wake up and work out,” he said. He trained for the Nashville Marathon with his wife and finished in 4 hours, 10 minutes.
The reason four out of five people who try quit smoking relapse again in six months is because they’re not just addicted to nicotine — otherwise, medications like Chantix and replacement products like the patch would be more successful. But the tobacco industry still raked in $117 billion in 2016, even as number of cigarettes sold in the U.S. fell by 37% from 2001 to 2016, because those who still smoke keep sparking up despite price hikes and studies warning about the health risks of cigarettes, which include emphysema, chronic bronchitis and lung cancer. And that’s because cigarettes burn themselves into your everyday life by becoming an anti-anxiety drug, an appetite suppressant, an oral fixation and a social lubricant — so smokers need to find a way to treat all of those things, as well as the nicotine dependency.
“Quitting smoking is probably the hardest thing you are ever going to do. I’d rather get people off crack,” Dr. Louis De Palo, Professor of Pulmonary Medicine at the Icahn School of Medicine at Mount Sinai, told Moneyish. “The recidivism rate is huge because it’s not just the nicotine. If you really want to be successful, you have to look at everything that one stick is giving you, which is why a combination of nicotine replacement and cognitive behavioral therapy has shown the most success.” Medication plus counseling doubles a smoker’s chance of quitting, according to U.S. Public Health Services.
A recent University of California – San Diego study also suggested that smoking cessation medications alone don’t help smokers quit, and called for a multi-pronged approach that includes behavioral counseling. “Thirty four percent of people who are trying to quit smoking use pharmaceutical aids and yet most are not successful,” wrote senior study author Dr. John P. Pierce. He noted that less than 2% of smokers using pharmaceutical aids are also getting any behavioral counseling, which in his studies was, “a recipe for relapse to smoking.”
“Smoking is not a ‘bad habit’ – smoking is an addiction, and this is how it has to be treated,” said Cindy Mendoza, health educator and tobacco specialist at Montefiore Medical Center.
So if you’re ready to butt out for good this year, here are some tried and tested tips from the experts and the quitters who remain smoke-free.
Set a quit date. Set yourself up for success by choosing a specific date to stop smoking, which gives you time to come up with a game plan, and to mentally and physically prepare not to smoke. “This way, you are in control,” said Mendoza. “You have it in your mind that this is something you really want to do, and this is how you are going to do it.” And Dr. De Palo urges to avoid quitting in the midst of a particularly stressful time in your life, such as during a divorce or a death in the family, when it’s going to be harder than ever not to self-medicate. “You’ve got to be in a good place in life and ready to do this,” he said.
Clear the ashes. Get rid of all of your smoking paraphernalia in your home, your car, your purse or coat pocket, and at the office. “Throw away your cigarettes, lighters, ashtrays – you cannot have anything like that,” said Mendoza. And don’t buy cigarettes or lighters for friends or relatives who smoke. If people around you are lighting up, then leave the room or area until they finish, or have something (gum, toothpicks, pretzels) to keep your hands or mouth busy.
Get your partner, friends and family on board. You’re more likely to be successful if your partner quits with you. “It’s better if you can do this as a team sport and support each other,” said Dr. De Palo. “Or you have to engage your partner in the process, and get your friends on board so that they are not shaming you for not going out with them to smoke. Explain why this is important to you.” Caballero and Gettler both credit their partners with helping them stay the course. “He is super encouraging and says he is proud all of the time. It means a lot,” said Gettler. “It’s hard, but he makes it doable.”
Replace the nicotine. Visit smokefree.gov or betobaccofree.gov for smoking cessation information, or access to free nicotine patches and gum, or prescriptions for medications like Chantix or Zyban. Medicaid members can check what stop-smoking medications their insurance covers here.
Replace the rituals. If you smoke when you wake up in the morning, then go for a run or do yoga instead. If you smoke while you drive, try chewing on gum or a toothpick. If you take breaks by smoking at work, swap that with deep breathing or walking around the block. Or pick up a hobby; Caballero put a keyboard in his office, and started playing whenever he felt the urge to smoke. “After 5 or 10 minutes, the worst of the craving symptoms will usually finish,” said Mendoza. And if you tend to smoke when you drink, switch to non-alcoholic drinks and temporarily avoid bars and places serving alcohol until the worst of your withdrawal has passed.
Put your money where your mouth is. Putting aside the money you’d spend on cigarettes can be another incentive to stay smoke-free. Every time Caballero felt the urge to smoke, he put $5 (the cost of a pack in Nashville) in his savings account. “I’ve watched that grow $150 a month to almost $1,700, and that gives me a different kind of satisfaction than the cigarette fix,” he said. “My girlfriend and I are talking about doing a destination marathon next year, and having that pay for it.” Calculate how much you can save here.
Don’t quit on quitting. Don’t admit defeat if you relapse and smoke once or twice. Just reset and try again. “The biggest mistake people make is giving up,” said Mendoza. “Keep trying, and one day you will definitely reach your goal.”
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