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Illness prevention and treatment

January 20, 2016

Smoking: Why it’s so hard to butt out

Despite health warnings, tax hikes and smoking bans, you may be among the millions of Canadians who still smoke. Here are tips to help you quit.

Nicotine patches, anti-smoking drugs, seeing a hypnotist and going cold turkey: Lyn Carlson tried everything to quit smoking over the years.

For the 51-year-old administrative assistant, smoking began with curiosity at the age of 10 and then developed into a “cool” social activity in her teens, but quickly became a physical and psychological dependency.

“Being a compulsive person by nature, I fell into heavier and heavier smoking, on average close to two packs a day,” says Carlson. “It was no longer enjoyable. It was just an unconscious action, necessary to maintain balance.”

Even respiratory health problems, including pleurisy, bronchitis and pneumonia, couldn't keep her from lighting up.

Carlson was accustomed to having a bad smoker's cough, but in her 40s she began experiencing shortness of breath, and the health warnings started to hit home. She knew she had to try again to quit, but kept reaching for a cigarette.

“The thought of life without cigarettes gave me anxiety,” she says. “I realized that to have any chance of overcoming this, I needed to convince myself that I might be able to do without cigarettes and that it didn't have to be forever.”

She also began focusing on the cost of smoking and chastising herself about paying to be robbed of her health. “Visualizing each cigarette as poison helped the fight.” she says.

At last: smoking habit kicked

In 2009, with support from her husband, Carlson put the nail in the coffin of her tobacco habit. With self-talk setting the stage and new anti-smoking medication in hand, she set a quit date that coincided with a healing and empowerment seminar. She hasn’t taken a puff since.

It is hardly news that more than 37,000 Canadians will die prematurely this year due to tobacco use, according to the 2014 report Tobacco Use in Canada: Patterns and Trends. Yet, despite the graphic health warnings on cigarette packs, cigarette tax hikes and smoking bans in many areas, millions of Canadians still smoke both out of habit and for pleasure. Many of these people, if asked, would say they feel as though they are hopelessly addicted with no effective way to quit.

The report indicates that 63.2% of Canadian smokers intend to quit in the next six months, and 47.6% will attempt to stop smoking each year. More than half (54%) of smokers who attempted to quit used some form of cessation aid (medications, chewing gum, patches, lozenges and inhalers), but the most common quitting strategy was to reduce the number of cigarettes smoked. Around one in five (21%) of smokers made a deal with a friend or family member to quit together.

So, why is it so hard to quit? A couple of reasons.

The physical addiction

First, cigarettes and other forms of tobacco contain nicotine — a powerful, mood-altering chemical that is extremely toxic and addictive, and takes just eight seconds to reach the brain after inhaling, explains Raelene Goosney, director of the Newfoundland and Labrador Smokers' Helpline. “Over time, your brain and body get used to this ‘buzz’ and need more to satisfy cravings or to feel normal,” she says.

According to the Canadian Lung Association, nicotine can act on the brain to produce a number of strong mood-altering effects:

  • It revs you up. Like coffee, it's a stimulant that makes you feel more alert.
  • It makes you feel calmer and more focused.
  • It makes you feel happier and can act as an anti-depressant.
  • It gets you addicted.

Nicotine withdrawal symptoms can include irritability, cravings, depression, anxiety, cognitive and attention deficits, insomnia and increased appetite. These symptoms may begin within a few hours after the last cigarette, quickly driving smokers back to tobacco use. No wonder people find it tough to quit!

The psychological habit

The other uphill battle when trying to quit is controlling the smoking-related triggers in your daily life, whether it’s enhancing your enjoyment of activities or coping with unpleasant things. It may be an automatic response for you to smoke a cigarette while reading the paper, taking a break from work or the kids, having your morning coffee or driving your car, or when you’re feeling bored. Anger and stress can also trigger a craving to smoke. Perhaps family members, friends and colleagues smoke, and it’s become part of the way you interact with them.

Resist cravings by building new routines

Remind yourself that your new routines may feel unusual at first, but in the long run they will help you be the healthy, smoke-free person you want to be. “Some associations are very strong and difficult to change, but it can be done,” says Goosney. Strategies include:

  • Recognize smoking triggers in advance of quitting. Learn to recognize your own triggers and use a few simple strategies to avoid or break them. For example, keep a journal and record each time you light up. Goosney says to note places, people, situations and feelings that set off your cravings and plan other activities or find methods to avoid smoking in those circumstances.
  • Avoid situations that spark a desire to smoke. The more thoroughly you change your usual routine, the easier it will be to steer clear of triggers. Goosney’s advice: “If you drink coffee in the morning, switch to tea, hot chocolate, juice or water, at least for the first few weeks. After a meal, wash the dishes right away to distract you from cravings. If you smoke to alleviate stress, go for a walk, listen to or play music, paint or do any activity you enjoy.”
  • Plan ways to resist smoking triggers you can’t avoid. Some situations and feelings can be avoided, while others may be inevitable. By acknowledging in advance that these are likely to ignite a craving, you can be better prepared to ride them out. For example, instead of putting a cigarette in your mouth, chew on flavoured candies or veggie sticks. Other useful strategies to resist triggers include taking a brisk walk to energize yourself, keeping your hands busy by squeezing a rubber ball or doing a crossword puzzle, and taking deep breaths.

It’s never too late to quit

Some tobacco-related health issues may be irreversible, but there are many benefits to quitting no matter when you stop, says Goosney. “Many people don’t know that your body will start to see benefits just 20 minutes after the last cigarette,” she adds.

Other advantages: Blood pressure, pulse rate and body temperature start to return to normal; within 48 hours, food begins to smell and taste better; and, after one year of being smoke-free, the risk of heart disease is half that of a smoker.

While there's no single approach to quitting smoking that works for everyone, options are available that can work specifically for you. Work with your doctor to develop a game plan, or talk to a smokers’ helpline counsellor in your province about quit programs to help you break your addiction, manage your cravings and join the millions of people who have kicked the habit for good.

Wherever you live in Canada, there’s help for quitting smoking:

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