Joel_Spitzer
|
1#
|
Rank:none
From: USA 
Registered:11/14/2008
|
RE:Craves and thoughts that occur over time
(Date Posted:11/17/2008 19:38 PM)
The Miserable Three's
In response to the "Miserable Three's" we hear so much about. The three-day thing is a real understandable phenomenon. It is how long we basically have nicotine left in our bodies after smoking cessation. As long as we have any amount the brain is demanding the full compliment. The lower it gets, the more your brain and hence body complains. Once the three-day mark is passed, pure nicotine is either excreted or metabolized into other bi-products. Those bi-products are what can be tested for in a drug tested for nicotine for up to two weeks, but they do not have the power to maintain an active state of withdrawal. Some people seem to metabolize more efficiently than others, seeming to only have physical withdrawal effects for one or two day periods, but once overcoming the third day, most people’s intense physical symptoms will diminish.
In clinic experience, the three-week mark never seemed to be a big issue. I still maintained contact heavily over the first month though, constantly reinforcing quitting concepts, and maybe, people left on their own devices didn’t internally keep up that kind of ammunition strengthening. Another factor may be friends and families. During the first week, maybe even the first two, everyone pays a lot of attention to the smoker who is quitting. They are worried that this time may not take. They ask constantly how the person quitting is doing, offer support and encouragement, tell them how great they are and how proud they are of them. All this attention is either greatly appreciated or drives the person quitting nuts. Either way, it in a sense keeps their attention focused on the quit.
But after a couple of weeks, the novelty wares off, to the ex-smoker and the family member themselves. At some point, people stop asking. Sometimes this is interpreted to the ex-smoker that people stopped caring. This is not the case. The family and friends just start to take for granted that the person is over it. They get complacent. Understand something though, the family and friends probably still cares, whether they show it our not. If the person relapses, they may have a fit, but if he or she stays off, that’s just the way things are.
This lack of attention to cessation often leads to the ex-smoker to feeling complacent too. Complacency is dangerous. That is when the thought is triggered by something, the ammunition has stopped being reinforced and the ex-smoker has lost access to their reasons for why they stopped and why they don’t want to go back. I don’t think three-weeks is a magic guide or absolute, like the three-day mark, but a variable due at least in part to this kind of mind set.
The three-month is another interesting time. If I had to venture a guess, I would say the thoughts are due to seasonal variation of activities, weather, clothing, etc. When you quit in the dead of winter, depending on where you live, you learn how to shovel snow, scrape ice, bundle up, watch football and hockey, in a sense, you learn to do winter activities without a cigarette. You learn this all by repetition, doing it once, then another time, then another, all without taking a cigarette. But when springtime rolls around, conditions may change. Maybe you do spring-cleaning. Last time you did spring cleaning, you were a smoker. Nothing you did in winter may have just the same flavor. How did you take breaks during spring-cleaning? You stopped for a cigarette. How did you reward yourself when finished? You smoked a cigarette. This is a new trigger. Then you start changing your wardrobe. Last time you wore that jacket, you were a smoker. You may even find cigarettes in pockets you paid no attention to when you quit. Sporting events change. Now you are watching baseball instead of football. Maybe even going to games. Every time you went to games before, you smoked. Win you watch your team win for the first time, you are supposed to smoke in celebration. After a couple of wins, you break the association. That doesn’t yet prepare you to watch them lose though, that you will learn quickly too. (At least if you are from Chicago, the Cubs you know. Sorry I digressed). And what about getting ready for tax time, this too smoking had always been part of.
Well, let three more months pass and we have summer time activities. The beach, the pool, outdoor activities, barbecues, picnics, all things that are basically new to an ex-smoker who quit during snow. And then fall and its color changes, it’s clothing, its basic change of flavor and nuances. All these changes are potential triggers.
While this may sound discouraging, that there are all these future changes awaiting the ex-smoker, consider this. Everything the smoker encountered the first three days was new. Everything! Getting out of bed, brushing teeth, using the bathroom, again, everything. And this is on top of drug withdrawal. The ex-smoker got through them all, breaking the day to day rituals and associations. That is why he or she is now an ex-smoker. That is why after weeks, he or she is not thinking about cigarettes every waking moment, but rather a couple of time a day.
At these seasonal times, new experiences trigger thoughts, but it doesn’t have the physical withdrawal complicating it. It’s still a battle, but now the all out war previously experienced. You all had the strength to win that war. You can beat these reactions too. Bring back your original ammunition, remembering why you quit. You were fighting for your freedom, your health, and eventually your life. Bring your reasons for quitting to the forefront of consciousness and when these thoughts are triggered, you will quickly squelch them. Next time the same circumstance will seem a little weaker, and after a few times, not trigger at all. Eventually days, weeks, at some point, even months will pass without a real problem. You will experience moments of thoughts, but at the same time be benefiting from thousands of hours of health and even greater serenity. If you want to permanently avoid making another year of constant new battles, remember…Never Take Another Puff!
Why am I still having "urges?"
For the benefits of newbies wondering if they will ever stop wanting a cigarette, I thought I would elaborate on the concept of "urges" that happen weeks, months or even years into a quit. When we say that the urge hits after any significant time period after being smoke free, it is a desire or a thought for a cigarette that is different than the physical "urge" experienced during initial withdrawal. Those urges are physiological craves, the body demanding nicotine to alleviate a drug withdrawal state.
The thoughts that happed down the road are triggers of fond memories. The thought is often that it seems like a good idea now to smoke a cigarette. Kind of like the urge you get to clean your house on a slow day. Seems like a good idea for a few seconds, but if you find something better to do, so be it. The same concept holds true for the thought of a cigarette.
Other times there will be thoughts of "I used to smoke when I did this." Not a desire for a cigarette or smoking, but a feeling that your timing or ritual is off. Sometimes there may even be a feeling that you are supposed to be doing "something" right now, but do not even realize what it is. All of a sudden you realize you used to smoke at this particular juncture of time or a specific new situation. Again, it is not that you want or need a cigarette in these two cases, just that the routine was a little off.
Years into a quit though, most days ex-smokers will go days, weeks and maybe even months without a thought. Even days which they call "bad" with desires, they may be going 23 hours and 59 minutes and 50 seconds without a thought, but because they think of it once, they think that was a lot. It really does get easier and easier.
The alternative side, smoking, is constantly riddled with thought of quitting. Whenever you are going to a doctor, a non-smoking friends or family home where you want to visit but cannot smoke, getting a new symptoms or aggravated by a chronic problem, read a news headline or hear a news report on television or radio on a new danger from smoking, have to pay another price increase for cigarettes, find another friend who has quit while you do not, stand outside in blizzards or heat waves or torrential downpour for the luxury of getting a quick fix or experience some horrible withdrawal because you can't escape for a cigarette or heaven forbid, you run out of cigarettes.
Yes there were plenty of times smoking made your life totally unmanageable. Not to mention the times that may come where a diagnosis of a horrible condition that require extraordinary measures to save your life that in themselves are almost as terrifying and painful as the disease itself. That unpleasant scenario still provides a chance of survival. There are frequently the cases where the first real symptom of a smoking induced illness is sudden death. Then you don't even have a chance to save your life. Why am I still having "urges?"
As an ex-smoker, there may be times you want a cigarette. As a smoker, there will be times you want to quit. Neither side is perfect, but the ex-smoker side has clear advantages. It will get easier and easier over time getting to the point of smoking becoming a thing of the past. The smoking side leads to a much more ominous road.
Keep focused, whether it is hours into a quit or decades into a quit. It was a good decision to quit, maybe the most important decision you have made in your life as far as quality and length of your life goes. To keep the decision alive and continue to reap the benefit, always remember, Never Take Another Puff!
Avoiding Triggers
Many years ago I had a man named Mark (not his real name) join one of my smoking clinics. Mark came to me on the first day of the clinic and told me how he had recently added an addition on to his house and one of the rooms he added was a home office. Mark lived in a suburb about 20 miles from his office in downtown Chicago. Mark had the luxury that he didn't really need to go to his downtown office much and could do most of his work from home. He was nervous though because his home office was more than just his office--it was also his smoking sanctuary. Mark had small kids who were allergic to smoke and his wife didn't want Mark smoking around the kids. Since the kids were never allowed in the office anyway, Mark agreed only to smoke in that one room of the house. The office had in essence become his smoking room. He had only had the home office a short period of time now but the relationship seemed deeply ingrained.
When Mark was telling me about the new home office smoking room he confided in me that he was really scared to go into the room for he was sure it would be too powerful of a trigger and cause him to smoke. I told him he should go into the room quickly to overcome the fear but he said he just wanted to give it a few days before he attempted it. I figured I would let it go, thinking it would actually be good for Mark to get the additional experiences of driving to the city and working with other people proving to himself that he could deal with the outside world and still maintain his quit.
Mark never brought up the home office smoking room again during the clinic and I had basically forgotten about it too. Mark completed the clinic and sounded great at graduation. I figured he was on his way to a complete smoke free life.
A couple of months after the clinic was over I was following up Mark's group on a Saturday morning. Actually I had talked to him numerous times over the two month period but this conversation took an interesting twist. While on the phone Mark had said something about his office downtown and for the first time since I met Mark I remembered his concerns about his home office. I asked him if he was still going downtown much or mostly working out of his home office now. All of a sudden there was an awkward silence on the phone. Mark kind of hemmed and hawed for a while and said, "Well, this is kind of embarrassing to admit be I actually haven't gone into the home office yet."
I quickly said, "Mark, are you telling me that you have been driving 20 miles to and from work every day for two months because you are afraid that if you go into your home office you are going to smoke." He said yes, but it was worth it. He loved not smoking. Not smoking was great. So while driving 40 miles a day was a tad inconvenient, it was worth the effort since it was helping him to save his life.
I agreed it would be worth driving 40 miles every day if it were necessary in order to sustain a quit and thus saving his health and his life. The problem was that it was not necessary--Mark could work in his home office and just not smoke. To that Mark replied that the association was just too strong and his quit was just to valuable.
I asked Mark if he had a phone in the room in question to which he replied, "Of course I have a phone, it's my office." I said, "Mark, I want you to go into that room and call me back at this number." Now it took some real effort for me to persuade Mark to go into the room and to call me back. He was scared for he was totally convinced that being in that room was going to undercut his quit but Mark eventually goes into his office and places the call.
So I start a conversation of small talk with Mark, making a point of checking the clock at the beginning of the call. I knew some of Mark's family members and friends, and I started asking him questions about these people and making a real concerted effort of never broaching the topic of smoking once. Now I know most of you reader here have only gotten to know me from my writings and have never seen me live and talking but I can assure you that if you talk to any of my family members or friends, or especially to my clinic graduates, they will all attest that I can talk for hours on end even though I have nothing really important to say. I purposely engaged Mark into a half hour conversation consisting of absolutely nothing important--just small talk.
A half an hour into the conversation of small talk I abruptly blurted out, "Hey Mark, you have been in your home office now for 30 minutes. Have you thought about a cigarette once." Mark started laughing. He realized what I had done, getting him into the room and talking his ear off just to show him that he could be in the room and on the phone and not need to smoke. I think Mark instantly realized that his fears were unfounded.
I saw Mark last year, for the first time in probably fifteen or twenty years. He had now been smoke free for over a quarter of a century. We didn't really talk about smoking issues much either. It was no longer an issue in Mark's life. I just did my obligatory warning about never getting overly complacent, pointing out to him that over the past four years I had two people who were once 35 year ex-smokers who lost their quits. He was still well aware of what we taught in the clinic and was still totally committed to never take another puff.
As most people who read here have probably noticed, they have started saving lots of money since they have quit smoking. I suspect Mark had also saved a small fortune. This may not have been the case if we had not had our little conversation that Saturday morning. For if we had not talked that day Mark may have been driving an extra 200 miles a week, plus paying for parking for a quarter of a century. I don't even want to try to do the math of what these additional expenses would have cost. The fact is that they would have been totally unnecessary. When a person goes 25 years smoke free he proves beyond a shadow of a doubt that everything he was able to do as a smoker he can now do as an ex-smoker. This is a crucial lesson for all to learn.
Putting off facing certain activities triggers will likely prolong the stress, anxieties and fears that you will not be able to overcome the specific situation without relapse. All people who quit must realize that all you did as a smoker you can do as an ex-smoker too. All it takes is proving it to yourself one situation at a time. You can continue to live your life and get through all events with your quit intact as long as you always remember to stick with your personal commitment to never take another puff!
(Message edited by Joel_Spitzer On 11/18/2008 11:16 AM)
|
Joel_Spitzer
|
2#
|
Rank:none
From: USA 
Registered:11/14/2008
|
RE:Craves and thoughts that occur over time
(Date Posted:11/17/2008 19:40 PM)
Actions speak louder than words—or thought.
A thought for a cigarette will never cause a person to go back to smoking—only an action can do that. The action is a puff on a cigarette or any administration of nicotine from any source for that matter.
Thoughts or words are not decisive factors of anything. Lets say you never quit smoking, and are eventually diagnosed with emphysema, and then knowing that every puff you took was destroying more and more lung tissue, basically crippling you a little bit more every smoking moment.
Should you then feel solace for saying as you are lighting up a cigarette, "Yes, I know I am destroying more lung tissue and I am likely going to be on oxygen soon and gasping for air at some point until my heart finally gives out from the overload, but at least I thought about quitting today.”
I don't think you or your family, friends, or doctor will look at this statement as a major accomplishment as you are lighting up one cigarette off the one that is about to burn out. Especially if you have said the comment earlier that same day, and have been saying it day after day for decades now.
If you think back to when you were first quitting, the odds were you had numerous thoughts for days and maybe weeks and still, here you are smoke free. It is because you never gave into those thoughts.
Today still your actions are speaking louder than your words or your thoughts. The action is you didn't take a puff yesterday and I strongly suspect if you are here reading now you are not planning on taking one puff today either. As long as you continue this practice, it does not matter if you never think of a puff again or if you think of it daily. You will never relapse as long as you never take another puff!
"I want one!"
I want one—no I don't. One sounds great—no it doesn't. Oh just one—not just one. If you keep thinking in terms of "one" this kind of internal debate is non-relenting—it will slowly drive you nuts. So, don't carry on this debate. Don't think in terms of one. Think in terms of full-fledged smoking. The full quantity, the social stigma, the stench, the costs, the risks. I'm not advocating looking at them negatively. Just look at them how they were—really were at the end.
They were making you sick and tired enough of them that you voluntarily put yourself into withdrawal to break free from them. You did it. Now just keep them in perspective. If you used to smoke 20 a day, say to yourself when the urge hits that "I want 20 a day, every day, for the rest of my life, till it cripples, then kills me." As soon as you hear yourself say it in that perspective you will likely find yourself next saying, "What am I thinking? I don't want to smoke that way." That will be the end of that particular discussion.
Look at smoking in real terms and you will walk away from each urge with a sense of relief and accomplishement. Fantasize about them and you may walk away with a feeling of deprivation. You are not depriving yourself of anything, you are ridding yourself of a deadly addiction. See them for what they are and you will stay forever resolute to never take another puff!
Fixating on a Cigarette
What happens to some people is when off a certain time period they start fixating on a cigarette. By that I mean they forget all the bad cigarettes they ever smoked, they forget the ones they smoked without ever really thinking about them even at the time they were being smoked, and they start to remember and focus on one good cigarette. It may be one the smoked 20 years earlier but it was a good one and they are now wanting one again. A common tactic is the ex-smoker will try to tell himself or herself that he or she does not really want that good cigarette. Well, the problem is at that moment he or she does want it. An internal debate erupts, "I want one, no I don't, one sounds great, not it doesn't, oh just one, not just one!" The problem is that if the ex-smoker focus on one there is no clear winning side. The ex-smoker needs to change the internal discussion.
Don't say that you don’t want one when you do, rather acknowledge the desire but ask yourself, do I want the others that go with it. Then do I want the package deal that goes with the others? The expense, social stigma, smell, health effects, possible loss of life. Do you want to go back to smoking, full fledged, until it cripples and kills you? Stated like this it normally is not a back and forth debate. The answer will normally be, "No I don’t want to smoke under these terms, and these are the only terms a cigarette comes with.
Normally if viewed like this the debate is over with almost immediately after pulled into focus. Again, if the focus is only on one, you can drive yourself nuts throughout the whole day. If they focus on the whole package deal, you will walk away from the moment relieved to still be smoke free and sufficiently reinforced to never take another puff!
Joel
Just think about something else
Sometimes you will encounter a person who says they are constantly thinking about smoking or sometimes you yourself feel that you fit into this category of individual. Generally when a person says they are constantly thinking about smoking, people around them tries to share the advice to think about something else. First, there is an inaccuracy about what the ex-smoker is saying. He or she is not constantly thinking about smoking, rather, he or she is fixating on "one cigarette" or "one puff." It's hard to think about something else because one puff seems like such a wonderful concept. They are often reminiscing about one of the best cigarettes, or more accurately, about the sensation around one of the best fixes they ever had. It may be one the smoked 20 years earlier but that is the one they are focused on.
So what about thinking about something else? Well, it's hard to think of something else that can deliver such pleasure as this magic memory. Even if they successfully think of something else and overcome that urge, they walk away from the moment with a sense of longing or sadness with what they have just been deprived of again.
So, what is an ex-smoker to do? Change the tactic. Instead of trying (often unsuccessfully) of something else, acknowledge the desire. Don't tell yourself you don't want one, you do and you know it. But remember there is a catch. To take the one you have to have all the others with it. And with the others, you have to take all the problems that go with "them." The smell, the expense, the embarrassment, social ostracization, the total loss of control, and the health implications. The health effects are the most serious of the implications considering they lead to slowly being crippled then death.
This is what to focus on when the thought of one creeps into consciousness, the package deal of smoking. Think about the hundreds of cigarettes that have to go with that first one weekly. Think about the thousands that go with that first one every year, or the hundreds of thousands that will go with it until it kills you. These are not exaggerated numbers. Do the math yourself; calculate how much you smoked in your lifetime and figure out how many more will be consumed if you didn't quit.
I am not saying to look at cigarettes negatively, just look at them exactly as they really were. If you pull the whole spectrum of smoking into focus, you will be able to walk away from the "urge" with the attitude that you are glad you are not doing that anymore. You won't feel deprived you will feel grateful. The more you remember smoking the less you will think about a cigarette. In a sense forcing yourself to remember will help you forget. Not forget smoking, but the fantasy, the appeal of a nicotine fix. A nicotine fix was not worth smoking for while you were a smoker, you can bet it is not worth it as an ex-smoker with freedom to lose now as well as all the other implications that always went with smoking.
In summing up, I will say that not smoking will never seem as good as the fantasy of smoking. But smoking was never that good either. The fantasy is "one" with no side effects, and no loss of control. The reality though is a dirty, disgusting, and deadly addiction. See them for what they are and you will stop wanting them as much.
Again, it can't be said too often, you are fighting for your health and your life. To win this fight is no more complicated than just keeping your commitment enforced to never take another puff!
|
Joel_Spitzer
|
4#
|
Rank:none
From: USA 
Registered:11/14/2008
|
RE:Craves and thoughts that occur over time
(Date Posted:03/26/2009 11:17 AM)
Smoking TriggersRecently
someone mentioned to me how when she had been off smoking for a week
she was hit with a major urge while in the ice cream isle of her
supermarket. Not only was it strong, but it lasted longer than most of
the urges she had in the days prior to this event. This is the
explanation I gave her as to why the thought was triggered and the
reason for the longer than average duration. It helps explains a little
further about smoking patterns.
My explanation:
There
is a reason the ice cream isle might have triggered the urge to smoke.
The ice cream isle was likely one of the last items you shopped for
since you didn't want it to melt. As a smoker, the half-life of
nicotine is 20 to 30 minutes, meaning after this time period you would
always be in a slight state of withdrawal. You were never allowed to
smoke in the store, so by the time you would leave, lighting up would
be an automatic response. You may always have had a tough time though
even before leaving. You would likely be in a hurry to check out and
exit by the time you hit that aisle for you may have already been in
withdrawal.
If
you had not shopped for ice cream since you quit, the first time would
probably be an automatic trigger. If not then, as soon as you would
leave the store it probably would have done it. Other situations which
will also trigger this way is when you first leave a movie theater,
library, or non-smokers homes who you have visited in the past and
never smoked at.
It's
kind of funny, it's the places some people try to escape to the first
week they quit smoking, places they never could smoke. What they fail
to recognize sometimes though is they have to leave those places. They
better understand that these times will be powerful triggers.
It
is important to do these things though to break the triggers. Time
doesn't teach you how not to smoke, experience does. The more thing you
experience and the sooner, the more you recognize that their is life
after smoking.
Don't
let it get you down, acknowledge the crave, recognize you don't want to
be a smoker and congratulate yourself for overcoming another trigger.
Oh yeah, enjoy the ice cream and when finished with the same sized
helping you would have had when you were still a smoker (don't increase
quantity even if it does taste better, calories you know), go for a
short walk and think to yourself that no matter how many triggers occur
like this, you will Never Take Another Puff!
Joel Some further clarification:
The
kind of trigger talked about here is not just when going out to
different places though, home based activities will have the same
reaction. Any activity that takes over 20 minutes would eventually get
tied into smoking. Mowing the lawn, laundry, using the bathroom, paying
bills, talking on the phone, basically, anything that took time very
likely became a smoking based activity or had built in smoking breaks
associated with them. The first time encountering any of these
activities after cessation would be a powerful trigger.
But
again, the only way to break these associations is by encountering them
the first times, and overcoming them. After a few repeated episodes,
not smoking will become the habit for the event. Again, not by time
passing but rather by repeated experience. But my closing statement
above still applies to them. No matter what triggers occur, all that
you need to do to overcome it and learn a new experience as an
ex-smoker is to Never Take Another Puff!
|
|
|