My standard reply to people
writing me about clinics in other areas:
I am generally unhappy with most programs I find on smoking cessation throughout the country. The vast majority of programs follow recommendations and guidelines that are considered the state of the art in smoking cessation, and unfortunately, the state of the art in smoking cessation generally produces dismal results. It is the reason I have tried to put everything I can out in the Internet, free of charge for all people to have no matter where they live.
Here is one article that I use describing what I though of programs that were used in the past on treating smoking:
“I Liked My Other Smoking Clinic More!”
Almost 30 years ago when I was conducting one of my first Stop Smoking Clinics, one of the successful participants, a lady named Barbara, told me that she had once attended another clinic and liked it more than ours. I asked her how long she had quit for in that program and she said, "Oh, I didn't quit at all." I then asked her how many of the other people quit. She replied, "I don't know if anybody quit." I then asked, if nobody quit, why did she like the program more? She answered, "When I completed the program, I didn't feel bad about smoking!"
The task of any smoking clinic should be to help the participant break free from the powerful grip of the nicotine addiction. To do this, each participant needs to have a thorough understanding of both why he or she smokes and the consequences associated with maintaining use of cigarettes. Cigarettes are addictive, expensive, socially unacceptable, and deadly. How in the world can any individual or clinic realize these effects and minimize the significance to the point where a smoker doesn't feel bad smoking?
The natural impulse of most smokers is to deny the health and social implications of smoking. When he picks up a newspaper and sees a headline with "Surgeon General", he will read no further. When he hears a broadcast on radio or television about the dangers, he either totally disregards the message or maintains the false belief that the problem doesn't apply to him. But eventually, even his own body complains. He may experience physical symptoms such as coughing, wheezing, pains in chest, numbness in extremities, headaches, stomachaches, hoarseness, and a variety of other complaints. He will generally pass the blame to the weather, his diet, to his stress, to a cold or flu, to allergies or any other excuse he can muster up to protect his cigarettes.
Our clinic was designed to permanently destroy all rationalizations of smoking by the smoker. He may make up lots of excuses for smoking, but he knows that they all are lies. Our clinic will accomplish one of two goals. Either the smoker will quit smoking, or the clinic will screw up his smoking for the rest of his life. No longer will he be able to sit back at the end of a day and think to himself in ignorant bliss how much he enjoyed his cigarettes. To the contrary, if any thought of smoking is allowed to creep into consciousness, it will be anger over how stupid it was to inhale 20, 40, 60 or even more cigarettes that day, and how sad it is that he is probably going to do the same again tomorrow.
Why do we want to make the smoker miserable about smoking? Because maybe if he gets mad enough about smoking he will stop it. Sooner or later logic may motivate him to stop. Maybe he will do it on his own, or maybe he will come back to us for help. How he does it is not important; what is important is that he does quit. For, while the concepts we instill in him may make him miserable, not understanding them can cause more significant long-term suffering.
If our clinic did what Barbara's first clinic accomplished - alleviating negative feelings toward smoking - it could result in the ammunition necessary to maintain smoking. Since cigarettes are responsible for over 400,000 premature deaths per year and the crippling of literally millions of others, alleviating the anxiety of smoking is not in the best interest of the smoker. Consider the physical, psychological, social, economic and any other personal consequences of smoking. Consider them all and - NEVER TAKE ANOTHER PUFF!
As I said above, most of the programs out there now rely on the state of the art quitting aids. Below are a series of articles discussing my views as to why I see real limitations in all of these aids and thus, most of the programs that rely on these aids.
I usually get a steady stream of one or two emails a month from people inquiring why I personally have such a critical view on the use of nicotine replacement products. Being that it takes time to personally answer all of these emails, I have assembled links to the series of articles that I have written to address the different issues involving the use of nicotine replacement products for smoking cessation.
Pharmacological Aids to Smoking Cessation
Pharmacological Aids Part II
40 Years of Progress?
Quitting Methods: Who Should You Believe?
So How Did Most Successful Ex-Smokers Actually Quit?
Most expert say "Don't quit cold turkey"
Hooked on the Cure
Is Cold Turkey the Only Way to Quit?
I originally wrote this to a member asking if we knew of a program that would lock her up so she would have to quit smoking:
Being Locked Up to Quit Smoking
I do think there are some clinics out there that do basically lock up people to quit smoking. But I wouldn’t put much stock in the technique. We lock up people all the time in our hospital and don’t let people smoke. It’s not in our smoking clinic; it’s in our intensive care unit. You can lock people up for days and weeks if the condition is serious enough.
Technically, these people are detoxed from nicotine. Heck, some of them were comatose and never even experienced withdrawal. In theory, this sounds appealing to some smokers. But the reality of the situation is often, in fact maybe more often than not; the first thing these patients do upon release from the hospital is grab for a cigarette. You see these people never quit smoking. They were smokers who were just not allowed to smoke.
They don’t learn anything about survival in the real world without smoking. They know how to be fed intravenously, they know how to use a remote on a television, but that is about it. The urge for a cigarette upon being released is incredible. It’s interesting though, there is a real easy way to stop the urge. Throw them on a gurney, stick an IV in their arm and all of a sudden they don’t need a cigarette. They are doing the one thing they learned, being a connected patient.
People need to face the real world as quickly as they can to start to break the associations of day to day rituals. Only then will they prove to themselves that there is life after smoking.
P.S. There actually was a hospital in the Chicago area that used to have an inpatient unit for smoking cessation. It went under in less than a year of operation. I had three of their patient’s come to my program to quit. Two of them made it. All of them said that they were basically doped up during the hospitalization. I think they were using a drug called clonidine at the time. Powerful antihypertensive that at one time was thought to be helpful. Never met anyone who actually got off smoking using it though. So if you find a program, check out what they do before assuming it’s a good plan.
I've tried everything to quit smoking and nothing works
For people who are a bit concerned that it is impossible for you to quit because you tried “all the other ways” before, don’t sweat it. It is usually that you tried a bunch of other ways that by their own limitations had a lousy chance of success. Even the cold-turkey you tried, if it was without a true understanding of the addiction and what you were fighting had severe limitations. It wasn’t that your ability to quit didn’t exist, your techniques or preparation were just not methods that a true drug addiction was going to be respond to. If you follow our advice and everybody’s lead here, this quit will be different.
Here is an article you will find of particular interest on that issue:
How Does Your Program Compare To...
“How does your program compare to hypnosis or acupuncture?” "Do you know anything about the single session treatment program advertised on the radio?" "I hear they have in patient treatment program at another hospital, what do you think of that for quitting smoking?" "My doctor said I should try nicotine gum, do you agree?" "I hear there are programs which promise no withdrawal or weight gain." "How about the shock treatments with money back guarantees?" "Why should I choose you over the free program offered at...?" Almost daily we will receive calls asking at least one of these questions. It seems everyone wants us to compare what we do with that of other "treatment" strategies. While the specific questions vary, my advice is inevitably the same. If you are considering us or another program, go to them first.
People seem to be surprised at this advice. I think some wonder whether or not I am receiving a kickback from the other organization. But money is not the factor influencing the advice to seek help elsewhere before attempting us. Or maybe they think I can't defend our program over the other "proven" method. This assumption is also incorrect. Why then, am I willingly turning away potential customers to the local competition?
Anyone who has gone through our clinic will attest that participation in our program requires a 100% effort and commitment to attempt quitting. That is not to say that every participant must know before hand that he is going to stop. The person must be resolved to the fact that he will try as hard as he can to stop for just two weeks, a day at a time. Then, once past the initial withdrawal syndrome, he can decide whether or not he truly wishes to smoke. We want him to reach the point where he has a free choice. But he must base his decision on his true options, smoke nothing or everything, there is no in-between.
Anyone coming into our program with a backup method in mind, is not normally willing to give the 100% necessary to break the initial grip. When things start getting tough, which they almost inevitable do, the person just throws in the towel and takes a puff with the idea that it is no big loss, he will just try the other program next time. But his assessment is grossly mistaken - taking that first puff may very well be the biggest mistakes he ever made in his life - one that may in fact cost him his life. He may never again have the desire, strength, or opportunity to quit again.
What of his hypothesis that the other program will probably work better for him? Well, let it suffice to say, that when I suggest that a smoker goes to another program to quit before coming to ours, I am not really worried about losing potential income. I am just postponing when I may actually meet and work with the individual. In fact, the odds are, our price will increase significantly by that time and they are usually willing to pay. In the interim, they spent hundreds to thousands of dollars trying all these magical programs or feeding their addiction.
But money is not the major factor which needs to be considered. Smoking an extra five years, 10 months, or even a few weeks carries a potential risk. You just don't know which cigarette may be the one to initiate an irreversible process, such as cancer or a fatal heart attack or stroke. Every day you puff these risks remain high. But the day you stop, you begin to reduce your risks, and eventually, they can drop to that of a person who never smoked a day in his life. Then, to keep your risk as low as possible and to never again have to go through the quitting process, simply - NEVER TAKE ANOTHER PUFF
The Easy Way Out!
Did you hear about the lady who went on two diets simultaneously to lose weight? Doing both at once she ate enough food to satisfy her appetite and figured she would lose weight twice as fast.
This humorous story illustrates a very serious point. Human nature dictates that we look for the easiest and least painful route to make necessary changes. Unfortunately, what often appears to be the easiest technique may not always be the best. If this lady really relied on this twisted logic, she would not only fail in losing weight, but would probably end up weighing more than before she started her diets. And while this story may seem farfetched, many people who try to follow medically unproven and controversial weight control programs often end up with this very dilemma.
But weight control is not the only situation where people rely on unsuccessful techniques. Cigarette smoking is another problem for which people try to find different solutions. People are always looking for new and easy ways to quit smoking. Many behavioral scientists believed that smoking is only a learned pattern. If this were so, there would be many different approaches available to quit. Behavior modification techniques such as reducing the amount of or exposure to a substance or situation, aversion therapy, hypnosis, acupuncture, record keeping, desensitization and countless other approaches have been used for years to help people unlearn unwanted behavior patterns.
But cigarette smoking is not simply a learned behavior or bad habit. It is more complex, more powerful, and worst of all more deadly than most bad habits. Cigarette smoking is an addiction. This fact becomes quite evident the first day of every smoking clinic. Just about every person in the group can relate some story which demonstrates that to some degree he or she is controlled by cigarettes. Some have gone so far as to rummage garbage cans in the middle of the night in search of cigarettes. Others take butts out of dirty ashtrays. Still others sneak cigarettes while hospitalized from smoking-related illnesses even though smoking is expressly forbidden by their physician. After hearing of these dramatic experiences, few people argue the point that the addiction to cigarettes exerts tremendous control over the smoker.
Addiction does not respond to cut-down approaches. Addiction does not lend itself to controlled use of the substance. If people try to treat an addiction as a bad habit, they will lose to the addiction. If, on the other hand, they treat an addiction as an addiction, they stand a good chance of beating it. Once a person is addicted to a substance, he must totally avoid any use of that substance or else relapse into a full- fledged drug dependency. This holds true for alcohol, heroin, nicotine, and a host of other drugs.
As far as nicotine is concerned, if the smoker quits cold he will overcome the strongest stages of withdrawal within 72 hours. After two weeks, physical withdrawal ceases. Then, once it is understood that any amount of nicotine administered in any manner will reinforce his dependence, he has all the ammunition he needs to overcome the occasional desire. He must always base the decision of whether or not he should smoke a cigarette on his true options. He has the choice of smoking none or smoking everything. There is no in between. Based on that, his choice is clear - NEVER TAKE ANOTHER PUFF!
Take advantage of the information we made available here at AskJoel, at www.whyquit.com, and the book, articles and video lessons available at www.whyquit.com/joel.
I really have tried to put all of the material and information out on the Internet to help people no matter where they are from and at absolutely no cost. Most people who have successfully quit smoking have done it with almost no understanding and information. Quitting is possible and with all of the information provided between these online resources, you will have a real edge.