PLANNING YOUR ESCAPE
By "DocNurse" Norma Stephens Hannigan
It’s hard to believe that the last column I wrote devoted to smoking was back in 2003. It surprises me because, as a former (heavy) smoker and current health care provider, I’m aware of how important this issue is and how we cannot stop bringing it to the forefront at every opportunity. I’m not going to burden you with all of the terrible health effects of smoking – I bet you already know many of them. We all have friends who now have or who have died from tobacco-related illness like lung cancer, heart attack or emphysema. We all know how much more dangerous smoking is in people who have diseases like diabetes or asthma. And, the truth is, if you’re not ready to quit, it doesn’t matter how many horror stories you hear – you are just not going to quit.
My own experience with smoking is a good example of that. I started smoking in high school, since being a smoker was essential to being cool. In spite of almost passing out the first time I was allowed to smoke at home, I persisted, even proud of my ability to overcome all the negative effects of smoking – like the dizziness and faintness. That was soon a thing of the past and before I knew it, I was a full-fledged smoker with a two-pack-a-day habit. Looking back, I’m amazed that I could even afford it! After a major surgery with lung complications, I continued to smoke – including right after respirator treatments.
It’s tough to quit because smoking is more than a habit – it’s an addiction. There is no way around it – the nicotine in cigarettes or chew causes a person to crave the tobacco and to have physical and psychological symptoms when the tobacco is withdrawn. Fortunately, in our modern age, there are now medications that can help ease the pain of the withdrawal. That’s how patches and nicotine gum work – you still get some nicotine, so you don’t feel terrible. While you’re still getting the small amount of nicotine, you begin to work on the behavior changes that must take place in order for you to quit smoking for good. And, eventually, it gets much easier to say goodbye to the patches or gum and good riddance to the tobacco.
Today, there are medications to help you quit smoking. Zyban, a pill you can take, works by lowering the “crankiness quotient” – you know, that nasty way you feel when you haven’t had a smoke and you want to crawl out of your skin. The newest drug, Chantix, works by interrupting the message to your brain that smoking is pleasurable. After a while, it just doesn’t seem like that much fun. And, of course, there’s still the old stand-by of quitting cold turkey. Yes, it’s possible to do with lots of planning and support from friends and family.
So, how do people decide to quit a habit like smoking? Usually it takes some “aha!” moment – like watching a loved one die or getting sick yourself. My “aha!” moment came when I started running. Going to an all-girls high school in the dark ages, we weren’t big into athletics, so I never really had the experience of running any distance. After my first distance running experience, if you can call an eighth of a mile “distance running,” I thought I was having a near-death event. I simply couldn’t breathe. It wasn’t until later that I discovered that the very mild asthma I had was getting worse, contributing to my inability to get any air into my lungs. Did I quit that day? No. But it started my “contemplative” phase – that stage of change when you begin to think more seriously about doing things differently from the way you have been doing them.
Once you begin to contemplate how you could make the change, you begin to plan for it. The most important thing about such a plan is that you not set yourself up to fail. For example, don’t say, “I am going to quit today and never, ever have another cigarette!” While I imagine perhaps that the super-heroes among us might be able to pull that off, I doubt that most mere mortals would succeed with such a plan. And what’s the problem with that plan? Well, how likely is it that you could actually achieve it? And what will happen when you realize you are not meeting your goal? You will get anxious and cranky and run right for the first pack of cigarettes you can find!
It’s very easy to sabotage yourself without even realizing you are doing it. So, for some folks, it might be best to say, “I will cut down five cigarettes a day until I have quit.” We have to be forgiving with ourselves when we don’t meet our goal the first time, or the second, or the third, etc. Addictions like smoking often involve relapse – it’s a natural part of breaking the addiction. Some people do better with it than others. It is important that you not be too hard on yourself if you relapse. The learning will be that you can quit – even if it’s only for a short period of time. At least you will know that it is not impossible.
I quit back in the days long before medications, when cold turkey was the only way to quit. The Seventh Day Adventist church had a good program to quit smoking (and they still do) which taught us how to drink lots of fluids to detoxify your system and how to break the associations you have with smoking. For example, you HAVE to have a cigarette if you’re having a cup of coffee or a beer, right? So, don’t have coffee or beer for a while when you are first trying to quit. You can always get back to it later when your identity as a non-smoker is a bit more solid. That’s right – your identity will actually change and you will go from smoker to non-smoker. Wouldn’t that be great!
There are a million more tips for how to quit smoking on websites all over the internet. Some good ones include www.smokefree.gov and www.cancer.org. You can also check out www.cdc.gov/tobacco for more help. Also, some states have programs where they will give you patches and/or gum for free to help you quit smoking. I am so grateful I quit because I regained control over my own life. As an added bonus, it made my insurance cheaper, too. Good luck planning your escape!
~ Dr. Norma Stephens Hannigan, who recently graduated with a Doctor of Nursing Practice degree, teaches at Columbia University in New York and has treated many truck drivers at the various clinics she has worked over the years. She currently writes from her home in Newburgh, New York.