Barriers to quitting
Smokers have different barriers to giving up smoking. It is important to identify these barriers as they are often the only thing that is standing between you and successful quitting.
Barriers are mostly based on misinformation and can usually be removed by knowing the facts and careful planning.
Coping with stress
Most smokers are surprised to find out that smoking actually increases stress!
When the nicotine level in your body falls between cigarettes, you start to feel anxious and restless (nicotine withdrawal). These feelings occur repeatedly throughout the day and are relieved by having another cigarette. It is easy to see why smokers feel that cigarettes relax them, when their smoking habit has actually created the problem in the first place!
Over time, smokers learn to use smoking to try and cope with other types of stress as well. However, while smoking relieves the stress of withdrawal it does not relieve other kinds of stress, such as a fight with your partner or the pressure of a deadline.
Some of the relaxation from smoking is due to having a break or having a few deep breaths, not the cigarette itself.
Many people feel guilty or ashamed of smoking and worry about the damage to health from smoking and this also creates stress.
Nicotine does have a temporary calming effect, but it is also a stimulant, releasing adrenaline and other chemicals that quicken the pulse, raise the blood pressure and increase arousal.
Quitting can cause stress in the short-term, however anti-smoking medications can usually relieve that. More importantly, studies show that former smokers often feel less stressed and happier after quitting. The improved mental health after quitting is generally maintained long-term.
The bottom line is that smoking is not an effective way to cope with stress and only makes things worse.
There are much healthier and more effective ways to relax, such as:
- Physical activity and exercise
- A relaxation technique:
- Reading, socialising, music
- Talking to a close friend or family member about your problems
- Getting professional help such as counselling, CBT (cognitive behavioural therapy); mindfulness; problem solving; assertiveness training; conflict resolution
Think about what relaxation method would work for you and commit yourself to starting a new strategy before you quit, so you are prepared.
Gaining weight after quitting is a major concern for many smokers, especially women.
As a smoker you are artificially underweight. When you quit the body returns to the weight it would have been if you had never smoked.
The average weight gain is only 2.6kg over the first five years, compared to continuing to smoke. This is not as much as most smokers think. Not everyone gains weight. One in four quitters loses weight or stays the same. However, some quitters will gain more than average.
The good news is that the substantial health benefits of quitting far outweigh the harm from any weight gain. It has been calculated that you would need to put on 42kg to offset the health benefits of quitting.
After quitting, your appearance will improve in a number of ways. Your skin colour improves and you will develop fewer wrinkles. You will lose those yellow tar stains on your fingers and teeth. You will no longer smell like an ashtray.
Why do people gain weight after quitting?
Weight gain after quitting is mainly due to stopping nicotine. There are two ways that nicotine keeps your weight down.
- Nicotine reduces the appetite. After you quit, you may become hungrier for a while and eat more.
- Nicotine also speeds up the metabolism and helps the body burn fat faster. As a result you may gain weight even if you don’t eat more.
Other reasons for gaining weight after quitting are:
- Using food as a substitute for smoking
- The improved taste of food after quitting
- Eating to relieve tension
Recent research suggests that smokers who quit by vaping gain less weight than smokers who quit with other methods. The nicotine from vaping stimulates the metabolism and flavoured vaping can be a substitute for eating.
Can weight gain be prevented?
Research has shown that trying too hard to control your weight when quitting does not generally work and can also reduce your chance of quitting successfully. The best advice is to follow a sensible, low-fat diet, exercise regularly and accept that some weight gain is likely to occur.
Simple dietary advice
- Eat more salads, fruits, vegetables, cereals, rice and pasta
- Reduce fried and high-fat foods such as cakes, pastries, creamy desserts, chocolate
- Eat less take-aways such as hamburgers, pizza and pies
- Choose low-fat dairy foods
- Beware of nibbling, especially on high-fat or high-sugar foods. Chew sugarless gum instead
- Drink lots of water or low-kilojoule drinks
- Try to reduce or avoid alcohol. It is fattening and can weaken your resolve to avoid overeating or smoking
- Watch your portion size
- Use sugar free gum and mints
Exercise reduces weight gain, relieves cravings and stress. It also reverses some of the health damage done by smoking. Choose an activity that is enjoyable and convenient. Where possible, exercise with family or friends. Try to exercise on most days of the week for at least 30 minutes at a time.
The bottom line
It is best to accept some weight gain in the short term if it occurs. Focus on quitting as your number one priority and deal with the weight gain later once non-smoking has become firmly established.
Withdrawal from nicotine
Cravings (the urge to have a cigarette) and withdrawal symptoms are a normal part of giving up any addictive drug and can be quite severe. They are the main reason that most ‘cold turkey’ quit attempts fail in the first week.
As a smoker, you get used to having a certain level of nicotine in your body. You control that level by how much you smoke and how deeply you inhale. When you quit, cravings develop when your body wants nicotine. Also, when you see people smoking or are around other triggers, you may get nicotine cravings.
Cravings can begin within an hour or two of your last cigarette. Each craving only lasts 2-3 minutes, although that may feel like forever! Cravings get weaker and less frequent over time but can last for many years.
Nicotine withdrawal symptoms are also mainly due to a lack of nicotine. They are at their worst in the first 2-3 days and typically last 2-4 weeks. It is helpful to see these as recovery symptoms, a sign of the body healing itself, and to remind yourself that they will soon settle.
Common withdrawal symptoms are:
- Irritability, frustration or anger
- Difficulty concentrating
- Increased appetite and weight gain (tends to be long lasting)
- Depressed mood
- Disturbed sleep (especially waking through the night or intense dreams)
Some people also get
- Mouth ulcers
- Head cold symptoms: cough, sore throat, runny nose, sneezing, headache, fever
- Cravings for sweet foods
Cravings and withdrawal symptoms can usually be treated successfully with anti-smoking medication and behavioural strategies:
All the anti-smoking medications work by reducing cravings and withdrawal symptoms to keep you comfortable while you focus on breaking the smoking habit. Medications usually give good relief, but if symptoms continue to be troublesome, you may need a larger dose or a combination of medications. The symptoms are not always fully controlled but are usually manageable.
- Behavioural strategies
A variety of techniques are available to help with cravings, such as distraction (thinking and doing something else), avoiding situations or people that trigger cravings, delaying a cigarette and escaping from a difficult situation.
A fear of failure
If you have tried several times to quit in the past it is natural that you will be wondering if you are able to do it this time.
It is important to understand that most smokers try to quit a number of times before they are able to quit for good. Failure is a normal part of the quitting process. The only real failure is to not keep trying.
Perhaps you think you don’t have enough willpower. However, willpower is not a magic quality that some people have and some don’t.
It is helpful to think of past ‘failures’ as learning experiences. Each time you try to quit, you learn something, for example that you can’t have ‘just one puff’ or that you are at-risk when drinking alcohol. You can use that knowledge to help you next time. Your chance of success improves with each attempt.
How did you quit in the past?
- Quitting without help (cold turkey) is commonly used but is almost always unsuccessful. Only 3-5% of attempts to quit cold turkey succeed.
- Did you use medication? Did you use it for long enough, was the dose sufficient, did you use it correctly? If one medication didn’t work, did you try the others? Different treatments work for different people.
- Perhaps you used unproven methods in the past, such as hypnosis, acupuncture, lobeline, NicoBloc etc.
Getting professional advice and support and using medication correctly will greatly enhance your chance of success this time. Hundreds of thousands of Australians quit each year and so can you!
Ask your friends not to offer you cigarettes and if possible not to smoke around you. If necessary, leave the room while they smoke.
Plan how to respond if you are offered a cigarette.
If your partner smokes, ask him or her to smoke outside.