You Smoked Again. Now What?

You quit. And then you broke down and had one cigarette -- or more.

“That happens to everybody,” says Frank T. Leone, MD, director of the Comprehensive Smoking Treatment Programs at Penn Medicine in Philadelphia.

It happened to Tiffany Roberson. She thought she’d quit smoking for good when her daughter turned 16, the same age Roberson was when her own mother died of lung cancer from smoking.

But when Roberson gave birth to a second daughter 2 years later, powerful cravings returned, and she gave in.

“I bummed a couple of cigarettes,” says Roberson, an elementary school teacher in Natchitoches, LA. “I felt really bad about it.”

Stop the Slide

One slip-up doesn’t have to lead to another. And a lot of people find it really hard to quit “cold turkey” or need to try several times.

“Forgive yourself and move on,” says Lee Westmaas, director of tobacco control research at the American Cancer Society. “Stressing about it probably makes you feel more prone to want to smoke to deal with those emotions, especially if you smoked when you were stressed out.”

Faced with going back to smoking or recommitting to quitting, Roberson went out and bought a nicotine patch to help her kick the habit. She has avoided cigarettes since. (Nicotine replacement products also come in other forms, including gum and lozenges.)

Trust the Process

Leone likens quitting smoking to a child learning to ride a bicycle. Now and then, you have to put a foot down for balance. For people quitting smoking, it’s the same thing.

“If a cigarette gets put to their lips, they need to think of it as a foot tap,” Leone says. “It’s a process. It’s learning a new set of skills.”

Luckily, if you’ve slipped and had a few cigarettes, you likely won’t face the same physical withdrawal as when you first quit, Leone says.

The True Problem

Triggers that make you want to smoke -- and how you respond to them -- are the big issue.

“It’s not about being strong enough to ignore the signal. It’s not about willpower to push through,” Leone says. “It’s about finding ways to reduce the impact, frequency, and severity of that signal.” In other words, to manage what you do when those triggers strike.

Continued

“I’m probably for the rest of my life going to deal with having those cravings,” Roberson says. “I just have to learn how to combat those desires.”

What to Ask Yourself

Ask yourself these questions about what happened when you smoked again:

  • Where were you?
  • Who were you with?
  • What time of day was it?
  • What was your mood?

You can also brush up on what Westmaas calls “the four D's”:

  • Deep breathing.
  • Drink water.
  • Do something else.
  • Delay for 10 minutes.

“You’ve resisted the craving to that point. There’s no reason you can’t do it in the future,” he says. “It’s a learning experience. That’s why it may take several attempts before you are successful.”

Tell Someone

A family member or friend can help, especially someone who has quit smoking and knows how hard it is. Tell them what happened and ask for their support.
There are also quit-smoking websites, support groups, apps, and text-messaging support services that can help you get back on track ASAP. Your doctor will also want to help, if you find that the urge to light up keeps coming back.

WebMD Feature Reviewed by Brunilda Nazario, MD on January 16, 2019

Sources

SOURCES:

Frank T. Leone, MD, director, Comprehensive Smoking Treatment Programs, Penn Medicine; associate professor of medicine, University of Pennsylvania Medical Center.

Lee Westmaas, PhD, strategic director of tobacco control research, Behavioral Research Center, American Cancer Society.

Tiffany Roberson, Natchitoches, LA.

The Cochrane Database of Systematic Reviews: “Nicotine replacement therapy for smoking cessation.”

Smokefree.gov: “Slips & Relapses,” “Why Quitting is Hard.” 

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