Surviving Without Smoke: Month 1

From the WebMD Archives

You just quit smoking. Literally. Five minutes ago you put out your last cigarette.

Now what?

How do you get through the next few hours and days, which will be among the toughest you’ll experience, in your journey to becoming an ex-smoker? You need practical strategies to help you survive the nicotine cravings and nicotine withdrawal, and help you break the psychological addiction to cigarettes.

After You Stop Smoking: What’s Happening?

After you quit smoking, a lot of good things happen to your body very quickly. Within just 20 minutes, your heart rate and blood pressure go down. Within 12 hours, the carbon monoxide levels in your body go back to normal. And within a couple of weeks, your circulation improves and you’re not coughing or wheezing as often.

But some pretty unpleasant things happen right away, too. The symptoms of nicotine withdrawal include:

And they kick in fast. Research has found that the typical smoker begins to feel the symptoms of withdrawal within an hour of putting out his last cigarette. Feelings of anxiety, sadness and difficulty concentrating appear within the first three hours.

These unpleasant -- some people might say intolerable -- symptoms of nicotine withdrawal usually hit a peak within the first three days of quitting, and last for about two weeks.

So before you can stop smoking for good, you have to quit for the first two weeks. After that, it gets a little easier. What can you do?

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Be Prepared

You should actually start making plans before you quit, says Coral Arvon, PhD, MFT, LCSW, a behavioral health specialist at the Pritikin Longevity Center in Miami, who is also a former smoker. During the week before your Quit Day, make the following preparations:

  • Put together a list of all the reasons you want to quit smoking. Print it out on index cards and stash the cards where you used to put your cigarettes -- in your purse, in your desk drawer, in your nightstand.
  • Pay attention to when you smoke, where, and with whom. Then make specific plans for what you can do instead. Do you usually have a cigarette with a cup of coffee in the morning? Do you take a “smoke break” mid-morning with a co-worker? Write down alternatives that will keep your mind and body occupied. Don’t wait until after you’ve quit and the craving strikes!
  • Pick a good “quit day.” We’re all under stress in our busy lives, but some times are more stressful than others. Don’t choose a day to quit smoking that’s in the middle of your most intense month at work, or right before finals, or while a loved one is seriously ill. “Try to quit at a time when you can avoid major stress for at least a week or two,” says Arvon.
  • For one week, gather the contents of your ashtrays. Put them in a jar with a lid, and pour some water on the resulting mess. Seal the jar. We’ll talk about what to do with it later.

After You Quit Smoking

So you’ve made your preparations, you’ve thrown away your packs, and you’ve smoked your last cigarette. Now it’s time to act like an ex-smoker. What next?

First, you need to learn to delay the urge. There will be an urge to smoke -- almost immediately. Any given urge to smoke lasts about 30 seconds before diminishing again, Arvon says, so you need to do things to keep your mind and body busy until the urge fades again. Some options:

  • Take 10 deep breaths, walk to the sink, pour yourself a glass of ice water, and drink it slowly.
  • Fix a healthy snack. Something that makes your breath and teeth feel fresh is great, such as carrot sticks or a citrus fruit. Or suck on a peppermint.
  • Keep a paperback book with you on a subject you want to learn about. When you feel the urge to smoke, pull the book out along with a pen or highlighter and read a few pages while making notes or highlighting passages. “You’re occupying your mind and your hands with something other than a cigarette,” says Arvon.
  • Take out your list of reasons why you’re no longer a smoker and read it to yourself. Out loud if you have to.
  • Call a friend or a family member who supports your efforts to quit smoking. You don’t have to talk to them about smoking or quitting -- just hold the phone in your hand instead of a cigarette, and talk about sports, the weather, or your next vacation until the craving passes.
  • Go high-tech. Download a quit smoking application for your smartphone that helps you delay your urges. Try Quitter, which tracks how long you’ve been smoke-free and shows you the money you’ve saved. Next time you want a cigarette, check out your riches instead.
  • Remember that jar with all your old ashtray contents? Keep it handy, in your desk drawer or under the kitchen sink. When a craving hits hard, pull out that jar, open it up and take a big whiff. “It’s really disgusting,” says Arvon. “It makes you want to never see a cigarette again.”

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Many people, knowingly or unknowingly, sabotage themselves during the first weeks of quitting, says Arvon. During this time when you’re very vulnerable, don’t put yourself in situations that will up the pressure to smoke. For example:

  • Don’t go out with friends who are smokers for a few weeks. This doesn’t mean to drop your smoking friends completely. Just tell them you’ll be taking a break while you’re in the early, difficult days of quitting and back when you’re feeling stronger.
  • Change your habits. If sitting outside your favorite coffee shop with your morning coffee and a cigarette is an old familiar routine, you might find it almost impossible not to light up there. Instead, have tea or juice on the front porch with your morning paper.
  • Many people associate alcohol with having a cigarette, so you might want to stay away from happy hour for a few weeks.

Instead of sabotaging yourself, reward yourself every time you succeed. Many people recommend rewards after the first week or two of quitting, but, Arvon says, why wait that long? Give yourself small rewards for every single day you make it through the first two weeks, and bigger ones at the end of week one and week two.

Small Rewards:

  • A new book, DVD, or video game.
  • A dozen golf balls.
  • New earrings.
  • A manicure (for your hands that will look so much more attractive without a cigarette in them).
  • A box of expensive, artisan chocolates. To avoid “quitter’s weight gain,” indulge in just one per evening.

Bigger Rewards:

  • A fancy dinner out.
  • Go to a sports event or concert.
  • Have your car detailed.
  • An evening at the movies or theater.
  • A full-body massage and facial.
  • A weekend away.

You know the things that motivate you. Dole them out to yourself for every day you don’t put a cigarette in your mouth.

Finally, says Arvon, you have to learn to overcome the learned ways of thinking that lead you to pick up a cigarette. “A lot of times, we smoke when we’re feeling stressed, anxious, or depressed. When that feeling comes on, stop and think about why you’re feeling that way.”

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For example, if you’ve missed a deadline at work, you may fear getting in trouble with your boss and losing your job. A smoker will think, “I need a cigarette!” But you’re not a smoker anymore. So instead of grabbing a cigarette, argue with yourself. Be your own devil’s advocate and dispute your irrational thoughts. “I’m going to lose my job!” “No, you’re not. You’ve done a lot of good work and your boss won’t fire you for one missed deadline.” Keep up that argument until the immediate feeling of stress or depression passes and you aren’t feeling that intense need to run out for a smoke.

“The hardest part of quitting is the first two weeks,” says Arvon. “We call the first week after quitting ‘Hell Week.’ The second week is ‘Heck Week.’ After that, it gets easier. The urges don’t go away, but most of them are lighter and you can get through them.”

WebMD Feature Reviewed by Louise Chang, MD on January 21, 2011

Sources

SOURCES:

Coral Arvon, PhD, MFT, LCSW, behavioral health specialist, Pritikin Longevity Center, Miami.

American Cancer Society, Atlanta.

National Cancer Institute, Bethesda, Md.

University of Pittsburgh Medical Center, Pennsylvania.

Hendricks, P. Psychopharmacology, 2006; vol 187: pp 385-396.

© 2011 WebMD, LLC. All rights reserved.

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