You had a good quit going, then you smoked one. Now what?
A slip is a red arrow pointing to a personal trigger challenge. A relapse is a red arrow pointing to a large space in your quit plan.
What to do next?
STOP. Go back to the very beginning. Every single quit - be it an hour, a day or a year - has within it all the tools you need to ensure your next quit is your best (and last) quit ever!
If you have quit for half a day, that means you have quit successfully before! It also means you know how to quit, how to get through an urge, what works good for you and what does not, when your hardest trigger times are and what has led to a slip or relapse in the past.
Move forward today by writing down a successful quit plan, one that is custom tailored just for you via your previous quit(s):
What are your 3 biggest smoking triggers?
How do you plan to get beyond them?
What worked before? What else are you willing to try? Write it down.
What are your 3 biggest motivators for being a nonsmoker?
What are 3 great benefits you noticed last time when you Quit?
Write it down!
Think of 3 more motivators or benefits and add them to your list.
Post your motivators on your refrigerator, bathroom mirror, car visor, desk and so forth. Be sure to Celebrate your Quit! Acknowledge how great you're doing to inspire more great days.
What are your personal emotional triggers?
How did you cope with stress, boredom, frustration and anger last time?
What else can you try this time?
Write it all down. Do it again + add some new options!
How did you reward, relax, comfort, enjoy, fill your time & socialize as a nonsmoker during your last quits? What else can you try? It is important your emotional needs are met, not ignored! If you reward, relax, comfort, enjoy and stay busy, then you will not be bored or stressed or feel like you are 'missing out' as a nonsmoker, so really think it thorugh and write it down.
Why did you slip or relapse this time? Why did you slip or relapse last time?
Using your answers from the above questions, what are 5 things you will commit doing this time instead of smoke when faced with each one of your relapse triggers?
What are 3 more things you are willing to try?
Plan ahead and write it down.
Now you have an outline of your quit personal 'get back on track' action plan.
Remember, NRT/Chantix/Zyban only work to the degree that the quitter works their quit process. Support products are very helpful and they 'take the edge off' as the quitter moves forward. Ultimately, it is the 'quitter moves forward' part that results in a successful quit.
Commit to get back on track with your quit. You can do this - you already have!
Good luck and keep going!
Master Certified Tobacco Treatment Specialist
You don't have to quit alone:
A healthy diet can be an effective quit tool to help reduce cravings, mood swings, withdrawal symptoms and weight gain. Fear of weight gain is a common barrier to quitting smoking, as well as a primary relapse trigger. Following a healthy diet can put you in charge of your weight and wellbeing. Myths surrounding diet and exercise create justifications for weight gain, continued smoking, and relapse. Many people assume the following:
- If I keep smoking, I won’t gain weight. Did you know many quitters are over their ideal weight, so smoking hasn't helped prevent weight gain?
- If I relapse, I will lose the weight I gained during this quit. Did you know most people do not lose weight when they go back to smoking, and that quitting is not usually the cause of weight gain?
- I can’t afford to gain any more weight; it is bad for my health. Did you know that the stress on your heart from a pack a day habit is equal to an extra 90lbs of body weight?
The Awesome Truth About Weight Gain
Weight gain does not happen overnight. To gain 5lbs of actual body fat, you'd need to consume 17,500 calories more than what is required to maintain your current weight! This means you are in control of weight gain - it does not attack you against your willl.
Weight gain is almost always a result of overeating. many people eat too much or eat foods high in sugar and fat. When this is done consistently without exercising, you take in more than you can burn off -- and you gain weight. Eating within individual caloric requirements prevents weight gain.
And, that weight gain alters your muscle to body fat ratio, further slowing your metabolic rate. The more muscle you have, the faster your metabiloc rate. The more fat you have, the slower your metabolic rate. Men generally lose weight faster than women, as they tend to have more muscle. People who are overweight tend to store more fat from the calories they eat than those who are slender. This is why losing weight is harder each time you give it a try. Overweight smokers may already have a reduced metabolic rate as a result of current eating habits, lack of exercise and weight gain. The key to managing weight successfully lies in making different food choices than those that led to weight gain. Adding exercise is a great way to help get a sluggish metabolism going again.
Nicotine is a stimulant, so stopping smoking can potentially affect metabolic rate to a small degree. Reducing calories by just 200 per day can offset any changes in metabolism after quitting. This is the equivalent of bypassing one tall mocha from Starbucks (no whipped cream) or half a ham & cheese sandwich per day. Preventing weight gain realted to quitting smoking requires minimal changes to current lifestyle.
‘Scale Weight’ fluctuates from day to day based on multiple factors, including food consumption, sodium intake, water retention, hormones, medications, amount of sleep and stress levels. Weighing daily is not advised for this reason, as it can needlessly discourage the quitter. Most quitters gain less than 10lbs, which can be managed by making reasonable daily diet choices.
Hormones and Weight Gain
Women who quit may experience symptoms from hormone fluctuations similar to PMS. These symptoms may include increased appetite, bloating, cravings and water retention independent of dietary intake. Women quitting during or after menopause may experience increased fat storage (usually in waist/abdomen area) and reduced metabolism independent of quitting smoking. Hormone levels usually balance out within several months of remaining smoke free.
Some studies show quitters who use nicotine gum, lozenge or bupropion to support their quit may be less likely to gain weight during their quit. However, this effect only lasts while on the meds.
The Best Kept Secret: Fruits and Vegetables!
Research shows that among current smokers, those who ate the most fruit and/or vegetables were more likely to smoke less than a pack a day and wait at least 30 minutes before smoking their first cigarette of the day. This reduced dependence on smoking is huge, and a testament to the importance of dietary choices during your quit. Research shows abstinence rates were higher for quitters that consumed the highest amount of fruits or vegetables, and 3 times higher for those who ate both. (1)
Fruit and vegetable consumption, non-caffeinated beverages and dairy products worsen the perceived taste of cigarettes. On the other hand, meats, caffeinated beverages and alcohol were perceived as enhancing the taste of cigarettes. Drinking coffee or a cold beer may increase your cravings, so choose wisely for success.
Fruit comes to the rescue! The sugars in fruit also increase dopamine levels and thus reduce the craving for a cigarette, resulting in fewer cigarettes smoked each day and less nicotine dependence. Fruit contains fiber and many other beneficial nutrients (such as vitamin C) which also interact with the dopamine system. By getting your sugar crave fed with fruit, the newly quit can avoid candy and other junk foods that lead to binging and weight gain.
Daily Diet Tips for Success
Eat small, healthy, frequent meals to keep blood sugar levels steady. This will reduce cravings, fatigue and mood swings while revving up the metabolic rate. This one tip alone may counteract potential metabolic changes from stopping smoking.
1. Eat lots of fresh fruits, vegetables! Half of your plate should be filled with F&V.
2. Eat nonfat dairy products, lean protein and whole grains.
3. Drink plenty of water, for both fullness and cleansing.
4. Avoid soda, junk food and excess sugar,fat and sodium.
Pay attention to what you eat, how much you eat and how often while consuming as many fresh fruits and vegetables as possible. These steps will ensure you keep both your quit and your waist line. The quit process brings opportunity to reach your weight management goals, as well. Another key component to success is exercise, which will be my next blog topic!
Keep going and KTQ,
Vikki Chavez CTTS-M
You don't have to quit alone:
(1) Reference: A Longitudinal Evaluation of Fruit and Vegetable Consumption and Cigarette Smoking Jeffrey P. Haibach, M.P.H., Gregory G. Homish, Ph.D., & Gary A. Giovino, Ph.D., M.S., Nicotine Tob Res (2012) doi: 10.1093/ntr/nts130
Quitting smoking is quite an accomplishment! You have braved your way through doubt, cravings, stress, triggers and other smokers, yet remained true to your Quit. Congratulations! You may find that your self confidence has increased since you quit smoking, and that confidence has spilled over to other parts of your life. If you think it hasn't, perhaps you need to step back and really take a look at the new you!
You have become an even better smoke-free version of You! Keeping your quit takes commitment, resolve, problem solving, delayed gratification, a willingness to change, let go and give up your well worn path for the unknown adventure ahead.
While going through the quit process, you also learned a lot about yourself! You learned how to control your response to emotions such as anger, sadness, loneliness, frustration, boredom, craving and irritation. You’ve sat with these emotions and come to accept that they are normal and will pass. You now understand your emotions instead of avoiding them, and have new coping tools so your needs are met. As a result, your emotions do not affect you – or those around you – adversely. By doing this, you've improved your overall well being!
Improved well being, self efficacy and healthy self esteem are the cornerstones of a happy life. They reduce stress, give you a sense of control over your choices, increase your ability to handle day to day life situations and help you work through challenging times successfully.
As a successful quitter, you continue to make ongoing, daily choices that enhance your life. That means you have discipline, courage and tenacity. Along the way, you've learned some new things about yourself, set new goals and acquired effective tools to make your goals a reality. Quitting smoking has an unexpected side effect - it opens the door to a healthier lifestyle on multiple levels.
The truth is, You are amazing! What will you do next with your newly discovered confidence, competence and success? Keep going, keep up the good work and KTQ:)
Master Certified Tobacco Treatment Specialist
No One Has To Quit Alone:
There are some misconceptions about quit support products, specifically surrounding the ‘support’ part! Take Nicotine Replacement Therapy (NRT) for example. As tobacco treatment specialists, we sometimes hear "My NRT is not working". Let's look at the role NRT plays for a basic overview of what to expect. NRT does not make you quit smoking. It does not remove the habitual want to smoke, or the emotional need to smoke. NRT does not eliminate withdrawal symptoms, nor does it prevent the detox process from occurring.
So what does NRT do? It takes the edge off cravings so you can focus on breaking your lifelong habitual, behavioral and emotional attachment to the daily ritual of smoking. NRT supports your efforts by reducing the physical cravings and withdrawal symptoms so you are more likely to stick with the quit process long enough to succeed.
NRT is not designed to match your smoking habit nicotine consumption milligram for milligram, but rather to reduce cravings by delivering a slow, steady dose of nicotine in your system based on the average amount of cigarettes you smoked prior to your quit date. This slow, steady dosing avoids the rapid and addictive 'rush/crash/crave' cycle that smoking provides (and makes quitting so difficult). NRT helps by lessening the intensity of physical withdrawal symptoms. Physical withdrawals will still occur as your body detoxes, heals and adjusts after years of inhaling toxic, chemical filled smoke, tar and gasses into your lungs and throughout your entire system. Nicotine is just one of the many thousands of chemicals in cigarette smoke.
NRT is advised to be used for at least the first 8 weeks of your quit while stepping down gradually. Stepping down as directed ensures minimal cravings and maximum quit support. Why 8 weeks? Research shows it takes a good 8 weeks of practicing new behaviors, habits and coping tools to learn a new habit, such as being a nonsmoker! Doing so with overwhelming physical cravings often leads to relapse before any of the learning new behaviors or habit breaking part takes place. Nicotine and temporary cravings are a small part of the Big Picture. Long term quit success comes from having 8 weeks of practice and actively working to learn new behaviors and coping tools, not from 'using NRT'. The Quitter must actively work their quit process in order for NRT support to be most effective.
So, how do you work your quit process? Start by identifying your top 3 tobacco triggers. Then, come up with effective new coping tools that will work for You. This is where you want to put your time, energy and focus during the next 8 weeks you have NRT support. Practice getting through stress, boredom, relationships, disappointments and day to day life situations without using tobacco. Practicing new coping tools ensures your quit process gets easier as time goes by. No amount of NRT can do this particular part of the quit, which is a good thing! It forces the newly quit to start really thinking about living their day to day lives without a cigarette. In each of those moments where you choose to do something else instead of smoke, you will be laying the foundation for becoming a nonsmoker.
The key to success is to let NRT do it's job by using it correctly as directed, while you do your job - actively work your quit process! Along the way, you'll discover lots of new things to do as you enjoy your healthy, smoke free lifestyle.
Master Certified Tobacco Treatment Specialist
Don't quit alone! We can help:
Debates between ex-smokers about the meanings of 'slip' and 'relapse' are often contentious. Such discussions generally reflect fears that a break in tobacco abstinence makes full relapse inevitable, or that anything short of NOPE (Not One Puff Ever) implies permission to light up at will. Many insist that quit-dates should measure absolute abstinence from tobacco, and that loose quit-smoking definitions threaten quit-smoking peers. Dually-addicted ex-smokers often object that if alcoholics or junkies ingested even a tiny amount of alcohol or heroin, they'd have to start over and change their sobriety date. The common consensus of these debates is that there should be no distinction made between slips and relapses.
So Is There a Difference Between Slips and Relapses?
In the quit-smoking world, a slip is defined as a simple break in abstinence, while a relapse is considered a return to previous smoking levels and behaviors. Both terms refer to smoking episodes, with the primary difference being the degree, duration or severity of smoking. Seems pretty cut and dry, but the issue gets more complicated when we consider a common psychological phenomenon called the Abstinence Violation Effect (AVE). If you've ever broken a New Year's Resolution or gone off a diet, you've probably experienced the AVE yourself; it's that little voice that told you, "You messed up, so you might as well give up." Among smokers, the AVE usually manifests as, "Well, you already had a puff and blew your quit, so just go ahead and buy a pack (or a carton)."
Post-slip inventories often uncover thought and behavior patterns that led to the abstinence break, but slips typically appear to be spontaneous, coming 'out of the blue' in moments of anxiety, boredom, or lowered inhibition. The power of the AVE requires an urgent response. Research consistently indicates that if promptly addressed, most slips can be stopped in their tracks before the AVE sets in. Treating a slip as just a temporary bump in the road can more effectively prevent a full relapse than heated arguments about definitions, resetting quit-dates or quit-stats, etc.
[Note: What distinguishes smoking slips from those of other addictions is environment: ex-smokers are more likely to have been breathing the secondhand smoke of others prior to their slip, meaning they were already ingesting their drug of choice before they made a choice to use it. In alcoholic terms, this would be analogous to a sober person drinking a diet Coke into which his peers were methodically dropping small amounts of booze.]
In our opinion, the question isn't really about slips vs relapses, it's about what the ex-smoker's attitude ought to be during the quit, and what their response should be if a slip occurs. The default position during quitting must be N.O.P.E. at all times. Not One Puff Ever. No level of smoking is safe, and any deviation from that position threatens the health of everyone connected to the smoker. But since nicotine is one of the most powerful addictive substances known to humans, and use of it can transcend normal willpower, we must be prepared for a slip and ready to prevent its escalation into full relapse. All other questions about quit-dates, accumulated time, and quit-statistics should be dealt with later on, once the quit is again secure. First Things First.
So What Does All This Mean to Ex-Smokers, and Those Who Support Them?
To the 'slipper': Avoid bad environments whenever possible, until you're strong enough to handle them. Pay more attention to your triggers. Connect with your support network often (and immediately, if you slip), by phone, text, internet, or personal visit, and next time reach out before you take that puff. Examine the thought patterns that seduced you into the lie about 'just one'. Be grateful you dodged the bullet this time; next time you may not be so lucky.
To those who care about the 'slipper': Try to be supportive, and be upset at the addiction, not the addict. Use tough love if you feel the need, but remember that slips and relapses are often part of the process, and can convince apathetic ex-smokers to be more committed to their quits. A good rule of thumb? "Say what you mean, but don't say it mean." Don't pressure the slipper to define quitting your way, or you may make it easier for them to conclude they can't succeed. And remember that tobacco is the toughest addiction of all to beat; if you've been smoke-free yourself since day one, you are blessed -- but not invulnerable.
KTQ, and visit QuitNet if you think you might slip,
Alan P, MTTS