Many people (especially women) fear weight gain is an unavoidable side effect of quitting smoking. There is nothing to fear! If you do not replace cigarettes with food, you will not overeat. And if you do not overeat, you most likely won't gain weight. Does that sound too easy? Well, it can be! Just plan new activities to cope with your personal smoking triggers that do not involve food, and choose low calorie, healthy foods when you do eat.
You can replace your old smoking triggers with these new activities, emotional coping tools and behaviors that support a healthy, smoke-free lifestyle:
- Stressed? Learn to deal with stress effectively with new relaxation tools and exercise and activities you enjoy.
- Bored? Engage in enjoyable activities that inspire or entertain you. Reach out for support from friends and family. Stay busy!
- Restless? Do Something! Take charge! Choose to live your life. Get busy and involved with doing things that interest and motivate you.
- Craving? Eat small, healthy meals throughout the day to keep blood sugar levels steady and reduce cravings. Exercise to reduce binging. A brief walk is all it takes to keep your quit and your waistline. Cravings for cigarettes can feel like food cravings, so know this going in and prevent weight gain by stocking up on 'ready to go' healthy snack choices.
- Have you replaced cigarettes with food in the past? That is common for many quitters. As a result, they fear quitting again due to weight gained from previous quit attempts. If this applies to you, remember that it is a result of the change in your eating habits -- not the act of stopping smoking -- that leads to weight gain. You may have an increased appetite at first, so plan ahead for this and you will do fine!
If you were at your ideal weight before you quit, then you already eat in a manner that maintains a healthy weight. Just keep doing what you are doing and be aware in those moments when you contemplate exchanging your old smoking triggers with overeating!
If you were not at your ideal weight before you quit, then smoking is not controlling your weight and chances are your eating habits and metabolism are already set towards weight gain. You can get your metabolic rate kicked up a notch by changing your lifestyle choices to include good eating habits and exercise as you successfully keep your quit!
Your current weight is not a result of you smoking now or due to you quitting smoking in the past. Weight gain is brought on by changes in food quantity, quality and overall daily caloric intake. Did you know that gaining weight actually slows down your metabolism? If you are carrying any extra weight now, that is why it may seem harder for you to lose weight today than it was for you in the past. This is also why it is easier to gain weight today than it was for you in the past.
The good news is, by making healthier food choices and moving more, you can pick up your metabolism and you will lose weight. It helps to focus on the healthy foods you can eat, not the junk foods you cannot eat and of course, to limit your portion size. Put half what you normally would on your plate, and see what a difference that makes over a 2 week period of time! Be sure to exercise to reduce stress, boredom, cravings and overeating. Patience is the key. You must keep going long enough for your metabolism to shift from fat storage mode to fat burning mode.
Here are some pitfalls that plague most people who try to lose weight:
1. Expecting the weight to leave overnight and looking for a quick fix instead of permanent long term changes brought on by healthy, long term behaviors.
2. Not adhering to good eating habits and exercise for even a month in a row, much less the 3 months it takes to create a foundation for lasting results. How do you make it a full month? If you do falter during the first 30 days, pick yourself right back up and keep going! It is the accumulation of many successful days that bring success, not the occasional slip up.
3. Not 'doing the work' long enough to kick up their metabolic rate and as a result, weight loss does not have a chance to occur. This sets up the 'on the diet' quick loss, 'off the diet' fast gain followed by an even slower metabolism than before.
4. Not planning ahead or following the plan, which leads to feelings of hopelessness, disappointment and failure followed by more overeating as the cycle continues.
You can do this! You can quit smoking and maintain your current weight or even lose weight, if that is what you would like to work towards doing. Once that first month of consistent, healthy eating and exercising is behind you, weight loss comes fairly quickly. By sticking with it, you'll make permanent lifestyle changes and alter your metabolic rate for long term success. You can get fit and KTQ!
Vikki Chavez CTTS-M
Master Certified Tobacco Treatment Specialist
Although some of us quit smoking on the first try, most of us have made more than one attempt. That's not necessarily a bad thing; each attempt taught us something valuable about staying quit. In fact, the more times we've 'failed' at quitting in the past, the better our odds of succeeding this time.
One reason many of us make so many quit-attempts is that we don't always have the motivation to quit, or to maintain our quits afterward. Most smokers first consider quitting because of external motivators--the pleas of spouses or loved ones, health scares, smoke-free workplaces or financial incentives by our employers, or increases in cigarette or insurance costs.
Many of us grudgingly agree to quit smoking to satisfy others, but don't really have compelling reasons of our own to do so. For us to have the best shot at quitting and staying quit, it helps if quitting is our idea. Just how do we make it so?
Some simple exercises can help to move us in that direction, at any time before or after our actual quit-day. Ask yourself:
- On a scale of 1-10 (with 10 being the highest), how much do I really want to quit right now? What would need to change for me to raise that number a couple of notches? Is that a change I can work on?
- Using the same scale, how confident am I that I could quit right now? What would need to change for me to raise that number a couple of notches? Is that a change I can work on?
Next, a set of pros/cons questions can help clarify what we really think about our smoking. Ask yourself:
- What do I like about smoking? (is it a welcome break from work, a reward, or time spent with friends?)
- What don't I like about smoking? (the smell, coughing, the hassle of smoking publicly, the health risks?)
- Do the negatives outweight the positives?
- Are there healthier replacements for the things I like about smoking?
Next, a sort of Cost/Benefit Analysis will help uncover fears and other obstacles to quit-motivation. Ask yourself:
- If I continue to smoke, what's the worst thing that could happen to me? What's the best thing that could happen?
- If I quit smoking, what's the worst thing that could happen to me? What's the best that could happen?
- Does the best or worst weigh most in my analysis?
Imagining a Smoke-free Life
Finally, an effective way of making quitting your idea is to imagine all the possible advantages of quitting, and to focus on them. A dramatic improvement in health is one possibility, as is a longer life. But there are other benefits, as well. You could look younger, with fewer wrinkles, softer skin, and shinier hair. You might save a lot of money that would have gone up in smoke, or been spent on treating tobacco-related illness. You could have more stamina and endurance, sleep better, enjoy more tastes and smells, have whiter teeth, increase your self respect, be a better role-model for your children and grandchildren, save your loved ones from second or thirdhand smoke--the list of great reasons to quit smoking is potentially endless.
- What are five good reasons for me to quit smoking?
- What are my three best reasons to quit smoking? Note: Record My Three Best Reasons, and keep that list for handy reference in your phone, wallet or purse.
Motivation isn't something we can turn on and off like a light switch, but once we set our brains in motion solving a problem (like smoking), they inevitably move us toward a solution (quitting). The process may take a day, month, or a year, but as long as we're contrasting and comparing our old ways to the new way, our old desires to the new ones, our smoking life to a smoke free life, our odds of developing the motivation to get us there are greatly increased.
Good luck, and don't forget to visit the Q for more education and support.
Alan P, CTTS-M
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
A recent flurry of provocative headlines was based on a new Massachusetts population study (1), which concluded that "persons who have quit smoking relapsed at equivalent rates whether or not they used NRT." Aside from the inaccurate press coverage, we believe the study's implications aren't justified, or even appropriate, in light of its limitations. In addition, they contradict a large body of previously well-established research.
In our estimation, these are the primary flaws in the study's methodology:
- It's not a controlled study. A population study is good for gauging behavior of a diverse demographic, but is unable to identify all factors which may skew results -- such as differences in smokers' addiction levels, number of quit attempts, type of NRT selected and/or professional support utilized, and so on. In addition, other population studies which reached different conclusions were apparently not considered by the study's authors.
- The follow-up survey response rates weren't high enough. Only about 1/3 of the original group responded to the final population survey—again, making it difficult to identify factors which could or would have affected overall outcomes.
- The NRT-using group was too small. Only 15% of the recent quitter group actually reported using NRT for the recommended length of time, and no determination was made of whether the NRT was otherwise used as recommended (proper dosage, frequency, etc).
- NRT is not a maintenance or relapse prevention aid. It's a short-term tool to increase chances of quitting in the first six months. Long-term quit integrity really relies on whether (and which) maintenance strategies are employed after the quit -- such as peer and/or professional support -- and this study is light on those details.
- The intent of the study is in question. The authors use their findings to advocate more tobacco control funding for large public health programs, which they describe as competing with individual treatment programs, but this study was not designed to compare the cost effectiveness of these two approaches, and did not do so.
The Centers for Disease Control has already officially responded to the study, pointing out that systematic reviews of clinical trials find cessation medications substantially increase 6-month quit rates--which is what they're intended to do. Counseling and NRT are even more effective when combined, and are especially important in helping smokers weather withdrawal during the first few weeks of their quit.
Unfortunately, controversy about the study's NRT conclusions masks the most important takeaway, for tobacco treatment specialists and ex-smokers alike: No matter how you quit, ongoing support and a quit-maintenance strategy are critical for continued smoke-free living.
Alan S. Peters, MTTS; Ann Wendling, MD, MPH
1. Alpert HR, Connolly GN, Biener L. A prospective cohort study challenging the effectiveness
of population-based medical intervention for smoking cessation. Tob Control . doi:10.
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