|
Ex-smokers:
persevere!
This
brochure is designed for people who have quit smoking
for more than 6 months.
Print
this brochure, rather than read it on the screen.
Congratulations
on having gone at least 6 months without smoking! You
should be proud of your success. However, you are not
completely free from the risk of relapse. Stay on guard:
20 percent of ex-smokers who have quit smoking for
six months relapse to smoking after one year. Staying
an ex-smoker is not just a question of willpower, but
demands specific
know-how. By reading this brochure, you can acquire
the know-how that has allowed many ex-smokers to avoid
relapsing.
Four
priorities to avoid a relapse
1-
Stay motivated
Do
not let your guard down. Instead, reaffirm your commitment.
For this, make a list of the advantages of having quit
smoking.
The
advantages of having quit smoking:.
By reading this brochure, you can acquire the know-how
that has allowed many ex-smokers to avoid relapsing.
Four
priorities to avoid a relapse
1-
Stay motivated
Do
not let your guard down. Instead, reaffirm your commitment.
For this, make a list of the advantages of having quit
smoking.
The
advantages of having quit smoking:
_____________________ _____________________ _____________________
Here
is what some ex-smokers told us about their experience
of quitting smoking:
- "I
spend less money."
- "I
have more energy." "I'm in better shape."
- "I
have rediscovered tastes and smells."
- "I
feel so much better." "I breathe better."
- "I
am quite proud of myself."
- "I
have better breath." "My clothes are not smoky
any more"
- "I
do not have to be preoccupied with my lungs."
- "I
do not cough anymore." "I do not have headaches
anymore."
- "You
impose less on those around you."
- "My
family thinks quite a bit more of me." "My
family is very pleased."
2-
Abstain absolutely from picking up a cigarette Very
often, taking one or several cigarettes leads to a relapse.
It is VERY IMPORTANT to
avoid taking even just a drag of a cigarette. It is easier
to refuse the first cigarette than the second!
3-
Prepare an "emergency plan" in case you pick
up some cigarettes again If
it happens, act immediately:
- Above
all, avoid starting smoking regularly. Do not buy cigarettes
and throw away the cigarettes in your possession.
- Tell
yourself that this cigarette was going to be the last
one.
- Look
back. Analyze the reasons why you smoked.
- Remind
yourself of your decision not to smoke.
- Consider
this hitch as a normal, learning experience, and not
as a failure.
- Do
not chastise yourself. Avoid making yourself feel guilty.
- Call
on the help of those around you.
4-
Think carefully about your possible previous relapses If,
in the past, you have already attempted to quit and relapsed
to smoking, a good way to prevent a future relapse consists
of reflecting back on the circumstances under which you
relapsed in the past.
The
last time, under what circumstances did you relapse?
_______________________________________________________________________
The
next time, how will you avoid a relapse under similar
circumstances?
_______________________________________________________________________
Know
how to respond to risky situations In
general, ex-smokers relapse because they do not know
how to respond to high-risk situations. It is very important
to recognize these situations, to anticipate them and
to use strategies to resist cigarettes in each of them.
Think carefully about this in responding to following
questionnaire:
|
High-risk
situations:
|
What
is your strategy to resist the urge to
smoke in this situation?
|
Confidence
(1-4)*
|
|
1-
In the company of smokers
|
|
|
|
2-
After you have been drinking
|
|
|
|
3-
In case of an urgent need to smoke
|
|
|
|
4-
After a meal or a coffee
|
|
|
|
5-
When stressed, nervous, or in an argument
|
|
|
|
6-
When you are feeling depressed
|
|
|
|
7-
If you gain weight
|
|
|
* Degree
of confidence in your capacity to resist smoking in each
of these situations:
1 =
not at all confident, 2 = a little confident, 3 = somewhat
confident, 4 = totally confident.
The
following pages describe strategies for how to resist
the urge to smoke in each of these situations. Focus
on the situations that you do not feel entirely confident in
your ability to resist cigarettes. By using multiple
strategies at once, you increase your chances of success.
1)
In the company of smokers
The
majority of relapses happen in the presence of other
smokers. Hence, it is very important that you know how
to resist the urge to smoke in this type of situation.
Prepare
yourself
Prepare
yourself mentally before going to a place where you know
you will encounter smokers (party, restaurant, etc.).
Visualize the situation ahead of time and prepare strategies
to resist cigarettes.
Rehearse
the scene like an actor
Play
out the scene where you refuse a cigarette you are offered,
as well as the scene where you respond to a person who
doubts your ability to remain an ex-smoker. Prepare a
humorous response, this can diffuse many tense situations.
Assert
yourself
It
is likely that some smokers will be jealous of your success
and might encourage you to take a cigarette. Prepare
responses that affirm your new identity as an ex-smoker.
Write below what you will answer to people who encourage
you to smoke or who doubt of your ability to refrain
from smoking:
_________________________________________________________________
_________________________________________________________________
2)
After you have been drinking
One
third of all relapses happen when ex-smokers drink alcohol.
Prepare your personal strategy for this type of situation.
Avoid drinking alcohol or limit your consumption. If,
after drinking, you think that you will "crack" for
a cigarette, leave the place where you are, and take
a walk or go and relax.
3)
In case of an urge to smoke
Over
time, the urgent need to smoke finally disappears. Since
these strong urges to smoke last for only a few minutes,
the best way to deal with it is to waituntil
they pass. You can also use activities that divert your
attention, such as:
- Drinking
water or eating some fruit.
- Chewing
some chewing gum or eating some sugarless candy
- Brushing
your teeth.
- Breathing
several times deeply and slowly.
- Thinking
of the disadvantages of cigarettes (odor, bad breath,
cough, etc.).
- Changing
places or activities, leaving wherever you are, taking
a walk.
- Telling
yourself it would be a shame to ruin all of your efforts
of the past months.
- Calling
your friends or family on the telephone for news.
4)
After a meal or a coffee
To
avoid being tempted to smoke, leave the table immediately
after you finish your meal and brush your teeth. Find
something else to do (e.g., take a walk or wash the dishes).
If coffee gives you the urge to smoke, replace it with
another drink (e.g., fruit juice). Remind yourself that
cigarettes do not make the meal better. Instead, they
reduce your sense of taste and smell; they interfere
with your full enjoyment.
5)
When stressed, nervous, or in an argument
Stress
is often a cause of relapse in people who, like you,
are in the "Maintenance" stage of change. It
is therefore important to know how to face stress without
smoking.
Attack
at the cause of the stress
Try
to understand what causes the stress, then attack at
the root of the problem. It is true that this may take
some time. Between now and then, find ways to respond
to stress other than smoking. The following questionnaire
can help you:
|
The
things that cause me stress
|
My
personal techniques for facing the stress in
this case
|
| |
|
Learn
how to react without getting agitated
It
is possible under some circumstances that your first
reactions will be to become agitated. Take things calmly.
Like an actor rehearses his or her role, play the scene
for yourself where you respond to stress calmly and collectedly.
Tell yourself for example: "In every way, a cigarette
does not improve this situation."
Breathe
deeply
Breathe
several times deeply and slowly. This will help you stay
calm. This technique has the advantage of being able
to be used in any situation.
Calm
yourself by changing activities
To
calm down, start a new activity that you particularly
like, like taking with someone, doing sports or exercise,
listening to music, reading, etc.
Use
a relaxation technique
This
can help you to manage your stress better. Enroll in
a yoga, sophrology or stress management course.
Do
more exercise
Physical
activity is a very good way to release tension. Calm
yourself by walking, swimming, gardening or doing some
sports. Doing sports increases the self-esteem and reinforces
your identity as a person who cares about being healthy.
Doing sports also generates endorphine, the pleasure
hormone. This is a pleasant and effective way to prevent
a relapse!
Express
your feelings
It
is much easier to cope if you talk about your emotions.
Openly and calmly express what you feel. Find someone
you can trust who knows that you are making efforts
not to smoke anymore and with whom you can speak of your
problems.
Manage
your time better
Instead
of just doing tasks as they present themselves, establish
priorities. Get to know your most productive hours and
use them for your priority activities. Control your interruption
better (telephone, visits, etc.). Learn to say no. Avoid
perfectionism. Foresee activities of relaxation to "recharge
your batteries."
6)
When you are feeling depressed
Since
nicotine is a stimulant, many ex-smokers feel a little
down after having stopped smoking. With time, this feeling
should disappear. Be proactive to deal with this problem;
go to see others. If the depression does not pass, take
it seriously and call on a doctor or a psychiatrist.
They can help you.
7)
If you gain weight
After
they stop smoking, certain people gain weight. This weight
gain is usually moderate (3 to 4 kilos, or 8 to 10 pounds,
on average). Some tell themselves that the only way to
lose to the weight is to start smoking again. This is
not sound reasoning. Actually, a relapse can make you
depressed, and depression may lead you to eat more and
gain weight. Remind yourself that if you were capable
of not smoking for many months, you are just as capable
of losing a few pounds or kilograms. To lose the weight,
use the same techniques you used to stop smoking. Start
by modifying your eating habits and by doing more exercise.
Control
what you eat
Eat
less fatty foods (butter, meat, sauces, chocolate) and
more fruits and vegetables.
Do
more exercise and sports
This
is a pleasant and effective way to lose weight. Take
the stairs instead of the elevator. Get off the bus one
stop earlier and walk to your house. Go by bike or walk
instead of driving your car.
Call
a professional
If
you cannot lose weight, do not hesitate to call on specialized
help. Ask your doctor or a dietician. Ask for the advice
of a doctor before you use drugs to lose weight, since
many of these drugs are ineffective.
Other
effective techniques to avoid a relapse
Get
help from your those around you Several
ex-smokers told us that the help of those around them
was a big aid to avoiding a relapse. Let people you trust
know that you stopped smoking, and ask for their help.
Limit your interactions with smokers that may be envious
of your success and incite you to pick up a cigarette
Interpret
the urge to smoke as a signal
Even
a long time after you stop smoking, you may feel the
urge to smoke. Do not consider this urge to smoke like
a failure: Rather, see it as a warning signal that is
telling you that it is time to use the strategies and
techniques described in this booklet.
Reward
yourself
Buy
yourself presents with the money you saved on cigarettes:
you deserve it! This system of rewards has encouraged
many ex-smokers to stay off cigarettes! Rewards act as
a compensation for the lost pleasure of smoking. Moreover,
why not offer a little gift to your friends or family,
who may have had to deal with your post-smoking irritability?
Make
the list of rewards that you will grant yourself:
___________________ ___________________ ___________________
Change
your environment
Avoid
keeping things around that may tempt you to smoke. Throw
away all your packages of cigarettes; store the ashtrays
and lighters.
Do
more sports or exercise
Sports
release tensions and allows to reduces the urge to smoke.
Doing sports increases the self-esteem and reinforces
your new identity as someone who cares about one's health.
It is a good way to prevent a relapse.
Be
active
To
avoid moments of boredom during which the urge to smoke
can creep up on you, always have projects (e.g., some
work to do, an interesting book to read, a sports activity,
a movie).
Be
positive
Avoid
negative thoughts and doubt. Use positive thoughts like
those suggested by the ex-smokers who participated in
our surveys:
- "I
am very proud of having stopped smoking, as I showed
that I have the willpower to deal with major difficulty.
In fact, for 18 years, I had believed it was impossible."
- "I
am more sure of myself and of my ability to change
my own habits."
Set
an example for others
Encourage
smokers around you to stop smoking like you . Relate
your experience. This will reinforce your identity as
an ex-smoker, which in turn will decrease your risk of
starting smoking again. Each year, one smoker out of
5 attempts to quit smoking. Many smokers are motivated
to stop and will be inspired by your experience. What
is more, if those around you stop smoking, you will have
even less of a chance of starting smoking again.
If
doubt gets the better of you
If
you are reconsidering smoking again, prepare responses
that will allow you to avoid taking a cigarette:
|
If
you think...
|
...tell
yourself that:
|
|
I
am just going to have one
|
This
strongly risks my relapsing into smoking again.
I have made it so far, it would be a shame to just
throw it all away.
"I
decided to stop smoking, and I am not going back
to coughing, to bronchitis."
|
|
I
will only smoke from time to time
|
It
is difficult to be satisfied with just smoking
from time to time. I risk rapidly increasing my
consumption to my previous levels.
It
was too hard to stop. I do not want to go through
this again.
|
|
I
cannot deal with my problems unless I smoke
|
Cigarettes
do not help me to solve my problems. I am
fully capable of dealing with my tasks without
smoking.
|
|
Write
below another reason that you think might incite
you to start smoking again:
____________________________________________
|
Find
a response against this reasoning:
__________________________________
|
If
you pick up some cigarettes
- Do
not jump ship!
- Put
your "emergency plan" to work immediately
(page 1).
- Do
not think that you have failed and that you have returned
to smoking. Most of all, you should avoid feeling discouraged.
Do not scold yourself or make yourself feel guilty.
- The
exact same accidents have happened to many other people.
Like millions of other ex-smokers, you are completely
capable of surmounting this difficulty and stopping
smoking.
- If
you have picked up one or a few cigarettes, it is assuredly
not that you lack willpower, but because a certain
situation appeared that you were ill-prepared to deal
with.
- Consider
this accident like a warning and a signal that you
should respond earlier. Take the lesson from this experience
to better prepare yourself for the next time. For this,
respond to the following questions:
1-
In what situation did you take a cigarette (where, with
whom, what activity, what was your mood)?
____________________________________________________________________
2-
Why have you not resisted to the urge to smoke in this
situation?
____________________________________________________________________
3-
The next time, how will you resist the urge to smoke
under similar circumstances?
_____________________________________________________________________
If
you have started smoking regularly again:
Do
not be discouraged. Instead, look at it as a positive
thing. Remind yourself that your attempt to stop smoking
has given you the insight you need to be successful the
next time you try to quit.
- It
is normal to start smoking again several times. On
average, ex-smokers try 4 times to quit before they
actually quit for good.
- Starting
smoking again does not mean you are incapable of stop
smoking. You were capable of going several months without
cigarettes. This in itself proves that you are completely
capable of succeeding. Your relapse is most likely
explained because you did not adequately react in a
tempting situation.
- Start
by reflecting about the reasons why you relapsed and
how you can better resist cigarettes in the future.
This will help you to have more success as well as
you next attempt. For this, fill out our questionnaire
on the previous page.
- Indeed,
persist in your efforts to quit smoking. Be tenacious!
Plan a new attempt to quit right now. The best is to
set a quit date in the next 30 days: try again and
again to stop smoking, and your efforts will be rewarded.
- Read
our brochure entitled "I started smoking again".
In it you will find advice that can help you cope with
the present situation and prepare your next quit attempt.
What
now?
Just
like a million Swiss and 8 million French, you are perfectly
capable of remaining an ex-smoker! Do not let down your
guard. Instead, follow the advice in this brochure. If
you would like, we can give you individualized
advice to help you stay an ex-smoker. To do
this, just respond to our questionnaire and return it
to us. You will receive, in return, an evaluation of
your personal characteristics. You can order this questionnaire
from the address found on the first page. If you have
access to the Internet, you can obtain the questionnaire
and the other brochures of this series at the following
address: . All of our material is free
of charge.
To
everyone, good luck!
Where
to find help and information about quitting smoking?
Internet
- Individualized
advice given by a system-expert: .
- The
Center for Disease Control's is put out by the Office
on Smoking and Health.
- The
QuitNet is an online resource and support center for
smokers struggling to quit and for those ex-smokers
working to stay quit.
- offers meeting information, a twelve
step program, and motivational slogans. A great thing
is that there are no fees for joining.
Additional
Internet Links
GENERAL
LINKS
HEALTH-RELATED
LINKS
DOCUMENTS
AND LITIGATION
ANTI-SMOKING
SITES
NEWSGROUPS
Articles
and Publications
- - MHN
Reading Room
- -
MHN Reading Room
- - The Harvard Medical School
Mental Health Letter
- - MHN
Reading Room
- - USA Today
Products
For Sale
- -
Smoking cessation program.
-
- -
Stop smoking focus cards
Software
- - Free software to help you quit cigarettes.
Treatment & Support
Services
- - Dr. Marc Kern
- - Calgary, Alberta,
Canada
Video
- - A NEW VIDEO
- , a live talk by Patrick Reynolds,
was recently made available on video. Filmed before
2,000 middle and high school students, this powerful,
multimedia presentation helps motivate youth to stay
tobacco free, and to resist the onslaught of tobacco
advertising and peer pressure.
The
stages of change
- Most
smokers pass through 5 steps (or stages) before they
become confirmed ex-smokers.
- We
have designed a brochure for each of these 5 stages,
as well as a brochure for those who have restarted
smoking after trying to quit (relapse).
- These
brochures can be ordered from the address located on
the first page.
- If
you are in the Maintenance stage (you have quit smoking
for more than 6 months), this is the brochure
you should read first.
- You
get the most out of these brochures if you make notes
on them, if you underline the important passages and
if you take note of the main points.
|
STAGE
|
DESCRIPTION
|
TITLE
OF THE BROCHURE
|
|
Precontemplation
|
You
do not seriously plan to stop smoking in the next
6 months
|
And
what if I stopped smoking?
|
|
Contemplation
|
You
seriously plan to stop smoking in the next 6 months
|
I
am thinking about stopping smoking
|
|
Preparation
|
You
have decided to stop smoking in the next 30 days
|
It
is final. I'm quitting smoking!
|
|
Action
|
You
have stopped smoking for fewer than 6 months
|
I
just quit smoking
|
|
Maintenance
|
You
have stopped smoking for more than 6 months
|
Ex-smokers:
persevere!
|
|
Relapse
|
You
have started to smoke again after stopping for
a short time
|
I
started smoking again
|
This
brochure was created at the Institute of Social and Preventative
Medicine of the University of Geneva, with the support
of the Swiss Cancer League, the Swiss National Science
Foundation, the Swiss-Romande Lottery, the Geneva Department
of Social Action and Health, the Swiss Federal Office
of Public Health, The Swiss Foundation for Health Promotion,
Pharmacia & Upjohn, the Swiss Pulmonary League, the
Cipret-Genève and the Jura Canton Health Service. We
thank the Swiss Association for Smoking Prevention (at)
for it help and support.
Copyright
(c) Jean-François Etter 1999. All rights reserved.
Author:
Translated
from French into English 1 March, 1999 by
If
you have an Internet site, we appreciate your linking
to the site .
Evaluation
of this brochure Please
complete this evaluation form!
Your
answers and suggestions allow us to improve this brochure.
THANK
YOU for responding !
You
can fax the evaluation form to +41.22.322.13.39
or
mail it to: J.-F. Etter. IMSP. CMU. CH-1211 Geneva
4. Switzerland.
Last
modified Aug. 15, 2000 by J.-F. Etter
|
