Although most of my academic research is on behavioural addiction, I do publish the odd paper here and there are on more traditional addictions such as alcohol and nicotine addiction (particularly in relation to the relationship to behaviours like gambling). Over the last few months (on a personal rather than level) I have thought a lot about nicotine addiction as I have had to watch my mother fight a losing battle with smoking-related lung cancer and chronic obstructive pulmonary disease. She died last Saturday (September 8th, 2012 aged 66 years) and had chain-smoked most of her adult life. This followed the death of my father who also died of smoking-related heart disease (aged 54 years).
Last week, the British government’s Department of Health (DoH) launched the ‘Stoptober’ campaign urging as many nicotine smokers as possible to give up smoking for 28 days from October 1st. This is the first time ever that such an innovative campaign has been launched on a national basis, and the DoH website claims that “people who stop smoking for 28 days are five times more likely to stay smoke free” compared to those that don’t give up for such a long period (I’m not sure on what empirical evidence that is based but it sounds reasonable). Those that decide to try and stop for the month will be given a lot of encouragement during the four-week period including access to the Smokefree Facebook page, and a downloadable Stoptober app. Those signing up to stop will also be sent daily emails providing additional encouragement. At present in the UK, smoking accounts for approximately one in four cancer deaths (and as I said, it’s something I’ve witnessed first hand).
I’m sure most people reading this are aware of the addictive nature of nicotine (it was one of the main reasons why my parents were never able to stop). As soon as nicotine is ingested via cigarettes, it can pass from lungs to brain within 10 seconds (and stimulates the release of the neurotransmitter dopamine). The release of dopamine into the body provides reinforcing mood modifying effects. Despite nicotine being a stimulant, many people use cigarettes for both tranquillising and euphoric effects. Most authorities accept that nicotine is one of the most addictive drugs on the planet and that smokers can become hooked quickly. One of the reasons my own parents were never able to give up was because of the prolonged withdrawal effects they experienced whenever they went more than a few hours without smoking. This would lead to intense cravings for a cigarette.
For those of you out there with an addiction to nicotine, I thought I would provide my 10 golden tips that may help you in taking steps towards giving up for good. The tips are not foolproof and I failed with my own parents. However, that doesn’t mean you shouldn’t give it a go.
- Develop the motivation to stop smoking: Many smokers say they would like to stop but don’t really want to. When you take stock, make sure you are clear as to why you want to give up. It may be to save money, to improve your health, to prevent yourself getting a smoking-related disease, or to protect your family from passive smoking. (It could of course be all of the above). Really wanting to give up is the best predictor of successful smoking cessation.
- Get all the emotional support you can get: Another good predictor of whether someone will overcome their addiction to nicotine is having a good support network. You need people around you that will support your efforts to quit. Tell as many people that you know that you are trying to quit. It could be the difference between stopping and starting again.
- Avoid ‘cold turkey’: Although some people can stop through willpower alone, most people will need to reduce their nicotine intake slowly. Gradually cutting down the number of cigarettes smoked per day is a good starting strategy.
- Use nicotine replacements: Cutting out nicotine completely is hard, so consider using some kind of nicotine replacement. Nicotine patches, chewing gums, and lozenges will help inhibit the cravings and will help you stabilize your behaviour.
- Use non-nicotine shaped cigarette substitutes: Smoking is also a habitual behaviour where the feel of it in your hands may be as important as the nicotine it contains. The use of plastic cigarettes or e-cigarettes will help with the habitual behaviour associated with smoking but contain none of the addictive nicotine.
- Use relaxation techniques: When cravings strike, use relaxation exercises to help overcome the negative feelings. At the very least take deep breaths. There are dozens of relaxation exercises online. Practice makes perfect.
- Treat yourself: One of the immediate benefits of stopping smoking will be the amount of money you save. At the start of the cessation process, treat yourself to rewards with the money you save.
- Focus on the positive: Giving up smoking is one of the hardest things that anyone can do. Write down lists of all the positive things that will be gained by stopping smoking. Constantly remind yourself of what the long-term advantages will be that will outweigh the short-term benefits of smoking a cigarette. In short, focus on the gains of stopping rather than what you will miss about cigarettes.
- Know the triggers for your smoking: Knowing the situations that you tend to smoke can help in overcoming the urges to smoke. Lighting up a cigarette can sometimes be the result of a classically conditioned response (e.g., having a cigarette after every meal). These often occur unconsciously so you need to break the automatic response and de-condition the smoking. You need to replace the unhealthy activity with a more positive one and re-condition your behaviour.
- Fill the void: One of the most difficult things when cigarette craving and withdrawal symptoms strike is not having an activity to fill the void. Some things (like engaging in physical activity) may help you in forgetting about the urge to smoke. Plan out alternative activities and distraction tasks to help fill the hole when the urge to smoke strikes (e.g., chew gum, eat something healthy like a carrot stick, call a friend, occupy your hands, do a word puzzle, etc.). However, avoid filling the void with other potentially addictive substances (e.g., alcohol) or activities (e.g., gambling).
Watching both my parents’ die of smoking-related diseases is enough incentive for me to never smoke a cigarette. Hopefully, you can find the incentives you need to help you give up permanently.
Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK
BBC News (2012). ‘Stoptober’ stop-smoking campaign launched in England. BBC Health News, September 8. Located at: http://www.bbc.co.uk/news/health-19506327
Department of Health (2012). Stoptober campaign will encourage smokers to quit for 28 days. September 8. Located at: http://www.dh.gov.uk/health/2012/09/stoptober/
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