SMOKING

Cigarette smoking is the leading cause of preventable deaths worldwide but despite being constantly bombarded with advertisements of the dangers of smoking, tens of millions of Indians continue to smoke.

Nicotine addiction can lead to the de person prematurely every six seconds. 50% tobacco users will die from tobacco addiction.This epidemic depicts the highly addictive nature of nicotine.

Smoking is commonly used as a stress buster, appetite suppressant and controlling weight

IMPACT OF  SMOKING

1.Circulatory problems. It affects the blood circulation in the body
2. Risk of impotence in men is 50% more likely in smokers
3. Sleep Disturbance- Smokers are four times likely to feel unrefreshed/unrested after a night’s sleep
4. Smokers have a lower bone density than non-smokers which increases the risk of bone fractures 

  1. Higher likelihood of developing heart diseases
    6. Ages your skin by upto 19 years
    7. 90% higher likelihood of lung cancer

SMOKING CESSATION

“Cigarette smoking is injurious to health.” 

How often do we hear this, yet continue to light up our favorite cancer sticks at every given a chance? Ever wondered why?

Cigarette smoking or tobacco smoking in different forms start as a statement of being “cool” by our peers and colleague and soon becoming the quick fix to an adrenaline rush on our bad days. Having an almost immediate effect on our hearts and our brains, nicotine is known as a highly addictive drug with increased tolerance through everyday use. 

Within 10 seconds of inhalation, Nicotine can cross the blood-brain barrier triggering dopamine to be released. Smokers feel pleasure and calm, reducing their withdrawal symptoms. 

Nicotine addiction is termed as harmful and as addictive as heroin or cocaine by the Royal College of Physicians, delivering a dose of nicotine rapidly to the brain. Classified by the Diagnostic and Statistical Manual of Mental Disorders, under the sub-category of dependence and withdrawal, smoking has soon become one of the most prevalent, preventive causes of death!

Dopamine depletion causes these symptoms return, and with it, the urge to smoke. The process of trying to quit smoking brings with it, unpleasant withdrawal symptoms such as anxiety and difficulty concentrating, irritability and depression, often leads smokers back to cigarettes.

Scary enough to make you want to quit?

Quitting sounds easy, but it is not really. Nicotine addiction is the silent killer that sneaks into your lifestyle without even you noticing it — preparing to live smoke-free works as the first step to making a successful plan to quit. However, laying your hands off those cigarettes still don’t seem easy. Let’s look at what happens once you decide “NO MORE”

What happens when you quit?

Other than your body saying a big thank you!  The positive impact of quitting can be seen as soon as 20 minutes, lowering your heart rate and improving your lung function as early as two weeks. Every stage of being smoke-free has a horde of benefits that you have silently been depriving your body of. A glance below sums it all!

HOW TO DIFFERENTIATE CASUAL SMOKING WITH NICOTINE ADDICTION

According to International Classification of Diseases(ICD-10), these are the symptoms of Nicotine Addiction

Dependence is a maladaptive pattern of substance use, leading to clinically significant impairment or distress, as manifested by three (or more) of the following, occurring at any time in the same 12-month period:

1. Tolerance, as defined by either

• a need for markedly increased amounts of the substance to achieve the desired effect
• markedly diminished effect with continued use of the same amount of substance. 

2. Withdrawal, as manifested by either the characteristic withdrawal syndrome for the substance, the substance being taken to relieve or avoid withdrawal symptoms.

3. Taking larger amounts of the substance or over a longer period than was intended.

4. A persistent desire for,  or unsuccessful efforts to cut down on substance use.

5. A great deal of time is spent in activities necessary to obtain or use a substance.

6. Abandonment or reduction of important social, occupational, or recreational activities because of substance abuse.

CHALLENGES TO SMOKING CESSATION

Withdrawal produces a collection of symptoms that tobacco users may experience when they stop tobacco use abruptly

Withdrawal symptoms vary but include a craving for nicotine, irritability, frustration or anger, anxiety, depression, difficulty concentrating, restlessness, and increased appetite (which can lead to weight gain).

Most symptoms reach maximum intensity 24 to 48 hours after cessation and then gradually diminish over a period of a few weeks.19 Some withdrawal symptoms, such as dysphoria,18 mild depression,18 anhedonia,18 and increased appetite,6,40,33 may persist for months.

It is not uncommon for smokers to relapse after a quit attempt. Most smokers who manage to quit will make 8 to 11 attempts before actually succeeding.6 For most smokers, quitting represents stopping an addiction they have had for many years. Aside from breaking the addiction to nicotine, smokers have to break the many associations they have with smoking (e.g. smoking while relaxing, talking on the phone, or in a car). It is not difficult to understand why so many smokers who have quit slip or relapse when these triggers are present. Slips can be defined as the re-engagement of some smoking behavior (e.g. smoking less than a whole cigarette).                               

THERE IS NO ONE -WAY TO QUIT

Cold turkey or gradual reduction, the choice is yours. Whatever you pick, you’ll never go wrong. A few people find it easier to quit smoking at one, no replacement, no medicines just cold turkey. While a few find this the best way to let go. Just ripping the band-aid off at once, a few find it easier to withdraw gradually. A researched fact about quitting cold turkey remains that only 4 to 7% of people who attempt to quit smoking can do it cold turkey. Getting support from your healthcare provider, which includes counseling and medication, can double your chances for a successful quit.

Cutting down on the number of cigarettes, a little bit each day can help you slowly reduce the amount of nicotine intake per day. Replacements such as nicotine gum, electronic cigarettes, vape pens, tobacco lozenges and pouches work as effective replacements for gradual quitters.

It is not all sunshine and daisies when you quit.

Short-term effects are known with smoking cession do include weight gain, irritability, and anxiety. Some people try several times before they succeed. However, ask us, we know that trying is what matters!

Whenever there’s an urge to use tobacco, remember that although it may be intense, it will probably pass within five to 10 minutes whether or not you indulge in your craving or give in to your urge. Each time you resist a tobacco craving, you are one step closer to stopping tobacco use for good.

Here are a few ways to quit smoking for good

 

  • Nicotine replacement therapy

 

Nicotine replacement is one of the most accessible alternatives to smoking, but should never be done without the consultation of a doctor. Nasal sprays, inhalers, nicotine patches, gum and lozenges available at over the counter. Prescription nicotine medications such as bupropion (Zyban) and varenicline (Chantix) work to curb the cravings as well. 

Short-term nicotine replacement therapies — such as nicotine gum, lozenges, nasal sprays or inhalers can help you overcome commonly intense cravings. 

1. Electronic cigarettes 

Grabbing attention around the globe, e-cigarettes or vape pens are an alternative to smoking conventional cigarettes. While easily accessible to children, these may be harmful due to prolonged use due to the presence of nicotine in the vape liquids as well. No research yet qualifies these as a long-term solution to smoking cession. 

2. Identifying triggers and Delaying cravings

The urge for a smoke is one of the greatest barriers to smoking cession. Habitual triggers such as smoking after food, with alcohol, after sex or due to stress, anxiety, loneliness or boredom may be identified through therapy and help in overcoming one’s cravings. 

It is very easy to fall back into a smoking relapse while encountering these triggers. If you typically smoke while you talked on the phone, for example, keep a pen and paper nearby to occupy yourself with scribbling rather than engaging in the act of smoking.

Delaying one’s cravings also helps take your mind off the urge. Waiting for a few more minutes, drinking some water or chewing on gum helps fight the craving. 

3. Do not give in to ‘just one’

You may be drawn to have just one cigarette to satisfy a tobacco craving. However, do not chump yourself into trusting that you can stop right there. In most cases, having just one leads to another, and you may end up indulging into tobacco again and losing track of your progress of trying to quit smoking.

4. Cognitive Behavioural Therapy (CBT) for smoking cessation

Clinically approved by researchers around the globe, CBT refuses to look at addiction as a lifelong disease, viewing it as a learned behaviour instead. The goal of Cognitive-behavioural treatment is learning new, more effective behaviours to take the place of the addiction behaviours. 

It focuses primarily on shifting one’s cognitions or thought process about smoking and replacing it with divergent behaviour instead. A change in your thoughts can be implemented by examining thought patterns that lead to smoking and then learning more effective pattern learning alternate behaviours involve identifying the functions that smoking serve, replacing smoking with other behaviours that serve the same function.  Physical activity, sports, exercise, swimming and varied muscle relaxation techniques have proven to help overcome urges which in turn help fighting the urge for one more cigarette.

The end to cigarette smoking is not impossible, difficult yes but never impossible. With multiple alternatives at our reach, it is time you put it out, before it puts you!

5. Motivational Interviewing for Smoking Cessation

This is a brief psychotherapeutic technique intended to facilitate the likelihood that an individual attempts to act on/alter their harmful behaviour. It has been primarily employed for the behavioural management of disorders. It has been used to treat alcohol abuse, drug addiction,weight loss, compliance with treatment for asthma and diabetes as well as for smoking cessation.

MINDFULNESS
           
HOW DOES MINDFULNESS HELP IN SMOKING CESSATION

By observing and non-judgmentally accepting uncomfortable mind- and body-states rather than reacting to them, MT may help individuals to replace stress-induced habitual reactions with more adaptive response. By helping people change their relationship to negative affect and physically unpleasant states (e.g. craving) and thoughts, MT may bolster their ability to ‘ride out’ cravings and subsequently quit smoking or other addictions 31,56,72. Smokers may learn to bring mindful awareness to the sensations and thoughts that accompany a craving, and just observe rather than immediately react to it. This awareness can lead to two important insights. First, by stepping back and exploring what cravings actually feel like in their body, an individual may learn that they are physical sensations and not something they have to get rid of immediately. Second, each time she rides-out a craving an individual may learn that they are not permanent and will subside even if unsatisfied. Cravings may continue to arise, but by learning to observe and not immediately react to them, an individual can begin to disrupt the associative learning process and dismantle the addictive loop


RAIN TECHNIQUE

  • Recognize the craving that is arising, and relax into it.
  • Accept this moment. Don’t ignore it, distract yourself, or try to do something about it.
  • Investigate the experience as it builds. Ask yourself, “What is happening in my body right now?”
  • Note what is happening. As you note pressure, dullness, tightness, or whatever, it becomes clear that these are nothing more than body sensations. You don’t have to act on them. You can simply ride out the sensations until they subside.

Being mindful can help you get past a craving. If a craving hits, try to:

  • Stop, take a breath, and notice what’s going on right now. How does your body feel? What thoughts are you having? Notice what is happening and take in the experience.
  • Imagine your craving like an ocean wave. It might feel like it gets bigger and bigger. But eventually it will become smaller and less intense, just like a wave. 
  • Recognize the physical feelings in your body that mean you’re becoming stressed. Take a moment to step away from what you’re doing and notice your breathing.
  • Take a walk outdoors. Walk slowly and really focus on being there. Notice what you see, hear, and smell. 
  • Involve yourself fully in something you enjoy, like a hobby. You’ll get positive effects from keeping your brain busy and having something else to think about instead of the craving.
  • Take a journey in your mind. Think of yourself at the beach or in a garden or the mountains…anywhere you want. Close your eyes and think about what it would feel like to be there right now. Enjoy all the little things in this beautiful place. Focusing on something else can help you get through your craving easier.
  • Formal practices consisted of: 1) the ‘body scan’ which teaches individuals to systematically pay attention to different parts of their bodies as a way to reduce habitual mind-wandering and strengthen their attentional capacities, 2) ‘loving-kindness’ meditation, which is practiced by wishing well for others, usually by repeating a phrase such as ‘may X be happy,’ and 3) ‘awareness of breath’ meditation in which attention is focused on the breath, with the additional intention of helping individuals become more aware of the present moment and refrain from habitually engaging in self-related pre-occupations concerning the future or the past. Informal practices consisted of 1) setting daily aspirations, 2) performing daily activities mindfully.

https://www.betterlyf.com/articles/stress-and-anxiety/how-can-i-control-my-emotions/

https://www.betterlyf.com/articles/stress-and-anxiety/am-i-sad-or-depressed/

https://www.betterlyf.com/articles/stress-and-anxiety/6-tips-to-become-your-own-stress-manager/

https://www.betterlyf.com/articles/stress-and-anxiety/how-to-overcome-anxiety/

https://www.betterlyf.com/articles/stress-and-anxiety/fear-of-failure/

https://www.betterlyf.com/articles/stress-and-anxiety/how-to-emotionally-heal-yourself/

https://www.betterlyf.com/articles/stress-and-anxiety/how-to-deal-with-negative-thoughts/

https://www.betterlyf.com/articles/stress-and-anxiety/how-to-deal-with-loneliness/

https://www.betterlyf.com/articles/stress-and-anxiety/how-change-in-beliefs-can-make-you-happy/

https://www.betterlyf.com/articles/stress-and-anxiety/how-to-deal-with-regrets/

https://www.betterlyf.com/articles/depression/smoking-cessation-how-to-quit/

https://www.betterlyf.com/articles/relationships/master-the-art-of-self-compassion/  

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