Beginner's Guide to Smoking Cessation

So, after 29 days, the withdrawal pangs are pretty much done and over with. What's even better, however, is that -- after starting this experiment out with around 10 nicotine lozenges a day -- yesterday I had only three lozenges. I suspect that every day won't be as good as that, but it's certainly a start toward not only a smoke-free life, but a nicotine free life.

I also faced down my biggest obstacle this entire month. Indeed, I spent the weekend in Las Vegas, where smoking is legal everywhere, where drinks run aplenty, and where cigarettes -- in many casinos -- are free. And if I can make it through a weekend in Vegas without smoking, I think I'm all set for the long run. Temptation, for sure, was everywhere. And I'll admit that the number of lozenges I had did increase, but it was the only way to defeat the need to smoke. I suspect had I visited Vegas within the first week, I never would've made it. But after 28 days or so of a smoke-free life, there was no way I was going to start the tally all over. What's more, however, is that after you've stopped smoking for a few weeks, you'll begin to feel the way others do around people smoking -- that the smoke smells awful, burns your eyes, and stinks. I'm still not one to raise my own stink - I think everyone should be free to smoke as they wish, but it's nice to know that the smell of cigarette smoke is more offputting than not.

Later this week, I'm going to give you the results on one of the absolute biggest hang-ups to quitting: Weight gain!

Posted by John at 4:33 PM | Permalink | Comments (0) | TrackBacks (0)

Back on Day 13, I talked a little about the frequency of relapse. Really, almost every first, second, third, and fourth time quitter will relapse, which is why it takes - on average - twelve times before most people can quit for good. But, like anything, you just have to keep trying. In fact, this may be the one time when quitting is not for losers.

So, what do you do when you relapse? Well, I suppose that depends. Some people relapse simply because they can't cope with the stress of withdrawal. Other people relapse simply because they really don't want to quit smoking - they just think they do. Most professionals say the best thing to do is jump back on the horse, and start the quitting process all over again. My advice is a little different.

You hear a lot, especially in the AA context, about people who have gone 60 days or 20 years without a drink. And, psychologically, the number of days, months, etc. makes you feel good about yourself. Relapsing starts the whole process over at Day One, unfortunately, which is a huge blow mentally. A lot of people who have to deal psychologically with starting all over at Day One just say to themselves, "Screw it. I'm at Day One anyway, so I may as well smoke my lungs out and then quit again later." Unfortunately, that later often takes weeks, months, or years to arrive again.

That's why, according to my plan, you get a couple of mulligans. If you absolutely positively must have a cigarette, here's my strategy. For many, the allure of that one cigarette is simple curiosity; you simply must know what it feels like again. So, this is what you do: First, make sure that before you give in that you've had a piece of nicotine gum or a lozenge. After that, you'll find that cigarettes are not as tasty as you remembered; if you've been off for long enough, they'll just taste bad, won't do anything for you, and leave an awful taste in your mouth. Hopefully, that one bad experience will be so unpleasant, that your efforts will be redoubled. In that case, don't start the clock all over. Just consider that one cigarette another part of the quitting process.

For some people who do have the one cigarette and find it unappealing, you'll become slightly despondent, thinking that your one small joy in life is gone or not what you thought it was. For those, the relapse will probably lead to two or three or 10 cigarettes; you're not going to quit smoking until you get that lovin' feeling back. I know how it goes. So, as long as you limit that smoking binge to one day, there is your other mulligan. Quit again tomorrow, and I give you permission to keep your string of consecutive smoke-free days together. After all, the psychological component is half the battle.

If, on the other hand, that one cigarette leads to two, which leads to three, and you find yourself smoking full tilt again, don't beat yourself up over it. And don't lie to yourself, promising to quit the next day or on Monday and fail again, which is incredibly dispiriting to one's psyche. Instead, try to get it out of your system. Give yourself a few weeks, and make sure you do all the smoking you need before getting back on the horse. If you're not ready, it's simply not going to happen, and you'll end up relapsing over and over again and basically just torturing yourself. There's no need in that. It's bad enough that you're a smoker and you want to quit; don't compound that by making yourself feel like a loser.

As for me, I'm at Day 20 with no relapse of any sort, even the one cigarette variety. I know well enough by now that that one cigarette will taste like after a three-week smoke-free life and all of this nicotine replacement. I won't like it. And I've failed enough and given into that one cigarette enough times that I know how it taste, what it feels like, and what I'll feel like. I don't need that again.

Posted by John at 2:09 PM | Permalink | Comments (0) | TrackBacks (0)

No. I didn't relapse. But I have before. Most people who quit trying to smoke will. Given how many times it takes the average person to quit before he or she quits for good, relapse is almost inevitable. In fact, the only reason I have as much experience with quitting is because I've done it so many times. I've made it days, weeks, months, and even years without relapsing. But, I've always relapsed, though I'm going to make damn sure that I don't this time.

Thirteen days in, the hardest part is nearly over. And by "hard part," I mean, the irritability, the crankiness, the withdrawal pains, and the physical symptoms of withdrawal. I say the "hard part" of quitting smoking is done, though quitting the nicotine replacement products is a whole other story.

Anyway, even with the worst part out of the way, the urge to smoke - at times - is no less powerful. I was faced with the strongest urge I've had so far this morning. My wife had a flight at 6 a.m. Given the beefed-up security of late, I had to get her to the airport by 4 a.m. And the airport is an hour and a half away from my house, meaning we left around 2:30 a.m. and woke up around 2 a.m., which means I was very sleepy this morning. And what does a smoker do to combat exhaustion? Smoke, of course. And what is one of the hardest triggers for a smoker? Driving, of course. And when is a quitter more likely to relapse? When no one will know, of course. And with my wife on a plane to another country for the next week, I'm flying solo, meaning I have no one to watch over me, no one to check on me, and no one to smell the smoke on my clothes if I decided to relapse.

And I'll admit that, at 4:15 a.m., while I was driving back from the airport, I had not been this tempted to buy a pack of cigarettes in a long time. But, when I quit smoking, I resolved to do so for good - and the desire to quit for the first 13 days was much more powerful than my desire to smoke again.

But when no one is around to check on you, you really find out why you decided to quit smoking. Was it for you? Or was it for someone else - your family, your friends, your wife, etc. And I found out at around 4:30 this morning, when I decided to forego the exit, that I was quitting for myself. I couldn't get caught. No one would know if I slipped up just this once. And I could just as easily go back to the nicotine replacement products tomorrow. Or the next day.

But, I didn't. There is no relapse in me this time. I'm done. And I've fought too hard over these last 13 days to give it all up during a prime moment of weakness.

And now I know for sure: I'm doing it for myself.

Posted by John at 3:18 PM | Permalink | Comments (0) | TrackBacks (0)

A lot of things happen to your body when you quit smoking. Chemically, your brain's reward system gets kind of whacked, your dopamine levels falls off until your brain figures out that a lot of those juicy substances it's used to aren't coming back, and your emotions end up playing tricks on you. People around you, those you live with and those you see daily, will probably suggest that your mood swings and general emotional dysfunction is purely psychosomatic, and I'd admit that there's a lot of truth to it. But, even symptoms that are mental feel no less real to someone who has recently quit smoking -- beyond purely physical withdrawal symptoms, the hardest part of quitting is probably the psychological torture your feelings inflict upon you.

In my case, I'm a pretty even-keel guy; I tend to worry a bit too much, and perhaps sweat over things I shouldn't, but yesterday I experienced a feeling that I only experience when I quit smoking. In fact, if it weren't something I went through -- at least for a brief period -- every time I quit, I'd never even know it's even related. It's hard to explain precisely; it's not depression, really, but more like a very high level of anxiety, an overwhelming feeling that life is beyond your control. I went through almost all of yesterday in this funk, and all day I tried to rationalize it. I tried to pinpoint some bit of uncertainty in my life that was responsible for the feeling so at least I'd be able to understand why I was feeling this way, but I never could properly identify it.

The best way I can explain it, perhaps, is by metaphor. It was like I was in charge of a newspaper. And a huge story had come through that I had to publish in the morning's edition or I'd be fired. Unfortunately, the reporter I'd assigned the task called five minutes before the deadline and told me that he'd quit, and here I am about to get fired, and I have absolutely no control over the situation. Completely helpless. And that's what Day 8 felt like for most of the day. Fortunately, the cloud began to disappear later in the evening, and while it kept me up almost the entire night, I woke after three or four hours of sleep feeling like it had finally passed, like the reporter had managed to get the story in with 45 seconds remaining.

And hopefully, that'll be the last of that feeling ... and if I could simply remember it, there's no way I'd ever start smoking again.

Posted by John at 3:11 PM | Permalink | Comments (0) | TrackBacks (0)

Today, I've officially gone 7-days without so much as touching a cigarette. A small feat, sure. But, it's a large step to becoming a lifelong non-smoker. And, to celebrate this occasion, I've done a lot of research over the Science of Addiction, which can be read in detail in our addiction section. But, on day 7, I will summarize some of my findings, some of which makes perfect sense, and some of which you may not have known.

First of all, scientist basically attribute the addiction to nicotine equally to both environment and nicotine. The environmental addiction is pretty straightforward, explaining why people start smoking (too look cool) and what external and internal environmental factors keep you smoking (or wanting to smoke), such as coffee, alcohol, the post-meal cigarette, and workplace stress.

It's the genetic factor that I found most interesting. As it turns out, many people are predisposed to nicotine addiction before they even pick up a smoke. Why? There is a particular gene in some people's genetic make up that processes and rids your body of nicotine much faster than in a non-smoker, meaning that those with the gene can smoke more without getting ill and they also build a much quicker tolerance than those without the gene. The people without the nicotine gene, on the other hand, are not only less prone to addiction, but once they start, can quit easier.

Other studies show that people with aggressive and or hostile personalities are also more inclined to smoke, perhaps because they, too, have the gene responsible for flushing nicotine out of their system quicker. Therefore, if you have a hostile, aggressive personality, you are predisposed to nicotine addiction before you even pick up a cigarette.

Finally, science shows that it is even more important for teenagers not to start smoking than previously thought. Why? Because the brain functions of teenagers are still forming, and those who smoke have their function form around their brain addiction. What studies have suggested is that a 12-year-old who smokes only a few (5 or 6) cigarettes a week, can develop an addiction just as strong as an adult who smokes a pack a day. More disturbing, however, is that people who start smoking in their teens have a much more difficult time quitting - on average, the addiction lasts around 20 years. Read more about my findings in our Science of Addiction section.

Posted by John at 3:06 PM | Permalink | Comments (0) | TrackBacks (0)

Aside from the daily pangs of withdrawal, the almost constant level of irritation, and the insufferable mornings before I'm able to get nicotine coursing through my system via the Commit Lozenge, one of the biggest hurdles to your quit-smoking campaign will be that first weekend, specifically the first social engagement that also might involve alcohol. For those of you who can withstand the coffee/cigarette association, many others will break down at the first whiff of Bud Light.

In fact, I've known smokers (myself among them) who have quit in the past, but make the "drink-in-the-hand" exception, which states that - so long as you're drinking - it's perfectly okay to smoke. In my experience (and that of others), the drink-in-the-hand rule, more times than not, just leads to more drinking, mostly as an excuse to smoke. In fact, I remember quitting one time several years ago, but making the drink-in-the-hand-exception, and finding myself at a local tavern from the second I got off of work until I stumbled home to bed. It's a lousy exception for your liver, and really, it's no way to get yourself off of cigarettes.

Anyway, for myself, Fridays will probably be the hardest days without cigarettes. Friday afternoons have long been an afternoon in which I engage in a creative writing project, and even when I was (almost) completely smoke free, I sometimes resorted to cigarettes to help get my creative juices flowing. This last Friday, knowing that I absolutely could not smoke, I instead downed a couple of beers, hoping that might help in the creative process. It may have, but the end result was a pretty bad craving for a cigarette that I couldn't dismiss with a few nicotine replacement products. Moreover, because alcohol has a tendency to metabolize the nicotine in your body (from the replacement products) even quicker, what I ended up with was an almost unquenchable thirst for nicotine, which I ultimately had to dull by eating ... probably a bit too much. Still, I made it through the day without smoking, so that was a major coup for me.

The rest of the weekend wasn't that much better; though I still have to combat thinking about smoking by resorting to work, even on the weekends, to keep my mind off of cigarettes, a Saturday evening meal in the backyard patio was the toughest test I've had so far. Most of my social smoking the last few months came on that backyard patio - my wife and I would have friends over, we'd open a bottle of wine, eat three courses and spend the evening smoking over conversation. In fact, the last night before I quit, this was precisely my request - smoking on the back patio with friends until I could smoke no more.

I made it through Saturday night, however. I had to stop myself at one glass of wine; not because I was afraid of drinking too much, but because the wine brought on some very bad cravings, and the matter wasn't helped much by my wife's own cravings (though she was never anything beyond an occasional social smoker, my wife has also quit in solidarity) after a few drinks. In fact, she walked around the house that evening looking for a hidden cigarette, to no avail. And, luckily, we both made it without breaking down -- I suppose the one advantage to drinking is that you're unable to drive to the store to pick up a pack of Parliaments.

So, that was my smoke-free weekend. And now I am a fully six days removed from smoking, and I'm hoping that - leading into week number two, things will gradually get easier, instead of harder.

Posted by John at 2:10 PM | Permalink | Comments (0) | TrackBacks (0)

So, I actually had my first meltdown yesterday afternoon. It was a normal husband-wife tiff about nothing -- as they all tend to be -- that exploded on me because I wasn't smoking. The nicotine replacement products are great for de-intensifying the withdrawal symptoms, as long as you aren't pushed. But, within a matter of seconds, in that tiny argument, my voice escalated and things just started coming out of my mouth fast and furious and I had little control over it. To be fair, my wife knew what was going on and she sort of shrugged at me and laughed it off. At one point, though, she did say, "Why don't you just have a cigarette and we'll talk about this when your sane again."

You see, people who quit smoking are - for a few days at least - sort of insane. We're like the Hulk - David Banner one second, and green and angry in the next.

I declined the offer of a cigarette and actually escaped to an empty quiet room for a few minutes to allow myself to calm down. I suspect I'm going to need a lot of meditative moments like these in the next few weeks.

Posted by John at 1:57 PM | Permalink | Comments (0) | TrackBacks (0)

Note to self: Pop Nicotine Lozenge right out of the shower. Again, on Day 2, once I got nicotine into my system, I had very little problems coping throughout the day. But, again, this morning, I tried to wait a couple of hours after I woke up, and I was okay the first hour, but as soon as I had to interact with someone, it was like I'd suddenly gotten Tourette's syndrome, as a mouthful of profanity just spewed forth for little reason. Later this month, I'll research and discuss why nicotine withdrawal makes us feel this way, but for now, I just need to continue using the lozenges hardcore, at least until I can get my hair-trigger irritability under control.

Meanwhile, I know from experience that for anyone going cold turkey, Day 2 and Day 3 tend to be the hardest, and if you're at that point in your quest to quit, I feel for you. I really do. I know that your irritability is on high alert, your concentration level is around zero, you spend half your day thinking about what a cigarette would taste like, and your bargaining with yourself, telling yourself that if you can do this and this or this, then you deserve just one cigarette. Don't do it. It won't be just the one cigarette, and you'll feel guilty enough after smoking it to drive you back to cigarettes. Also, if you're a cold-turkey Day 3, I suspect you're having a hard time staying awake, falling asleep sometime around 8 p.m. at night. Just let it happen. If it all possible, try to sleep it off; tomorrow, the withdrawal pangs will be a little easier.

Hang in there. Meanwhile, I'm going to continue with the Nicotine Replacement Therapy. It's working well, as long as I stick to it. And for now, I'm closing in on 72 hours smoke free.

Posted by John at 1:13 PM | Permalink | Comments (0) | TrackBacks (0)

So, overall, Day 1 was a piece of cake. I managed to keep ahead of the cravings by popping around 6 lozenges yesterday, which is about the equivalent of 12 cigarettes. The cravings never really overtook me, and I got a lot of assistance from the 100 degree weather, because as smokers know, cigarettes don't do much for you in the hot weather. Since I work in a home/office, I'm pretty used to stepping out every hour and a half or so for a smoke, but I was actually thankful not to have to yesterday, since the sun was blazing. It also didn't hurt that I was able to keep my mind off of smoking, in large part, by working from the time I woke up until around 10:30 last night. Keeping your mind on something else not only helps with the cravings, but it makes you an awfully productive person.

Though it is early, Day 2 hasn't been nearly as easy. Whether it was the lack of nicotine or not, I was unable to sleep much last night, tossing and turning and spending much of the night awake. And, this morning, I felt the withdrawal symptoms coming on pretty strong; I was testy, irritable, and when my A/C unit started to leak Freon into my bedroom, I was forced to keep my anger in check. During times like these, it's probably best to avoid people; before my wife set off for work, I had to simply ask her to steer clear, because I'm not myself this morning. I'm not sure how other smokers' symptoms manifest themselves, but my blood feels like it's rising to the top of my skin, my eyelids feel like they are swelling, and it feels a little like my eyeballs are swimming. In short, I'm a bitter, bitter man this morning.

Thankfully, I popped my first lozenge about 20 minutes ago, and the irritation is subsiding. The coffee helps. But, on the way to get coffee this morning, I had my first trip down nostalgia lane, picturing myself with a cigarette, even in the heat. It was a great image. Without the nicotine lozenge, there is no way I would've made it.

Here's to a better Day 2 than the way it started.

Posted by John at 12:13 PM | Permalink | Comments (0) | TrackBacks (0)

In general, the first day is often one of the easiest. Truth is, on the first day, your excitement for quitting generally outweighs your need for a cigarette, your resolve is on full-tilt, and -- if you planned correctly -- you probably smoked enough the night before to inject enough nicotine into your bloodstream to get you through most of the day. Still, don't leave anything to risk - and don't test your willpower anymore than you need to. If the first thing you do in the morning is wake up and grab a smoke, then I'd suggest waking up and chewing a piece of Nicorette, popping a Commit Lozenge, or immediately applying your first Nicotine patch.

What I would not recommend, however, is waiting as long as you can until your first urge comes on and then trying to beat it back with Nicotine Replacement; it may be too late. Don't let your pride get ahead of you; when it comes to cigarettes and pride, a pack of Parliament Lights will win more times than not.

Also, make absolutely certain that, before you've gone to bed the night before, that all cigarettes are out of your house -- if you're like me, you smoked them all, anyway. And, for the first day or three, I might even recommend giving your ATM, credit cards, etc. to someone else to hold on to, and keep just enough cash to buy necessities. If you have money, and cigarettes are easy to come by, you're more likely to run out and get one. Try to at least create a few obstacles for yourself -- sometimes, determination plus a healthy amount of laziness is enough.

Also, if you work in an office, and if you take regular cigarette breaks or sneak out for a cigarette at lunch, try to create a new schedule for yourself. Find somewhere else to go for your break; enjoy a Nicotine Replacement product, and -- if you can -- avoid other smokers, at least for a few days. We all know that our fellow smokers enjoy seeing us fail -- if you finally break down and bum a smoke, you're probably going to get praise instead of disapproval. Conversely, if you don't break down, try not to bore your co-workers too much with your decision to quit.

As for me, on Day 1, I'm pretty stoked. A lot of books and professionals will recommend that, if you normally have a cigarette with coffee (and really, what's better) that you avoid coffee all together. Personally, I tend to double up on the coffee - use it as a replacement for cigarettes, and then I have a Commit lozenge to go along with my coffee. I think the best thing you can do is try to replace your cigarettes with something else -- so, attach an association of coffee to nicotine replacement product as soon as you can. It may help you to forget about cigarettes after a few days (or weeks, at least).

I do suspect that things will get much harder for me by the end of the day. But, I'll report on that tomorrow. Until then, good luck, and happy quitting.

Posted by John at 11:04 AM | Permalink | Comments (0) | TrackBacks (0)

If what they say about smoking being a low-class addiction, growing up dirt poor in the South, becoming a smoker was almost inevitable, I suppose. I was surrounded by it from birth -- I have no doubt that the doctor who delivered me probably did so one-armed, with one hand waiting for my release from the womb and the other holding a cigarette. My mother smoked, my brother started before he'd hit puberty, and my sister followed soon thereafter in her teens, so it was borderline miraculous that I was able to avoid it as long as I did. I'd picked up one now and again during college, but -- for the most part -- I saw the addiction as representative of the impoverishment and weak-willed nature of the schlubs who lived in my neighborhood, the kind of folks I was determined not to be.

In Hollywood, of course, smokers are depicted as aloof introverts with squinted eyes and a brazen coolness, who are often novelists or PI's whose sex appeals somehow exudes through the fog of smoke. In reality, however, smokers are more often than not the mullet-wearing and the obese, who manage to suck down Winston's in the walk between their beat-up 20-year-old Escorts and the door to Taco Bell, where they will gobble down the day's maximum recommended calories in one sitting before rushing back out into 90 degree temperatures to wash their Big Beef Nacho Supremes down with another cigarette. Indeed, for many people, a simple trip to the Wal-Mart parking lot of any small-town American town ought to be enough to turn you off of Virginia Slims forever. Repulsion therapy, unfortunately, rarely works, however.

As for myself, I never really got into smoking until my first-year of law school; and I'd like to say it was the stress that drove me to nicotine, but it really had nothing to do with it. For me, it was the fact that the smokers in my law school were the antithesis of the future corporate drones who wore Polo shirts and khakis and talked fondly of tax law. Cigarettes provided an "in" to the fringes of law school, where I longed to be. It was never really about peer pressure or even approval, it was more about finding an excuse to huddle with the other smokers, who seemed to have a like-minded fondness for anything that didn't pertain to the law. In fact, it took me a few weeks to even get into smoking; I'd buy a pack and struggle through, giddily anticipating the addiction because, without it, I saw nothing otherwise appealing about ingesting a lungful of smoke and then blowing it out into the atmosphere. And I sure as hell never felt cool doing it.

But, the addiction did eventually take hold, and over the upcoming months, smoking became less and less a group activity, and a more singular need. Certainly, a Marlboro Light did provide a much needed reward in between classes, and there is nothing more sanguine than holding a beer in one hand and a smoke in the other; but, expectedly, cigarettes became a necessary accessory to coffee and beer, and eventually, to everything else.

So, I smoked. And what was once an occasional cigarette among friends after Constitutional law class was now a pack-a-day habit that I scheduled my life around. And if you've read this far, you probably know the rest of the story; cigarettes became an unwanted distraction to my career, to my romantic life, and to mere existence. Of course, I made plans to quit almost as soon as I got hooked, but the reckoning day got pushed back further and further. Sometimes, after a two-pack night that left me breathing ash the next morning, I would make myself quit -- but it'd only last a day or so before I made an excuse to start again. Between 2001 and 2003, I suspect I quit half a dozen times, but it never took longer than a week.

But, finally, when the city of Boston passed their smoking ban in May of 2003, I finally managed to break the habit. If I couldn't smoke in bars, I reckoned, there wasn't much point in it anymore. So, I quit -- starting with the nicotine gum, then the nicotine patch, and finally the nicotine lozenge, which I absolutely cherished almost as much as an actual cigarette, which is probably why it took me two-and-a-half years before I managed to quit even the Commit lozenge, by phasing it out with the nicotine patch again. And for three months, I was totally, wholly nicotine free.

As you can guess, however, my anti-addiction stranglehold didn't last much longer. It started innocently enough with one, and then a couple, and now -- three months later -- I'm back to a pack a day. For a smoker, it's really not an interesting story -- the quit and relapse is more or less a way of life for many of us -- an abusive relationship with someone you love, I guess. And, of course, because we smokers don't "bottom out" or hurl into a downward spiral, our addiction is given second-class status to the alcoholics and drug fiends, which is fair enough, I suppose. They don't make a lot of movies about folks quitting cigarettes, and nicotine rehab is kind of out of the question, though I suspect that has something to do with the tobacco lobbies and our nation's reliance on the tobacco crop. No one feels pity for a smoker, though; we're just expected to suck it up and quit. But, I'm getting into politics, and that's really not what this experiment is about.

What is it about? Well, starting on August 1, 2006, I'm going to make my final break from cigarettes once and for all. And I've volunteered to chronicle my cessation for the good people at Beginnerguide.com. I suspect that I'll update this blog daily for the first 30 days or so, and assuming all goes well, I'll keep you posted sporadically in the months thereafter. At the same time, within this section of the Beginners Guide, I'll explore in more detail the mythology of nicotine addition, offer some guidance, and sift through the research and statistics, in the hopes of making the Beginners Guide to Smoking Cessation one of the more authoritative places on the Nets to get your quit on.

I'm certainly not suggesting that I have a better story to tell (I don't), but I'm hoping that I have a voice that many of you might find relatable, especially to those of you who don't have that one definitive reason to give up smoking, but who are just doing it because you think you should, or because the malevolent stares you get for lighting up on the subway platform have gotten a little out of hand of late. I'm also not here to demonize smokers or the habit -- in our existing cultural landscape, smoking is often that one last vice we are allotted and the decision to give it up should be our own, and not some Orwellian monkey stumping for votes under the guise of looking after our own health. After all, the decision to choose our own means of death is our birthright, and if we want to go out in a blaze of nicotine and tar, more power to us. But, as for me, I'm kicking it -- I've always been fond of the hit-by-a-bus scenario; it's a lot more sexy than hacking my blackened lungs onto my pillow late into my senior citizenship.

And please, during the course of this experiment, I do not expect pats on the back, or encouraging words from the occasional reader. Avoiding that brand of lockstep, 12-step mentality is exactly the reason I picked up the habit in the first place -- to avoid conformity. But, I suppose, there are better ways to differentiate one's self than self-inflicted halitosis.

So, by all means, stick around. Add a bookmark. Stick me on your blogroll. Keep checking back -- and if you have the sudden urge to nuke your own habit, play along at home. There's nothing I love more than the war stories of someone giving up one of the few things in life they love. But, it's probably for the best, right?

Posted by John at 10:22 AM | Permalink | Comments (0) | TrackBacks (0)

The less popular nicotine replacement therapies tend to be the nicotine inhalers and the nose spray, and they may be less popular simply because they require a doctor's prescription, which can be pretty annoying for many of you who up and decide to quit overnight and don't have the time to make a doctor's appointment. The inhaler (sometimes called the "puffer") works sort of like an asthma inhaler -- you stick it to your mouth and release a small burst of nicotine whenever you have a craving. Most inhalers have around 400 puffs in them, which delivers around the equivalent of six cigarettes, so you may go through quite a few inhalers in a week's time. Some of the inhalers, also, are easy to carry around and even hold/twirl in your hands, which might relieve some of your hand fixation issues -- it can sort of mimic the act of smoking a cigarette (in fact, I've seen people who simply chew on the inhalers in between puffs). I have to be honest, I've not tried the inhaler for any extended period of time -- I've borrowed one or two from friends, and they seem to work okay, but if you're using 6 - 16 cartridges a day, plus the doctor's bill, I can image it would run into quite an expense.

Likewise, I've never even tried the nicotine nasal spray, and quite honestly, I have no desire to do so. Snorting droplets a nicotine through my nostrils simply doesn't have a lot of appeal, especially in public places, though I do imagine that the nicotine is delivered into your bloodstream quickly, because it travels through the nasal membranes (which is why people snort cocaine). However, it might be inconvenient to stick a nasal spray bottle up your nostril twice an hour, which is what is recommended. Moreover, from what I understand, the side effects include nasal irritation, a fast heart rate, and diarrhea, which I'm not okay with. Plus, it has the same hang-ups that the inhaler does, in that you have to get a prescription to use it.

Inhaler and Nasal Spray: C -

Posted by John at 5:27 PM | Permalink | Comments (0) | TrackBacks (0)

The other major nicotine replacement product is the Nicotine Lozenge, and the most popular brand name is Commit. Personally, the lozenge is my preference. I'll admit that, at first, it doesn't always taste that great and can feel somewhat strange in your mouth, but after you get used to it, some of you (like myself) may actually like it almost as much as smoking. It's basically just a mint that you stick in your mouth that generally last around half an hour or so. It tastes pretty good after you've had a few, it doesn't leave canker sores like the gum often can, nor does it leave the weird aftertaste that the gum does. Moreover, though it doesn't solve the hand fixation, it will satiate your need to have something in your mouth. I'm a big fan of that, because for many people who quit smoking, you're inclined to replace cigarettes with food, and at least while the lozenge is in your mouth, you can't really eat. So, in a way, the lozenge doubles as nicotine replacement and helps to curb your desires to munch.

A few warnings, however: 1) In my opinion, the lozenge -- because it offers few drawbacks -- can be pretty addictive. I was actually on the lozenge for around two years before I was able to wean myself off of it with the patch. And 2) sometimes, they can cause hiccups, if you suck on them too fast. Also, whatever you do, don't swallow them, otherwise you're in for about 2 hours of hiccups and probably a pretty bad headache.

Overall, however, I give the nicotine lozenge a solid A-.

Posted by John at 5:26 PM | Permalink | Comments (0) | TrackBacks (0)

The Nicotine transdermal patch is probably the second most popular option. Basically, it works by delivering a low-level of nicotine into your blood stream through your skin over the course of the day. You can buy them in 21, 14, and 7 mg levels, and I'd suggest buying the patch that is equivalent to the amount of cigarettes you smoke and then working your way down -- if you smoke a pack a day, start with the 21 mg, and if you are a light smoker, the 7mg level might work for you.

I'm not a huge fan of the patch, except in its value to wean you off of other nicotine replacement products. It does, in fact, help to curb the cravings, but it does nothing insofar as your oral or hand fixations. Because of that, there have been many reports, some even myths, of people who smoke while they are on the patch, which can sometimes lead to unpleasant consequences, such as heart attacks and seizures. Moreover, the patch can get a little itchy at times, and it tends to leave these really big black sticker circles on your skin, which can be a little annoying. Also, some people are susceptible to rashes.

However, though I don't think it's recommended to sleep with the patch on, I will tell you that -- if you do -- it gives you some really wicked dreams. They are very vivid, and sometimes harrowing nightmares, but occasionally you'll get a pretty cool dream out of it. For those of you who like that sort of thing, I suppose the patch can be fun. Also, if you do take it off before you go to bed, the cravings for cigarettes may be pretty strong when you wake up, and the patch takes several hours to take full effect. If you are going to try to the patch, I might suggest that you supplement it with the gum, for those times when you're really hard up for a smoke.

Overall, I'd give the Nicotine Patch a C.

Posted by John at 5:26 PM | Permalink | Comments (0) | TrackBacks (0)

The most popular amongst the nicotine replacement products is nicotine gum, and Nicorette is the most popular brand name, though most (if not all) nicotine gums are about the same, though the generic packaging is a little less sexy. Nicorette does have the added advantage of offering several different flavors, none of which taste particularly good. I mean, you're not going to get Hubba Bubba here, but the Mint and new "Fruit Chill" flavors aren't particularly disgusting.

The way nicotine gum works, as you'd expect, is that it delivers low levels of nicotine into your system, and if you do it right, you can keep the flow running for most of the day, which does tend to curb cravings and it helps, to some degree, with the oral fixation issue many cigarette smokers have. An unintentional, though beneficial, side effect to nicotine gum is that, for those of you who slip, you may find that cigarettes don't give you near the same pleasure after chewing on a wad of nicotine gum -- the gum doesn't necessarily block the nicotine from cigarettes from coming into your bloodstream, but it does certainly feel like it.

The nicotine gum literature usually suggest that, if you're a person who waits at least half an hour after waking up in that morning, that you should go with the 2mg gum, and if you have to puff away before you've even left your bed, that the 4 mg gum is more ideal. I'm not entirely sure why they've come up with this distinction, but I might suggest that heavy smokers, or even moderately heavy smokers might want to go straight to the 4 mg gum, because it does offer you a better chance at avoiding the relapse. Until you've really gotten comfortable with not smoking, I wouldn't recommend bumping it down to the 2mg level, though the packaging does offer some helpful guidelines, which even suggest that you start out with around 10-12 pieces a day, which -- even for a heavy smoker -- may feel like overkill. Basically, I recommend having a piece whenever you feel the craving coming on, and don't wait until it's already hit you, cause then you'll be jonesing for a Marlboro.

There are some disadvantages to the gum, however. One, for folks looking for something to do with your hands, it doesn't offer a lot of reprieve. Second, well, it doesn't taste particularly good, especially after the flavor has disappeared, which generally only takes around 10 minutes, but you may find yourself chomping on it for another hour. You're also advised to chew it a little, and then plant it in between your gums and your cheek, where the nicotine has a place to enter the bloodstream. I'd advise doing as much, but I would warn that -- in my experience, at least -- I have run into problems with canker sores after chewing the gum for an extended period of time.

Overall, however, I'd give the nicotine gum a solid B in terms of effectiveness. It certainly goes a long way towards curbing the cravings, but you sometimes don't look particularly flattering when you have a piece of chewed gum stuck between your top lip and your gums, which isn't so great for board meetings and the like.

Posted by John at 5:25 PM | Permalink | Comments (0) | TrackBacks (0)

I'm not sure why they call them nicotine replacement therapies because there is little therapeutic about chewing a wad of gum loaded with the sweet, sweet relief of nicotine, but I don't recommend anyone trying to quit without one of the popular nicotine replacement products. The more stubborn amongst you may insist on going cold-turkey, but a lot of evidence shows that people who go that route are much more susceptible to relapse -- and nicotine replacement has proven to work for many a quitter (I do believe that the research shows that folks who use NRTs are twice as likely to stay quit).

Certainly, I'm as skeptical as the next guy about the fact that many of the nicotine replacement products are actually produced and marketed by the tobacco companies, which basically suggest that Phillip Morris wants to get your money coming and going. And, I do know that many people like myself have just as much difficulty weaning themselves off the nicotine replacement products as they do cigarettes -- I am reminded of a Gwyneth Paltrow line in the film, Bounce, in which Gwyneth started smoking to ease herself off the nicotine gum. Still, as bad as nicotine might be (especially for your heart), it doesn't even come close to comparing to cigarette smoke, which is laced with tar, carbon monoxide, and other dangerous carcinogens that basically obliterate your heart and lungs. Nicotine, on the other hand, I simply think of as a potent form of coffee -- it's not good for you over the long haul, but for a lot of folks, it's the only chance you have to quit smoking.

At any rate, I've basically tried them all, and in the next few sections, I'll go through the more popular nicotine replacement products, and perhaps we can come up with the one to your liking. Before you step in, however, I'd also warn that the average cigarette contains about 1 mg of nicotine; so, at first, many of you may actually receive more nicotine from the replacement therapies than the actual gum. Where possible, try to keep the nicotine at relatively the same levels as when you smoked and don't try to rush yourself off of the nicotine products, because you may find yourself back on the cigarettes if you do. Another point: All the nicotine replacement products do seem kind of expensive. At best, you'll be plunking down $30 to $40 just to get started (though, some workplace and even local government do offer some financial assistance or free nicotine replacement products), but -- if you do it right -- it averages out to around the same cost as smoking a little less than a pack a day. However, the expense can be a little daunting to those who are used to throwing down only around $5 a day for a pack of smokes -- just try to think of it in budgeting terms, and, sometimes, the cost does inspire you not to go back to cigarettes, since you've already put down a substantial amount of money on the replacement products.

Posted by John at 5:25 PM | Permalink | Comments (0) | TrackBacks (0)

As most smokers probably know, smoking is not necessarily an immediate addiction. Speaking from experience, the body tends to reject smoking on the first few attempts. It's generally not a pleasant experience. However, it doesn't take long to develop the addiction, and the bigger problem is that addiction not only develops quicker but is harder to break the younger you start. In fact, one study showed that 12-13 year olds, who only smoked a few cigarettes a week, began exhibiting the same symptoms that adult heavy smokers experience. In other words, it is as difficult for an 11 year old to break a cigarette habit of only a three or four cigarettes a week as it is for a pack-a-day adult to quit! Moreover, for children, it takes about 20 years to break the addiction.

Posted by John at 2:04 PM | Permalink | Comments (0) | TrackBacks (0)

All sorts of genetic research indicates that the addiction to smoking is, in some part, related to your family history. Why? Because certain people are predisposed to nicotine addiction because of a particular hereditary gene responsible for metabolizing nicotine. Indeed, non-smokers are twice as likely to possess a gene mutation that actually helps the body rid itself of nicotine; smokers with the same gene also smoke less because the nicotine leaves their bloodstream slower. Conversely, people without the gene mutation tend to smoke much more, because nicotine leaves their system quicker. Indeed, people with certain genetic mutations can tolerate cigarette smoking much more without getting sick, thus building a higher tolerance, and thus necessitating the need to smoke more. One study has even suggested that genetic predisposition accounts for one half of the reason why smokers get addicted (the other half is attributed to environmental factors). One study has also suggested that people with the non-smoking gene are also less likely to develop smoking related cancer, because the body is less efficient in turning the ingredients in cigarettes into cancer-causing carcinogens.

Yet another study shows nicotine addiction is even harder to break for people with aggressive personalities. Indeed, for aggressive people, nicotine helps to control social response; therefore, if you have a hostile, aggressive personality, you are predisposed to nicotine addiction before you even pick up a cigarette. Conversely, those people with low-hostility rates are less inclined to start smoking and find it much easier to quit if they do pick up the habit.

Note, however, that this genetic predisposition doesn't make it impossible to quit; it just makes it more difficult. And those with a history of nicotine in their families should be that much more inclined not to smoke, because the habit will be that much harder to break.

Posted by John at 2:04 PM | Permalink | Comments (0) | TrackBacks (0)

Like absolutely no other addiction (including heroin, crack, or marijuana), cigarette smoking has an immutable link to both internal and external environment. What does this mean? That certain situations and moods reinforce the need to smoke. And what are the most common environmental cues? Having a cigarette with coffee, after dinner, or while stressing out. And, because these social cues are almost as common as waking up, the habit is all the more difficult to break -- indeed, when you quit smoking, you add stress to your life, and that stress triggers the need to smoke. Moreover, even ex-smokers - people who haven't smoked in years - still suffer from pangs when these environmental cues are triggered, making the break from addiction all that more difficult. It is classic conditioning, no different than the Pavlovian dogs slobbering when the bell rings.

Posted by John at 2:03 PM | Permalink | Comments (0) | TrackBacks (0)

Scientific studies have suggest that those who start smoking in their formative years have more difficulty quitting. Why? Because during one's younger years, areas involved in cognition and your brain's reward system are fine tuned. And if your brain is fine tuned around addiction to cigarettes, then teenage smokers are more likely to become seriously hooked than those who start smoking at a later age. Indeed, studies on rats have suggested that, when rats start young, they need twice as much nicotine as adult rats to satiate the need. Therefore, it is even more important that teenagers not smoke, because it's that much more difficult to quit later in life.

Posted by John at 2:03 PM | Permalink | Comments (0) | TrackBacks (0)

Neurons, or nerve cells, conducts electrical and chemical signals throughout the brain. And neurotransmitters, like dopamine or serotonin, are the chemical messengers that allow your brain cells to communicate. Once neurotransmitters are released, your brain's receptors are either excited or inhibited. Nicotine acts directly on those receptors, which results in increased and continued stimulation. The problem with cigarette addiction is that your brain gets used to having an outside substance stimulate your receptors and your brain stops doing the work for you. Moreover, nicotine affects your dopamine receptors, making you feel good. And, of course, once your brain feels good, it wants to continue feeling good, hence the cravings. Additionally, when you stop smoking, you experience withdrawal symptoms because your brain no longer provides the pleasurable stimulation -- the severity of withdrawal basically depends on the strength of the substance, the frequency of use, and the level of tolerance.

Posted by John at 2:03 PM | Permalink | Comments (0) | TrackBacks (0)

What most people don't understand is that, like alcoholism, like cancer, or like chronic depression, addiction is a disease in its own right. Addiction, in fact, is defined as a strong emotional or psychological dependence on a drug or substance that has progressed beyond voluntary control -- beyond voluntary control.

Once you've started, once you've gained the addiction, the need for smoking is beyond your control. And, unfortunately, one addiction is often linked to another: indeed, there is a proven link between smoking at a young age and recreational drug use at an older age. One study has even suggested that people who both drink and smoke were twice as likely to use street drugs. Why? Because addiction itself is a disease. If you're addicted to cigarettes, you can just as easily become addicted to alcohol or drugs.

Fortunately, however, our society has increasingly recognized that addiction is itself a disease, and not just a sign of weakness. Once addicted, without the substance of choice, you will build a tolerance, requiring more of the substance, and if you don't have the substance, you will suffer symptoms of withdrawal, which can be as painful or uncomfortable as the symptoms of other illnesses.

Because the smoking addiction is a disease, many doctors and medical providers actually believe that medical intervention is required, and that drugs - such as nicotine replacement products or Zyban -- should be prescribed.

Posted by John at 2:02 PM | Permalink | Comments (0) | TrackBacks (0)