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FREQUENTLY ASKED QUESTIONS (FAQ) FOR ALT.SUPPORT.STOP-SMOKING (AS3) ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Part 2: Techniques, Troubleshooting, and Tips The urge will pass whether you smoke or not. - unknown The urge will pass whether you kill or not. - Graham King 23. Why is quitting smoking so difficult? You have probably quit smoking (or using tobacco in another form) before, and you have probably gone back to the habit. Whether your "smobriety" (to use a term from the addiction recovery program Nicotine Anonymous) lasted an hour or a year, you no doubt learned a basic truth: breaking away from tobacco products can be, at best, unpleasant, and at worst, a living hell. And the memory of that unpleasant experience may have left you with a fear of trying again. Understanding the source of your physical and emotion reactions can help get you through those difficult early days. Quitting smoking will be one of the hardest things that you will ever do. This is because smoking is actually a three-fold problem: you have developed psychological, social, and physical needs for the drug nicotine. As a smoker, all your emotions were medicated with a nicotine packed cigarette: you relaxed with nicotine; you laughed with nicotine, wept with nicotine, digested with nicotine. You used smoking to pass the time, ready yourself for a crisis, calm yourself after one, even (ironically) to catch your breath during a difficult task. You began your day by dosing with nicotine, your drug of choice (perhaps one among others), and ended it the same way. No wonder that, suddenly deprived of all that, your mind and body go wonky for a little while. Nicotine attaches itself to you physically. From the American Heart Association: Nicotine Addiction When a person smokes a cigarette, the body responds immediately to the chemical nicotine in the smoke. Nicotine causes a short-term increase in blood pressure, heart rate, and the flow of blood from the heart. It also causes the arteries to narrow. Carbon monoxide reduces the amount of oxygen the blood can carry. This, combined with the effects produced by nicotine, creates an imbalance in the demand for oxygen by the cells and the amount of oxygen the blood is able to supply. Smoking further increases the amount of fatty acids, glucose, and various hormones in the blood. There are several ways that cigarette smoking may increase the risk of developing hardening of the arteries and heart attacks. First, carbon monoxide may damage the inner walls of the arteries that encourages the buildup of fat on these walls. Over time, this causes the vessels to narrow and harden. Nicotine may also contribute to this process. Smoking also causes several changes in the blood. They include increased adhesiveness and clustering of platelets in the blood, shortened platelet survival, decreased clotting time, and increased thickness of the blood. These effects can lead to a heart attack. The 1988 Surgeon General's Report, 'Nicotine Addiction,' concluded that: * Cigarettes and other forms of tobacco are addicting. * Nicotine is the drug that causes addiction. * Pharmacologic and behavioral characteristics that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. For additional information on this subject, contact your local American Heart Association office or call 1-800-242-8721. The social attraction of smoking is perhaps the most insidious prong of the nicotine addiction. Until recently, even after the dangers of smoking were well known, smoking was widely seen as essentially harmless; though this opinion is now held by fewer people (and I'll wager that most of them are still smoking), it has not disappeared. We still often hear smoking defended with the argument that the sale, purchase, promotion and use of tobacco products are legal activities nearly everywhere in the world. While true, this statement obscures the question of the safety of smoking and fails to raise other explanations for its legitimate status, such as the financial contribution which the tobacco industry makes to the world economy. And, greater public awareness of the harm that smoking does has not greatly altered its image as sexy, cool, adult, fashionable. Books such as Christopher Buckley's Thank You For Smoking and movies like Reality Bites (where the sole non-smoker is Ben Stiller's dorky outsider character) override those public service announcements and notices on the sides of cigarette packages in the minds of the tobacco industry's most important consumers: adolescents and teens. (Incidentally, we have it from a very reliable source that the people who make a certain brand of popular cigarettes featuring a certain dromedary on the package paid for the actors in Reality Bites to smoke their cigarettes. And for more proof of this common industry practice, here's an interesting letter http://galen.library.ucsf.edu/tobacco/docs/html/2404.02/2404.02.1.html from one of America's top action stars.) Give it a minute's thought: do you really like smoking, or do you just like your smoker image and the props associated with it (the cigarette, the nifty smoke rings, the ash; the holes in your clothing, yellow stains on your teeth, nasty taste on your breath)? The minute you quit smoking your life changes drastically. Your identity as a smoker is gone; the crutch which helped you handle situations is kicked out from under you; your body and mind begin to play quite clever tricks on you to get their drug. All these changes can be nearly overwhelming, but the important thing to remember is that things will get better as you learn new and better ways to live your life. And everyone can learn; a few hundred of us at AS3 alone will testify to that! (Paraphrased from 'The Cigarette Papers' by Dr. Stanton Glantz) According to researchers, nicotine stimulates the Hypothalmus to produce the same chemicals it does in stressful situations: corticosteroids. This makes one feel less anxious, and yet possibly more focused. Add nicotine to a stressful stiatuion, and you get more than a regular dose. Over time (and number of cigarettes), the hypothalmus adjusts. Now, "without" a cigarette, you're getting less than average corticosteroids, but smoking brings you back up to a normal level, maybe not even surpassing what a non-smoker gets, but compared to a lowered baseline it feels good. After quitting, over time the hypothalmus adjusts back. The research doesn't say how fast. (AS3 may be able to add some estimates to that). 24. I smoke lights. Aren't they safer? (Excerpted from New York Times News Service, May 2, 1994) Quote: WASHINGTON--Smokers of cigarettes low in tar and nicotine may be getting more of those substances than they think, Federal Trade Commission officials and experts on smoking say. ... National polls conducted by the Gallup organization have found that smokers believe that cigarettes labelled "light" are less hazardous and will deliver less tar and nicotine. But evidence has accumulated that the measurements, which are carried out by tobacco company laboratories under the supervision of the FTC, bear little or no relation to how much nicotine and tar smokers actually get from smoking. "The commission has been aware for a while that the test has problems regarding the actual intake that consumers will get," Judith D. Wilkenfeld, assistant director in the FTC's Division of Advertising Practices, said in a telephone interview. The FTC cigarette tests are carried out by machines that hold the cigarette and draw air through them in 2-second puffs once every minute until the cigarette is burned down to the filter. But cigarettes now include several features that make the machine tests meaningless, according to Dr. Jack Henningfield, chief of clinical pharmacology research at the National Institute on Drug Abuse. For example, a majority of cigarettes now have tiny, nearly invisible hole in their filter paper or in the cigarette paper near the filter. When the smoking machine draws on a cigarette, a large amount of air is drawn in, and this dilutes the smoke getting to the measuring device, making today's cigarettes appear to contain less tar and nicotine. But smokers do not handle the cigarettes the same way machines do. They find the diluted smoke milder, and to make up for the "lighter" taste, or less satisfying amount of nicotine, they puff more or draw deeper, pulling in more total smoke, so that the result is the same amount, or more, of nicotine and tar. In addition, the tiny filtration holes are often blocked by smokers with their lips or hands, thus cutting off the air that would have diluted the smoke. ... Scientific studies over recent years have shown that smokers get about the same amount of nicotine and tar no matter what kind of cigarette they use. Endquote 25. Are cigars any better? [From the on-line page "Ask Dr. Weil," Copyright =A9 1994, 1995, 1996, 1997 HotWired, Inc. All rights reserved. Used without permission] Quote: Cigar consumption is climbing rapidly in the United States, where people smoked 3 billion cigars last year, compared to 2.1 billion in 1993. Around the world, cigar makers are especially trying to target women by promoting their wares as a sign of affluence and sophistication. There are cigar magazines, cigar bars, and even instructional cigar dinners. Donald Shopland, coordinator of the smoking and tobacco control program at the National Cancer Institute, calls the increase in cigar consumption "astounding" - particularly since it has been in decline for many decades. Alarmed, the institute plans to issue a report on safety, chemical composition, advertising, health policies, and other cigar issues in the fall. I'm not impressed by the sophistication of rolled brown tobacco leaves lit up in anybody's mouth. If you smoke cigars, you're tripling your risk of lung cancer compared to not smoking at all. True, cigarette smokers have nine times the risk of developing lung cancer, so I suppose that's one good point. Cigar smoke is harsher than cigarette smoke, so most people can't inhale it deeply enough or often enough to establish the pattern of chemical dependence on nicotine that makes cigarette smoking so risky. But if you inhale regularly, the risk is the same as with cigarettes. You are also increasing the possibility of head and neck cancers, cancer of the esophagus, and cancer in the oral cavity. If you compare cigars and cigarettes smoked in equal amounts, the risk of mouth and throat cancer are the same. Cancer of the oral cavity is one of the nastiest cancers that can occur, in many cases causing disfigurement and death. Sigmund Freud smoked 20 cigars a day and died of tobacco-related oral cancer. Ulysses S. Grant, the 18th US president, also smoked about that much and died of throat cancer. He dropped 70 pounds and became addicted to cocaine in his efforts to escape the pain. Also, cigar smoke is at least as hazardous to the people around you as cigarette smoke. In a recent study published in the New England Journal of Medicine, tobacco use - including cigar smoking - by spouses increased the risk of lung cancer by 30 percent in people who didn't smoke at all themselves. Exposure in the workplace and social settings bumped up the risk even more. Eating fruits and vegetables, or taking supplemental vitamins, didn't improve matters for the spouses. A new California Environmental Protection Agency report released after years of peer review and government scrutiny (and some would say suppression), blames secondhand tobacco smoke for the deaths of at least 4,700 nonsmoking Californians a year. The report says California smokers cause between 4,200 and 7,440 deaths from heart attacks and stroke each year among the people around them, and 360 deaths from lung cancer. Their secondhand smoke is responsible for up to 3,000 new cases of childhood asthma annually. Cigar smoke billows out in greater volume and contains high quantities of unhealthy substances, so it's not an improvement. There are plenty of healthier ways to satisfy an oral fixation. Try carrots. Disclaimer: All material provided in the Ask Dr.Weil program is provided for educational purposes only. Consult your own physician regarding the applicability of any opinions or recommendations with respect to your symptoms or medical condition. 26. Should I switch from smoking to smokeless (chewing) tobacco? It would be a very poor trade-off to use smokeless tobacco as a replacement for smoking. For one thing, it's pretty disgusting to watch someone chewing - and spitting out the tobacco juice. And though the risk of developing lung cancer and emphysema may be lowered, chewing has its own set of horrors. David Drupp (firstname.lastname@example.org) writes: "I have been asked to explain why smokeless tobacco is not a safe substitute for smokers who want to quit. "First of all my wife works for an oral surgeon, and she is my main drive, along with my 2 young sons, to quit this nasty habit. "She has told me of this one guy who had to have his entire jawbone removed and had hip bone taken to replace it. This was a direct result of smokeless tobacco wreaking havoc and causing cancer that had gotten to the bone. This guy, early 30s (who I would love to meet myself) has to wear a face shield with pins in his neck area to hold the hip bone replacement in place until it bonds and starts to grow. If that isn't bad enough to not start this habit then what is. This is not the only case they had on smokeless tobacco users -I can only imagine how many people have it and don't know. I am one of the lucky ones who had access to the warning signs but most don't. I started when I was 15 years old playing baseball and am now 29 years old married almost 10 years with 2 kids. I am damn lucky I didn't have anything happen to me. The absolute clincher was when a 24 year old came in to have a biopsy on his lip and found out he had cancer. 24 years old - think about it!!! "For those who must chew - please do not put the chew in the same place every time you chew. This is what causes the breakdown of the lip. It first turn white - leukoplakia is the term - which is a pre-cancerous sign. Then is may get hardened and change color - IF you have any of these signs - GO GET CHECKED!! "I never put it in the same spot twice and had as many as 6 areas I used so I wouldn't get the bad spots on my lips. I am not condoning chewing but IF you must and are reading this - move it around until you have the courage to quit." 27. How can I prepare to quit smoking or chewing tobacco? It is generally agreed around here that preparation is the single most important factor in successfully overcoming nicotine addiction. Getting yourself to a state of psychological readiness starts with the thought that you may be about ready to stop smoking, and when that thought occurs, IMHO you've begun the process of becoming a non-/ex-smoker. Then, if you read the posts in alt.support.stop-smoking, soon you may find, as many have, that you've begun to think that you are ready to stop. Before you know it, you'll be setting a quit date! Once you've reached that stage, here are some suggestions to aid in your preparation: a. Set a quit date, preferably around a relatively stress-free time, although you shouldn't wait until the perfect time, because it doesn't exist! If you like, announce your intended quit date to the group and ask for quit buddies, or join in a group which has already formed. Belonging to a club usually gives you extra support, and makes you extra accountable! b. Until your quit day, smoke without guilt, but do keep planning. Think about what provisions you will have on hand to comfort you, what (brainless) projects to keep you busy, what comfy quiet spaces if you find you just want to sleep, and whether you'll have access to AS3 and to e-mail. If the people you spend time with have not had the pleasure of seeing you go insane before, consider apologizing in advance for any bad behaviour you may exhibit. :) (After you quit, the statement, "I just quit smoking" will excuse much. Milk it for all it's worth!) As you read other people's posts and the info available on the web, you'll get some ideas that will help you. c. Make any appointments, join any classes, lay in any provisions (herbal teas, cinnamon sticks, licorice root, comfort foods, Valium, etc.), and buy your patches, spray or Nicorette, if you decide to use nicotine replacement therapy. d. Start emptying your ashtrays into one or more clear glass jars which you'll save as long as needed - I kept one for a few months after I quit. (ed.) This 'revulsion therapy' will be of help after the initial motivation begins to leave you and you start thinking that smoking wasn't so bad after all. And each time you open the jar to add more butts and ashes, you'll get a whiff of negative reinforcement. Some people add a bit of water to their 'butt jars' to make them that much more nauseating - not recommended for those with sensitive stomachs! e. Keep a running list of reasons you want to quit. Especially as your date gets closer, really study the list; pick one of the most compelling reasons and repeat it to yourself over the course of the day. It's best to keep the reasons positive, upbeat; e.g., instead of saying "I want to quit so that I don't die a horrible ravaging death by lung cancer" you might say "I want to take a proactive role in my good health." f. [Hot off the cyberpress! From Ask Dr. Weil, downloaded 21 Nov. 96]: Quote: If you smoke, do breathing exercises. They will help motivate you to quit and help you with your cravings for cigarettes. Here's how to start. Sit with your back straight. Place the tip of your tongue against the ridge of tissue behind your upper front teeth, and keep it there throughout the exercise. o First, exhale completely though your mouth, making a whoosh sound. o Next, close your mouth and inhale quietly through your nose to a mental count of four. o Next, hold your breath for a count of seven. o Then exhale completely through your mouth, again making a whoosh sound, to a count of eight. This is one breath. Now inhale again and repeat the cycle three more times. Endquote. g. [From the same Ask Dr. Weil column; see above.] "If you smoke, you should take antioxidant vitamins and minerals, which to some extent can reverse the changes in respiratory tissue caused by smoking, and so help protect against lung cancer. Also, increase your intake of dietary sources of carotene (carrots, sweet potatoes, yellow squash, and leafy green vegetables)." h. Visualize: Start looking at people functioning normally without smoking. People who don't smoke are capable of having an argument, talking on the phone, waiting for a bus, playing pool, and basking in the afterglow just as well as people who smoke. Picture yourself getting through moments you normally associate with smoking, without doing so. Don't overwhelm yourself, i.e., you don't need to picture yourself getting through life or even the day without smoking; just one activity at a time. Watch someone enjoying a cafe latte without smoking. You can be in that picture! i. Keep reading alt.support.stop-smoking daily (hourly, if necessary!), so that you'll start to get a sense of what to expect (good and bad), and post whenever you like, as often as you like, and as nonsensically as you like! Try not to loosen your withdrawal temper on another AS3 poster, though. Most important, keep in mind that quitting smoking is a journey, not an event. You will run into many obstacles on that journey, and meet many false friends. The more you can feel good about the place you're heading (the smober life) and unsentimental about the place you're leaving (life chained to nicotine), the more strength you will have to complete that journey. 28. How long will the physical withdrawal last? Physical withdrawal symptoms last anywhere from between 48 hours to two weeks. This can vary from person to person depending on the amount that you smoked and your physical and psychological make up. Many in the group have found the physical effects typically last between 3 to 7 days. Unfortunately, you will probably not arise on the 15th day after stubbing out your last fag to find yourself completely disinterested in nicotine. Even once the drug is out of your system, you will have desires to smoke which will feel very much like withdrawal symptoms. They are not. Know that your mind is playing tricks, and fight the urge! 29. Can't I have just one last one? And then what? You don't want just one more, you want every one. The nicotine addiction is a very clever animal which is capable of putting strange thoughts into your head, such as: It's been three months since I quit; let me smoke one just to make certain I'm not addicted anymore. Or: I haven't smoked in six months; let me remind myself how much I hate it. Or: Now that I have a decade of smobriety behind me, I can be a social smoker. There is simply no reason to smoke 'just one more' cigarette. You prove that you're not addicted by not taking the drug. And you know you'll never be a social smoker. And if you really listen to yourself, you also know that 9.99 times out of 10, a social smoker is an addict in the making. It is not safe to smoke even a single cigarette as this could send you right back to smoking as much or even more than you did prior to quitting. Furthermore, it's not sensible. There is no reason to consume tobacco, and every reason not to. Remember: You're only a puff away from a pack a day. And if you don't believe this FAQ, read AS3; you'll see stories of people who found that just one cigarette was enough to send them back into smoking even after years of not smoking. Here's Mona's experience: "My experience during the nine years I was smober was that I almost never thought about cigs in any way remotely like I wanted one. In fact, that quit, after even the first couple months, I was so damned proud of myself that even if the junkie old part of myself momentarily thought it wanted a cig, I was clear that I was very happy to be a non-smoker, and that 'urge' just went away, nearly instantly. "Of course, the fact I'm here, quitting again, the 13th time in my life, is proof that, on some days nearly anyone can be unconscious or stupid or downhearted enough that the cig devil sees his opportunity -- the old junkie (me) who used the cig as emotional comfort encourages one to have one, don't worry, you've quit all these years, you don't have to smoke tomorrow, just let yourself have one now, when you 'need it'. HAH! "I hope I'll never be that unsuspecting again! I hate quitting, and love being smober." Thoughts to close the Alt.Support.Stop-Smoking FAQ, Part 2: One cigarette is too many, and a thousand are not enough. - unknown What lies behind us and what lies before us are tiny matters compared to what lies within us - Ralph W. Emerson Hang tough, don't puff! - Barry Pekilis Please go on to Part 3.