Читать книгу Quit Smoking for Life - Suzanne Schlosberg - Страница 8
Оглавление• The ties that bind you to cigarettes
• You’re addicted, but you’re not helpless
Before her plane landed for a layover at the Atlanta airport, Christine Burke was already on edge. She hadn’t seen her 21-year-old son, an Air Force aircraft inspector, in three years or met his wife or baby daughter. Now she was heading to Salt Lake City to visit them for a week. “I didn’t know if his wife was going to like me or what my son was going to look like after so long,” says Burke, 50, a church custodian in Oak Island, North Carolina. “The stress was eating me up.”
By the time she deplaned in Atlanta, Burke had gone four hours without a cigarette, no small feat for a 37-year, pack-and-a-half-a-day smoker who often lit up if she awoke in the middle of the night. But what sent Burke spiraling, upon arrival, was the airline’s announcement: Due to mechanical problems, her next flight would be delayed.
Awaiting further news, Burke didn’t dare stray from her gate in search of a designated smoking area. Besides, she was traveling with her 11-year-old daughter, who’d have given her the “stink eye and the silent treatment,” Burke says, if she’d dragged her across the airport to smoke. Two hours passed. Then three. Then four. Fidgety and miserable, Burke paced the terminal until she reached her breaking point. “I wanted a stinkin’ cigarette,” she says. So she ducked into the restroom.
“Next thing I know, I’m hanging over a toilet, blowing smoke into the water,” she says. “That’s when reality slapped me in the face. I thought, You’re as much of a junkie as a heroin addict. It was infuriating that I couldn’t even obey the law. I saw that smoking wasn’t just something I did to reward myself or cope with stress. It was an addiction.”
Dependence on cigarettes is a powerful addiction. It’s also a stealthy one. You might not realize you’re hooked until you try to quit, only to find yourself overwhelmed by a craving; next thing you know, you’re fishing through the trash for a half-smoked butt. Or, like Burke, you may not realize it until you’re stranded in a smoke-free zone, feeling irritable and panicky. When reality does strike, you might feel the way she did: mystified that a measly cigarette can seize hold of you and frustrated that others can walk away from cigarettes when you can’t. “My mom quit cold turkey after smoking for 40 years,” says Burke. “Everyone knows someone like that, and it makes you feel awful that you can’t do it yourself.”
If you’re struggling to quit, you shouldn’t feel embarrassed. It doesn’t mean you’re weak. It means you’re normal. For most smokers who want to quit — and 69 percent of all smokers do want to stop, according to the U.S. Centers for Disease Control2 — beating cigarette addiction is hard. The tobacco industry has poured billions of dollars into making sure it’s hard. In this chapter we explain why quitting smoking is such a challenge and why determination alone is often not enough to counter the addictive pull of cigarettes.
But don’t allow this to discourage you. Given the tools, anybody can quit. Everybody can quit. Christine Burke quit and, as you’ll read in later chapters, she transformed her life in ways she could never have imagined.
For the moment, don’t worry about quitting. Now might be the right time for you, or it might not. We’ll explore your readiness in Chapter 3, Deciding to Quit. Instead, use what you learn in this chapter to better understand your addiction. That way, you’re better equipped to do battle.
Burke’s low moment in the airport restroom marked a turning point. For the first time, she owned up to her destructive relationship with cigarettes. Upon arriving at the Salt Lake City airport, she got a second dose of reality. “When I walked off that plane, the first thing I wanted to do wasn’t hug my son but light a cigarette,” she recalls. “That’s what cigarette addiction does to you. In the back of my mind, I was thinking: This is not what I want for myself.”
The Addiction Triangle
If you smoke daily, your body is almost certainly hooked on nicotine, and that’s no small predicament. Nicotine is so addictive that a quarter of teens, the age range when 90 percent of smokers begin the habit, start to lose control after smoking just three or four cigarettes; after smoking five packs, nearly 60 percent are dependent.3 Long-term use of nicotine can actually change the structure of your brain, and the longer you smoke, the more significant the changes. So even if nicotine were the sole basis for addiction, quitting would be a challenge. But nicotine dependence doesn’t fully explain why cigarettes are so tough to give up. There are two other reasons: 1) Smoking also is driven by habit — unconscious, repetitious behavior patterns — and 2.) It’s strongly influenced by an emotional connection to cigarettes.
You take about ten puffs on each cigarette you smoke. If you smoke one pack a day, over a year you’ll take more than 70,000 puffs. Christine Burke smoked about 30 cigarettes a day for 37 years. That’s almost four million puffs. If you do anything four million times, especially something that triggers a jolt of pleasure, you’ve developed a deep-rooted behavior. Burke smoked within five minutes of waking each morning, a sure sign of nicotine dependence. But her smoking patterns were driven by something far more complicated than nicotine levels. Over time, like so many smokers, she had developed triggers throughout her day that prompted her to smoke. Every night, for instance, Burke capped her supper with a cigarette, even if she had stubbed one out right before eating. That cigarette wasn’t her nicotine-deprived brain cells talking. It was the result of decades of repeated and reinforced behavior that had turned smoking into a way of life.
And her stress-fueled urge to smoke in the Atlanta airport? Sure, she craved a cigarette because her bloodstream was low on nicotine and because she habitually relied on smoking to relax. But Burke also pined for a cigarette because she’d come to consider cigarettes a dependable companion, always in her corner in good times and bad.
Think of the three facets of cigarette addiction — the physical, the habitual, and the emotional — as the corners of a triangle. Your triangle may have somewhat different dimensions than the next smoker’s. For some folks, the physical nicotine dependence looms largest; withdrawal symptoms are a beast. Others are surprised to discover they weren’t heavily addicted to nicotine, yet they’re hit with an intense urge to smoke every time they drink coffee or pick up the phone. Answering the following questions will give you a picture of your own triangle of addiction. In the coming chapters you’ll learn strategies for dealing with the physical part, the habits, and the thoughts or feelings. You are more likely to succeed if your strategies are tailored to your particular challenges.
Physical Addiction:
How do you feel physically when you haven’t had a cigarette for a while?
When are your cravings strongest?
What do you do when you are somewhere you can’t smoke?
Habits and Behavior:
Is smoking so much a part of your daily routine that you can hardly imagine what you’d do if you weren’t smoking?
Would your social life change if you quit smoking?
Do you always smoke with alcohol or coffee?
Thoughts & Feelings:
Do you use a cigarette to deal with emotions such as stress, boredom, or anger?
Is being a smoker part of the way you see yourself?
Do you have fond associations with cigarettes and smoking, or think of cigarettes as your friend?
Now, let’s take a closer look at each corner of the addiction triangle.
Your Brain on Nicotine
When you take a puff on a cigarette, nicotine gets sucked into your lungs and then catches a ride, via your bloodstream, to your brain; there it triggers a release of extra dopamine, a brain chemical that makes you go, “Ahhhh.” This process takes all of ten seconds. That’s five seconds faster than it would take intravenously injected heroin to reach your brain. Thanks to this lightning-quick buzz, you develop a strong association between the act of smoking and the feeling of pleasure.
But the party doesn’t last. Within minutes after you finish a cigarette, the nicotine level in your blood starts dropping, shutting off the dopamine release. When you’re addicted to nicotine — if your brain relies on the drug to keep you feeling “normal” — you start to feel restless or prickly after about an hour. You might also begin feeling low on energy or have trouble concentrating. Soon you’re thinking about your next cigarette.
When you go to the movies, do you notice a small crowd storming the exit as the credits roll? Maybe you’re one of these folks, reaching into your coat pocket as you hit the lobby, pulling out the cigarette pack as you leave the theater, and then lighting up twenty feet from the building. This mad rush happens because two hours, the length of the average movie, is the point at which the typical nicotine-addicted brain starts shouting, “More. NOW!” The more addicted you are, the sooner your brain will make the demand.
None of this is an accident. You might think of a cigarette as nothing more than tobacco and a fuzzy filter rolled up in paper. Not too state-of-the-art, right? In fact, tobacco companies have put an astonishing amount of engineering into making cigarettes maximally addictive. For example, cigarette tobacco is treated with ammonia to change the molecular structure of nicotine; as a result, it’s absorbed much more quickly than nicotine from untreated tobacco. Consider, too, the design of cigarette filters. Nicotine rides on small particles of tar, the stuff that turns the filter, and your lungs, brown; filters are devised to deliver tar particles that are precisely the right size to penetrate deeply into the lungs, optimizing the potential for addiction. Sophisticated filter technology also reduces throat-burning sensations. So as you take a drag, you’re less likely to think you’re doing any harm to yourself.
If cigarettes are that addictive, why can some people smoke on occasion without developing a compulsion? Why can some teenagers experiment with cigarettes and move on while others become hooked? Science hasn’t nailed down definitive answers yet, but some people seem to be genetically predisposed to nicotine addiction. Also, children exposed to secondhand smoke may become prewired to receive a particularly strong neural reward from smoking, if and when they try it. Certainly you’re more likely to become addicted if you take your first puffs as a teenager. Because the teenage brain isn’t fully developed, research suggests it’s more susceptible to becoming dependent on nicotine.
For various reasons, some smokers become more physically addicted to cigarettes than others. If you smoke within 30 minutes of waking, that’s a sign of a powerful addiction. Even “light” smokers can be addicted to nicotine and struggle mightily to go from five cigarettes a day to zero. But no matter where you fall on the nicotine-dependence spectrum, you can undo the wiring that years of addiction have put in place, and the strategies in this book will show you how. Before long you’ll be able to comfortably sit through a feature film, as well as enjoy all the other pleasures that come from a smoke-free life.
Smoking Without Thinking
Wheezing with every deep breath, Andrew Van Ness went to his college health center assuming he had a chest cold or an allergy flare-up. As it turned out, he’d developed a lung infection related to smoking. Twenty years old and otherwise healthy, Van Ness wasn’t convinced he needed to quit, but he did decide to cut back. “I told myself I would only smoke at specific times,” he says, “like when others were smoking or only when I was drinking.”
But instead of smoking less, Van Ness simply drank more to justify more smoking. And instead of waiting to smoke until he was around other smokers, he sought them out. His smoking patterns had become so ingrained, he says, that he couldn’t seem to disrupt them. “I’d get out of class and light up without thinking about it,” he says. “I’d finish homework and light up. After dinner, I’d light up. If someone else lit up, I’d light up.”
So much of what we do in life is controlled by habit rather than conscious decision-making. The half-decaf you order, the dollar you tip, the way you load the dishwasher, the brand of shampoo you buy — when you make these “choices,” you’re operating largely on autopilot. And so it is with smoking. The rituals you use to open a cigarette pack or hold and light a cigarette also reinforce these habits. Over time, you’ve made an unconscious connection between smoking and the activity, location, or feeling that came before it, whether it’s having a beer, sitting on your deck, or feeling stressed out. These become your triggers, your cues to smoke.
Your smoking habit is far more strongly rooted than, say, your shampoo-buying habit, because you’ve done it thousands, if not millions, of times and because the payoff linked to this habit is so pleasing and immediate. This connection may be so powerful that you become convinced you can’t pay your bills, start your car, or talk to your mom on the phone without a cigarette in hand. Even if you make a deliberate decision to stop smoking, you’re going to run up against a force that can defy common sense and your best intentions.
Habits like smoking are literally imprinted in your brain almost like a tattoo. As with a tattoo, this imprint can be removed, but only with serious effort and some discomfort. To quit tobacco for good, you need to dismantle your old routines and construct new ones. Andrew Van Ness did it, and so did Christine Burke. You can, too. Unlikely as it might seem now, you will find ways to drive, pay bills, celebrate, relax, collect your thoughts, and get through the day that are less destructive and more rewarding than smoking.
The Ties That Bind You to Cigarettes
Nearly a pack-a-day smoker, Van Ness was no doubt addicted to nicotine, and he smoked largely out of habit. But five or so times a day, he estimates, he’d pull out a cigarette simply to connect to good memories related to smoking. “When I’d smoke, I would think about parties I’d been to or hanging out with certain friends,” he says. “Smoking also gave me time alone to think about my future. I felt like: No one’s going to bother me now. My favorite cigarettes were the ones I smoked by myself.”
Emotional attachment to cigarettes can take many forms. You may, consciously or not, consider smoking integral to your identity — as a member of your family or your work crew or your part of town, as a rebel of sorts, as a young person at heart. Maybe cigarettes are the bond between you and your spouse. Maybe they’re your reward for tolerating a job that bores or exhausts you.
We all develop ties to places and people that don’t serve us well. Maybe you’ve resisted leaving a town that offers no opportunity because it’s a familiar place. Surely you’ve clung to an unhealthy relationship because the alternative — being alone — seems too sad and daunting. Ties just as strong and irrational can bind you to cigarettes. Nicotine addiction is the obvious reason so many smokers struggle in vain to quit, but don’t underestimate your emotional bonds with cigarettes.
You’re Addicted, But You’re Not Helpless
With more insight into your addiction, you might be feeling empowered to take it on. We hope so! But we also recognize you might be feeling more discouraged. Maybe you’re figuring the tobacco companies have rigged the game against you or that you’re hopelessly hooked. Maybe you’re thinking: I’m a goner.
Don’t believe it. Quitting probably won’t be a breeze, but becoming a nonsmoker is absolutely within your control. “There was a time when I declared quitting to be impossible,” recalls Burke. “Addiction is so complex that even an addict has trouble understanding it. I did and still do. But in hindsight I can see the biggest obstacle to ending an addictive behavior is fear.” In the next chapter, we explore common fears related to giving up cigarettes and help you overcome any anxieties that may be holding you back.
One morning when Amanda Abou-Zaki was 23, she looked in the bathroom mirror and recoiled at what she saw: “a soulless pod person, a zombie,” with pale skin, black eyes, and a bleak future. Having lost herself to cocaine, ecstasy, and methamphetamine, she’d hit bottom. That day she quit drugs for good and re-enrolled in college.
She also shifted her cigarette addiction into overdrive.
“I associated cigarettes with healing,” says Abou-Zaki, now 28 and a graduate student in psychology. “I told myself: I can quit drugs if I smoke.” So she did — more than a pack a day, sometimes a whole pack in an evening.
It took Abou-Zaki a year to realize that cigarettes were holding her back from achieving her dream at the time: recording an R&B album. “My range had changed. I couldn’t hold notes anymore,” she says. “After singing for an hour, I’d be exhausted, and my throat would get tired. People would say, ‘Have you been smoking?’”
Having quit cocaine and meth, Abou-Zaki figured she could fairly easily kick cigarettes. She couldn’t. “I realized I was super-emotionally attached to my cigarettes. I associated drugs with one emotion: wanting to escape. But cigarettes I associated with all emotions. When I wanted to celebrate, I smoked. When I was stressed or angry, I smoked.”
She smoked out of sheer habit, too. She’d done drugs once a day, in one or two places; she’d smoked twenty to 30 times a day, everywhere. “You start to associate smoking with everything: You wake up; you smoke. You eat a heavy meal; you smoke. You get into your car; you smoke.”
Adding to the challenge, smoking seemed to have no obvious, immediate downside. “When you’re coming off coke, your head hurts, you get hot flashes, your palms are clammy, you have a migraine. You feel like crap all day. But with a cigarette, you never say, ‘I smoked too much.’ There’s no comedown. It’s more subtle. You’re stressed out and irritable, but to fix that, you just go smoke.”
The first two weeks after she quit, Abou-Zaki was cranky and impatient. “I’d yell, ‘You’re in my chair — get out’ like a kid screaming, ‘Don’t play in my sandbox.’” To mark a fresh start, she splurged and got her car detailed. To sort through her emotions, she started journaling. To ease her stress and build stamina, she took up jogging. “Pretty soon, I could sing longer and hold notes longer,” she says.
One afternoon three months after she quit, Abou-Zaki jogged her favorite trail, near her home in Lynnwood, Washington. “The trail ends at the beach, and I remember standing at the water’s edge and taking this wholehearted, from-your-gut breath. I could actually taste the fresh air and smell the water, the sand, and the trees. I thought: You don’t get to do this when you smoke.”
“You can’t go to a gas station and buy cocaine, but cigarettes are everywhere. You don’t have to hide it like you do illegal drugs.”
2 Centers for Disease Control and Prevention. Quitting Smoking among Adults—United States, 2001–2010. Morbidity and Mortality Weekly Report [serial online] 2011; 60(44):1513–19
