Friday, July 25, 2014

What is a Tobacco Treatment Specialist and how can you help me quit smoking? Can't I just quit smoking on my own?

A Tobacco Treatment Specialist (TTS) is a person who has been specially trained in the treatment of nicotine addiction. I was trained at the Mayo Clinic. I also belong to a professional organization: The Association for the Treatment of Tobacco Use and Dependence(ATTUD). A TTS will use evidence based material (proven strategies) to help a smoker become smoke-free. One guideline that is used is the The Clinical Practice Guideline: Treating Tobacco Use and Dependence. This publication has delved into all of the research into tobacco treatment and has complied the best practices. Methods are rated A, B, C.

  • A = This method has been proven to work on a consistent basis.
  • B = These methods have conflicting information. 
  • C = No clinical controlled trials to show efficacy.

Many smokers do quit on their own, just like other addictions such as alcohol, cocaine and heroin. But many need help to kick their addiction, especially nicotine. I have had former heroin addicts tell me that heroin and/or alcohol were easier to quit than smoking.

Have you ever talked to a former smoker and asked what helped them to quit? They can tell you the long trial and error process they used and what ultimately worked for them. It doesn't mean that it will work for you. Working with a professional will shorten your learning curve in what will help you quit and stay quit.

Here is what you can expect when working with a professional Tobacco Treatment Specialist:

  • A detailed personal history. Every smoker is different. There is no one-size-fits-all when it comes to tobacco treatment, not even a one-size-fits-most. You will be asked about how much you smoke, for how long, your previous quit attempts, your medical and mental health history, previous or current substance use, your common triggers, assessment of your nicotine dependence and your perceived obstacles to quitting. 
  • From your detailed history, an individualized treatment plan is developed. It will include information of what medications may help and what practical counseling skills are needed for your particular situation including: emotional cues, dealing with stress, weight gain, handling withdrawals with or without medications, being around other smokers, and relapse prevention.
  • Motivation when times are tough. Some days you will feel that nothing can ever drag you back to smoking and other days you will feel that nothing will help except a cigarette. 
  • Explanations for any questions or myths related to smoking. I have had many clients whose doctors have told them that if they quit they would: breathe better, have lower cholesterol, their neuropathy will improve etc. yet they didn't believe their doctors. Why? Because their doctors didn't take the time to fully explain what smoking is doing to their body and how the body heals itself when you quit. 
  • Someone who understands how difficult it is to become smoke-free. While I am a former smoker having quit 9 separate times for at least 3 months and I personally know how hard it is, many TTS's have never smoked but with their specialized training and after working with countless smokers, they don't need to know what it is like. Just as an OB/GYN doctor doesn't need to know how it feels to be pregnant to deliver a baby. 
Signs that it is time to use a TTS instead of trying to quit on your own:
  • You have quit multiple times, only to relapse back to smoking. 
  • Have a history of other substance abuse and/or addiction, or a history of mental illness.
  • A sense of shame or guilt that you are still smoking. Shame is when you feel there is something wrong with you that you can't quit. Guilt is when you feel you should quit and want to quit, but are still smoking. These are normal emotions that a TTS can help you work through instead of letting these emotions stop you from moving forward. 
  • You've tried everything and nothing works. A TTS will help you cut through the "noise" of quitting, helping you focus on what will work. Too often a smoker relies on the latest fad or gimmick to quit instead of what will work, or will rely on just one tool instead of developing several coping strategies. A TTS will focus on the process of quitting, not just the method, since every method will work for some smokers, NO method will work for every smoker.  
Call me today at 760-333-1270 for a FREE 15 minute counseling session to see how I can help you. 

I just turned 50, had a physical and my doctor says I'm in great health. Why should I quit?

It is common to believe that you are one of the "lucky" ones who can smoke without it doing any physical damage, especially when hearing something like this from your doctor. Or believing that when your doctor listens to your chest and says, "Your lungs sound fine", thinking this means smoking has done no damage. This is called having an "optimistic bias".

The average life expectancy for men is 76 and for women 80. Smokers die about 10 years earlier than non-smokers. But since we all have to die of something, it might as well be something you enjoy -right?

Age 45 to 50 seems to be the tipping point. What your doctor should say is, "How do you want to live the last 20 years of your life? If you stop now, you will probably stay healthy and be able to continue doing the activities you enjoy most. However, if you keep smoking, you will probably end up disabled from heart disease, cancer, stroke, or emphysema."

Here is a graph that shows the progression of lung function decline of smokers, non-smokers and quitters leading to disability and ultimately death.

The truth is that no one who smokes is healthy. Fifty percent of all smokers will die from their addiction but almost all will develop some type of disability from smoking. The problem isn't that you will die too young from smoking but you will live too long suffering from a horrible debilitating disease. So quit now while there is still time to stay healthy. Turn your optimistic bias into believing that if you do quit, you will continue to be healthy but if you continue to smoke, you will suffer the disabling effects.

Monday, July 14, 2014

I just quit smoking, when will I feel better?

Most smokers feel better in three to four weeks. By this time the nicotine withdrawals have subsided or are being effectively managed and "habit" cigarettes have gone away.

Nicotine withdrawal is the main reason why smokers relapse the first month they quit. Physical withdrawal symptoms are: Cravings, depression, anger, irritability, insomnia, hunger or weight gain, fatigue, restlessness and frustration. For some smokers these symptoms can last up to six months.

There is no reason why a smoker should feel uncomfortable during this first month because there are seven FDA approved cessation medications to help with physical withdrawals. Often a combination of medications works better than using one. A recent study showed that the combination of Chantix with the Nicotine Patch worked better and had higher quit rates than using either of them alone. A professional tobacco treatment specialist can help a smoker figure out what combination of medications may work best.

Habit cigarettes are often seen as the hardest to quit. The one with your morning coffee, in the car on the way to work, or the one at break time. The cigarettes are a conditioned response. Your brain has associated different activities with the jolt of nicotine. This is the same conditioning as Pavlov's dogs. The dogs were taught to associate the ringing of a bell with food. Every time they heard a bell, they started salivating because they knew food was coming. A smokers brain is exactly the same - you smell the coffee and your brain immediately thinks of a cigarette. You get into your car and your brain immediately thinks of a cigarette.

What most people are not aware of is that Pavlov also taught the dogs to stop anticipating food when they heard the bell. It's called "extinguishing the condition". It takes about three to four weeks or about 30 different times where you have a cup of coffee without a cigarette. After this amount of time, your brain no longer anticipates getting a cigarette.

When nicotine withdrawals and the habit cigarettes are no longer an issue, a smoker will feel "normal" again. This is when a smoker may think they have the problem beaten. They have mastered their addiction. But they have only mastered two parts and the tools used for withdrawals and habit cigarettes are not the same tools needed to overcome what is needed to overcome the reasons for long-term relapse: stress, weight gain, emotional triggers, alcohol and being around other smokers.

So just because you feel better soon, don't let your guard down but develop new tools and strategies tostay quit for forever.

Monday, June 30, 2014

Looking for e-cigarette stories to be published.

Have you tried e-cigarettes? Did they help you stop smoking or was it waste of money? I'm looking for real world experience with e-cigarettes or personal vaporizers to include in a new e-book I am writing. This will be an informational e-book presenting both sides of the e-cigarette controversy.

For participating I will send you a FREE copy of the e-book once it's completed. You can either leave your experience in the comment section or I can call you and do an interview, whichever is easiest for you. Send an email to : with your phone number and the best time to call. All comments will be anonymous.

Friday, June 13, 2014

How to Make a Plan to Quit Smoking

Imagine you are at your doctors office and he just told you that you have to stop driving a car. It's bad for your health and if you continue you risk disability and/or death. You must stop today!

Did you just go into a total panic? You might be thinking, "But how am I going to get home from here? How to I go to work tomorrow? Or take the kids to soccer practice? Or go grocery shopping?

The thought of never being able to drive again might just cause you to rebel, go into denial and ignore your doctors advice. You might tell yourself, "It's too hard. I've been driving for too long to change. I might be one of the lucky ones. Bad things happen to other drivers but not to me."

But if you had six months to make a plan on how to use other forms of transportation, you could do it. You might get a bus schedule and map out the routes to work, the grocery store and the mall. You might ask coworkers if you can car pool with them and a neighbor if you can tag along to the grocery store.

You discover there is a wide variety of modes of transportation and you have options: planes, trains, buses, bicycles, skates, unicycles, skateboards, walking, motorcycles, scooter, boats, ships, canoes, rick-shaws, tuk-tuks, horseback, helicopters, cable cars, tramways, funiculars, sailboats, yachts, elevators, ski-lifts, escalators, chauffeured limousine and even a spaceship.

Not all of these options may apply to your particular situation but you do have options. You might need a different option for every time you used to drive a car but by getting creative it can be done; and what works for someone else might not work for you. It might not be easy but not impossible.

Quitting smoking is exactly the same. If you had to quit today, what would you do? Would you go into a panic because you don't have a plan on how to have your cup of coffee without a cigarette? Or what to do at break-time? You might need a different idea for every one of your cigarettes.

Here is an except from my book, "How to Win at Quitting Smoking" which you can get a free copy just by signing up for my blog. This is how to break your smoking habit BEFORE you quit:

Activity: Make a smoking corner, away from all household activities, -- someplace you do not normally go and only smoke there. It could be the side of the house, by the garbage cans or in a corner of the garage. Don’t make it someplace you enjoy going to, but someplace you do not like and do not spend time there.
Even if you already smoke outside, like on the patio or porch, find someplace new. After you quit smoking, you want to be able to go to this place without it triggering a craving to smoke. Change the place where you used to smoke to a new relaxation corner where no smoking is allowed. Practice your relaxation techniques there and/or use this area to work on your Action Plan.
Smoke by the clock. Do not smoke whenever you want to but instead let the clock dictate when you smoke. Choose a time schedule so you smoke often enough to not have strong withdrawals or cravings. Smoking a pack a day is one cigarette every hour; 10 cigarettes a day is every two hours; two packs a day is every half hour. If you do not feel the need to smoke when it is your time to smoke, you don’t have to, but you can’t have another cigarette until it is your next time to smoke.
Do not try to cut down -- the purpose is to learn new behaviors while your brain is still calmed by smoking and to break your old associations.
When it is your “time” to smoke, go to your smoking corner, stand (unless you have a physical challenge) and smoke. In your smoking corner, do not do anything else except smoke. Do not take your coffee with you. Do not take your cell phone. Do not listen to your iPod. Do not leave a window open and watch TV. Do not talk to others. The purpose is not to multi-task when you smoke but to give yourself time to be conscious of what you are doing. By separating your smoking behavior from your other behaviors, you are “breaking your habit”.
After you have smoked a cigarette, go back into the house and go about your normal activities. Have a cup of coffee or watch television. See how it feels to be doing this activity without smoking. It might feel weird but that is normal. Remind yourself that this strange feeling is just a thought about smoking and not a physical craving.
Stop Smoking in your car. If you are driving when it is your “time” to smoke, pull over to a safe area and get out of your car to smoke.
Do not smoke with other people. If your work place has a designated smoking area, do not go there to socialize with your fellow smokers, but only go there at your time to smoke; do not get distracted by talking to other smokers. Leave as soon as the butt is put out. 

For more good ideas to break your habit sign up for my blog in the right hand column and receive a FREE copy of "How to Win at Quitting Smoking".