Tuesday, February 9, 2010

Time to think of nicotine addiction in a different way

Last night was graduation for the participants in my smoking cessation workshop. All had quit smoking for varying lengths of time from a couple of days to two months. For most, it had been three weeks but a common thread was, "Why is it still so hard? Why do I still have cravings? Why doesn't it seem to be getting any easier?"
Those comments are an example of still thinking of smoking as just a bad habit to be broken instead of the true physical addiction that it is. I have worked with many recovering alcoholics and substance abusers that have told me that it was easier to quit alcohol, heroin, cocaine or whatever their drug of choice was, compared with trying to quit smoking--it is often the toughest addiction to overcome. For other addictive substances, it seems quite acceptable for the addict to go into rehab for 28 days, insurance will even pay for it. Once released, the advice is 90 meetings (AA, NA) in 90 days. So for other addictive substances it is recognized that the addict needs support and help for at least the first 4 months, yet when it comes to nicotine addiction, the effects are expected to disappear within a short period of time.
My quitters  agreed that when a craving did pop up, it wasn't as intense or as often as they had experience on their first or second day of quitting. They also agreed that for some behaviors, it was getting easier. Certain habit cigarettes such as answering the phone, drinking coffee and driving, were getting easier because they had the tools in place and had practiced now for three weeks. It is unrealistic to think that after 40 or 50 years of smoking, that the addiction will disappear in a very short period of time.
 It's time to think of nicotine addiction in a different way. Nicotine is more addicting and harder to quit than alcohol and other substances. So obviously it is much more than just a bad habit where the smoker just puts the cigarette down, walks away and is done with smoking. Put into this context, after three weeks, these quitters are still in rehab and still have a ways to go before becoming former smokers. Right now they are smokers who are choosing not to smoke, working their way to a life without nicotine. It is a journey and a process, not a one time event.