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Professor Robert West, smoking cessation, tobacco controlRobert West, Professor of Psychology at University College London and author of The Stop Smoking Formula, shares his top tips on how to quit, staying strong and coping with cravings.

Understanding the urge to smoke

In one sense stopping smoking is incredibly easy – you just don’t smoke! You are perfectly capable of doing that – physically. But then so is not scratching an itch, not eating when you are hungry or drinking when you are thirsty. The problem is not your physical ability – it’s your psychological ability to resist the feeling, urge or desire.

To understand how this works think about trying to hold your breath for as long as you can. As time passes the urge to breathe gets stronger and stronger because of the build up of carbon dioxide in your bloodstream. The only thing stopping you from giving in is your resolve not to breathe. And where is that coming from? Simply your decision to try to hold your breath. You know that you can give in at any time. When the urge becomes more powerful than the resolve, you give in.

And so it is with smoking. Your attempt to quit gives you the resolve not to smoke but years of consuming nicotine from cigarettes has changed your brain so that it experiences the urge to smoke – and sometimes this can be very strong indeed. The difference is that with breathing the urge gets ever stronger over time while after the first few days the urge to smoke usually gets less strong over time – although it can still strike months or even years later.

Keeping your resolve strong

So the secret of stopping smoking is to keep your resolve strong and to what you can to avoid or minimise the urges. The best way to keep your resolve strong is to change your mind set – you have to become an ex-smoker in the very core of your being. You have a new identity as someone who used to smoke but you simply don’t do that any more. You would no more smoke a cigarette than you would hit someone who has annoyed you or rob a bank. You are not that kind of person. And the reason is that you realise that it is a stupid waste of money and is killing you. Even if you have enjoyed it in the past, those days are gone. So, when someone offers you a cigarette your answer is ‘No thanks, I don’t smoke any more’, not ‘No thanks, I’m trying to stop’.

If you can’t bring yourself to think like an ex-smoker, you need something else to keep your resolve strong – at least in the early days after stopping. For some people it is a health scare related to smoking. For others it is wanting to be around for one’s family. For many people it is wanting to feel healthier, while for others it is wanting to save money. It might even be the commitment you have made to yourself or other people that you will stop smoking. The more of these you have and the stronger they are, the greater will be your resolve. But remember that resolve can come and go and you absolutely need to have something that will keep it strong when you most need it – at those moments of temptation.

The stress test

What about the other side of the equation? The urge or desire to smoke. A lot of smokers think that this comes from the way smoking helps with stress, or the need to have something to do with their hands. Neither of these are true, and it’s easy to show this.

My research over the years has shown no link between how much people smoke to control stress and the strength of cigarette cravings. There is also now a wealth of evidence that smoking does not actually help with stress – it only appears to; and the reason it does this is because feeling edgy and irritable are withdrawal symptoms from nicotine. Actually, once smokers have got over the initial withdrawal symptoms a couple of weeks after stopping, their stress levels are typically lower than when they were smoking.

To realise how absurd the idea that the activity of smoking is as a driver of craving, just imagine smoking a cigarette but just not inhaling the smoke! If anything this would just make the craving worse.

Champix and NRT

So, how to reduce the urge to smoke? There is a prescription drug that does this very well. It is called Champix in most parts of the world and Chantix in the US. It is a pill that you take twice a day and it is like an appetite suppressant for ‘nicotine hunger’. It works by attaching itself to parts of brain cells that nicotine would normally attach to and stimulating them just a little bit but also blocking them so that nicotine can’t get on them. You take it for 12 weeks, or longer if it takes you a week or two to stop smoking completely. As with all drugs, there are side effects. The common ones are feeling sick and having difficulty sleeping. These usually subside over time. Some people taking this drug have experienced suicidal thoughts or become aggressive but research with hundreds of thousands of users of the drug have failed to show the drug to be causing these symptoms and they are probably (though not definitely) caused by something else.

Another option is to use some form of nicotine replacement product. This could be a nicotine skin patch, chewing gum, nasal spray, inhalator or an e-cigarette. Many smokers have tried these and not found them helpful but this could easily be due to not using them enough or thinking that they are going to be like smoking. They are not the same as a cigarette – the nicotine absorption is typically slower and the smoker is not getting all those features such as the taste, smell and experience of the cigarette smoke going into the lungs that they are used to. The result is that they typically don’t give the same satisfaction as a cigarette – at least not at first. Perseverance and resolve are still needed. It’s also important to say that it is best to use a nicotine skin patch alongside one of the other products – this will do a better job at stopping the craving.

I strongly advise using either Champix or a nicotine product for at least several weeks – it really does make a huge difference; but there are other things you can do to avoid or supress the urge to smoke. Simply staying away from situations where you would normally smoke can limit cravings. When cravings strike it is very important to do something positive – not just wait them out. Simple breathing exercises can help and so can going for a walk or finding something interesting to occupy the mind. Cravings are often worst in the evenings and going to bed early is something a lot of smokers do.

People power

So to stop smoking the goal is to keep resolve high and minimise urges to smoke. There are lots of ways of doing this and some will work better with some people than others. Going to see a qualified stop-smoking practitioner can help you decide what method will work best for you. They will also be able to give you that extra resolve you might need, make sure you are using your medication or nicotine product to best effect and help you deal with any unforeseen problems you might encounter. In Wales, getting to see a practitioner is really easy. Just call Help Me Quit on 0800 085 2219 or click here.

For more information on the best ways of stopping smoking you can read The Smoke Free Formula (Orion Publishing) , and for a lively introduction to the topic of motivation you can read Energise: The Secrets of Motivation  (Silverback Publishing) .

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  • Tahir Turk

    Nice article but worth mentioning that most smokers eventually quit quite succesfully on their own and not emphasise difficulties but benefits of quitting. More times you try the better your chance of success.

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