How to Avoid a Smoking Relapse

"Quitting isn't so hard. I think I've got this thing licked and can handle smoking just one cigarette tonight. I'll get right back to my quit program tomorrow."

Otherwise known as romancing the cigarette, or junkie thinking, this kind of thought pattern gets us into hot water fast. Time away from smoking can blur the edges of the reasons we had for putting those cigarettes down in the first place. We forget the chronic cough and lose touch with the racing heart and breathlessness that came from climbing a flight of stairs.

As we gather a head of steam and start logging smoke-free time, it's easy to fall into thinking that we have control over our addiction. Make no mistake about it, though; as nicotine addicts, we will always be susceptible to dependence once again if we introduce nicotine back into our systems. The only way to maintain control for the long haul is to have a zero tolerance policy with nicotine. Remember that there is no such thing as just one cigarette, and adopt N.O.P.E. as your motto.

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Hydrogen Cyanide

Cigarettes can contain up to 599 possible additives, all of which are approved for use by the U.S. government.

When the ingredients in cigarettes are burned, they produce a whole host of chemical compounds, many of which are poisonous and/or carcinogenic. Hydrogen cyanide, a colorless, poisonous gas, is one of the toxic byproducts present in cigarette smoke.

Under the name of Zyklon B, hydrogen cyanide was used as a genocidal agent during World War II. While no one would willingly breathe hydrogen cyanide into their lungs, smokers do it multiple times with every cigarette they inhale. And because hydrogen cyanide is present in secondhand smoke, nonsmokers are also at risk of breathing in this poison when they are exposed to cigarette smoke. Smoking cigarettes is probably a major source of cyanide exposure for people who do not work in cyanide-related industries.

In manufacturing, cyanide is present in the chemicals used to make numerous products such as paper, textiles and plastics. In gaseous form, cyanide is used in pesticides to exterminate rats and other undesirable vermin.

While it is unlikely that a person would suffer cyanide poisoning from cigarette smoke, breathing in small amounts of hydrogen cyanide may cause: headache dizziness weakness nausea vomitingLarger amounts may cause: gasping irregular heartbeats seizures fainting rapid deathGenerally, the more serious the exposure, the more severe the symptoms. Similar symptoms may be produced when solutions of cyanide are ingested or come in contact with the skin.

Treatment for hydrogen cyanide poisoning includes breathing pure oxygen, and in the case of serious symptoms, treatment with specific cyanide antidotes. Persons with serious symptoms will need to be hospitalized.

See Also: Pesticides in Cigarette Smoke

Source:

Facts About Cyanide. 27 January, 2004. Centers for Disease Control.

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Smoking and DDD

Ex-smoker Michelle Boisvert suffers from degenerative disc disease (DDD). Diagnosed at the age of 33, she has since learned that cigarette smoking is a leading risk factor for degenerative disc disease.

From Michelle:

As someone who is very grateful to have found freedom from nicotine addiction and as someone who suffers from a smoking-related illness, I have been prompted to research and offer my findings about the relationship between smoking and degenerative disc disease.

I was diagnosed with severe DDD in 1998 when I was 33 years old and still a smoker. My orthopedic surgeon discovered the DDD while he was performing surgery after I ruptured a disc in my lower back. Discs are the pliable “cushions” found between the vertebrae, which serve as shock absorbers for the bones in the neck and back.

The term “degenerative disc disease” has met with criticism by some because all discs do degenerate naturally over time. It is a normal part of the aging process, but in some younger adults the discs degenerate more quickly than in others, causing the discs to lose fluid, become less pliable and less able to protect and support the vertebrae. The result can be chronic and debilitating pain.

Although genetic predisposition is the #1 risk factor, a growing number of studies indicate that smoking is a leading risk factor for DDD, both in the lumbar discs (lower back) and cervical discs (neck). Research suggests that smokers have a 3-4 times higher risk of developing DDD and that smoking can exacerbate pre-existing disc degeneration.

Nicotine deprives disc cells of vital nutrients. In addition to nicotine, smokers introduce carbon monoxide into the blood stream and from there into body tissues. These poisons inhibit the discs’ ability to absorb the nutrients they need from the blood. The result can be prematurely dehydrated, less pliable discs – degenerated discs.

As the discs become more and more malnourished, there is a greater risk of a ruptured disc. This occurs when the disc contents break through the outer layer of the disc, often impinging on nerves and causing great pain, numbness, and in some cases nerve damage in the legs or arms. These same poisons also interfere with the absorption of calcium, leading to a compromised vertebral structure.

Coughing, which is more prevalent among smokers, can also add to the risk. Coughing causes increased pressure between discs. This puts added strain on the spine and discs, creating greater risk of disc bulges and ruptures, especially in a spine already weakened because of smoking-related toxins.

Inactivity, which is also frequently associated with the smoker’s lifestyle, can result in a higher frequency of back pain in general, and unfortunately pain associated with DDD can make an active lifestyle more difficult to enjoy.

Treatment for DDD and disc ruptures range from doing nothing to major surgery, including spinal fusion. This surgical procedure involves removing disc material and fusing the vertebrae together with bone grafts and sometimes metal plates, rods and screws.

Anyone who is still smoking by the time this surgery is required is strongly advised to quit smoking prior to surgery. Many surgeons will not perform the surgery until the patient has been smoke-free for several months. Smoking impedes new bone growth, which is instrumental in the success of spinal fusion. Researchers have determined that nicotine is a bone toxin and as a result, the failure rate for many types of fusions can be 3-4 times higher for smokers.

More research is being done to study the relationship between smoking and DDD, but there is ample evidence already to suggest that quitting smoking now may reduce the risk of developing or exacerbating DDD.

To those who might be contemplating quitting and wondering if you have another 10, 20, or 30 years to smoke before you do any real or lasting damage, please think again and don’t take the gamble. It’s so risky, and I urge you to think about what you’re putting on the line. For every warning actually listed on a pack of cigarettes there are many more illnesses, diseases, and complications that smoking can cause. Quit now, and at least know that from this day forward you are doing all you can to protect your health and well-being.

Please take advantage of the wealth of knowledge to be found at the About.com Smoking Cessation web site and check out the Smoking Cessation Forum for the best support on the web.

~Michelle Boisvert~

Sources:

Effect of Nicotine on Spinal Disc Cells. Akmal M, Kesani A, Anand B, Singh A,et al. 1 March, 2004. National Center for Biotechnology Information.

Lumbar Degenerative Disc Disease. Rajeev K Patel, MD. 3 August, 2009. EMedicine.com.

Degenerative Disc Disease and Low Back Pain Thomas G. Lowe, M.D. Spine Universe.

Cigarette Smoking and its Impact on Spinal Fusions. Larry Davidson, M.D. 13 August, 2007.

Spine Surgery and Cigarette Smoking. The Burton Report.

More from Michelle:

]Michelle's Quit Story
Michelle's 1 Year Milestone
Michelle's 2 Year Milestone
Michelle's 3 Year Milestone
Michelle's 4 Year Milestone
Michelle's 5 Year Milestone
Patience With the Process
A Perspective on Using NRT's
There is No Substitute for Time
Managing Quit-Related Depression

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Quit Aids and Weight Gain

I'm so afraid I'll gain weight when I quit smoking. I've heard that Zyban or Wellbutrin will help me avoid weight gain. Is this true?Answer: Bupropion hydrochloride, better known as Zyban or Wellbutrin, has a side effect for some people of a reduced appetite, which can be a nice benefit for people who want to quit smoking. Bupropion is a prescription drug though, and must be used under a doctor's direction.

Nicotine lozenges may also help curb appetite to some extent early on in a person's quit program. A year long study looking at the efficacy of nicotine lozenges was conducted in 2002. It followed approximately 1800 people who quit smoking using either nicotine lozenges or placebos. Indications were that those participants using 4-mg nicotine lozenges had 45 percent less weight gain 6 weeks after quitting than those using the placebo. At 12 weeks quit, weight gain was 21 percent less, and at 6 months, the difference in weight gain between the two groups wasn't enough to be of significance.(1)

Medications to Help You Quit Smoking:

Some of the above medications are available without a prescription, however, do check in with your doctor and discuss your options in order to choose a quit aid that's right for you.

See Also:
The Chubster
Minimizing Weight Gain When You Quit Smoking
Maia's Thoughts on Weight Loss at 6 Months Smoke Free

(1)Arch Intern Med. 2002;162:1267-1276

Updated: 2-20-2006

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Replacement Therapy

One of the Smoking Cessation forum's spunkiest and most determined quitters has got to be Kerri (aka Wonder Woman). Kerri has an outstanding quit story on our site quitsmoking.about.com, and has always been a source of inspiration for myself and many other forum members. One of the things she has been very open about, is that at around three or four months, she experienced a real wall in her process. She realized that it had to do with the extra time we have that smoking takes up, something we don't always realize from the start.

When you think about it - it took me about 7- 10 minutes to smoke a sickorette, depending on whether I was in a rush, or lounging at home writing in my journal. I smoked about a pack a day, and was getting to the point of smoking more. There were 25 sicks in a pack. Times that by 30 and thats 300 minutes, or about 5 hours a day. So let's give some leeway and say you don't smoke as much, we'll even give more time and round it down to 3.5 hours a day. Three hours a day!! Spent feeding our addictions. OH what we could do with that precious, precious time. Not to mention the incredible life force and energy the poison sucks out of us (and we think we're the ones inhaling!).

So what does one do when one quits? For Kerri, it was discovering new hobbies and interests. First it was knitting, then it was running, now she's a marathon runner. Now that's finding a constructive way to fill your time. For Maria it was cycling with her husband and getting fit at the gym, after just over a year, she has a stomach you could slice bread on.

For me unfortunately, it's been food! But as mentioned earlier, that is definitely changing. I did start to crochet earlier on, but never really could stick to it. When we were kids, we always found time to play, time to explore, time to create. We never thought about smoking or missing a crutch. Perhaps this is like a second childhood in a way, an opportunity to re-discover new things, pour our energies into something we want to build, make or discover.

In the Nicotine Withdrawal Category of About.com Smoking Cessation is a list of 101 things to do instead of smoke. It's an excellent list, and I've copied some of my favourites below. If you're about to quit, start researching things you've always wanted to do (I really want a karaoke machine - now that I can hit those notes again, I used to love to sing!), and if you've already quit, keep exploring. There's a whole huge healthy world out there with tons to do and learn, and now you've got the money to do it, and the most precious commodity of all, time. Do a jigsaw puzzle, or work with clay. Go for a run or a swim, or even the best excercise of all...go for a walk. Write a poem, a short story, a love letter. Go outside and take pictures of your favourite park, building or statue. Take an exotic cooking class. Learn a new language. Organize your boxes of pictures, create memorable and interesting captions for them. Visit the SPCA and adopt a pet, or go get a fish - aquariums are loads of fun. Go to a Karaoke place and sing, sing, sing!Find something you love. Make a list of your interests; it can even be things you wanted to do when you were a child. Anything goes, just rediscover what it was that brought you happiness and find ways to implement it into your life. Take the time you have and spend it on yourself.

It's your gift to you!

More from Leslie:
One Full Week
The Seduction
The Smokescreen
Not One Puff Ever (N.O.P.E.) - Part One
Not One Puff Ever (N.O.P.E.) - Part Two

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The Will to Quit Smoking

A part of me desperately wants to quit smoking, and I know I should quit smoking, but do I feel I must quit. Truthfully, I love smoking, and know that I'll be miserable without my cigarettes. They've become a part of me, and I almost can't bear the thought of giving them up. Yet I know I have to...

Sound familiar? Does your mind bounce back and forth on the issue of smoking cessation? Or do you quit, only to find yourself smoking again within days, or at most, a few weeks? Does your smoking habit make you feel weak? Powerless? Do you wonder if you'll ever find a way to quit smoking for good?

You're not alone.

Nicotine addiction is powerful, and smoking cessation involves a lot of work for most people -- it's not handed to us on a silver platter. You can, however, quit smoking successfully, and the good news is that thousands of people do just that every year. They've found their way out of the prison of nicotine addiction. And most of them thought, just as you do, that they couldn't quit.

How did they do it?

How did they turn a feeling of should into the certainty of must? How did they turn dreams of quitting into a reality in their lives?

While there is no magic bullet that makes smoking cessation easy and pain free, there are steps you can take to develop the commitment necessary to quit smoking permanently.

As smokers, we often think of lighting up as an enjoyable pastime. Cigarettes offer comfort, entertainment and companionship -- or so we think. At the same time, we relate smoking cessation to feelings of pain, misery and sacrifice, and for most of us, these opposing feelings exist and are reinforced on a subconscious level. They're below the surface of our thoughts, and the result is that we adopt unhealthy and inaccurate beliefs as facts of life when in reality they are only our distorted perceptions of the truth.

It’s been said that the average person has approximately 60,000 thoughts a day; a significant percentage of those thoughts are negative and usually directed at ourselves. We're almost always our own worst critics. A first step in successfully developing the will it takes to quit smoking involves learning how to pay attention to what we tell ourselves and correct false statements as soon as they occur. It takes practice and patience, but if you keep at it, listening in consciously on the thoughts that go through your mind on a daily basis will become second nature, as will correcting those that don't serve you.

Just as we condition our bodies to build strength and endurance, conditioning our minds is an exercise in building new associations that will help us put smoking permanently in the past.

Work with the thoughts that don't serve your best interests, and do it as soon as they crop up. Change the language. Restructure your thoughts in terms that will help you. For instance, if you tell yourself: "I won't enjoy the party, because I can't smoke. I'll be miserable and hate every minute of it. In fact, I'm already miserable just thinking about it."What will be the result? At a minimum, you'll feel deprived and unhappy at the party. The stage is set for a smoking relapse, because on a subconscious level, you are giving yourself the message that smoking cessation is a sacrifice. Shift your focus and correct the language by countering with something, such as this: "Going to the party smoke-free will be a challenge, and I may feel uncomfortable, but it will provide me with the practice I need to learn how to live my life without leaning on cigarettes. After all, practice makes perfect. I know these discomforts are a temporary stage of healing from nicotine addiction."Positive self-talk is a stepping stone to positive action. Once you manage the event without smoking, you'll find it easier to believe the positive corrections you're making the next time around.

When you say: "My friends get to smoke; why I can't I?"Remind yourself that your friends don't get to smoke, they have to smoke because they're addicted to nicotine. Give yourself a positive mental cue by counteracting your feelings of self-pity with: "My friends wish they could quit smoking like I have. I remember how desperately I wanted to quit every time I lit up. It was a vicious cycle that I'm free of now."Or when you start reflecting fondly on your old smoking habit with thoughts, such as: "I'm bored without my cigarettes. Life isn't fun without them."Adjust your mind-set by looking at it from another angle: "At 10 minutes smoking time per cigarette, I used to waste nearly 3 hours every single day smoking! It's no wonder I feel a little fidgety and empty. I'll take up a hobby and do something productive with the time I used to spend smoking."And, when you're feeling the discomforts of nicotine withdrawal, be careful to reinforce that the pain you're feeling is because of smoking, not quitting: "I feel so irritable without my smokes. I'm impatient and angry without cigarettes."Reinforce this way: "Cigarettes did this to me. Once I’m free of this addiction, I’m never going back to the slavery that nicotine forced me in to again."Or if you say: "I think about smoking nonstop! My day feels like one long, incessant craving!"Add this statement: "I know that nicotine withdrawal is a temporary phase of the recovery process. The discomforts won't last forever. I'm growing stronger with every smoke-free day."You get the idea. Replace thoughts that don't help you with ones that do. Train yourself to change the way you think and feel about smoking. If you persist and work with yourself enough, consciously trained thoughts will ultimately lead you to a new set of beliefs, and from there, you can make changes that will stick -- permanently.

Quit Aids and Support

Fortify the resolve you're working to build by considering one of the many quit aids available today and by connecting with like-minded people at the About.com Smoking Cessation support forum.

Smoking cessation is a gift that will reward you with benefits far beyond what you can probably imagine, so be patient and do the work to change your mind about smoking. Believe in yourself. You can do it!

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Oral Cancer Personal Story

From your Guide to About.com Smoking Cessation, Terry Martin:
I feel fortunate to have met and helped Marlene share her story. Throat cancer is a horrible disease, and one that most smokers fear. I cannot imagine losing my voice, let alone going on to "speak" before groups of children, using my disease as a powerful example to help them avoid smoking. This is just what Marlene does today though, every chance she gets. She is a remarkable woman, and is nothing short of inspirational. I hope that her story touches you as it has me.

I am writing this story about my life as a smoker in hopes it will not only entertain whoever should read it, but maybe prevent someone from using tobacco or entice someone to quit using tobacco.

I tried my first cigarette at the age of 11. The preacher's son gave it to me behind the church, where a lot of us kids went after church services on Sunday morning. I was a bashful and timid girl, and just wanted to be included in the group. I did not actually start smoking then, full time that is. I would sneak one here and there with the other kids, but by the time I was 12, I was hooked.

Now that I've analyzed this I realize tobacco turned me into a sneak, a liar, and a thief, right off the bat. I'd sneak to catch a "drag" here and there, then I graduated to stealing cigarettes from anyone who happened to leave a pack around. When asked about it, I lied and said, "No, I haven't been smoking" and "No, I didn't take any cigarettes." I started stealing money to support my habit. I did it so I could hang out with the kids and be part of their group.

I moved in with my dad, step mom, and step sister when I was 12. My step sister, who was 10, took me to the backyard where a old trailer was sitting. She crawled under it and came out with her cigarette stash, a "stolen pack of daddy's cigarettes." That's when I really started to smoke. Stealing from my dad was easy. He never seemed to miss them, until one day when he caught me. I knew I was going to get the beating of my life; my dad had a bad temper when pushed to his wits end.

He ordered me into the house, where he sat me down at the dining room table. He made me roll 20 cigarettes from the old roll; your own "strong, stinking tobacco" with the papers, remember those? Does anyone still use that stuff? When I finished rolling them, he made me sit there and smoke every one of them. No supper, nothing to drink. I had to just sit there and smoke. Well, even a surprise to me today, I did it. It took me a few hours, but I did it. You see, I inherited his stubborn streak.

When I finished the last one, he said, "Well, you proved you can handle it, so you have my permission to smoke, but if I ever catch your sister smoking, I'll give you the beating that you thought you were going to get today." I got up from the table, feeling rather sick, went into the bedroom and told my sister, "If daddy ever catches you smoking, I'll beat you to death!"

I have since thought of that time and truly wish he would have give me the beating of my life instead of handling it like he did.

So,with my dad's permission to smoke, I smoked all the time and everywhere, except grandma's house. Forget the beating, she would have killed me.

Over the years, cigarettes caused a lot of turmoil in my life. Smoking put me in the hospital 3 times that I can remember. I had severe bronchitis and breathing problems. I was put on breathing machines and breathing medications several times. As soon as I would get to where I could breathe freely again, I would light up. Is that insane or what?

This went on for 39 years, at which time I was smoking 2-plus packs per day and still lying about it. I lied to the doctor that diagnosed me with cancer. "No doctor, I only smoke less than a pack a day." Lies, Lies, and more lies for 39 miserable years.

In 1996, I developed a sore throat that would not go away. I tried everything over the counter -- cold medicines, lozenges, throat sprays. Nothing worked.

I went to the doctor, who put me on one antibiotic after the other from October until December. Still, the sore throat wouldn't go away. Finally, he sent me to an oncological ear, nose and throat specialist, who ran a scope down my nose and throat. He saw something and suggested I go to the hospital and have a biopsy.

I had the biopsy on Thursday. After it was over, the doctor didn't stay to talk to me. Instead, he left instructions for me to go home, rest my voice, not to talk to anyone, and left a prescription for a rather strong pain medication. He told the nurse to instruct me to be in his office the next day at 5 p.m. I knew he did not take appointments that late in the day. I also knew you do not get pain medication like that, with refills unless something is really wrong. Also, I wondered, "Why can't I use my voice?" I knew the news was going to be bad.

I went home and waited for 5 p.m. Friday to come. I didn't talk to anyone. I just waited, and it seemed like a long time. When the time finally arrived for me to leave, I wanted to run in the opposite direction. I dreaded that trip to his office, but I went and he said right out, "You have cancer, and it's the worst kind; it spreads rapidly. I suggest we operate as soon as possible. I want to perform a complete laryngectomy on you. There's good news and bad news; the good is I think I can get it all. The bad... you will never talk again."I told him I'd get back with him on what I wanted to do.

Marlene's Surgery and Beyond

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