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Plan ahead for the Great American Smoke Out

Smoking, Smokeless Tobacco and Health are three words that do not align with each other, unless you are talking about negative effects. To society, or anyone outside a smoker/tobacco user's world, smoking or using smokeless tobaccos does not make sense.

Statements may range from 'don't they know how bad it is and the diseases it causes' to 'I can't believe they continue to smoke when it is so expensive'. Let me assure the non-tobacco using world that the majority of tobacco users know the risks and yes, understand the expense. Society's solution: just quit. Let me explain why it is not that simple. Whether it is a person with 30, 10 or one year of tobacco use, the act of quitting is not that easy. Many have quit before, but maintaining abstinence can be the toughest battle. Mark Twain said it best: "It's easy to quit smoking. I've done it hundreds of times". The 2008 Clinical Practice Guidelines to Treating Tobacco Use and Dependence recognizes tobacco dependence as a chronic disease, needing ongoing assessment and repeated intervention. Health care providers, the tobacco user and their family and friends need to begin approaching nicotine addiction as they do other chronic conditions.

The use of tobacco is linked to three areas in each individual's life. The tobacco user and their family and friends need to consider:

  • Biological: Do you have withdrawal symptoms when you try to quit? Have you developed a tolerance and increased your usage over time? Do you have a persistent desire to use, and use even though you know it may have negative health effects? These are a few criteria that are used to diagnose chemical dependency. Chemistry in the brain is altered when someone uses a drug, including nicotine. Nicotine acts on the reward center in the brain, which stimulates release of neurotransmitters: dopamine, serotonin, etc.., which are responsible for the tobacco user to feel motivation, pleasure and calm. Why would treating these chemicals be any different than treating other physical imbalances? (Would a diabetic not take insulin if needed?)
  • Psychological: How have you been raised in relation to getting help from the medical field for emotional or mental health concerns? Growing up, how did you see your parents or others handle stress, anger, or other difficult emotions? What did they use as a coping skill? We learn what we see.
  • Social environment: Do you hang with other tobacco users: co-workers, family and friends? Is tobacco usage acceptable and even expected in your social network? What are the dynamics at home or at work? Situations that are stressful in any part of your life will affect your overall coping.

The tobacco user needs to consider other health conditions they have: physical or mental? Some people have physical diseases that will improve with cessation of tobacco. Some people have preexisting mental health conditions, which is ok!!! If someone has depression, anxiety or other, they need to be monitored by a Primary Care Physician (PCP). Always seek guidance from a health care person, before starting any tobacco cessation plan.

The first step is to examine the type of person you are and kind of smoker you are. Based on your past experiences with tobacco and with quitting, sometimes you have a preexisting thought about what to use this time around on your quit try. Some people try cold- turkey, which is acceptable too. Some will try the Nicotine Replacement Therapy (NRT) and others will try medications to assist them: Bupropion (Wellbutrin) or Varenicline (Chantix). Just because you tried one of the above and are still smoking, doesn't mean it won't help you this time. Have an open mind about the aids available to assist tobacco users. Get educated on how they work and side effects to consider. An educational class about tobacco use and quitting is also recommended. You will need to think of new ways to cope with anger, frustration, etc, other than tobacco. Also, think of other ways to reward yourself instead of using tobacco: after a meal, before a task or after something is completed. Quitting tobacco is not as simple as "I use today and will be quit tomorrow". A person that is quitting has to not only create a plan to quit, but also activate that plan.

Great American Smoke Out information can be found at:

Article provided by Dana Breeding, RN Health Educator with Community Outreach.