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Quitting Tobacco for New Year's

Resolution(s): a formal intention made (purpose, goal or objective), a decision (choice, conclusion or judgment), or the act of determining (defining, shaping or forming) an action (deed, accomplishment or achievement).

An extinguished cigaretteFor many, this sounds overwhelming and difficult. Does it really take this much effort to make a healthy change? Yes… and no.

Yes? Changes to be healthier or have a more balanced life are worth spending the time to create a plan. A well thought-out plan will ensure that change happens and is permanent, even if challenges exist along the way. What goes into the plan? That depends on each person and the behavior to be changed. If it is a behavior that a person started a few weeks/months ago, then it may not require as much effort. If it is a behavior that a person has used for 30-40 years as a life coping skill, then it will require much more effort and much more time.

No? Another definition of resolution is the process of separating something into basic parts. To use an old saying, written about in a book by Bill Hogan, "How do you eat an elephant? One bite at a time". Apply this to a health/lifestyle behavior change: What are two or three action steps – small things that can be done right now – that will help to achieve the larger goal? Practice them until they are new behaviors, and then add another one. As these small action steps become new small behaviors, the larger goal of a health/lifestyle behavior change will follow.

New Year's resolution: Do not make New Year's resolutions that do not involve well thought out plans to achieve a new behavior you want permanently in your life.

Quitting tobacco is a typical New Year's Resolution. If a person tries to quit without a plan, they may not smoke or use smokeless tobacco for a few days, but they feel nicotine withdraw: irritability, frustration, anger, depressed mood, anxiety, craving of a cigarette or chew/snuff, difficulty concentrating, restlessness, insomnia, decreased heart rate and/or hunger and weight gain. Any of these alone is hard and many people feel multiple withdrawals at one time. About this time is when a friend or family member buys them a pack of cigarettes or a tin of snuff, throws it at them and says "Use this! Everyone is miserable!" The person trying to quit now perceives this as another failure at quitting tobacco. It is not a failure at quitting, but a lack of planning.

Part of a well thought out plan to quit using tobacco is to accept that nicotine use is an addiction. It is recognized as a chronic disease. Each person, with their health care provider's help, may need to try several times to quit, which is ok. Many quit aids exist to address the addiction of nicotine. First-line medications increase a person's chances of quitting tobacco. Bupropion and Chantix are two non-nicotine medications. Nicotine Replacement Therapy (NRT) comes in long acting patches and short acting gum and lozenges. Combinations of medications and NRT can be used and increases a person's chances of quitting. Be sure to speak with a Certified Tobacco Treatment Specialist to understand how and which ones work together. Also, many myths exist about quit aids so learn the truth about them before deciding which one will or will not work.

Another essential part of a quit plan is to understand how tobacco is used as a coping skill to deal with life's stressors. Nicotine hits the reward center in the brain within seven seconds of inhaling smoke. It is also absorbed quickly through the membranes in the cheek with smokeless tobacco. When nicotine hits that reward center, the user feels pleasure from the dopamine surge and calm from the serotonin surge. So when a person feels sad, mad, frustrated, or irritated, a quick hit will have them feeling happy, pleasure and calm. This is self-medication to feel better. To break this reinforcement, a person will have to learn new coping skills. New skills are learned by practicing them (one small new action at a time). Calling a friend, taking a walk, deep breathing, listening to music, and taking a hot bath are just a few examples of other things to do instead of using tobacco. They must be practiced to become part of a person's regular coping routine.

One final part of a tobacco quit plan is to recognize how a person perceives what happens to them in life and consider changing that frame of mind. The Mayo Clinic recommends using the four A's when reacting to stress: Avoid the source of stress, Alter your reaction to it, Accept things as they are or Adapt by changing your expectations. Again, these small action steps/changes in perception, take practice.

Quitting tobacco is challenging and life does not stop while a person tries to quit. Practicing new coping skills for what life delivers and changing the perception of stressors are two very important parts of a quit plan to master to be able to stay quit. Attending a tobacco quitting class can help people learn and practice coping skills as well as gain knowledge about quit aids that are available. Quitting tobacco is not as simple as "I use today and will be quit tomorrow". A person has to not only create a plan to quit, but also activate that plan. Let the journey of small changes begin.

For more information regarding tobacco cessation - quitting tobacco, please contact Dana H. Breeding, RN in Community Outreach of Augusta Health. Phone: 332-4988 or 932-4988, or email at dbreeding [at] augustahealth.com.