"Cold Turkey" is for the Birds

Hi again! Carrie here. I wanted to briefly update everyone regarding my 24 hours of
being smoke free AND to answer Dr. Kleinman's previous post. Well, it wasn't as easy as I thought it was going to be. On average, I smoke between 7 to 10 cigarettes a day. If we were to create a smoking scale with "Super Stinky Smoker" being on one end, who smokes more than two packs a day (I can't even fathom that), and "Miss Social Smoker" on the other end, who smokes one cigarette a week when she's hanging out with her "cool friends" in the Marina, I imagine that I would fall in the middle, closer to "Miss Social Smoker" and all her "cool" friends. Given my place on the smoking scale, I really thought that going for 24 hours without a cigarette would be a piece of cake. In fact, I was a little nervous that I wouldn't have anything to write about. Well, I grossly overestimated my willpower. I made it through 24 hours but just barely.

So how was my day? Before coming to work, I had a typical morning--showered, got dressed, and fed my cat, Oscar. I gathered all my "quit smoking" supplies and put them in my bag. Walking out the door, I looked back at my feline moocher to say good bye, and I added, "Wish me luck, mister." He gave me a look that said, "Whatever
Typically, I light my first cigarette of the day when I leave my apartment to go to work. I've always felt that the "morning cigarette" is not a crucial one. There are some days when I skip it (that's typically when I've run out and don't have time to buy a pack). I popped in a piece of sugarless gum, anticipating my day to go smoothly and thinking over the tips Deborah taught me on Wednesday. By the time I made it to work, I noticed my jaw was sore from chewing my gum practically to disintegration. "No problem, I'll just have a diet Pepsi," I thought to myself.

What I call the "itch" began as soon as I started writing my first "Quit Smoking" post. Maybe it was writing about the act of smoking; maybe it was that my cubicle-mates (as wonderful as they are) appeared to be talking extra loud that day, making concentration even more difficult; or maybe, just maybe, it was Blogger.com up to its typical shenanigans and being the biggest pain in my more-than-ample backside. If you're a Google employee and happen to come across this post, I have feedback for you: my experience with your product, Blogger.com, is driving me to smoke and pull out my hair! I was having a tough time with getting my images to upload properly, and creating links was causing me to lose text. Anyway, the point is my nerves were tingling with frustration. I was snapping at people. Someone playfully tried to steal my "Turkey Masterpiece" sandwich, and I just about jumped out of my seat and smashed their face into the table...I needed a cigarette. I needed to inhale that luscious nicotine in smoke format and feel it percolate through my body, assuaging my frayed nerves. Instead, I popped in the nicotine gum. It wasn't bad, but it wasn't the same as a cigarette.

---

Ode to Mr. Cigarette
Oh, Mr. Cigarette, how much I miss thee! Shall I count the ways?
I took a walk without thee--oh, how lonesome I was!
I "smoked," "toked," and chewed pretty plastic party straws--I'm sorry, my dear, it was you I wanted in my jaws.
Juices from sugarless candies, swallowed I did, but no comparison to your smoky caresses did it give.
I drank diet Pepsi's 'til Mr. Porcelain God said, "Please! No more!"
I took deep breaths--my lust for you subsided, but my longing resided.
I repeated in my head, "a lot of guys won't date girls who smoke." I thought, "So what?! Life is but a joke."

---

Giving up smoking for a day was painful when stress was involved. So what helped when I was at work? I would say the nicotine gum helped more than I thought. If I started to feel like I just couldn't take it anymore and that I was about to loose my...sh...patience, I would chew a piece of this mouth watering gum. There's a trick to chewing this gum, and if you screw it up, you'll be hating life for a good 30 minutes. It must be chewed for a short period of time and then tucked away in your cheek like a nut in a squirrel's mouth. If you chew it like regular chewing gum, your mouth will water like you need to puke, you'll feel nauseus like you need to puke; your stomach will start to sputter like it needs to puke; and you just may puke. Another thing that really helped was being visited by the dogs in the office. If you're trying to quit smoking, get a dog. They help a lot.

Once I removed the stress, i.e. left work and went to a bar, my cravings were sleeping tight, and the bed bugs--not a bite. I ignored Deborah's advice to avoid the "scene of the urge" and met a friend at a hole-in-the-wall bar. I smoked my plastic straws, embarrassing the blush right out of my friend's cheeks. We had a couple of drinks, talked about the danger of choking on melon balls, and time passed by like stealth does at night. It really wasn't that bad. The cravings were snoring away. I had band practice later that night. We drank a bottle of wine and made merry our music. Around 11:16, I started to feel a stirring. By the time I made it home, I was a dried up leaf lost in the desert. I was chewing the nicotine gum like a cow does cud. As I was walking home, across the street I saw a nice looking chap sitting on a stoop. I noticed a mist around his head and a red light that shined every 8 seconds for about 3. It was the devil, and he sat their innocently enough, tempting me, telling me that it was okay, because I made it through the day. My watch said 12:02. I had made it for 24 hours and 2 minutes. I deserved a reward. So I caved in...to a menthol, of all cigarettes. I've now made it for 25 hours and 10 minutes since that mint tobacco crap, and well, another cigarette would hit the spot right about now. Nicotine gum is hanging out behind my lip and a plastic straw is dangling from my mouth.

I'll be contacting Deborah next week. We'll see how it goes over the weekend. The devil will be in full force, I guarantee. One thing I've realized is that quitting "cold turkey" is for the birds, besides I like my turkey hot.

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Checking In With Carrie

So, how did your day go? What were your most difficult moments and how did you work through them? Were there any surprises? Do you feel more confident in your abilities?

DrK

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24 Hours Smoke Free

Hi, my name is Carrie. I'm a Healthline employee...and a cigarette smoker. So you might ask, how can one work at an online company devoted to providing up-to-date health care information to the public and still smoke? Well, it's not easy, and I certainly don't advertise it...well, until now. Today, and in the following weeks, I will be guest blogging for Dr. Kleinman. You see, I'm a "contemplator," which is known in the smoking cessation world as one who thinks of quitting, but just hasn't quite done the deed. Today is the Great American Smokeout, so I thought this would be an opportune time to try and quit for, at least, a day. Last night, just before the clock struck 12, I polished off a glass of wine and smoked my last cigarette. To be honest, it was quite heavenly. I suppose it's analogous to having a chocolate chip cookie right before you start an all protein diet. I savored every inhale and then I said, "Good bye, Mr. Cigarette," as I squelched its fire in the ash tray.

With the quit smoking tips suggested by Deborah, Dr. Kleinman's wife and partner at the Quit Smoking Center, I will be trudging through the day without a cigarette. So far, I've had three diet Pepsis and gone through one piece of gum and a couple of hard candies--all of it sugarless. Not bad for the beginning of the afternoon. Of course, I'm about to kill someone. Deborah and I talked for about an hour yesterday about how to plan for this day, as well as quitting forever. For today, Deborah gave me several tips for dealing with the cravings...the cravings that start to simmer and then bubble over like lava from a volcano. I think I'm starting to get itchy. Anyway, below are the tips I received from her:

• Line up support people: Have coworkers and friends check on you to see how you're faring. Have them take you out to lunch to celebrate your smoke free day (so far, I've only been teased and ignored. Free lunch?! Fat chance...Thanks, everyone!)
• Avoid the "scene of the urge": I'm not talking about the local bakery here. I'm talking about where you typically take your smoke break. You just might have to avoid coworkers and friends who smoke. (This actually isn't so bad for me. I've irritated most of the smokers in the office, by trying to get them to join me in this effort. That's okay--they smell anyway.)
• Deep breaths: Take deep breaths for as long as it would take you to finish a cigarette. Make sure you do this in an area with no smoke. Have faith that the craving will go away. Deborah assures me that it does. (I'm practicing my deep breaths right now. My coworker on the other side of the cubicle wall thought there was a perverted old man peeping in on her.)
• Walk or climb the stairs: Exercise can help with those itchy cravings. (I wore my walking boots today,because that's what they were made to do)
• Get your supplies: Gum (regular and with nicotine), sugarless hard candies, healthy snacks, mint toothpicks, straws cut in half for chewing and pretending, hot tea, and a special snack. (Here's a picture of my supplies: party straws to celebrate this smoke free day; sugarless hard candies; my healthy snacks--carrots and nuts; tennis shoes for the marathon I will run later; and my special treat, organic Cheetos with no trans fat.)
• "Scramble your day": Turn off the auto-pilot in your brain and take a different route to work, fold some origami, watch an extremely intense documentary which requires deep thinking--basically do something that will take your mind off your cravings.
• Predict and then plan: The day before you quit, identify the times you typically have a cigarette through the course of the day. Determine what strategies you will use to control your cravings at these times.

The two main things to remember are to practice slow deep breathing and to remind yourself that the craving will go away. You may even want to choose a mantra to cycle through your head. Mine is "a lot of guys won't date girls who smoke." Besides this reason, there are a lot more for quitting smoking:

• Oral cancer
• Lung cancer
• Emphysema
• Wrinkles - "Smoking produces oxygen-free radicals, which are known to accelerate wrinkles and aging skin disorders and increase the risk for nonmelanoma skin cancers. Studies also suggest that smoking and subsequent oxidation produce higher levels of metalloproteinases, which are enzymes associated with wrinkles."
• Your kids or future kids

So if you're a smoker, I really hope you will consider quitting for at least one day. Use the tips provided above, and remember "a lot of guys won't date girls who smoke." And the cravings will eventually go away! All right, everyone. I'll keep you updated on the status of my progress. Leave a comment and let me know how you're doing with quitting. Have a smoke-free day!

P.S. Hi Mom and Dad! I know that you started reading the blogs recently to help support my new career. I really appreciate it. So you may be a little shocked to find out that I'm a smoker, and I just now outed myself. I just want to say I'm sorry. You did not raise me to be a smoker; you tried to instill good values in my judgment process. I don't know what went wrong, but it's not your fault. Please don't be mad--I'm trying to do the right thing now. Can't wait to see you for Christmas!!

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The Great American Smokeout

Millions of Americans are expected to take part in the 30th anniversary of the American Cancer Society's "Great American Smokeout" tomorrow. For three decades, the third Thursday in November has been designated as a day for smokers across the United States quit smoking for the day. Many go on to stay quit for good.

According to the American Cancer Society, an estimated 45.4 million Americans are addicted to nicotine, and about one in four adults and one in five teens in the United States are current smokers. Unless more is done to help them quit, 10 million to 20 million current smokers will eventually die from tobacco-related diseases.

Research tells us that people are more likely to successfully quit if they have some means of support, such as nicotine replacement therapy, prescription medication and/or counseling. Unfortunately, only about 22 percent of current smokers report using any of those therapies during their last shot at quitting.

Tomorrow is a good day to to see what it feels like to quit for a day. However, you don't want to experience withdrawal symptoms so I suggest putting on a nicotine patch tonight. That way you won't wake up in withdrawal and you can spend your day trying out some of the behavioral strategies that reduce cravings.

Check out this website for some of those: http://www.cancer.org/docroot/PED/PED_10_4_Great_American_Smokeout.asp

DrK

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Everyday Situations Can Cause Relapses

Most people who have tried to quit are well aware that quitting can be an intense battle. One reason is due to the severity of cravings and the role that cravings play in putting us at risk for relapse. A recent survey found that almost nine out of ten smokers (87 percent) who quit smoking started again because of everyday "situational cravings" and more than 3/4 of smokers (80 percent) believe they could quit
if they were able to get through their daily cravings.

Situations in which we tend to smoke include everyday circumstances such as driving in the car, talking on the phone, or drinking coffee. Our brains have made a false connection between performing these activities and lighting up. After they are repeated on a daily basis for years, they seem to just go hand in hand. When we quit, it may seem like something is missing for a while until our brains erase the false connections we made.

When you are making your quit smoking plan, be sure to consider the things that have become connected to smoking. In fact, it is important to make a list of these connections and to think about what you are going to do when you are drinking that cup of coffee and all of a sudden get a huge craving for a cigarette.

Next, let's talk about some ways to deal with those cravings that can hit you like a ton of bricks.

DrK

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How Do We Know If A Cessation Technique Really Works?

I copied my response to a comment left by a reader about my Bogus Quit Smoking Programs post. I think the issue deserves its own posting.

Smoker's Edge seems to be akin to using a piece of sucking candy when you get a craving. This approach may be of benefit as an adjunct to a proven method but it should not be advertised as a stand alone method.

This raises an important issue. Namely, how do we judge a product that claims to be able to help you quit smoking? How do we know the product is safe? How do we know it really works?

The only way to really know is to perform what's called a clinical trial. Basically, in a clinical trial a group of people use the product and another group uses a placebo. Nobody in the groups know if they are using the real thing or the placebo. If the people who used the product quit more than the people who used the placebo, we have a winner.

As far as I know, Smoker's Edge has not done a proper clinical trial. They may have some word of mouth reports, but those are not considered valid because they are prone to error.

That's not to say that the product doesn't work. What we can say is that there is no scientific evidence that it does. It's clearly important when dealing with what is literally and life and death situation that we use methods that are proven to work.

To this point, we all know people who have tried to quit and were unsuccessful. Next thing, they have lung cancer and we are dealing with a huge problem. Whose to say when that cancer developed? Maybe it could have been avoided were the person to have used a proven cessation technique and been successful. Maybe by using something that was not proven to work they ended up smoking long enough for cancer to develop.

When it comes to quitting there is a lot on the line. My advice is to stick with what's ben shown to work.

DrK

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Bogus Quit Smoking Programs

There are quite a few of these out there. One in particular advertises a quit smoking shot that's 80% effective. As the saying goes, if it's too good to be true it's probably not true. That definitely applies here.

The shot has been advertised in some shape or form for many years. It's basically a mixture of three drugs; atropine, scopolamine and chlorpromazine. There is absolutely no legitimate research to support the use of these medications. The companies that sell the shot like to advertise that these are FDA approved medications. Well, they are. However, they are not FDA approved for smoking cessation.

These shots have been known to cause harm. There are many reports of people suffering hallucinations and mental breaks hours after the injection. One patient reports feeling disoriented and so agitated that she tried to jump out of a moving car. All of this for a mere $400.00!

There are better ways to quit and better things to do with your 400 bucks. My advise is to stay clear of any quit smoking shot.

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