Concerned you might relapse to smoking?

Most ex-smokers who have succeeded in quitting for many months or years, have occasional periods where they feel at risk of relapsing to smoking. There are many potential triggers, but the most common include (a) after having an isolated “lapse” cigarette, e.g. at a party (b) when in a different kind of environment and feel you “deserve” a break…e.g. on vacation (c) while under a lot of psychological stress. In all of these situations, the presence of accessible cigarettes is a major risk factor for relapse. That is why we always advise smokers who are trying to quit to make sure there are no cigarettes, tobacco or other smoking materials (e.g. lighters) in the house.

Of course, this means that living with a smoker can be a major relapse risk itself.

Right now, many people in the United States are experiencing the stress associated with the very bad economic situation. Many have lost their jobs or are concerned that they might. Many have lost their homes or are concerned that they might. This is precisely the kind of stress that may cause some people to start craving cigarettes again.

Here in my home state of New Jersey we were particularly impacted by the terrorist attack on September 11th, 2001. Many people living in New Jersey either worked in Manhattan at the twin towers or knew people who did. The data on smoking rates within the state appear to show a slight increase in smoking among middle-aged people. Although we don’t know this for sure, I suspect that was due to a significant number of ex-smokers relapsing to smoking after the events of 9/11. I remember hearing the story of one man who had quit smoking for a long period at our clinic. On 9/11 he found himself over a thousand miles from home on business. Because of the disruption to flights at that time, he decided to rent a car and drive home. He relapsed to smoking on the journey.

So what should an ex-smoker who feels at risk of relapsing do to prevent it?

One thing to note is that if you have quit for years and had either no tobacco or a few lapses, then you are not currently nicotine dependent in the same sense as a current smoker. You would not have any nicotine withdrawal symptoms just now. It is therefore very important to avoid becoming highly dependent again. But having not smoked for a long time, it is not appropriate to use a medicine (NRT, bupropion or vareniclene) to help you stay stopped.

One of the most obvious things to do is to make sure there is no tobacco around that is easily accessible. If there is any tobacco in the house, car or garage, get rid of it properly. If a family member or person sharing your accommodation smokes, make sure they don’t smoke in the building and don’t leave their cigarettes laying around.

The other main thing I recommend is to take some time to reconsider the reasons you quit smoking in the first place, and the reasons why it is important not to go back to smoking now. You may have quit before you had kids, but they provide a good additional reason to stay quit now. You may have hated being addicted and struggled really hard to quit. The desire not to become addicted and have to go through all that again, may strengthen your motivation. You might have quit partly because of the expense of smoking….well the expense is even higher nowadays. But really it is best for you to bring to your mind and maybe even write down the reasons you don’t want to smoke again. From that list, pick your top 2 or 3 reasons, and bring them back to your mind whenever you have a thought of smoking.

Below are links to a couple of previous posts that may be particularly relevant to ex-smokers feeling vulnerable to relapse.

Quitting smoking while living with a smoker. 3/25/07

One cigarette wouldn’t do any harm, would it? 11/05/07
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About the Author

MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.