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Marlene M. Maheu, Ph.D.

If you are a smoker or tobacco chewer, you've probably heard it all at one time or another - the desperate pleas and threats from family, the "serious warnings" from doctors, and the snide remarks from people who don't even know you. You probably are smart enough to realize what you need to do. BUT YOU JUST CAN'T.

Well, you are not alone. Most tobacco users are stuck in the same boat with you. They've tried to stop, but have realized they are addicted to nicotine, and just don't know what to do about it. Worse yet, helping professionals often aren't educated about the scientific findings that clearly show how to help you. Usually, one way or another, they end up telling you to "just get some willpower and do it!"

Fortunately, researchers have uncovered the probable causes of your discomfort when you stop using tobacco. Nicotine works on the nervous system in two ways, it is a mild relaxant and a mild stimulant,depending on the situation. Its potency comes not in the level of mood shift, but in the frequency one uses it to shift mood. If you are a bit drowsy and light up to make yourself more alert, you've shifted your mood slightly. If you are irritable or nervous and you light up to "take a break and relax," then you are using nicotine to shift your mood.

To make matters worse, many people tend toward either depression or anxiety with increased age. Using nicotine for decades often hides the body's natural shift toward depression and anxiety. Using nicotine helps older people keep these reactions somewhat under control, or at least more under control than otherwise. When they stop using nicotine, their real state of depression or anxiety surfaces and overwhelms them. Add to these bodily effects the "habit" component - the loss of a 200 - 600 time-per-day, soothing, medicating activity (puffs on a cigarette). Add to that the normal two week withdrawal symptoms,and it often is just too difficult to even try anymore.

You might never want to try again, but here are some tips for the wise who just don't give up:

Look back on your family history. Did you have a parent who tended toward depression and/or anxiety? If they lived a long life, did their symptoms get worse when they were your age?

If you have depression and/or anxiety in your family history, consider the possibility that you've been "medicating" your genetic predisposition toward depression or anxiety with nicotine. If this is so, find a "medication" with fewer negative side effects. Anti-depressants are often the best choice because their side effects are not as lethal as nicotine when taken according to directions. (Nicotine is the only substance sold over the counter that, when taken according to directions, will kill you.) Antidepressants can be used to help with anxiety as well as depression. Talk with your physician. If you already are taking antidepressants, do not increase your dose without consulting your physician. You might need another type of antidepressant instead. Also, let your physician know of your plan to stop using tobacco.

If you choose to try an antidepressant, start taking it at least 3 weeks before your next attempt to stop using tobacco. It will take at least that long to see if the medication is the right one for you. Make sure you are stabilized on a medication before stopping smoking, chewing, or dipping tobacco. Watch for interactions with other medication you might be taking.

Talk to your physician about using the nicotine patch or nicotine gum. These products have been shown effective in helping people through the withdrawal symptoms. If you use the patch or gum, start nicotine replacement on the day you give up cigarettes, follow directions and use them for at least 6-8 weeks. If they didn't work the last time you tried, try again. You might need something extra, like coaching, rather than eliminating the gum or patch altogether.

If you've failed repeatedly, hire a coach. Increasing numbers of counselors are getting specialized training to be able to help you benefit from scientific research. Such help is available in two formats: group and individual sessions for learning a comprehensive behavioral program. Make the necessary investment of money and time.

Use psychology to your benefit. Tell yourself that you'll get all the help you can find, and then become "willing to go to any length" to reach your goal. Haven't you gone to extraordinary lengths to use tobacco in your life? Give yourself the benefit of at least that much effort to stop using tobacco.

Keep at it. The average smoker needs four solid attempts to quit smoking before they are successful. That means some people can do it in one attempt, and others might need ten all-out efforts.

Success has tremendous advantages in terms of improved quality of life. Don't do it for "someone you love." This type of motivation rarely passes the test of time. Make a list of the reasons YOU want to quit, and stop passing the buck to others. Put yourself in the driver's seat. Once you've taken responsibility for your own situation, you'll be in a much better position to handle any difficulty that arises.


Marlene M. Maheu, Ph.D. is the founding Director of the Nicotine Recovery Institute. She is the designer of the Nicotine Freedom System, and specializes in the treatment of nicotine-related disorders. Such disorders include underlying depression and anxiety. She has worked extensively with smokers and tobacco chewers in hospital, industrial, and private settings, and is available for individualized consultation and program design. Her program and materials have been developed after completion of her doctoral dissertation in smoking cessation, and following a decade of work with thousands of smokers. Through colorations with SelfhelpMagazine, she offers telephone based services for individuals and groups seeking freedom from nicotine in any form. For more information on this convenient application of her program, email her directly.


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