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- FREQUENTLY ASKED QUESTIONS (FAQ)
-
- FOR
-
- ALT.SUPPORT.STOP-SMOKING (AS3)
- ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
-
- Part 3: TECHNIQUES, TROUBLESHOOTING, AND TIPS
-
- They don't get to smoke, they have to smoke.
- - Dave Whiteis
-
- Why so sad and woebegone? Will the world not heed you? Courage! Even you
- have won friends you may rely upon when they really need you - Piet Hein
-
- 30. What is the best method for quitting?
-
- The best method to use for quitting is the method that works for you. If
- one method doesn't help, try another! Don't let external images get in the
- way of your success (such as, it's weak to use the patch, or acupuncture is
- too New Age). Whatever works for you is a good method - with one big
- caution: be very wary of using unmedical miracle cures you may see
- advertised on the WWW or - gasp! - occasionally on AS3. They can be, at
- best, very overpriced, and at worst, dangerous. Please be cautioned that
- AS3 does not condone or encourage the practice of advertising on Usenet,
- and it does not recommend any product which may be advertised on the group.
-
- Here is information on some conventional and not so conventional tools for
- smoking cessation, along with some feedback from AS3 members. And remember,
- being prepared is key, no matter which method you try.
-
- a. Rational Emotive Therapy (RET)
-
- I put this one first because it can be - and IMHO, should be, - used in
- conjunction with any of the other methods listed in this section. It also
- seems to me to be closely related to the advice of Allen Carr, whose method
- is described below.
-
- Don't shy away from what may sound like a technical discussion; RET
- basically is no more than a way of changing your attitude.
-
- Steve Polansky ("DD [Dare Devil] Steve") introduced RET to the group in a
- follow-up to a post by Shirley Shaw.
-
- Shirley observed:
-
- "The fear was the most uncomfortable thing about the day. Perhaps that is
- one of the reasons we smoked...the fear of being uncomfortable."
-
- DDSteve responded:
-
- "I had an opportunity several years back to be introduced to Rational
- Emotive Therapy [RET]. About all I remember is that: between the occurrence
- of an event and our reaction to it, there is a mental dialogue that
- probably determines what our reaction will be to that event. ... [T]he
- dialogue is usually one that we are unaware of on a conscious level.
- =46urther, that by altering the script of that dialogue, we will alter our
- reaction to the event.
-
- "When I look back at why I smoked, what I remember is that I seldom smoked
- a cig because it tasted good or because it felt good. I usually, like any
- chemical addict, smoked so that I wouldn't be/feel uncomfortable. A sagging
- nicotine level brought on that awful feeling we called a nicotine fit. What
- were its characteristics? Nervousness, trembling, sweating, irritability? I
- remember these and there are probably others, all uncomfortable sensations.
-
- "And how did we 'cure' the condition? We smoked a cigarette. Pretty simple
- solution, and effective. This is where I see the internal dialogue being
- established. As neophyte smokers we 'learned' to relieve discomfort by
- smoking a cigarette. I'm sure very few of us willingly waited till we were
- uncomfortable. The onset of the sensations associated with a sagging nic
- level triggered a response that, with practice, happened more
- automatically, [until] we were no longer consciously in the loop.
-
- "Here is where I make a connection that may not be valid. Once we had
- established the dialogue that went "when I feel a sensation that feels like
- a nic fit, smoke a cig to cure it", then any event that produced feelings
- similar to a nic fit should/could be cured by smoking a cig. I very much
- doubt that we looked closely at why we lit a particular cig. With every cig
- smoked, with every repetition, the pattern became more ingrained.
-
- "... I was talking to a friend who had quit cold turkey a few months
- earlier. He was telling me how much he wanted a cig. That sometimes he
- craved them so badly he felt like he was being turned inside out. Talking
- to him, it seemed that the only thing that had changed was that he was no
- longer putting a cig in his mouth. But the rest of his habit was somehow
- still intact. He really believed that a cig would relieve his discomfort. I
- wonder if his inner dialogue is telling him that 'a cig will make you feel
- better'.
- =2E..
- "If we don't alter the script, we run the risk of relapse. If we do change
- the script, we can comfortably and confidently carry on with our lives with
- no risk of relapse."
-
- b. Cold Turkey
-
- This is certainly the cheapest, oldest, and simplest method: just stop
- smoking. Aside from its economic and operational advantages, going Cold
- Turkey means that the nicotine in your body will clear itself out as fast
- as possible - so your withdrawal period will be short, but it will also be
- intense.
-
- c. The Patch
-
- (Material for this FAQ was contributed from various sources, as credited.)
-
- [Adapted from Brad Olin's contribution.]
-
- The 'patch' is the common name for a nicotine replacement therapy (NRT)
- which delivers varying dosages of nicotine to the bloodstream via a plaster
- which adheres to the skin. There are several brands of the patch available,
- manufactured by different drug companies in different dosages and with
- slightly different properties, but all operate by weaning the nicotine
- addict off the drug over a period of weeks or months. (Nicotine gum is
- another form of NRT - see below.) Your body has become addicted to
- nicotine, and nicotine addiction is a medical problem that can be treated
- medically. However, NRT is not a sure-fire way to quit smoking.
-
- Used properly, the patch can provide relative comfort from the physical
- symptoms of withdrawal (e.g., irritability, frustration, anger, anxiety,
- difficulty concentrating, restlessness), allowing those who feel
- overwhelmed by the physical addiction some relief while dealing with the
- behavioral habit. The discomfort felt when going from smoking to the patch,
- or when reducing dosages, is not as sharp as that felt when going cold
- turkey. But, some quitters contend that because the patch stretches
- withdrawal out over a longer period of time, it isn't any easier than
- quitting cold turkey.
-
- Cravings may not be as intense when using the nicotine patch, but do not
- expect them to disappear magically. For most smokers, nicotine addiction is
- just one part of the habit. We develop behavioral and psychological
- addictions as well. Certain feelings, times of the day, or activities all
- become strong cues and make us crave a cigarette.
-
- How many cigarettes does a patch equal? The nicotine released from the 21mg
- patch during a 24-hour period is roughly equivalent to that ingested from a
- pack of 20 cigarettes, whether they be high or low tar and nicotine.
- (Cigarettes are made 'light' by modifying the filter, not the tobacco; but
- it has been shown that smokers of 'Lights' and 'Ultra Lights' then modify
- the way they hold and inhale cigarettes, so that they get the same amount
- of nicotine as with the stronger brands.) You and your medical provider or
- pharmacist/chemist will determine, based upon factors such as your weight,
- general health, and smoking habits, the nicotine dosages you use and the
- length of time you will remain at each level.
-
- Nicotine from the patch is not delivered to the bloodstream in the same way
- as it is when you smoke. When you inhale, the nicotine in cigarette smoke
- enters your bloodstream through your lungs. It is carried to your brain
- very quickly (faster than an injection into your veins) and it almost
- immediately satisfies your craving. At least for the moment. The amount of
- nicotine in your blood is known as 'blood nicotine level.' After a
- cigarette, the level of nicotine drops quickly. When it gets to a low
- level, your body signals that it needs more and you experience a craving.
- The desire is temporarily satisfied when you inhale your next cigarette.
- You may need a cigarette every 20 to 30 minutes. Throughout the day your
- blood nicotine level is raised and lowered like a roller coaster, and your
- system becomes a participant in a constant 'need-feed' cycle of addiction.
-
- The nicotine patch, on the other hand, delivers the drug at a controlled
- rate into your bloodstream through your skin. The rate is intended to be
- steady, but it's not perfect. When the patch is first applied, the blood
- nicotine level quickly increases to its peak at about the two hour period;
- it remains at peak delivery through about the sixth hour; then it slowly
- tapers off through the remainder of the 24 hour cycle.
-
- [Please note that nicotine remains in the blood for several hours even once
- the patch is removed; therefore, it is crucial that once you begin using
- the patch, you do not smoke. A nicotine overdose can result in illness,
- heart failure, even death. Also, a significant amount of drug remains in
- the patch itself even once it is discarded. See information provided by
- Michiko Walraven further on in this section.]
-
- While nicotine is nicotine regardless of its delivery system, using the
- patch is not as harmful for you as continuing to smoke cigarettes. First,
- you receive no more nicotine, and usually far less, through the patch than
- you do from smoking. The patch does not contain tar or the poisonous gases
- that are found in cigarettes. The patch does not present health hazards,
- via second hand smoke, to those who share your living space. And most
- important, the patch is easier to stop using. It is not associated with
- qualities such as sexiness, rebelliousness, or creativity; nor will you
- look to it to see you through tough times or to join you in celebrations
- (though you may find yourself giving it a little pat now and again)! And,
- as explained above, the relatively constant nicotine level supplied by the
- patch, delivered passively and regardless of whether you think you need it
- or not, ends the need-feed cycle, allowing the body to disassociate itself
- from the expected reactions to nicotine intake.
-
- It is unfortunate that the cost of the nicotine patch sometimes presents a
- barrier to its use, and although national governments and insurance
- companies agree that smoking is a highly significant source of senseless
- illness and premature death, few back up this belief by subsidizing the
- cost of this treatment. But even if your health insurance won't pay for the
- patch, remember that the cost of using the patch is usually no more than
- continuing to smoke a pack a day. And patch use will usually end within 10
- to 16 weeks; cigarette buying never ends until the smoker stops, one way or
- another.
-
- Not everyone can use the nicotine patch, so be aware of potential medical
- side effects associated with using the patch. It is possible, and not
- uncommon, to have some mild itching, burning, or tingling when the patch is
- first applied. This is normal and should go away after about an hour. After
- you remove a patch, the skin underneath might be somewhat red. Your skin
- should not stay red for more than a day. If you get a skin rash after using
- the patch, or the skin under the patch becomes swollen or very red, call
- your doctor. You might be allergic to one of the components of that
- particular company's patch. You can try switching brands, and see if you
- react more favourably. And, if you know you have problems with adhesives
- plasters/bandages, then consult your doctor before using the patch.
-
- Most brands of the patch comes in different dosages, and using the wrong
- one could result in side effects including headaches, dizziness, upset
- stomach, diarrhea, blurred vision, weakness, and vivid dreams. Also, you
- must inform your doctor that you are using the patch if he/she prescribes
- other medication.
-
- The happy side effect: Many people using the patch, especially one of the
- brands designed to be worn round-the-clock, experience unusually vivid
- dreams. One friend told me that the patch gave him extremely erotic dreams
- every night! It seems that the patch's steady nicotine delivery system
- keeps the brain relatively active even during sleep, which in turns
- produces lively dreams.
-
- If the patch is causing insomnia, however, or if the excessive dreaming is
- disturbing, ask your doctor about switching to a 16 hour patch, or removing
- the one you're using during the night.
-
- [From The Journal of the American Medical Association. Distributed by: JOIN
- TOGETHER: A National Resource for Communities Fighting Substance Abuse.
- Tel. 617/437-1500. Fax. 617/437-9394. 441 Stuart Street, Sixth Floor,
- Boston, MA 02116. info@jointogether.org]
-
- _The Effectiveness of the Nicotine Patch for Smoking Cessation: A
- Meta-analysis_
-
- - Michael C. Fiore, MD, MPH; Stevens S. Smith, Ph.D.; Douglas E. Jorenby,
- Ph.D.; Timothy B. Baker Ph.D.
-
- "Our objective was to estimate the overall efficacy and optimal use of the
- nicotine patch for treating tobacco dependence. Our data sources were from
- nicotine patch efficacy studies published through September 1993,
- identified through MEDLINE, Psychological Abstracts, and Food and Drug
- Administration new drug applications. Our study selection was double-blind,
- placebo-controlled nicotine patch studies of 4 weeks or longer with random
- assignment of subjects, biochemical confirmation of abstinence, and
- subjects not selected on the basis of specific diseases (e.g., coronary
- artery disease). Pooled abstinence rates and combined odds ratios (ORs) at
- end of treatment and 6-month follow-up were examined overall and in terms
- of patch type (16-hour vs 24-hour), patch treatment duration, dosage
- reduction (weaning), counselling format (individual vs group), and
- intensity of adjuvant behavioral counselling. Across 17 studies (n=3D5098
- patients) meeting inclusion criteria, overall abstinence rates for the
- active patch were 27% (vs 13% for placebo) at the end of treatment and 22%
- (vs 9% for placebo) at 6 months. The combined ORs for efficacy of active
- patch vs placebo patch were 2.6 at the end of treatment and 3.0 at 6
- months. The active patch was superior to the placebo patch regardless of
- patch type (16-hours 24-hour), patch treatment duration, weaning,
- counselling format, or counselling intensity.
-
- "The 16-hour and 24-hour patches appeared equally efficacious, and
- extending treatment beyond 8 weeks did not appear to increase efficacy. The
- pooled abstinence data showed that intensive behavioral counselling had a
- reliable but modest positive impact on quit rates. Our conclusions were
- that the nicotine patch is an effective aid to quitting smoking across
- different patch-use strategies. Active patch subjects were more than twice
- as likely to quit smoking as individuals wearing a placebo patch, and this
- effect was present at both high and low intensities of counselling. The
- nicotine patch is an effective smoking cessation aid and has the potential
- to improve public health significantly.
-
- "Abstract Source: Fiore M.C., Smith S.S., Jorenby D.E., Baker, T.B., (1994)
- The Effectiveness of the Nicotine Patch for Smoking Cessation: A
- Meta-analysis. The Journal of the American Medical Association, JAMA 271
- (24) 1940 Article Source: Fiore M.C., Smith S.S., Jorenby D.E., Baker,
- T.B., (1994) The Effectiveness of the Nicotine Patch for Smoking Cessation:
- A Meta-analysis. The Journal of the American Medical Association, JAMA 271
- (24) 1940-1947. Date: 8/9/94"
-
- [From Michiko Walraven, michiko@islandnet.com]
-
- Warning to Patch Users
-
- This is a summary of an article I found yesterday morning in our local
- newspaper. I hope this will help all the patch users who live with small
- animals/children:
-
- Excerpts from Victoria Times-Colonist, Jan 12, 1995, page B3.
-
- "A man in Duncan, BC has been on nicotine patch for the past 40 days trying
- to quit smoking. He noticed that the patch sometimes gets loose and falls
- off. So, he has been using duct tape on occasion. Last night his patch fell
- off during his sleep, and his pet kitten (11-month) accidentally swallowed
- it. The cat survived her nicotine blast and was recovering fine at the time
- of newsprint. BC Drug and Poison Information Centre representative says:
- 'With nicotine patches, when children get them stuck on them, we've had
- problems with nicotine toxicity where they get very shaky, stomach cramping
- and if untreated sometimes there's always the risk of seizures.' She
- recommends that users of patches consider returning the used patches to
- their pharmacies for proper disposal rather than just throwing them out
- with the normal trash. The spent patches could still contain traces of
- medicine."
-
- d. Nicotine Gum
-
- Another form of nicotine replacement therapy (NRT) is chewing gum laced
- with nicotine (sold under the brand name Nicorette in Canada, the U.S., and
- Europe. Like the patch, it provides nicotine to the person quitting smoking
- via a less psychologically- attractive delivery system, and allows for a
- more gradual (and theoretically more comfortable) departure of the drug
- from the bloodstream. Another factor which might appeal to some people is
- that the quitter has full control over gum use; unlike the patch, which is
- designed to deliver a steady and constant flow of nicotine, the gum is used
- in response to withdrawal cravings. You use it when you feel the need, and
- wean yourself off the drug by using fewer pieces of the gum per day. Even
- if you take months to go off the gum entirely, you will still be realizing
- many health benefits from not smoking.
-
- That the nicotine gum requires the user to take an active role in nicotine
- dosing may make it an undesirable tool for some people. It may seem too
- much like smoking in that you are responding to the body's urges for
- nicotine by supplying it on an as-needed basis, only with gum rather than
- with a cigarette. OTOH, you may prefer to have control rather than use the
- patch, which sends nicotine to you whether you think you want it or not.
- If you find the gum upsets your stomach, you may be using it incorrectly.
- The package directions for Nicorette gum specify that you should chew a
- piece with small chews every minute or so, and "park" it between your cheek
- and gums when you're not chewing. The package also states most of the
- nicotine will be released within the first thirty minutes. If you chew
- Nicorette like regular gum before the nicotine is released, this could and
- probably will upset your stomach. Note that after the 30 minutes you can
- treat it as regular gum and chew as often or as vigorously as you want.
-
- e. Nicotine Nasal Spray
- [Provided by Dixie, randixoe@digisys.net]
-
- "The spray is called Nicotrol NS and is manufactured in the U.S. by McNeil
- Pharmaceutical. It was just approved by the FDA in July of 1996. It is a
- prescription medicine. It is sold in a spray bottle containing 10 mg/ml
- nicotine in an aqueous solution. Each time you spray the Nicotrol NS into
- each nostril you receive about the same amount of Nicotine as smoking 1
- cigarette.
-
- "One spray in each nostril is considered 1 dose. Instructions are not to
- use more than 5 doses per hour or more than 40 doses in 24 hours. The
- suggestion is to use the spray no longer than 3 months. The cost is $38.30
- for 1 bottle that contains approximately 100 doses (200 sprays).
-
- "Now for my experience with this nose spray. Although I had the
- prescription for Nicotrol NS, I wanted to see if I could quit 'cold turkey'
- first. Well the first day, towards afternoon I was turning into a miserable
- bawling mess. I decided to try the Nicotrol NS and to my amazement within 1
- minute I was a new girl. I couldn't believe how well it worked, compared to
- the patches I had tried years ago.
-
- "That day I used the spray 6 times. Since then I have used the spray about
- 15-16 times a day. I really don't want to use any more than I have to
- because in a couple of weeks I'll want to discontinue the use of the spray
- also.
-
- "The nose spray really did sting some when I first used it but doesn't
- bother me much at all now. (They do give a warning for people who have
- sinus problems, etc. to check with their doctor before using.)
-
- "From everything I've researched on this Nicotrol NS I think that someone
- who isn't careful could have problems being addicted to and continuing the
- spray longer than appropriate. My suggestion to anyone who decides to use
- it is to use as little as you can but don't let yourself get to the panic
- stage before you use it. I was smoking 2 1/2 packs a day when I quit and
- like I said I'm using about 15-16 doses a day. If I did that for a whole
- month it would end up costing me about $190-$200 per month."
-
- f. Cutting down
-
- Is there one among us who has not tried cutting down our tobacco intake at
- one time or another? Perhaps you weren't even thinking of quitting smoking
- as the ultimate goal, but of trying to reduce the damage or risk or save a
- little money. I have personally notched many a cardboard matchbook cover in
- my day. What I got for my trouble was an obsession. How much time has
- passed since my last smoke? Can I have another yet? How do I make this <x>
- number of cigarettes last me through <y> hours?
-
- It would seem to be self-evident that gradually cutting down on smoking
- would be a viable means to quitting altogether. After all, the less you
- smoke, the less drug in your system, and this is the logic behind the
- nicotine patch and Nicorette gum, right? But in fact, whether your goal is
- to smoke less or to quit entirely, you're not doing yourself any favours by
- cutting down, because each cigarette that you light sets you right back
- down in the middle of your addiction cycle. The further apart you stretch
- the supply of drug, the longer you suffer the discomfort of withdrawal. The
- only way out of this cycle is to stop feeding the addiction altogether.
- That way, the body eventually gives up demanding the drug, and you're on
- the road to freedom.
-
- Switching to a lighter brand might seem sensible, and theoretically it is.
- But keep in mind that what makes a cigarette's nicotine content less is
- manipulation of the filter, not the tobacco, and smokers in reality manage
- to compensate for that manipulation by holding the cigarette a certain way
- and/or inhaling more deeply.
-
- Having said this, there are some people who have quit by cutting down,
- delaying smoking further and further into the day, limiting the places
- where they smoke, and/or switching brands. And if it works for you, great!
- If not, next time you can try another strategy. The important thing is that
- you keep trying to quit.
-
- g. Acupuncture/Acupressure
-
- i. Before quitting
-
- [Contributed by Grant N. Mazmanian <grantmaz@ix.netcom.com>]
-
- "QUOTE I went to an M.D. specializing in anesthesiology at a local hospital
- outside of Philadelphia at the recommendation of a friend. The doctor gave
- me references and claimed a 75% success rate. I called several doctors and
- nurses at the hospital and they all reported the same results: they stopped
- smoking after one or two treatments, minimal withdrawal symptoms, little or
- no weight gain and no apparent side effects. They all had tried to quit
- several times and failed and were very enthusiastic about the procedure.
-
- "My visit lasted about an hour. Sterile, disposable acupuncture needles
- were inserted along my arms, hands, ears and head. There was little to no
- pain. A final needle was placed on the top of my head and an electrode was
- connected to a mild electric current. I rested in a chair during the
- procedure.
-
- "At the end of treatment, I was given an herb to mix with hot water to make
- a tea. I was instructed not to smoke and if I had any cravings, to drink
- the tea. If the tea didn't work, the doctor gave me his beeper number.
-
- "For the first few days I felt a craving but I didn't know what I wanted;
- it wasn't for a cigarette but I was at a loss to describe what the craving
- was for. I called the doctor about it and he told me that it was a normal
- response. I went for a second session because I wanted to reinforce the
- first treatment but I honestly didn't think I needed it. After a week, the
- craving subsided. The usual cigarette 'triggers were gone after two weeks."
-
- [N.B. - Grant does not know the herb he was given - ed.]
-
- ii. After quitting
-
- [Contributed by Tina <tivity@dti.net>]
-
- "I was getting discouraged that after sooooo many days without nicotine, I
- was still longing to smoke all the time. It didn't seem to make sense to
- reintroduce nicotine into my system via gum or patches (though if I'd
- planned my quit, I would have used one of them). I went to an acupuncturist
- instead, and thought I'd post a report. ...
-
- "After swabbing my ears with alcohol, she used long tweezers to poke a
- little ring into the upper arch of my left ear, and another one at the
- nest-like hollow in the lower part of my right ear. These rings are less
- than 1/8 inch diameter, and though they seem to be laying flat on the skin,
- they must have a pointy part facing into the skin because a) I could feel
- them being placed as if they were poking my skin (although this might have
- been the tweezers) and b) I was instructed to tap the rings to activate the
- pressure points in question. Using small pieces of clear surgical tape, Dr.
- Lee secured the rings to my ears. She issued the following instructions:
- lightly tap the points 20 times each morning upon awakening; tap them 5-7
- times any time I feel the urge for a cigarette. I could swim, shower,
- sleep, etc without fear of disturbing the rings, but I shouldn't scratch at
- them. They would help me be free of urges to smoke, and even if I did have
- a cigarette, it would taste bad and I wouldn't want to smoke it. (Junkie
- thinking ALERT: It did cross my mind to test this theory....) Because I had
- already quit for 2 weeks, she thought a week would do me, and I should drop
- by (no appointment needed, because it's so fast) to have the rings removed.
- The visit cost $50.
-
- "So, how is it, you're asking. From the first, I noticed that tapping the
- rings did seem to help get over cravings. The first day, I did this many
- many many times. Fewer the second day, and, you guessed it, fewer each day
- than the last. Also, I could feel a little soreness, especially in the
- left, at the beginning, and this too diminished.
-
- "The experience, especially noticeable with the 20 a.m.-taps, is sorta...
- Eastern. That is, the cravings don't feel like they're being wiped out, as
- if with a drug, but rather that you are becoming slightly better balanced,
- and therefore your need for something to fix you, like a cigarette, is
- less. I can't imagine that this subtle effect would be enough to have made
- me quit had I still been smoking. And I have not tried what it would taste
- like to smoke a cigarette."
-
- h. Hypnosis
-
- [Contributed by Michiko Walraven <michiko@islandnet.com>:
-
- "I had decided to use hypnosis simply because: (1) I knew I did not have
- strong willpower; (2) I honestly believed that I would go under very
- easily. Also, the initial session was covered by our medical insurance,
- since it was a referral from my physician. My appointment with the doctor
- (a General Practitioner with a certificate for hypnotherapy) was 9 a.m. on
- my birthday (sheer coincidence, which turned out to be a great motivator
- later). I had my last smoke in the car in the parking lot at 8:59 a.m. The
- doctor asked me at the beginning of the session to describe to him why I
- was going to quit. It was, I told him, because I knew I had to quit
- eventually, and that it was as good as any other time (rather laid-back
- attitude). One thing I really emphasized was that I didn't want to turn
- into an ex-smoker who would become a strong anti-smoker, poking his/her
- nose into everybody else's (i.e. smoker's) business.
-
- "My session began. He asked me to look back for the first happy moment I
- could remember as a non-smoker. That took a lot of going back... I had been
- a smoker since 16 or so. I was about 12 years old or so in that image. The
- doctor then told me that I no longer needed to smoke, and asked me if I
- could visualize myself being a non-smoker in that image, only at the
- current age. After some time I would see myself being a non-smoker. He then
- asked me if I could see myself being a non-smoker one week from that day,
- one month, 3 months, etc. etc. finally down to one year from that day.
- =46ortunately I could really see it.
-
- "That was basically it. I did not become violently ill at the smell or
- sight of smoke, I did not turn into a radical anti smoker. I am just a
- happy and proud non-smoker for over two years now. Of course this newsgroup
- helped a LOT, particular at the beginning, and when I was going through
- some legal/family trauma. Sure, the thought comes to me 'Boy, a smoke would
- really hit the spot' once in awhile. But if necessary, I can always go back
- for a follow-up session. Actually I was told to have an follow-up after 2
- weeks/months, but never bothered because (1) I did not need it all that
- much, and (2) it would cost me $80.00 CDN. (First session was covered by
- the medical insurance, lucky!)
-
- "If you are interested, ask your family doctor. That is exactly what I did,
- and he recommended doctors who could do hypnotherapy (1 hr) for my purpose.
- It was strictly a private session. I don't know how a group session would
- have worked for me, since I wasn't interested."
-
- Here is more on hypnotherapy, from a licensed practitioner.
-
- Bob Christofferson asked a hypnotist who posted to AS3:
-
- "Do you have any advice for how to select a hypnotherapist? Is one session
- enough, or are results better with more sessions? Are group sessions any
- good? Is there a way for a person to tell if he or she would be a good
- candidate for hypnotherapy? Is that enough questions for now? :) "
-
- Edward Hutchison, a practicing hypnotist, responded:
-
- "First, I don't know any sure guide to picking a lawyer, a good school, a
- wife ... or a hypnotherapist. There really aren't any good accrediting
- agencies with universal recognition for hypnotists or psychotherapists so
- about all I can suggest would be to ask friends or perhaps your family
- doctor. But, to be honest, although hypnosis is taught at some medical and
- dental schools it is not a part of the typical MD's training. Consequently,
- not enough of them are aware of its full potential and some patient might
- ask a question about it and, as you probably know, MD's are bred to never
- say 'I don't know.'
-
- "As to the number of sessions: it depends. I prefer to see people once,
- and for about 70%, that one visit is enough to quit smoking. Crassilneck
- and Hall have published a study with an 82% success rate but it is
- predicated upon four sessions and the only subjects seen were males with a
- medical referral.
-
- "I have conducted numerous group sessions - usually where some employer
- undertakes the expense of the program. The success rate is only about 50%.
- But in terms of cost-effectiveness these programs, especially in the
- absence of other options, can be very worthwhile. They last three hours
- (with two brief breaks) as opposed to about 70 minutes for the individual
- sessions.
-
- "The last question is the easiest. Virtually everyone with the intelligence
- to ask the question is a good candidate for hypnosis. That is to say,
- about the only people who have any difficulty in obtaining the light trance
- necessary for stop-smoking suggestions are those who are very dull and
- those who are actively psychotic. In a long private practice I have only
- about one percent who were, in my opinion, refractory to hypnosis. Of
- course, the goal is not hypnosis, but change, and unfortunately no good way
- exists to measure the motivation so essential to all change."
-
- i. Herbs
-
- Herbal Teas. Excerpt from: Using Herbs To Quit Smoking by Elizabeth
- Phillips, "The Herb Quarterly"(ISSN 0163-9900), Winter 1993.
-
- A regimen of teas to take for a few weeks:
-
- * First thing in the morning to relax: 1/2 teaspoon valerian root; 1/2
- teaspoon chamomile
- * 11 AM to aid in withdrawal: 1/2 teaspoon licorice root; 1/2 teaspoon
- comfrey
- * Noon to cleanse blood: 1/2 teaspoon black cohosh; 1/2 teaspoon burdock
- root
- * 2:30 PM to clear lungs: 1/2 teaspoon slippery elm; 1/2 teaspoon
- fenugreek. NOTE: if after two days you are not coughing or bringing up
- mucous, you can discontinue this tea)
- * 4:00 PM to aid in quitting: 1/2 teaspoon magnolia; 1/2 teaspoon pepperm=
- int
- * 6:00 PM to boost immune system: 1 teaspoon of Echinacea in a cup of
- boiling water
-
- These teas are brewed for ten minutes in four ounce teacups. Of course
- there are always words of caution: check with your doctor before trying any
- herbal remedy. Do not mix herbal remedies with over-the-counter
- prescription medication. If you have allergies to ragweed or hay fever to
- not take chamomile. You can substitute skullcap. If you have heart problems
- do not take licorice root or goldenseal tabs. If you have high blood
- pressure do not take vitamin E capsules. I would further recommend that you
- get a copy of this article ... this tea regimen is for 3 WEEKS ONLY.
-
- Thanks to the original poster, Barbara R.
-
- j. Cream of Tartar
-
- A few of us (myself included) saw this remedy presented on some breakfast
- television-type show, and one poster shared his experience:
-
- Mark <river1824@andorra-c.it.earthlink.net> wrote:
-
- "Well, I am getting ready to quit ... I have been using the cream of tarter
- for a few days now. What you do is take 1/2 teaspoon in a glass of orange
- juice, and it pulls the nicotine out of your system. You might sweat it out
- at night or urinate more. You can buy cream of tarter at the grocery store
- at the cooking spices. Cream of tarter is used to make meringues have more
- holding power and also is a component of baking powder (if I remember
- correctly). It is natural, as it is the dried powder of the remnants left
- in wine vats, from grapes. The idea is to smoke only when you actually
- crave ... not habit but craving. As you do this each day, you crave less
- and less as more and more nicotine has left your body. The eventual idea is
- to work your nicotine level to a tolerable and controllable level, that you
- can then quit completely. Without the terrible full strength withdrawal. I
- recommend it. It is an inexpensive way that might work for some. I would be
- interested in hearing from those that try it. My neighbors tried it with
- some success, however, they did not want to quit smoking at the time. They
- did, however, notice a difference."
-
- k. Zyban a/k/a Wellbutrin and Other Antidepressants, w/ or w/o NRT
-
- Wellbutrin (generic name, bupropion) was recently released under the name
- Zyban for marketing as a smoking cessation aid. They are the same drug,
- made by the same company, Glaxo-Wellcome.
-
- During testing of the antidepressant Wellbutrin, it was realized that the
- test group experienced a reduced desire for nicotine. Studies have since
- been done using Wellbutrin as an aid in smoking cessation, both in
- conjunction with nicotine replacement therapy (in the form of the patch),
- and without. No conclusive results have yet been published. The following
- information was written and contributed by Scott Leischow
- <leischow@ccit.arizona.edu>.
-
- "Greetings! Wellbutrin is one of several medications being tested for
- smoking cessation. Keep in mind that no medication has been found to be
- efficacious for a large percentage of people, and that different approaches
- work differently for each person. There are data to suggest that Wellbutrin
- (bupropion) increases the chances of quitting - see studies by Linda Ferry
- at Loma Linda Medical Center. Note that other medications being tested
- include Inversine (mecamylamine) in combination with nicotine, lobeline,
- cotinine (a metabolite of nicotine) - and new nicotine replacement options
- will eventually be available as well, such as nicotine nasal spray,
- nicotine inhaler, nicotine lozenge. Mint nicotine gum is now available in
- Canada, Mexico, and several European countries, and an even more flavorful
- gum is or will be available in the UK (made by Ciba-Geigy). Meds, of
- course, are not the answer - they can work to enhance personal motivation.
- All of these changes will definitely increase uncertainty about what to use
- (if anything), and whether we should be concerned about people using pure
- nicotine for long periods of time. There seems to be a growing consensus in
- the scientific community that we should not be too concerned about long
- term use of nicotine - if the alternative is returning to smoking. Just as
- with methadone versus heroin, the lesser 'evil' is the pure nicotine. I am
- not suggesting we should not be concerned about long term use, just that we
- put it in perspective. Note that I have no financial interest in any
- treatment approach - I do research on smoking cessation treatments at the
- University of Arizona (including on several of the methods I mentioned
- above). Send me a note if you have questions/comments/flames."
-
- But before you run out and demand a prescription from your doctor, please
- consider this information, written and posted by Bob Christofferson
- <rechris1@facstaff.wisc.edu>:
-
- "Prozac (generically, fluoxetine) is a selective serotonin reuptake
- inhibitor (SSRI) and Wellbutrin (bupropion) is a heterocyclic
- antidepressant which affects reuptake of dopamine as well as serotonin.
- (Because of the affect on dopamine, by the way, Wellbutrin has been tried
- for alleviating symptoms of cocaine withdrawal, with inconclusive results.)
-
- "Effexor (venlafaxine) affects reuptake of serotonin and norepinephrine and
- only very weakly affects dopamine.
-
- "This will be on the exam, so take notes. :)
-
- "Seriously, most of us have no reason to try to remember this stuff, but
- it's worth mentioning, I thought, partly as an example of the individuality
- of brain biochemistry. All of the drugs mentioned, and a lot more, are
- useful for some people who have symptoms of clinical depression. But the
- response to any particular drug by any individual patient is unpredictable
- -- it may have no effect, or even make the depression worse. But in someone
- else, with the same clinical symptoms, the drug will work a miracle.
-
- "The same sort of individual difference applies, I think, with regard to
- smoking cessation -- how hard it is, how long it's hard, what helps --
- these are widely different and unpredictable. So, it's worth keeping in
- mind that even with all the things we have in common, the experiences of
- any one of us may not be very predictive about anyone else. In other words,
- I need to keep in mind that even if you do exactly what I did, you may not
- have the same results.
-
- "It's also worth comparing to smoking cessation, I think, because in cases
- where one antidepressant doesn't work, another one very well might -- just
- like one method of smoking cessation may not do it for an individual, but
- there are a lot of other choices to try. And (to tie this into a bow) one
- method that may be the key to smoking cessation for some people is to take
- antidepressant medication. It certainly wouldn't be the first suggestion
- I'd make for anyone, but for those who have not succeeded with other
- methods, and especially for anyone who thinks they may be using nicotine to
- self-medicate depressive symptoms, I would recommend talking to a medical
- professional about the possibilities."
-
- l. Mecamylamine and the Patch
-
- Another drug being tested in conjunction with the nicotine replacement
- patch for use in smoking cessation is mecamylamine, a prescription drug
- frequently prescribed for high blood pressure. A detailed summary of the
- original controlled study, see Clin. Pharmacol. Ther. Vol. 56 no. 1 pp.
- 86-99; also available on the Internet from the Medline page. Here's the
- short, layman's version: Source: The Mirkin Report #6455 (online)
-
- "Jed Rose of Duke University has discovered that 6 weeks of taking a
- nicotine skin patch with mecamylamine pills, a drug that blocks the effects
- of nicotine, helped more than one third of smokers to stop smoking one year
- later. In high doses, both nicotine and mecamylamine have horrible side
- effects. High doses of nicotine cause high blood pressure, a fast thumping
- heart beat and shakiness. High doses of mecamylamine cause shakiness,
- dizziness, fainting, constipation and even convulsions. However, when the
- two drugs are combined in low doses, people trying to stop smoking seldom
- suffered side effects and many were not smoking one year later. The
- recommended doses were standard nicotine skin patches daily and 2.5 mg of
- mecamylamine twice a day."
-
- m. Allen Carr
-
- Discussion of Allen Carr's books (Allen Carr's Easy Way To Stop Smoking
- (Penguin; ISBN 0-14-013378-X), later revised and reissued as The Only Way
- to Stop Smoking Permanently (Penguin; ISBN 0-14 024475-1)) is the closest
- AS3 comes to making a commercial endorsement. So many of us have been
- helped by Carr's work that it is a frequent topic of discussion. Even if
- one part of the method doesn't seem right for you, something else may be
- just the thing that rings your personal bell. Unfortunately, Carr's books
- are very difficult to get in North America. See below, a couple of avenues
- interested parties might try. But many might be helped even by this summary
- of the Carr method, written and contributed by David Moss
- <moss@irch.kfk.de> and originally posted to AS3.
-
- "First, Allen Carr's qualifications: he's not a doctor or a psychologist,
- he's a guy who smoked five packs per day (I didn't even know that was
- possible!) and who quit one day with no difficulty whatsoever. He was so
- astounded by this that he subsequently devoted his time to finding out why
- quitting had been so easy for him, and then wrote a book about it.
-
- "He understands how smokers' minds work, so he doesn't fill his book with a
- load of horror stories on why you shouldn't smoke. We all know that
- already, and it doesn't help. Allen Carr turns it around and asks, why
- smoke? Our bodies tell us 'have a cigarette' and we give way, or we fight
- it with huge amounts of willpower. Instead, we should ask our bodies 'what
- for?'. He takes all the stock answers - it tastes good, it helps me relax,
- it helps me concentrate, it relieves stress, it relieves boredom - and
- disproves them one by one. In fact, we smoke to relieve the withdrawal
- symptoms that we all suffer between cigarettes, because nicotine is a fast
- acting, fast decaying drug. All the other justifications are
- rationalizations which don't stand up to scrutiny. The logical conclusion
- is that you shouldn't even think in terms of 'giving up' cigarettes,
- because you're not giving up anything - you're just stopping smoking
- because you simply don't need cigarettes.
-
- "His next point is that quitting is actually very easy. Most smokers make
- the mistake of confusing the physical withdrawal symptoms with the
- psychological "crawling up the walls" cravings and panic that you get when
- you want to smoke and can't. The actual physical withdrawal symptoms are a
- mild, empty, hunger-like feeling, which doesn't hurt and which is easy to
- ignore. The psychological cravings, because they're psychological, will
- simply cease to exist if you can develop the right mental attitude. For
- this reason, Carr is very insistent that the reader continue to smoke until
- he's got his attitude right (i.e. until he's finished the book), so as to
- avoid the negative experience of a failed attempt to quit. Think about the
- question given above - what positive benefits do you get from smoking -
- until you're completely convinced that smoking gives you nothing. You don't
- need huge feats of willpower, because you're not giving up anything. Making
- quitting into a test of willpower only makes it harder. You don't need
- replacements like sweets or gum, because you're not giving up anything that
- needs replacing. You don't need nicotine patches or nicotine gum, because
- you don't need nicotine. Enjoy the withdrawal symptoms, because that's how
- it feels when you defeat your addiction.
-
- "We all know that it takes about three weeks for the body to be cleared of
- nicotine. But don't think in terms of 'making it' three weeks without a
- cigarette, which would lead you to expect something wonderful to happen
- after three weeks. Nothing happens, because the physical withdrawal
- symptoms are so mild that you don't even notice they've gone. That
- wonderful thing happens in the moment you stub out your last cigarette and
- become a non smoker. Don't get melancholy and depressed about life without
- cigarettes, because you're not giving up anything. Enjoy life as a
- non-smoker, it's better in every way. Don't even try to avoid thinking
- about cigarettes - every time you think of them, think about how wonderful
- it is that you don't need them.
-
- "Allen Carr gives five point that need to be internalized before you begin:
-
- "1. Be quite clear in your mind, you're going to quit. Not hoping to quit
- or trying to quit, just going to quit. It's easy.
- "2. You're not giving up anything, but you're gaining a hell of a lot.
- "3. There's no such thing as 'just one cigarette'. Your choices are to
- quit, or to smoke for the rest of your life.
- "4. Don't think of smoking as an unpleasant habit. It's an addiction, and
- it's getting worse every day. The right time to quit is now.
- "5. Understand the difference between the chemical addiction and the
- 'junkie' mentality. As soon as you stub out your last cigarette, you're a
- non-smoker. Non-smokers are people who don't use cigarettes.
-
- "If you've really taken these points on board, quitting will be simple and
- absolutely painless. You don't believe it? That's not surprising, we've all
- been brainwashed by advertising, by films, by society's generally tolerant
- attitude to smoking, and by our own addiction. You need to open your mind
- and think about what Carr is saying in order to ditch this conditioning and
- realize that Carr is right.
-
- "Finally, a disclaimer - the above is my personal summary of Allen Carr's
- book, and I may have left out or misunderstood something important. If in
- doubt, read the book. The title is Allen Carr's Easy Way To Stop Smoking,
- and it was published by Penguin Books, London, in 1991. The ISBN number of
- my copy is 3-442-13664-4, but be careful because I have the German
- translation (Endlich Nichtraucher, Goldmann G1290).
-
- "I very much hope that this information will make quitting as easy for
- someone out there as it was for me, and I'd be happy to deal with any
- follow-up questions.
- David <moss@irch.kfk.de>"
-
- How to get Carr's book in North America:
-
- I've recently heard that an American publisher is being sought for The Easy
- Way To Stop Smoking. In the meantime, for the convenience of those in
- North America, here are some options:
-
- 1. Order from one of the established Internet booksellers. I've used the
- Internet Bookshop, originating in the U.K., without problem, but there are
- several others you can check for comparison 'net shopping.
-
- 2. Try contacting one of the directors of an Allen Carr clinic. You can
- find a listing of the clinics at this URL:
- http://www.qwerty.co.uk/allencarr/
-
- 3. A company called Videocom sells a package of the book and audiotape for
- US$ 29.95 plus US$ 3.50 shipping and handling (U.S. cheques or money orders
- in U.S. funds only. They do not offer the book alone. The company's address
- is: Videocom Inc., 502 Sprague Street, Dedham, Massachusetts 02026 USA,
- Attention: Quit Smoking. If anyone tries the Carr package, I'd appreciate a
- report for the FAQ.
-
- n. Programs
-
- This information was supplied by Carolina Johnson. It is of use mostly to
- those in the U.S. and Canada; I would welcome receiving information on
- similar organizations from our members in other parts of the world.
-
- American Lung Association, 1740 Broadway New York, NY 10019. (212) 315-8700
-
- The American Lung Assoc. sponsors stop-smoking groups in most cities. It
- also publishes an excellent guide to quitting, Freedom from Smoking for You
- and Your Family. This book guides readers through a step-by-step 20 day
- program that leads to quitting and provides guidelines for remaining a
- non-smoker. The book is available from your local chapter of the American
- Lung Assoc. (consult your telephone directory for the address and phone
- number) or from their national headquarters at the address above.
-
- American Cancer Society, 4 West 35th Street New York NY 10001. (212) 736-303=
- 0.
-
- Local affiliates of the ACS sponsor a four-session stop smoking program
- called "Fresh-Start." Sessions last one hour each and extend over a
- two-week period. Sessions focus on behavior modification, goal setting,
- mastering obstacles, and social support. The ACS also publishes a free
- handbook for potential quitters, the "I QUIT KIT", which is available from
- your local chapter (consult your telephone directory for the address and
- phone number) or from their national headquarters at the address listed
- above.
-
- The Breathe-Free Plan to Stop Smoking Narcotics Education Inc., 6830 Laurel
- Street, N.W., Washington DC 20012.
- Many local affiliates of the Seventh-Day Adventist Church run a highly
- recommended program that is usually led by a pastor physician team. The
- Breathe-Free Plan to Stop Smoking is based on motivation, lifestyle,
- modification, values clarification, modelling, visualization, affirmation,
- positive thinking, and self-rewards. There is also an optional
- nondenominational spiritual component. The plan consists of 8 sessions that
- take place over three weeks, with periodic phone contacts for one year
- thereafter. Prospective group members are invited to attend the first two
- sessions before making a decision as to whether to register for the
- remainder of the course. During the 3rd week a graduation ceremony is held.
- Successful quitters receive a BNS (Bachelor of Nonsmoking degree) during
- the 3rd week. MNS (Master of Non-Smoking) degrees are awarded at six
- months, and DNS (Doctor of Nonsmoking) degrees at 12 months.
-
- Smokers Anonymous, PO Box 25335, West Los Angeles CA 90025.
- This group provides information on starting your own support group. They
- will also let you know if there is a Smokers Anon group in your area. Write
- to them at the above address enclosing a self-addressed stamped envelope.
- [N.B.: This is not the same organization as Nicotine Anonymous, a 12-step
- recovery program. - ed.]
-
- o. Alternative Healing
-
- Here are summaries of tools and techniques described in New Choices in
- Natural Healing (a Prevention magazine book), ed. by Bill Gottlieb
- (Pennsylvania: Rodale Press, 1995), pp. 505-507. I haven't tried any of
- them except imagery, and make no recommendations or endorsements. They
- could help, or they could be a colossal waste of time and money. As one of
- my univ. profs used to say, Yer pays yer money and ya takes yer choice.
-
- Aromatherapy
- To ride out cravings, mix essential oils as follows: 3 parts lemon, 2 parts
- geranium, 1 part everlast (aka 'immortelle' 'helichrysum') in a small
- bottle. Inhale from bottle whenever a craving hits. "'Lemon is a
- detoxifying agent, and geranium helps balance the adrenal system,' explains
- [aromatherapist Victoria] Edwards. 'Everlast is a powerful cellular
- rejuvenator and will help your body heal the damage smoking has done.' This
- blend is also good when used in a diffuser, says Edwards.
-
- Ayurveda
- To help you quit smoking or cut down on your habit, try chewing on small
- pieces of dried pineapple (about 1/2 teaspoon's worth) mixed with 1/2
- teaspoon of honey, suggests Vasant Lad ... director of the Ayurvedic
- Institute in Albuquerque, New Mexico. He says to use this remedy whenever
- you desire a cigarette.
-
- =46ood Therapy
- No, not eating everything in sight! :) According to Dr. John Pinto of
- Cornell University Medical College and a nutrition researcher at
- Sloan-Kettering Cancer Center, load up on Vitamin C well beyond the
- Recommended Dietary Allowance; its antioxidant qualities will help repair
- damage done by smoking. Thomas Cooper, D.D.S. concurs but note, he says to
- avoid orange juice if you're using the patch: "By making your urine more
- acidic, the juice will clear your body of nicotine faster. But the purpose
- of the patch is to keep some nicotine in your body as you try to wean
- yourself off the weed.
-
- Hydrotherapy
- The body wrap, or wet sheet pack, can help detoxify your system if you're
- trying to quit, according to Charles Thomas, Ph.D. ... This treatment can
- be done at home but will probably require help from a partner. After
- warming up with a hot shower, lie down on a bed with your entire body
- wrapped in a sheet wrung out in cold water. Then wrap yourself in one or
- more wool blankets. While the pack feels cool at first, your body heat will
- gradually dry the sheet, and you will begin to sweat. Leave the wrap in
- place=00=00=00=00=00=00=06=FD to two hours after you start perspiring. Dr.=
- Thomas suggests
- using this treatment once a day until you no longer feel as intense a
- craving for cigarettes.
-
- Imagery
- See yourself smoking. While you're doing it, do you perceive yourself as a
- smoker? In your mind, continue to see yourself smoking, but say to yourself
- 'At this time, I have the habit of smoking, but I am not a smoker,' says
- Dennis Gersten, M.D., a San Diego psychiatrist .... Now picture something
- that is good for you that you desire tremendously. It could be health,
- better looks or more control of your life. Focus on your desire. See
- yourself as an incredibly healthy, beautiful or self-reliant nonsmoker. Let
- that image overpower any desire that you have to smoke. Dr. Gersten
- recommends using this imagery for 10 to 20 minutes twice a day.
-
- Relaxation and Meditation
- 'Studies have shown that many smokers use tobacco to help them reduce
- anxiety and tension. If you meditate, your mind learns another way to
- counteract that anxiety, so you may become less reliant on cigarettes,'
- says Dr. [Sundar] Ramaswami [a clinical psychologist]. ... Meditate for 20
- minutes twice a day or for a few minutes whenever you feel the urge to
- smoke, suggests Dr. Ramaswami.
-
-
- Thoughts to close the Alt.Support.Stop-Smoking FAQ, Part 3:
-
- "The Willpower Method is based on giving up something you want to do and
- thus have to resist the desire to continue doing it. The Easy Way is to
- change your thinking so that you are not giving up anything, but becoming
- free of something that you don't want to do. That way you can enjoy it. -
- gecko@ibm.net"
-
- "Once you get to the point where your mind is made up once and for all, it
- is very difficult to fail. - Cindi Smith"
-
- Please go on to Part 4.
-
-
-
-
-
-