Thursday, December 31, 2009

Quit Day Tomorrow? CLEAN OUT SMOKING REMINDERS

If your quit date is set for tomorrow there are some last minute things to do in preparation. First clean up your house, Throw your ashtrays out and wherever you smoked remove all reminders that it was ever used for smoking. It is especially important to get your car clean. If you can, spend the money on getting your car detailed. Make sure that all smells of smoking are gone, ashtrays clean, and handy substitutes for doing something with your mouth are available. This might be playing with a straw, toothpick or gum. Some people have a nicotine inhaler there so that they can use it when the desire for a cigarette comes. Others might use a Nicotine Nasal Spray then. The inhaler has the look and feel or a cigarette which can be a comfort. I even have a friend that used a baby pacifier. It worked for him and you can't get better than that.
Whether tomorrow, next week or after you get your Cessation Medication set up and you quit at the end of January remember that it helps to have no reminders of smoking around you. Some people avoid going to bars with friends until after they have been quit for several months. It always feels good to enter a new beginning with a clean house and car so begin the new you in a clean place.

Learn From Other Quit Attempts, Journal about what you learned

Every time a person quits for a day, week, month or year, they learn alot about what helps them be successful and what is really hard for them about quitting. In your diary I would like you to think back on other times you quit and think about what led to the relapse. It might be helpful to include the following information: Where were you, and what was happening? Were you at a bar, or did you light up during a stressful parenting situation? Everything you can learn about quitting will help you, especially if you know what times are places are most difficult to get through. These times will give you clues to what your really vulnerable times are and you can prepare for them by having a strategy for alternatives to lighting a cigarette up.


I also think it helps to look back at the tactics you used when you successfully didn't light up, even when things got pretty hairy. These entries looking back at your successes can really be a wealth of useful ways to avoid cigarettes for when you quit. I want you to use these entries to build your confidence. You really have gotten through some difficult times without lighting up. This time you are prepared and you will be able to do what you want to do, QUIT!

Friends and Partners

I mentioned in the last blog that it was important to enlist help from co-workers, family and friends. The support from loved ones, and co-workers can be invaluable. A lot of people I have worked with are embarrassed to ask for help from others but I know how helpful these folks can be. First they are the ones near you and will possibly be there when you encounter a difficult craving. They will be in a position to help and most everyone wants to help. Your smoking friends, if they know you are trying to quit might be ambivalent because they don't want to lose their ties to you. Reassure them that you like being around them but you will need to be together in a non smoking time, like a movie or walking and chatting together. Some smoking friends I know decided to take a walk around the hallways at work instead of going out for a smoke. They all benefitted from one persons decision to quit. A reason that some give for not speaking to their friends and family about quitting say something like I have tried to quit so many times that it is a joke. Remember that it often takes 7-12 times of quitting before everything that you need to learn about how to be successful is achieved. That is why it helps to do the exercises that I have encouraged this week because you learn things that will help you be successful! Be confident, this is your time to quit, you know why you want to quit and how to quit, you will be able to quit. Tell them of your plans and ask for their support and help. Ask a friend or your partner that you know is an especially supportive and caring person to be your main support and turn to them when experiencing a difficult time. Have them on Speed Dial, or have them expecting your text when you need them.

Your partner, husband, boyfriend, or room mate is an important person to have by your side in quitting. His he a smoker too, if he is have you talked to him about quitting with you? It is very important to have him encouraging you and it really helps if he is quitting too. If he isn't quitting with you, can he commit to never smoking near you. Have the important conversation and tell him how important it is to your baby, children and you. Give him the scientific information about what second hand smoke does to your baby and also include how hard it is on you when you see him smoke and how hard it is for you not to also smoke. Make sure that if he is not going to quit that he won't smoke in the car or near you.

You have friends and family members who love you and your child. They will want to help you, so ask.

Wednesday, December 30, 2009

Diary of a Smoker Who is Going to Quit

This week is a time to ask yourself some questions like: Why do I smoke, When do I smoke, and what situations make me want a cigarette. Basically if you understand what contributes to your smoking then quitting becomes a doable project. The answers to these questions are different for everyone but a lot of the preparations you do this week will pay off in January 2010, when you quit. I have a homework assignment for you today.

The first is a Diary of When you smoke, how you feel or your emotions at the time of your cigarette and how important is the cigarette. Some people put a 3X5 note card in their pocket and every time they smoke they record the time, a word like stressed, or frustrated or happy and a plus or minus sign to show the importance of the cigarette. Others have wanted to explore their addiction more deeply and will want to carry a spiral notebook around and write about what was happening right before each cigarette and how you felt at that time and why. They also want to explain if it was done just to pass the time or if they really craved it and felt they needed to smoke badly. Which ever method you choose the diary will tell you a lot about what motivates each cigarette and will help you develop alternative strategies for not smoking in a similar situation after you have quit. When you have completed the diary for a day or two then the real work of using the information you have learned about yourself and about your smoking routines will help you develop strategies to get you through the difficult times of quitting.

There are often a few cigarettes that are very important to you; one often is the first cigarette upon waking. Those times are identified by the Smoking Diary and then an alternative can be planned. Often changing a morning routine is necessary to drop that morning cigarette. Drinking tea instead of coffee, and if you always sit at the kitchen table you might want to consider sitting at the breakfast bar instead. After you have a day or two of writing in your smoking diary and you have identified when the cigarettes that have the most ritual and routine associated with them or seem the most important to your day you can work up a different ritual and routine to supplant the old. You will want to find an enjoyable or workable alternative. Exercise works for a lot of people and can get those endorphens working for you; it might mean you take a walk around the block, or head to the gym but take the time to enjoy being able to breath deeply and experience the beauty of the time and place you are in. Enjoy a friends company or take the time for some solitary moments before the demands of the day are upon you. A strategy might be the 4-4-4-4 Breathing exercise that is described in an earlier blog.

A Diary is beneficial in another way. If you can identify the feelings that trigger a cigarette then when you experience that feeling you will already have a strategy in place to deal with that emotion. It is often stress that seems to demand a cigarette. Remember that cigarettes and smoking is in itself a contributor to stress in your life; whether because of the cost or because smoking is often not socially acceptable it is stressful to smoke. There are healthier and better ways of dealing with stress than smoking. There are breathing exercises that help, relaxation exercises, and even aromatherapy can help. Sometimes it isn't the cigarettes that are helping with a stressful situation but the act of a moment of solitude that is beneficial. Mothering is stressful and a bathroom break, a bath, just a moment outside in the back yard taking some deep breaths gives you a moment away from the children. Some moms feel guilty taking a moment but we all need these little times away; the important thing is that you are close by and the children are safe.

Other situations that might be recorded in your diary are when you smoke as part of social situations. This might be your daily cigarette break at work, or when a friend drops by for a visit. Do co-workers and friends gather outside for a cigarette at ten. Does quitting mean you don't get a break from work? It is hard to miss time with friends, but I know you can find other alternatives; hey, maybe they want to quit with you? Don't miss your break, instead find another place to meet and chat, or, take a few minutes to walk around the block together, or have a cup of coffee together. Talk to your friends and ask them to support your efforts to quit, I bet they understand your reasons and have some ideas about how they can support your effort.

There are places that trigger a desire for cigarettes too. You might find, after studying your diary, that you always smoke in the car, or on the front porch. It might be you always smoke when you are on the phone. The brain's nicotine receptors each carry a memory of where the cigarette was smoked when that receptor became a part of the brain. If you are in that same place the brain will send a signal that this is where you smoke and will remind you to smoke. When you can't avoid places that remind you to smoke then have an oral alternative and other strategies planned. In the car you might want to have some thing like a straw in your mouth helps or a cinnamon tooth pick.

Enjoy writing in the Smoking Diary and consider turning it into a Quitting Diary. In this way it can continue to give you insight into what works and what is helpful as you deal with the cravings and stress of Quitting. Good Luck and if you need help with strategies and alternatives to smoking routines and rituals then email me at alicemcovey@gmail.com.

Tuesday, December 29, 2009

Questions and Other Things to Think About Before Quitting

Answering the questions I pose to you will help you understand your smoking better, the things and situations that will help you quit, and how much you want to quit.

1. Why do I want to quit, list the reasons to quit?

2. When you tried to quit in the past, what heled and what didn't?

3. What will be the most difficult situations for you after you quit? How will you plan to handle them?

4. Who can help you through the tough times? Your family? Friends? Health care provider?

5. What pleasures do you get from smoking? What ways can you still get pleasure if you quit?




From 1 to 10, 1 being not important and 10 being very important what number would you put how important it is to me to quit smoking?

This is how confident I am in my ability to quit smoking. 1-10?

This is how ready I am to quit smoking 1-10?

Medications to help quit

Bupropion SR 150 - Prescription Only: Zyban, Wellbutrin SR, Generic SR
CAUTIONS: Not for use if you
*Currently use a monoamine oxidase (MAO) inhibitor
*Use bupropion in any other form (Zyban/Wellbutrin)
*Have a history of seizures
*Have a history of eating disorders
SIDE EFFECTS:
* Insomnia
*Dry mouth
DOSAGE:
*Days 1-3:150 mg each morning
*Days 4-end: 150 mg twice daily
USE:
* Start 1-2 weeks before your quit date; use 2 to 6 months

Nicotine Gum (2 mg or 4 mg) -Over the Counter only as Nicorette and Generic
CAUTIONS:
* Don't drink acidic beverages during use!
* Caution with dentures
SIDE EFFECTS:
* Mouth Soreness
* Stomach ache
DOSAGE:
* 1 piece every 1 to 2 hours, as cravings dictate.
* 2 mg: if smoking 24 cigarettes or less per day
* 4 mg: if smoking 25 or more cigarettes a day or use chewing tobacco
USE:
* Use up to 12 weeks or as needed

Nicotine Inhaler, Kind of a misnomer as it is not inhaled but is absorbed through the lining of the mouth. - Available through prescription only
CAUTIONS:
* May irritate mouth/throat at first but improves with use.
* DON'T drink acidic beverages during use. coffee, cola drinks or caffiene drinks
SIDE EFFECTS:
* Local irritation of the mouth and throat
DOSAGE:
* 6-16 Cartridges/day
* Inhale 80 times per cartridge , may save partially-used cartridge for next day
USE: Up to 6 months, taper at the end

Nicotine Lozenge, 2mg or 4 mg -OTC only as Commit, or Generic (Nicabate)
CAUTIONS:
* Do not eat or drink 15 minutes before or during use
* One lozenge at a time , no more than 20 in a 24 hr period.
SIDE EFFECTS:
* Hiccups
* Cough
* Heartburn
DOSAGE:
* 2 mg: if smoking after first 30 minutes you're awake
* 4 mg if smoking within first 30 minutes you're awake
* Weeks 1-6: every 1-2 hours
* Weeks 7-9: 1 every 2-4 hours
* Weeks 10-12: 1 every 4-8 hours
USE: up to 12 weeks

Nicotine Nasal Spray, -Prescription Only as Nicotrol NS
CAUTIONS:
* Not for patients with asthma
* May irritate nose (Improves over time)
* May cause dependence
SIDE EFFECTS:
* Nasal irritations
DOSAGE:
* 1 dose = 1 squirt per nostril
* 8 - 40 doses per day
* Do NOT Inhale
* 3-6 months, taper at the end

Nicotine Patch, Over the counter as Nicoderm CQ, Nicotrol or through Badger Care and some other insurance coverage, Prescription: Generic Legend.
CAUTIONS:
* Do not use if you have severe eczema or psoriasis
SIDE EFFECTS:
* Local skin reaction
* Insomnia and or weird dreams
DOSAGE:
* One patch per day , if have bad dreams take off at night
* If more than 10 cigs/day: 21 mg for 4 wks, then 14 mg for 2 wks, then 7 mg for 2 wks.
* If less than 10 cigs/day: 14 mg for 4 wks, then 7 mg for 4 wks
USE:
* 6-8 weeks
Varenicline - Prescription Only, 1st pick a quit date!
CAUTIONS:
* Not encouraged if you suffer from depression
* Use with caution and consider dose reduction in patients: with significant renal impairment, or undergoing dialiysis
SIDE EFFECTS:
* Nausea
* Insomnia
* Abnormal dreams
* Headache
DOSAGE:
*Days 1-3: 0.5 mg every morning
* Days 4-7: 0.5 mg twice daily
* QUIT CIGS, Days 8-end 1 mg twice daily
USE:
* Start 1 week before QUIT date; use 3-6 months.

Read the information, think about what fits your situation and speak to your health care advisor, then decide on a medication to use. Many people find that using more than one medication is helpful, for example the patch and during a bad craving also using the Nicotine Nasal Spray, or the Nicotine Inhaler. Research shows that medication can increase your likelyhood of success with Quitting.

Monday, December 28, 2009

Planning to Quit in the New Year

Many people are taking the opportunity that a new year brings of changing something in their lives, they are even now considering New Year Resolutions. Are you contemplating what you resolve to change in the new year to improve your life, and your families' life. Are you thinking of quitting smoking as your new year resolution? If so now is the time to plan, people that make a plan to quit are more successful than people that just decide to quit without thinking about what will help them be successful. There isn't a better time to quit than 2010!

The first thing to think about is medications. If you aren't pregnant or nursing there are medications that are FDA approved that can be very helpful. Now is the time to call or make an appointment to see your health provider and visit with them about which medications will work best for you.

Questions to Think About
These are some questions to ponder as you prepare to quit in the new year.
1. Why do you want to quit?
2. When you tried to quit in the past, what helped and what didn't?
3. What will be the most difficult situations for you after you quit? How will you plan to handle them?
4. Who can help you through the tough times? Your family? Friends? Health care provider?
5. What pleasures do you get from smoking? What ways can you still get pleasure if you quit?

Every day until New Years I will blog about things that will help you be successful. Return to the blog each day and be ready to think through some of the reasons you smoke and how to be successful when you quit. I am looking forward to each day.

Monday, December 21, 2009

Celebrate

It is the season to celebrate, it is the season to celebrate quitting. This holiday season, from Thanksgiving to New Years, is a time when we think of what we are Thankful for, how important family is and think about what we want new and different in our life. If you quit smoking in 2009, then it is time to be proud of the strength and fortitude you found within yourself to quit. To be grateful for the help others offered, and to be grateful that you have quit! Take a few minutes and think about what it took to quit and savor the feeling of success. It was a hard won effort but you did it. Remember all of the things you didn't like about smoking and how good it feels to be smoke free. Remember that you worked through the cravings and that you are a stronger women because of the effort you gave to quitting. Congratulations, you are strong and committed and you have accomplished a difficult yet worthwhile achievement!
If you haven't quit this is a great time to quit. It is an opportunity to think about your family and what a great gift quitting would be to and for them. It is also a gift of health and life to yourself. Your family's health is really important to you and quitting will improve their health and protect them from the many toxins from exposure to tobacco,and tobacco smoke. You have been contemplating quitting and now is the time to really make the commitment to quit and give the gift of being smoke free to yourself and your family. The new decade is just around the corner, make the next ten years and more smoke free! A new year and a new decade is such a great time for a new beginning of health. It is a wonderful beginning for you and your family.

Monday, December 14, 2009

Celebrations

During this season there are many things that are celbrated, Hanakah, Christ's birth at Christmas, and the New Year. These events bring with them times with gather as families, friends and office parties and with food and drink celebrate together. For pregnant and nursing mothers this means celebrating without both the usual alcohol and cigarettes which is often a very difficult. It is a difficult decision but an important one. Alcohol and cigarettes are both very harmful and babies should not be exposed to either of these substances. I have often written about the harm done when babies are exposed to tobacco but let me also speak to the harm caused by exposure to alcohol. Babies bodies are not as able to process alcohol or tobacco and the toxins associated with it. Their bodies are much smaller but their blood will have the same amount of alcohol molecules in it as you, yet your body is larger and better developed to handle it. Please don't ever drink while you are pregnant. It is not good for your baby.

Tuesday, December 8, 2009

Holiday Stress Busters

Well the holiday season is going full strength. There are some wonderful reasons to love this time of year, with children being at the top of my reasons to enjoy Christmas time. It is such a busy time of year, with lots of stress built into that we sometimes get overwhelmed by it all. Beware of the stress sometimes bringing a person back to tobacco as a stress reliever. Remember that it is a temporary solution that will bring long term stress of quitting again. If because of the many things to do, the stress will sometimes take you to a cigarette. Know that relapse is not unusual, the difference can be in your reaction to the relapse. The important thing is to not continue to turn to a cigarette during times of stress but to remember breathing, exercise or any of the many things that you have used to handle cravings and stress. Let this be an opportunity to go back to better ways to handle stress than a cigarette, to return to the other ways to handle cravings. I would like to remind you that it is ok to take a short break from children. By this I mean when you used to give yourself a cigarette break when the children would bicker, whine or be difficult in any way I would encourage you to take a break with a book, or to do some breathing exercises, whatever would work the best for you and your situation. I would suggest that you take this break in a different place than you use to take your cigarette breaks. Your brain associates places with where you use to smoke and if you take breaks in those smoking places people often find that they will have stronger cravings in those spots or times. Choose a new place of momma breaks and try some deep breaths maybe using 4-4-4-4 breaths. If you have forgotten what that is look at the archives and review them. Take a deep breath and chill.