Wednesday, April 15, 2009

In Which DuWayne Discusses Quitting Smoking

I would like to state before you read further, that I discuss e-cigarettes in this post, as a potential aid to quitting smoking. I want to be very clear that there is little to no evidence supporting the safety or efficacy of e-cigs as a smoking cessation tool. While it is reasonable to assume that these are safer than smoking (they are basically nicotine vaporizers), it should not be assumed that they are safe. I look at it as a harm reduction technique for quitting smoking, not as a safe alternative to regular cigarettes.

I have tried several times over the years, yet the best I've managed is a couple months. And even then, I broke down five or six times and had a smoke. I just don't have the luxury of putting it off any longer - the price has gone way beyond my ability to afford it, my body needs me to quit and my children need me to quit.

Before the first (when the federal tax went into affect) I stocked up on about a months supply of tobacco and decided that when that was gone, I am quitting. One of the reasons I discussed the medications I am currently taking, was that the Clonidine and Welbutrin, aside from being found effective for both bipolar and ADHD, are also useful for quitting smoking. Welbutrin is good for smoking specifically, while Clonidine is good for treating the symptoms of withdrawal from heroin, (possibly) alcohol and tobacco. But with all of that, I am still rather nervous about quitting.

My smoking addiction is far more than just nicotine craving, more even than habit. There are some fairly deep seated issues involved with my smoking that have made it extremely difficult for me to even consider quitting. And honestly, I really love smoking - in much the same way that some people love fine beers, great whiskey or excellent coffees (all of which I am fond of). Combined, this just makes it very hard for me to quit - yet quit I must.

So I am arming myself with tools that I am hopeful will make it easier for me to quit and quit successfully. Now I already mentioned the meds, which are not really for quitting smoking, but the smoking cessation properties of which I definitely considered when I discussed them with my doctor. I am also discussing smoking and why I smoke with my therapist. Finally, I just ordered something that I am very hopeful will get me the rest of the way. Already vetted by a couple of people at school and a few folks I am in email contact with, I bought at E-cigarette.

The E-cigarette, is basically a nicotine vaporizer that is shaped like and hits like a regular cigarette. It even tastes a lot like a cigarette, though according to the four people I have discussed it with, it definitely isn't exactly the same. And it does come in several flavors, though I am not the least interested in trying any but the tobacco flavor - at least for now.

I bought one of the cheapest models, found here. This same model is available with only five cartridges, for about eight dollars less or can be bought with even more cartridges - the cartridges of course becoming cheaper the more you buy. I also bought a bottle of the liquid that goes into the cartridges, to see how well that would work out and to get some variety within the tobacco flavors. I am really looking forward to trying this out, as all four of the people I know who've gotten one are really pleased with it and have been very rapidly weening off of actual cigarettes. One of them switched entirely from actual cigarettes, as soon as he got it and while he occasionally wants a real one, seems to be managing well enough.

I am also looking forward to utilizing this product as a step-down method for quitting nicotine as well. The cartridges and liquid comes in different strengths, including nicotine free. As well, they advertise an herbal formula that purports to help reduce the nicotine craving.

I will definitely be writing about slowing down and quitting smoking, as I make progress. I will also be writing about the E-cigarette specifically, as I am hoping that it will be as effective for me, as it seems to be for the folks I know who already have one. Regardless of how it works for me, by many accounts (there are forums) this seems to be a very effective tool for a great many people.

I would note however, that there is little to no evidence as to the safety or efficacy of E-Cigs. On the other hand, they vaporize a mixture of nicotine, glycerin and flavoring, rather than burning actual tobacco, which alone is rife with chemicals and to which more chemicals are often added.

I will also email some of the medi-bloggers I know and see if I can get them to weigh in on the e-cigs.


scicurious said...

I really want to hear about e-cigs! I've heard a lot about them in terms of harm reduction and smoking cessation, I'd love to hear a first hand account.

DuWayne Brayton said...

I will definitely be writing about it and how it works out for me. I should have it by Saturday or Monday...

JLK said...

I am so with you, dude. I'm supposed to be quitting smoking while my husband is gone because he has been forced to quit while there.

But so far, all I have achieved is smoking MORE. My problem is mostly habit and the love of it. So I am definitely interested to see if these e-cigs work for you.

Anonymous said...

A friend of mine who didn't smoke bought some nicotine gum and managed to get himself addicted to nicotine. Now he's a smoker.

Abby Normal said...

Hi DuWayne. I don’t know why I never stopped by your blog before. But I’m glad I did. I always enjoy your comments on various ScienceBlogs and it’s fun and interesting to see you originating topics.

On the topic of smoking, I quit two years ago last February. As is so often the case I was like you. I really enjoyed smoking. I wasn’t just feeding an addiction. It was a pleasure. It was a social tool that could either get me closer to some people or keep people away, depending on their preferences and how I chose use it. It was a stress reliever. More than that, it was one of the things that I did to help keep my out-of-whack brain running on a more even keel. So I thought I’d share my experience in hopes that some part may resonate and help. It feels a bit audacious, me telling you anything about addiction. But you know, not enough for me to actually stop typing. ;-)

So, here’s what worked for me. I should note that I used nicotine lozenges, which provided me with both the drug I craved and an oral component. So it’s somewhat similar to the e-cig, but I think different enough that I won’t try to draw further parallel. Rather I’ll speak to the prep work and mental tricks I used.

First and foremost I picked a quit date, after which I would never smoke another cigarette. To give myself adequate time to prepare I picked a date ten weeks out. Now, there were two ways I could look at that date, as something to dread or as something great. I chose to only think positively about it. It was the date of my emancipation, a celebration of me and the start of a better life. That’s not to say there were never times the dread would creep up. Particularly while puffing away, a stray thought like, “how could I give this up,” would come to mind. But I refused to entertain such thoughts. Instead I would acknowledge my fear, accept it and then congratulate myself on my courage for facing it. From there it’s just a mental hop, skip and jump to once again being excited about quitting.

Next I looked at my smoking patterns. I noticed there were actually two patterns. One type happened at regular times, like 10 AM or 3 PM. I came to think of those as scheduled smoke times and they occurred independently of what I was doing or how recently I had smoked. The second pattern was event driven, like a smoking after a meal or when feeling stressed. I then set about changing my patterns but without significantly altering the amount nicotine I was taking in per day. My goal was to break my smoking habits before tackling withdrawal.

The scheduled times were fairly simple. I started by pushing the schedule back one hour. So instead of 10 AM, I’d wait until 11. Once I got used to not smoking at my scheduled times I came up with a system to semi-randomly set my daily schedule to help keep me from simply falling into a new routine. I should mention that I often failed to meet my goals, particularly at first. When that happened there was a temptation to beat myself up about it, like if I made myself feel bad about failing I’d be less likely to fail again next time. But I think that would have been a mistake. It would have been like telling myself I wasn’t strong enough to resist, that the addiction had power over me. Obviously that’s the exact opposite of the message I needed. So instead I would remind myself, “I chose this cigarette. Next time I can make a different choice,” then relax and enjoy my smoke. Surprisingly quickly the little failures tapered off and before long I’d gained control of that aspect of my habit.

The event driven smoking was more difficult for me. In fact, now two years latter, when I get a craving it’s most often triggered this way. The best I could come up with, at least in the beginning, was to eliminate the smoking event whenever possible. Instead of having a cigarette with my coffee first thing in the morning, I started my day with tea. (I’d get coffee at the office instead. One addiction at a time, ya know? *grin*) I stopped going to pool halls or bars, places I tended to smoke continuously. For triggers I couldn’t eliminate, like meals, or wouldn’t, like orgasms, I’d try to find something to distract myself (Occasionally leading to another orgasm. Nice fringe benefit there.) Mostly I just did my best to power on through and, in case you haven’t picked up on the theme, stay positive. Over time the habitual smoking mostly fell away.

Now in better control of when I smoked I started to cut back on how much I smoked. The idea was not try and kick my addiction by the quit date. I knew I’d start using the lozenges at that point. But I set a goal of reducing myself to 2/3 of my usual quantity. I would make the transition that much easier. But primarily it gave me more practice handling cravings. I would do whatever I could to distract myself. I played fast paced, head-to-head video games, which required little higher thought and a lot of adrenaline fueled action. The main thing was to avoid is repetitive self-denial. Dwelling was the enemy. If I could avoid dwelling by any means other than smoking, I would. If not, I’d smoke.

I wanted to keep it light and avoid the whole “smoking is the enemy” mentality. I knew that if I made it me against the smoking then I’d create a situation where I perceived smoking as something outside myself and that this would give it power and I would be a victim. Instead I looked at quitting as if I were training. Like learning to put aside my ego and welcome criticism, it was counter to my natural impulse, but a skill I could learn, even master to point where it happens without thinking. It was training myself to choose not to smoke without having to think about it. But the choice, the power, was always mine.

That’s what worked for me. Ten minutes before the midnight that would mark the start of my quit date I sat on the sofa with my very last cigarette. There was a feeling of ceremony about it. I was about to light it when suddenly I realized I didn’t want to smoke just for the sake of saying good-bye. So I snapped it in half said good-riddance instead. Let me tell you, it feels good to be free.

Good luck and I look forward to reading about your progress and whatever else you decide to write about!

DuWayne Brayton said...

Hey Abby, I'm really excited that you stopped over. And please, talking to me about addiction isn't audacious in the least - I actually really appreciate your comment and am really tempted to post it on the front page, or possibly throw together a sub-blog for folks to post about their experience quitting or attempting to quit.

I think that one of the most important things to avoid when quitting smoking (or dealing with any addiction really) is to avoid thinking of it as the enemy. By doing so all you're doing is empowering the addiction.

I am going about it rather differently, in that I'm not setting a specific date. I have a finite amount of tobacco left and won't be buying more. I will continue to smoke until I either run out or decide that it just isn't necessary anymore. This seems to be pretty common on the e-cig forums and a lot of folks end up switching off tobacco before they ran out, or before the date they had set.

And having had the opportunity to try one (a couple of flavors - I chose the one's I ordered wisely), some of my still smoking friends may well inherit some of the last couple pouches I have left - which would be a bonus for the one who would, because I decided to finish with some of the very best rolling tobacco in the world.

Abby Normal said...

"[I] am really tempted to post it on the front page, or possibly throw together a sub-blog for folks to post about their experience quitting or attempting to quit."Either one sounds cool to me. Glad you liked it.

DuWayne Brayton said...

I will definitely do one or the other - I am going to see what kind of response I can get from others who might be interested in posting...

DuWayne Brayton said...

Hey Abby, posted it here, to the shiny new Quitters Blog....

Anonymous said...

I got hooked on smoking while in the Army, from C-ration cigarettes. The tobacco companies knew what they were doing when they gave away free cigarettes to soldiers, with their meals. When I got out, I was paying $1.86 per carton, and the sticker shock hit me, because I then had to pay ~$.80 per pack. I started using 'smokeless tobacco', or snuff, just to cut back. I soon didn't even want a cigarette, and used snuff full-time. My wife was not completely enamored of this, for some reason. After a few years of this, I decided to try to quit. I found that it was largely a psychological problem, and that having something in my mouth helped. I used a product called mint snuff, which was actually just common mint, packaged and prepared much like the Skoal I had been using. I started alternating snuff and mint, and eventually weaned myself to just the mint. As long as I had something between my cheek and gum, I was OK. After realizing I had been using just mint for more than two weeks, I decided I could quit, and did. I had cravings for several years, though. Quitting the tobacco was the hardest thing I ever did, and one of the best things I ever did.

mack said...

Considering the long term benefits of smoking cessation such as low risk of succumbing to cancer, a significant reduction in mental stress, odorless breath et al, it is definitely necessary for you to start your quit smoking regimen as soon as possible. However, during the first few weeks, it may appear extremely difficult to get rid of this addiction, but as you consistently try to quit smoking for a certain period of time, your smoking cessation efforts would yield results.