The benefits of stopping smoking are well documented and even the most ardent smoker will be aware of the risks of getting lung cancer if he or she fails to quit. Why then does he keep it up?
Once you start, smoking is a difficult habit to break. Cigarettes are addictive and there are hurdles to be crossed if you want to stop.
Coping with the physical and psychological effects of nicotine withdrawal on your body after quitting is one.
Another, the smoking cue, is less tangible but no less important. It is part of the addiction package.
Smoking cues are prompts to smoke. They are everywhere, at parties, by the bar, on TV, inside your head, in a scent or lurking in the office waiting to explode. They are a type of conditioned response to prolonged smoking, and smoking behaviour.
They can provoke an intense craving for cigarettes which is not easy to resist. Time after time they dump the quitter back at the hard end of addiction, even when he feels in control. They act with nicotine, and long after it has left the ex-smoker's system.
You should be aware of triggers that prompt you to smoke. They don't go away when you quit.
Below are examples of social and not so social smoking cues:
Smoking and drinking at the same time is a habit many smokers enjoy and miss in the weeks and months after stopping. For the anxious quitter a pub without cigarettes is like one without beer. When he first stops smoking he finds it hard to relax with a drink, fidgeting and fumbling without a cigarette to appease him. Getting drunk doesn't help his chances of success.
The urge to smoke while drinking can be intense because of the strong social, physical and psychological link between tobacco and alcohol. This passes with time, sometimes quickly, and you acquire the taste for drinking again. Beat the alcohol cue and you have made major progress in your quit attempt.
These are dangerous smoking triggers, especially at parties and in lively smoking company. The mere sight of someone lighting up, or the sniff of smoke, can blow a determined quitter's effort apart. Cigarettes play tricks with his mind, prodding and probing for 'weak moments'.
Smokers can underestimate the power of the simple cue which is a lighted cigarette, and overestimate their own willpower. It's a common mistake.
Paraphernalia like ashtrays, tobacco pouches and unopened boxes of cigarettes are also potent triggers to smoke.
3: Family and Friends
Being surrounded by friends, relatives or a partner who smokes is a real challenge to the addict, especially when smoke is wafting into his face and his desire to smoke is intense.
This situation is one you have to deal with in your own way. But if the temptation to smoke is unbearable consider moving until you are confident you can withstand the pressure.
Staying in an active smoking environment decreases your chances of quitting successfully. Hanging out with non smoking friends who avoid drugs, another smoking cue, improves them considerably.
Work can be testing and awkward customers, fuming bosses, a good sale or late night deals are all familiar cues to remind you of situations where you'd like to smoke again, and which commonly catch the unwary smoker off guard.
Joining colleagues for cigarette breaks is a no-no after quitting. They may be friends but they are also smoking cues, at their most dangerous in the early weeks after you stop.
5: Individual cues
There are as many smoking cues, triggers or traps as there are smokers. The urge can hit if you
- are bored
- drive the car
- watch TV
- argue with your partner
- play poker
- see 007 light up
- finish a meal
- have coffee or tea
- visit the newsagent
- wake up
- have sex
- see an ad for cigarettes
- chat on the phone with a friend
What they all have in common is an association with the individual smoker's behaviour. It is this, rather than nicotine withdrawal, which can be the trigger to smoke. It could also be both.
Some cues are inexplicable and unique to the smoker. Others, like a lighted cigarette, are universal.
Before you stop you need to take smoking triggers into account and avoid the more dangerous ones after quitting. Consider listing the times, places and situations where you enjoyed or felt the need to smoke in the past. Plan a diversion like taking up exercise. Above all, don't be fooled by innocuous but lethal smoking cues. Too may smokers are.
Dr Brogan is a stop smoking specialist and an ex smoker