Beware of the Crazies

The American Cancer Society, whose answer to the question ‘Why is it so hard to quit tobacco?’ I critiqued earlier this year, also asks another question on their website: ‘How do I get through the rough spots after I stop smoking?’ So you can expect to have rough spots. Thanks for the encouragement. Now for the advice on how to deal with them. (Paraphrased and condensed.)

  • Spend as much free time as you can in public places where smoking is not allowed
  • Drink water, but don’t drink alcohol, coffee, or any other drinks you link with smoking
  • Instead of a cigarette, hold a pencil, paper clip, coin, or marble
  • For the feeling of something in your mouth, try toothpicks, cinnamon sticks, or munch on celery
  • Take deep breaths to relax
  • Think about how awesome it is that you’re quitting smoking
  • Brush your teeth and enjoy that fresh taste
  • Exercise in short bursts
  • Eat 4 to 6 small meals during the day instead of 1 or 2 large ones
  • Reward yourself for doing your best and plan to do something fun

That should keep you busy for a while. But there’s more. They have some helpful advice about what to do ‘When you get the “crazies” [sic]’. Unfortunately, they don’t say what the crazies are, but by delving into the bulleted points that follow, it seems the crazies consist of ‘frustration, anxiety, irritability, and even depression’. Oh dear. And worse, we are told that these feelings ‘are normal after quitting tobacco’. The bulleted points on how to deal with all this include the advice to take ten deep breaths one after the other, go for a walk, take a shower or bath, learn to relax quickly and deeply, and wear a rubber band around your wrist to snap whenever you think about smoking.

It seems to me these patronising, impractical, and discouraging suggestions have been thought up by someone who has never actually treated smokers for their nicotine addiction.

Incidentally, note how they suggest you think about how awesome it is that you’re quitting smoking, not that you have quit. This means you’re in the process of quitting, which means you’re still smoking, so you haven’t quit yet, if you ever will. The idea of quitting smoking is meaningless: you either smoke or you don’t.

Furthermore, these bullet points show an unfortunate lack of understanding of why people smoke in the first place, and why they find it so difficult to stop: they sound like an attempt to change one’s thoughts and perceptions about smoking through brainwashing.

Picture our hypothetical smoker (I’ll assume a male) who’s trying to follow this advice:

He spends much of his day in churches, libraries, malls, and museums to avoid being tempted to smoke by the sight of other smokers; he avoids alcohol and coffee because these are linked in his mind to smoking, so he drinks only water; he takes plenty of deep breaths to feel relaxed and goes around reminding himself that it’s awesome not to smoke even though he’s apparently still doing it; he brushes his teeth several times a day to enjoy that fresh taste; and while he’s wandering around in libraries and malls, every so often drops to the floor to do twenty press-ups in order to exercise in short bursts; and he eats four to six small meals a day. And finally, when he’s struggled through all this, he may well be in need of doing something fun for a change.

But now let’s come back to the most serious misperception of the American Cancer Society about smoking: that anger, frustration, anxiety, irritability, and even depression are normal after quitting tobacco. If this were true, smokers would be afraid to face each new day until they had topped up their nicotine levels by smoking one or more cigarettes—in order to avoid the onslaught of anger, frustration, anxiety, irritability, and even depression!

This means—if you believe the American Cancer Society (why can’t they call it the American Society for the Prevention of Cancer?)—that smokers are in a terrible state. They must be afraid to stop smoking because, if they weren’t aware of it before, they now know that when they cease inhaling poisonous tobacco fumes, it is normal they will suffer anger, frustration, anxiety, irritability, and even depression.

Where does this idea come from? It seems to be copied from one textbook or journal article to another—but is it true? In my experience of having asked hundreds of smokers what they actually feel when they haven’t smoked for a while, such an idea is grossly exaggerated or plain wrong: smokers hardly ever say these things.

What they do say, if they can think of anything to say at all, is that they may become aware of mild irritation and anxiety, or mild anxiety and irritation. It is rare for smokers to mention frustration, anger, and depression. Of course, smokers, like anyone else, may experience these feelings but the mistake often made by those in the Smoking Cessation Industry, and which, understandably, may be taken up by smokers themselves, is that any unpleasant symptoms experienced after stopping smoking are due to the absence of smoking. A serious symptom like depression would have a different cause and needs to be assessed on its merits.

Text © Gabriel Symonds

 

Gabriel Symonds

Dr Gabriel Symonds is a British doctor living in Japan who is interested in helping smokers quit. He has developed a unique simple method without nicotine, drugs, hypnosis or gimmicks that he has used successfully with hundreds of smokers. Further information can be found at www.nicotinemonkey.com

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