Taking the first steps towards smoking cessation

In order to begin the steps required to tackle an addiction, the individual has usually reached a stage of readiness or motivation to actively engage  in the change process.
 
Five stages of change are proposed by Prochaska, DiClemente and Norcross (1992), these are as follows (as applied to smoking):

  1. Pre-contemplation stage – the individual is not currently in a phase were they are considering their smoking behaviours as a problem;
  2. Contemplation stage – the individual is willing to at least explore their smoking behaviours as something they may like to change at some point;
  3. Preparation stage – the individual now wants to initiate change, but may not know how to go about it;
  4. Action stage – the individual has begun taking action aimed at smoking cessation;
  5. Maintenance stage – now change has occurred the individual continues to maintain it using various strategies that work for them.

Managing addiction of any sort is a difficult process and it can be common for there to be occasional lapses whilst in any of the stages of change.

However, a lapse or  temporary slip-up is not the same as relapsing (going back to smoking) as long as the individual decides they are ready to re-enter the change process at the relevant stage for them.  Those who relapse may also re-enter the contemplation stage etc again at a later time.  

Just because someone starts smoking again does not mean there is no hope of change at a later point in time.

The physiological challenges of giving up smoking are well known such as the withdrawal symptoms that may be experienced via the process of reducing a substance your body has become used to receiving.  Prescribed nicotine reduction aids such as patches may help manage this initial withdrawal phase. 

However there are also psychological components to be aware of too during these stages of change.  The following are just three pointers that may help during this time:

a) Conditioning factors - there may be certain times of the day, locations, activities or individuals that over the years you associate with smoking.
 
Knowing this can help you make plans to manage these situations by trying predict potential problem scenarios for you and to consider alternative courses of action rather than being taken by surprise.
 
For example you may wish to change your bed time routine so that you are doing something else when you would normally smoke, or when friends go outside for a smoke – you stay inside and focus on something else until they return.

b) Problem thinking – how we interpret lapses may define whether it becomes a full relapse or whether we continue  with the change process.  Because of the strong link between thinking and mood, it follows that if we excessively criticise ourselves when we slip up “Its me, I’m weak” then we will generate excessive negative emotion.  This in turn increases the risk of falling back on default coping strategies such as smoking.

Instead practice adopting a more compassionate approach to yourself.  For instance, what kind words would you offer a friend in this situation and take this on board yourself.

c) Stress prevention – take a step-back and review what demands and potential stressors you have on your plate and consider what you can do to reduce these. 
Review what you are doing in terms of activities that are good for your wellbeing such as hobbies, interests, exercise and social contact.  If there is an obvious imbalance between stressors and ‘replenishing’ activities then there may be a risk of increased perceived stress, which may increase the likelihood of going back to previous coping strategies such as smoking.

There is no doubt that giving up smoking is a challenge, however, there are services out there to assist.  Even if you are at the contemplation stage, contact your local smoking cessation service to find out more about how they can help you.

Jamie Patterson
Cognitive-Behavioural Psychotherapist
Abermed Limited 

 

 

 

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