Useful and Positive Strategies

From the moment you quit smoking, you’ll begin a new stage. In this chapter, we present a series of strategies that will help you on that path.

One of the most useful strategies is to avoid high-risk situations. For that reason, we suggest some risk factors that may predispose you to smoke, so you can decide whether you want to avoid them:

Risk factors

• Times of day when you used to smoke: after meals, when leaving work, during breaks, etc.
• Associated places: bars, outdoor terraces, etc.
• Types of food associated with smoking: heavy meals, alcohol, coffee, etc.
• People who smoke.
• Weight gain can be a concern for people who quit smoking, and a risk for relapse. It’s worth trying to maintain your weight to prevent weight gain from leading to use.
• Difficult experiences: family problems, boredom, stress, crises, a breakup, losing your job, etc.
• Celebrations during the year—such as Christmas, New Year’s Eve, birthdays, or vacations—can also be times when you think about smoking. Alcohol use predisposes you to losing control. We suggest you prepare your response or your way of handling the situation in advance, and that in these high-risk moments you leave as little room as possible for spontaneity. Preparing will make you stronger.
• The illusion of control, which consists of false confidence after a few days or weeks of abstinence. Remember that the drug controls the person, not the other way around.

As for positive strategies, we also suggest a list:

Useful strategies to fight the urge to smoke

• Exercise: helps maintain an ideal weight, reduce cholesterol and blood pressure, distracts you from cravings, generates well-being and relaxation after you do it, and increases internal coherence (between what you want and what you do), satisfaction, self-control, and self-mastery.
• Mindful, balanced breathing. Try inhaling through your nose and exhaling through your mouth. Use the QuitNow feature that guides your breathing.
• Talk to someone, avoiding making tobacco the topic of conversation.
• Distraction: go for a walk, play music at a high volume to occupy the foreground of your attention, reading, etc.
• Wet your hands, mouth, or your whole body with cold water (or warm water if you feel anxious).

You’ll find more strategies in the following bites in this module and in modules 2 and 3!

Be careful with strategies that are useful, but not positive! For example, eating a lot of sugar, switching to another drug, or engaging in risky behaviors (speeding, practicing extreme sports, etc.) may help you think less about smoking, but these activities can create other problems.

There is no magic formula. There are different tips and strategies that can be helpful, but there are no miracle remedies. You have to keep assessing which ones work for you.

In that sense, we ask you: What is your ideal of quitting smoking? How do you think you should quit? It’s possible that you’ve built, more or less consciously, the idea that there is a certain or correct way to quit smoking. For example: without help, or without making changes to your routine, or without giving up contexts where there is smoke.

All processes are valid, whether more resources are needed or not. Asking for help is not a sign of weakness, and there is nothing wrong with finding a way to make abstinence as easy and comfortable as possible.

Accepting help is an indicator of strength because it means exposing yourself and accepting your own difficulties. Having external resources makes you stronger. There will continue to be good moments and not-so-good moments in your life. Having new tools will make you better prepared for adversity.

We also briefly explain what types of medications exist for the treatment of nicotine addiction:

Medication

• Nicotine replacement, in the form of patches, gum, or lozenges: no prescription is needed. They are less effective than other medications. In fact, it should be considered that they consist of taking nicotine through routes other than smoke. This avoids the harmful effects on the respiratory tract, and psychologically the process of breaking the habit of the act of smoking continues, but dependence on the drug may still be fed. If you don’t feel very strong urges to smoke, it’s better to avoid it.

  Taking nicotine in the form of gum or a patch will actually reinforce your sense of deprivation when you stop using them. The addiction is perpetuated through another route.

  It should be added that it is much better for you to use gum, patches, or lozenges than to smoke. It has been shown that these resources, although they contain nicotine, are less addictive and less harmful than cigarettes, and can help you quit.

  In no case are vapes or electronic cigarettes recommended, because either they contain nicotine, or if they do not, they can cause respiratory diseases due to the combustion and the smoke that is inhaled.

  Nicotine pouches, also called white snus, should never be an option to quit smoking. Even if they may seem like it, they are not a medication. They are marketed by large tobacco companies because, unlike snus, they often fall outside the law, since they don’t contain tobacco. It has not been proven that they help people quit smoking. On the contrary: they contain nicotine salts, which contribute to addiction (in the case of some pouches, higher nicotine levels than in conventional cigarettes have been measured) and toxins such as nitrosamines, benzene, arsenic, lead, and mercury.

• Partial agonists of nicotinic receptors. These are medications that stimulate the receptors that usually receive nicotine from tobacco, but they do so more weakly than tobacco. They reduce the urge to smoke and ease withdrawal symptoms:

  • Varenicline: a prescription is required. The active ingredient of the medication has this name, although the brand name of the drug may be different.
  • Cytisine or cytisinicline: a prescription is required. The active ingredient of the medication has this name, although the brand name of the drug may be different. It was already used in Eastern Europe in the 1960s. Now it is being used more and more and is replacing varenicline, since it has similar effectiveness but fewer side effects. It is a molecule similar to nicotine that comes from the plant called broom. During World War II, soldiers would chew it and realized it calmed their urge to smoke.

• The nicotinic receptor antagonist called bupropion: a prescription is required. This drug blocks nicotine receptors by binding to them, but without generating any biological effect of its own. It is also used as an antidepressant and is therefore contraindicated with other psychotropic medications.

Any medication can have different effects depending on the person, and all medications can have side effects.

Medications cannot replace personal motivation and the decision to change. A medication taken without truly wanting to quit smoking will probably fail. In fact, in many public health systems, the requirement for prescribing these medications is that the person wants to quit smoking, and if not, it should not be prescribed.

It is an add-on, and it can help you feel fewer cravings to smoke, but it cannot create the motivation you need. At this point we remind you of the first section in which we explained that, in order to move forward, it is necessary to see yourself as an active part of the change and not as a mere passive patient who takes medications.

Since it is an add-on, we say that treatments must be comprehensive. This means that they must address all spheres of the phenomenon: psychological, biological, and social.

Personal resources

Close your eyes and imagine yourself in the long term: a year or five years from now. What do you see? What’s new in your life? What things have you removed from your life and what things have you kept? Why?

Now, with your eyes closed, imagine that your future version comes to visit you—your self from a year from now. This version of you comes to tell you what resources worked well in their process and what others did not. What would they tell you?

To finish, imagine that you can travel through time and visit yourself on your deathbed. This future version of you is about to say goodbye to life. Ask them: What are they especially proud of? What has been important in their life? What things went well to remove from their life, and what other things have enriched it? How did they do it? What advice would they give you?

Remember that quitting smoking is more than a one-day decision; it is a process. It can be difficult, but never impossible. Unfortunately, there is no magic formula or foolproof recipe to quit, although we know it requires a certain firmness, flexibility, sometimes effort, openness, and lots of creativity!