Freedome Fron Nicotine

www.WhyQuit.
com
Freedom from Nicotine The Journey Home

by John R. Polito
john@whyquit.com
Copyright John R. Polito 2009, 2012
Medic l !d"ice #i$cl imer - This book is designed to support, not replace, the relationship that exists between a reader and his/her physician. Do not rely upon any in ormation in this book to replace indi!idual consultations with your doctor or other health care pro!ider.
%&'oo( # te) 12*31*0+ Re"i$ion # te) 0,*01*12
#edic tion
This book is dedicated to all still capti!e to nicotine"s in luence. #ay mastery o the $%aw o &ddiction$ make reedom a keeper.
!c(nowledgment$
This book would not exist i not or the insights o 'oel (pit)er, the support o *atricia *. &rnold, and the encouragement + inspiration o ,arriet #c-ryde 'ohnson, who le t us on 'une ., /001.
Freedom from Nicotine - The Journey Home
Table of Contents
Introduction 2..................................................................................................................................7 Ch pter 1) .icotine !ddiction 101 .................................13 That First Subtle "Aaah" ................................................................................................................13 Chemical Slavery's Onset................................................................................................................1 Tolerance.........................................................................................................................................!" #icotine ...........................................................................................................................................!$ As Addictive as %eroin&...................................................................................................................!' Addiction #ot #e(s to Tobacco Industry........................................................................................3! Freedom Starts (ith Admittin) Addiction........................................................................................3' Ch pter 2) /he 0 w o1 !ddiction .............................................*" The +a( ,e-ined..............................................................................................................................*" The +a( .e-lected in Studies...........................................................................................................*! /issed +essons ...............................................................................................................................*3 0ust one rule 1 "#o #icotine Today2"...............................................................................................*$ Ch pter 3) Quitting 23ou2 ................................................... *7 3uittin) vs. .ecovery.......................................................................................................................*7 4uried Alive by #icotine "Aaah"s....................................................................................................*' An In-ected +i-e................................................................................................................................*5 For)otten .ela6ation.......................................................................................................................$" For)otten Calm ,urin) Crisis.........................................................................................................$1 For)otten 4reathin) 7 8ndurance..................................................................................................$! For)otten Sensitivities.....................................................................................................................$* For)otten Senses..............................................................................................................................$$ For)otten /ealtime.........................................................................................................................$ 86tra 9or:(ee:s..............................................................................................................................$7 For)otten ;riorities< Forsa:en +i-e ................................................................................................$' Ch pter -) 4$e R tion li5 tion$ .............................................. " Inventin) =se .ationali>ations........................................................................................................ " Chemical to Friend.......................................................................................................................... ! "I li:e it" 1 "I love it"...................................................................................................................... $ "It relieves stress and an6iety"......................................................................................................... ' I'm ?ust a little bit addicted"............................................................................................................7" "I do it -or -lavor and taste".............................................................................................................71 "/y co--ee (on't taste the same".....................................................................................................7! "It hel@s me concentrate" ..............................................................................................................7! "I do it to relieve boredom".............................................................................................................73 "I do it -or @leasure"........................................................................................................................7* "It's my choice and I choose to use"................................................................................................7$
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"It's ?ust a nasty little habit"............................................................................................................7 "I'll lose my -riends"........................................................................................................................77 "I'm still healthy".............................................................................................................................7' "I can't sto@"....................................................................................................................................75 Chemical to ,emon.........................................................................................................................'! 0ust One< 0ust Once.........................................................................................................................'3 Ch pter 6) P c(ing 1or the Journey 7ome .................................... '* 9hen to Start %ome 1 #o( or +ater&..............................................................................................'* ;ac: -or .ecovery............................................................................................................................'7 ,ocument Aour Core /otivations....................................................................................................'7 ;ac: ,urable /otivations...............................................................................................................'5 ;ac: ;atienceB One %our< Challen)e and ,ay at a Time..............................................................53 ;ac: a ;ositive Attitude...................................................................................................................5 The Calue o- ,ocumentin) Aour 0ourney........................................................................................55 .e-uelin)........................................................................................................................................1"" ,estroy All .emainin) #icotine ...................................................................................................1"5 Ch pter 8) Common 7 5 rd$ 9 Pit1 ll$ .......................................11! 8arly Alcohol =se..........................................................................................................................11! Avoidin) 4lood Su)ar S(in) Sym@toms........................................................................................11$ Aour 4lood Ca--eine +evel 9ill ,ouble.........................................................................................11' 9ei)ht Dain...................................................................................................................................1!" Crutches ........................................................................................................................................1!7 Cessation ;roducts........................................................................................................................131 #e)ative Su@@ort...........................................................................................................................1*! 4reathin) Second1%and Smo:e.....................................................................................................1*$ 86tremely Civid ,reams o- Smo:in)E=sin)...................................................................................1*7 4ad ,ays........................................................................................................................................1*7 /enstrual Cycle Considerations...................................................................................................1*' ;re)nancy......................................................................................................................................1$" Ch pter ,) /he Ro dm p 7ome ............................................. 1 " .ecovery Timetable........................................................................................................................1 1 8ndin) #icotine =se .....................................................................................................................1 3 "9hat should I call mysel-&" .......................................................................................................1 ;hysical .ead?ustment...................................................................................................................1 ' 8motional .ead?ustment................................................................................................................1 5 Subconscious .ead?ustment...........................................................................................................1 5 Conscious .ead?ustment................................................................................................................17" Arrivin) %ome...............................................................................................................................171 Ch pter +) /he :ir$t ,2 7our$ ............................................... 173 Summary o- 4asic .ecovery Ti@s...................................................................................................17* .ecovery Sensations 1 Dood< #ot bad.........................................................................................17
Ch pter 9) Phy$ic l Reco"ery ............................................17' #euronal .e1sensiti>ation ..........................................................................................................175 Sym@toms.......................................................................................................................................1'" ;ossible /edication Ad?ustments..................................................................................................!"! ;ossible =nderlyin) %idden Conditions.......................................................................................!"! Celebratin) T(o 9ee:s o- %ealin)2..............................................................................................!"$ Ch pter 10) %motion l Reco"ery ........................................ !"7 ,enial ..........................................................................................................................................!11 An)er..............................................................................................................................................!1! 4ar)ainin).....................................................................................................................................!1* ,e@ression.....................................................................................................................................!1$ Acce@tance.....................................................................................................................................!17 Ch pter 11) ;u'con$ciou$ Reco"ery .................................... !1' The =nconscious /ind..................................................................................................................!1' Common =se Cues ........................................................................................................................!!7 Are crave e@isodes really less than 3 minutes&.............................................................................!31 %o( o-ten do crave e@isodes occur&.............................................................................................!33 Cue 86tin)uishment.......................................................................................................................!3* The 4i))er the 4etter.....................................................................................................................!*1 .e(ard ..........................................................................................................................................!*3 Crave Co@in) TechniFues..............................................................................................................!*3 Seasonal< %oliday and In-reFuent Cues ......................................................................................!*' Ch pter 12) Con$ciou$ Reco"ery ..........................................!$" The Final Truth..............................................................................................................................!$" ,i)nity's ,enial.............................................................................................................................!$* Tearin) ,o(n the 9all..................................................................................................................!$ /ore +ies.......................................................................................................................................!$5 Conscious Fi6ation........................................................................................................................! $ "0ust once< ?ust once2"...................................................................................................................! ' The 0oy o- Smo:in)&......................................................................................................................! ' Ch pter 13) 7omecoming .................................................. !7! A Silent Celebration ......................................................................................................................!7! +on)1Term 3uiet and Calm ..........................................................................................................!7! Dradually ,iminishin) Thou)hts and =r)es.................................................................................!73 Ch pter 1-) Compl cency 9 Rel p$e ....................................../13 Carin) -or Our .ecovery...............................................................................................................!'1 .ela@se...........................................................................................................................................!'7 %arm .eduction.............................................................................................................................!5! Appendix: Sample Recovery Journal/Diary......................................!55
www.WhyQuit.com :reedom 1rom .icotine & /he Journey 7ome
<ntroduction
4ou may be like me. 5"m not a big book reader. -ut i wanting to end nicotine use, this book is worthy o your time. 5 allowed, it can help turn ear to excitement, dread to delight, anxiety to calm, bondage to reedom and destruction to healing. &s hard as this may be to belie!e, ending nicotine use need not be horrible or e!en bad. 5n act, it"s my hope that someday soon you"ll look back upon this temporary journey o readjustment as your greatest personal awakening e!er. 4ou see, nicotine addiction is about li!ing a lie. %i e here on 6asy (treet is calm, rich and wonder ul, not stress ul, boring or horrible. 7ith knowledge as your ally, you"re about to disco!er that you"!e journeyed ar rom that peace ul pre-addiction mind that you once called home. ,ow many times ha!e we heard the phrase $knowledge is power$8 -ut when it comes to breaking nicotine"s grip upon us, until now you"!e probably resisted de!oting the time needed to educate your intelligence. 5nstead, most o us turned to worthless products, pills or procedures9 to quick ix magic cures promising ast, easy or e ortless success. 4ou"re about to become smarter than your addiction is strong. :o longer its capti!e, somewhere along the way it will hit you, that knowledge and insight truly is a reco!ery method. ;nderstanding and the con idence lowing it can destroy needless ears that ignorance once estered into anxiety or e!en panic. Think about it. 5t"s nearly impossible to appreciate the beauty gradually un olding be ore us i consumed and gripped by anxiety and ear. &nd during prior attempts <i any= our ears were many9 ear o ailure, ear that li e as an exsmoker would be horrible, that we were lea!ing something !aluable behind, that we"d be unable to cope with stress, that the next challenge would be too big to handle, or e!en ear o success, that we really had smoked our last cigarette e!er.
The anguish o attempting to break ree in ignorance and darkness can easily o!erwhelm reedom"s dreams. -y diminishing or destroying needless ears, the long-term reedom that seemed beyond our grasp is brought within reach. This book"s objecti!e is to remo!e the mystery and as much anxiety as possible, so as to a ord you the ability to notice and sa!or the ull la!or o coming home. >nowledge is about to put you in the dri!er"s seat o your mind. ?elax and enjoy the ride@ 5 wish 5 could claim credit or most o what you are about to read. 5 can"t. The insights that ollow weren"t disco!ered during my own thirty-years o chemical capti!ity. :or do they low rom my own ailed history, roughly a do)en serious attempts. This book is not the result o the in!ention o some new method or product, or o ideas or concepts born inside this mind. 5nstead, nearly all o the lessons shared were mined rom the disco!eries and accomplishments o others. 5t"s the reason or more than .00 ootnotes. Take your own poll o all the ex-smokers who ha!e been ree rom all nicotine and all stop smoking products or at least one year. ,ow did they do it8 4ou"ll likely disco!er a giant elephant in the room, that someone has been lying to you. Those selling stop smoking products want you to ear your natural instincts. They will ne!er tell you that, depending on where you li!e, cold turkey continues to be the reco!ery method responsible or generating A0-B0C3 o long-term success ul ex-smokers. These ex-smokers owe their success to ending use o all nicotine, not to de!ices that replace it, designer drugs that imitate it, !accines that partially block its entry into the brain, or to magic herbs, !itamins, hypnosis, needles, lasers that imitate needles, to motion sickness shots that make you too sick to smoke or to -illy -ob"s %ima -ean -utter. There are hundreds o millions o worldwide cold turkey success stories. 6ducation and understanding hold promise to swell their numbers e!en greater. -ut it takes strong obser!ational skills to both notice the elephant in the room and then accurately separate truth rom iction. Drankly, this book would not exist without the insights and teachings o 'oel (pit)er o Ehicago.
3 Doran E# et al, (moking status o &ustralian general practice patients and their attempts to quit, &ddicti!e -eha!iors, #ay /00F, Golume H3<I=, *ages AI1-AFFJ Diore #E et al, #ethods used to quit smoking in the ;nited (tates9 do cessation programs help8 'ournal o the &merican #edical &ssociation, #ay 3BB0, Golume /FH</0=, *ages /AF0-/AFI.
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(ince /000, 5"!e studied and shared 'oel"s clinical obser!ations. They are insights he began har!esting as early as 3BA/, irst as a !olunteer smoking pre!ention speaker or the &merican Eancer (ociety, and then as a smoking cessation counselor and paid sta member in 3BAA. 5 challenge you to locate any other person who has de!oted their entire work-li e, nearly .0 years, ull-time, to helping smokers break ree. #ore than HI0 six-session stop smoking clinics, FB0 single-session seminars, and an additional do)en years working online with smokers, 'oel truly is the ,enry &aron or -abe ?uth o smoking cessation. Kn 'anuary /0, /000, out o the blue, a man 5"d ne!er met e-mailed me o ering to share the more than 10 stop smoking articles he"d written. 'oel"s articles quickly became the centerpiece at both 7hyLuit.com <7hyLuit=, a moti!ational website 5 started in 'uly 3BBB, and at Dreedom, / what was then an anything-goes, ree online peer-support reco!ery orum that 'oel could clearly see was loundering horribly. 'oel had written his collection o articles as ollow-up rein orcement and relapse pre!ention letters, which were sent to graduates o his two-week clinics. During his program he"d taught them to take reco!ery just one challenge and day at a time. :ow, or the irst time, he used the closing o each article to remind them how to stay ree, by simply sticking with their original commitment to $:e!er Take &nother *u @$ &s 5 read through the 10 articles 5 was hammered by ringing truths on a wide range o cessation issues. 'oel raised scores o concerns that 5"d ne!er once considered. ,ow could 5 ha!e o!erlooked all this8 5 was le t stunned and humbled by how little 5 actually knew about smoking or stopping.
/ Dreedom rom Tobacco - Luit (moking :ow was ounded on (eptember 1, 3BBB as a ree peer support orum at #(: Mroups. Kn Debruary /3, /00B #(: shut down all #(: Mroups. 5n anticipation o the closing we mo!ed Dreedom to 4uku"s ree orums where we o icially opened $Dreedom rom :icotine$ at www. n.yuku.com on 'anuary 31, /00B.
A youn) 0oel S@it>er holdin) (ra@@ed slices -rom the lun)s o- a smo:er and non1smo:er.
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7ho was 5 to think that 5 was somehow quali ied to create and co-manage an online stop smoking support group8 This guy was the real deal@ :icotine"s relationship to eating, stress, alcohol, !itamin E, anger, its in luence upon heart rate, depression, and sleep, how did 5 miss all this8 7here had 5 been8 7hy hadn"t 5 seen smoking nicotine as true chemical dependency, how replacement nicotine undermines resol!e, or grasped the importance o cra!e trigger extinguishment or cessation crutch a!oidance8 -e ore 'oel arri!ed, Dreedom"s coounder, 'oanne Diehl, and 5 had 0oel on Fo6 #e(s on /ay 1!< !""* challen)in) @harma grown horribly rustrated. industry assertions that nicotine )um is not addictive. #embers were relapsing to smoking le t and right. Dailure was e!erywhere. 5t was as i our support group was somehow ostering de eat. 6ach new announcement o a member"s ailure and return to smoking brought lots o !irtual member hugs, and encouragement or them to once again jump into the pool. 5t was as i the group"s a ection and attention was an in!itation or others to relapse too, so that they could return and enjoy their own relapse party. #ore than once 'oanne had wanted to pull the plug and shut Dreedom down. -ut now, here was a guy whose entire li e had prepared him to deli!er on the orum"s name, Dreedom rom Tobacco. 7ithout hesitation, we begged 'oel to take charge o what was then little more than an anything-goes moti!ational pep-rally. &lthough he declined, he did agree to join us and assist as a co-manager and become our director o education. 5 ondly named his collection o rein orcement letters $'oel"s %ibrary$ and placed them centerstage at both 7hyLuit and Dreedom. #ore than a decade later, that"s where they remain, reely a!ailable to all. The collection has grown to more than 300 articles and now includes more than 300 ree !ideo counseling lessons. 'oel"s li e"s work continues to be the heart and soul o our online
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work.H Today, the o ten-repeated title o 'oel"s ree e-book, $:e!er Take &nother *u ,$ has become relapse pre!ention insurance or countless thousands. & recent email rom ?oy, who is six weeks into reco!ery, said it well. $The ":e!er Take &nother *u " sentence is one o the most power ul sentences 5 ha!e e!er heard in my li e. 5t can mo!e mountains. 5t was my only shining light in a mass o darkness and guided me back to a normal nicotineree li e. 5t is e ecti!e because it is so simple and innocent. 5t has the power o innocence.$
5"!e searched long and hard or any work comparable to 'oel"s. 6xcept or indi!idual lessons here and there by particular counselors and authors, and &llen Earr"s excellent assault upon smoking rationali)ations, 5"!e been unable to locate any collection o work that comes close. 7hat 5 did ind were indi!idual studies by scores o dedicated researchers, studies that aid us in better understanding the ama)ing e ects upon humans o this chemical called nicotine. 5 took my last pu o nicotine on #ay 3I, 3BBB at 30900 pm. (ince then, 5"!e been on a quest or answers and at e!ery opportunity possible ha!e shared what 5"!e learned at 7hyLuit.com. &ccording to ;.(. Moogle rankings, since /003 7hyLuit has been the N3 $nicotine cessation$ resource. 7hyLuit has a!eraged 3.I million unique !isitors per year rom /00B to /03/. 5t"s my hope that this book helps expand the reach o our work beyond the 5nternet. (o here it is in a nutshell. &s health care uturist 'oe Dlower puts it, you"re about to ind yoursel $in the mush,$ the same mush 5 encountered when 'oel arri!ed. &ccording to Dlower, there are our phases to change induced learning9 <3= unconscious incompetence Onot :no(in) that I :ne( almost nothin) about my addiction P, </= conscious incompetence O0oel ma:in) me a(are o- ho( little I :ne(P, <H= conscious competence Omasterin) 0oel's teachin)sP, and <.= unconscious competence Ohavin) those lessons become as second nature as (al:in)P. &s Dlower suggests, once competence is achie!ed it becomes di icult to recall how we could e!er ha!e been anything else..
H . (pit)er, ', 'oel"s %ibrary, www.7hyLuit.com/joel Dlower ', 5n the mush, *hysician 6xecuti!e, 'an-Deb 3BBB, Golume /I<3=, *ages F.-FF.
0oel @resentin) one o- his more than 1"" -ree video counselin) lessons.
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5 this book aids you in achie!ing conscious competence, please don"t allow it to collect dust on some shel or become lost in your computer. Eonsider sharing it with a riend or lo!ed one still trapped in acti!e dependency. -eing depri!ed o the insights needed to end our sel -destruction is a horrible reason to die. 5 just starting out, congratulations on your decision to reclaim your mind and li e@ 4ou are about to li!e the time-tested adage that $knowledge is power@ 4es you can@ -reathe deep, hug hard, li!e long,
'ohn ?. *olito :icotine Eessation 6ducator
www.WhyQuit.com Ch pter 1
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.icotine !ddiction 101

/h t :ir$t ;u'tle 2! h2
?emember how your body reacted to that
irst-e!er inhaled pu , dip or chew o tobacco8 &lthough some took to smoking like ants to sugar, what most recall is how utterly horrible it tasted. 4ou may ha!e elt di))y, nauseous or i like me, your ace cycled through six shades o green. #y mouth was illed with a terrible taste, my throat on ire, and my lungs in ull rebellion as scores o power ul toxins assaulted, in lamed and numbed all tissues touched. *rior to that moment, you may ha!e heard that tobacco can be addicti!e. -ut a ter such an unpleasant introduction you were con!inced that it couldn"t possibly happen to you. ,ow could it8 5 like most, you didn"t like what just happened. ,ow could you possibly get hooked8 &s strange as this may sound, like or dislike ha!e little to do with chemical dependency. -eneath our body"s rebellion to that toxic chemical onslaught, nicotine had acti!ated our brain dopamine pathways, the mind"s sur!i!al instincts teacher and moti!ator. The primary purpose o that brain circuitry is to make acti!ating e!ents extremely di icult to orget or ignore. ,ow do brain dopamine pathways teach and moti!ate action8 >nowing will aid in understanding both how we became hooked and why breaking ree appears !astly more daunting than it is. ?emember how you elt as a child when irst praised by your parents or teachers or keeping your coloring between the lines or or spelling your name correctly8 ?emember the $aaah$
1-
satis action sensation8 ?emember that same eeling a ter making and bonding with a new riend8 $&aah@$ 7e had just sampled the mind"s moti!ational reward or accomplishment and peer bonding. &n earned burst o dopamine was ollowed by an $aaah$ wanting satis action sensation. 5t caught our attention, alerted us to what was important, and created a memory o the e!ent that would help establish uture priorities. -ursts o dopamine were also elt when we anticipated accomplishment, peer bonding or other species sur!i!al acti!ities. 7e were now being moti!ated and working to satis y dopamine pathway wanting, the $aaah$ relie sensation elt when anticipating or experiencing desire"s satis action. Kur sense o wanting being satis ied is generated by the release o dopamine within multiple brain regions, primarily in our mid brain, inside cell structures known as the !entral tegmental area <GT&= and the nucleus accumbens.I Two di erent yet o!erlapping dopamine pathways are responsible or wanting and its satis action. Kur $tonic,$ background or baseline dopamine le!el determines our le!el o wanting, i any. Kur $phasic$ le!el or bursts o dopamine generate the $aaah$ sensations sensed prior to wanting"s satis action. Menerally, as our tonic or background dopamine le!el begins to decline we experience wanting. &s phasic burst releases occur, our tonic le!el is gradually replenished by burst o!er low into our tonic pathway, and wanting subsides.F The word $tonic$ means to restore normal tone. -rain dopamine pathways were not engineered to act as wanting satis action brain candy. (atis action is earned. -oth a carrot <phasic= and a stick <tonic=, they are a preprogrammed and hard-wired sur!i!al tool that teaches and rein orces our basic sur!i!al instincts. Dopamine pathways are present and strikingly similar in the brains o all animals. They originate in the deep inner primiti!e, compulsi!e region o the brain known as the limbic mind,
I ?owell **, Golk >&, :icotinic acti!ation o mesolimbic neurons assessed by rubidium e lux in rat accumbens and !entral tegmentum, :eurosignals, /00. #ay-'uneJ Golume 3H<H=, *ages 33.-3/3. F Mrieder T6 et al, *hasic D3 and Tonic D/ dopamine receptor signaling double dissociate the moti!ational e ects o acute nicotine and chronic nicotine withdrawal, *roceedings o the :ational &cademy o (cience ; ( &. /03/ Deb /3J30B<1=J pages H303-H30F. 6pub /03/ 'an /0.
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and extend orward into the conscious, rational, thinking portion o the brain. *retend or a moment that you"re extremely thirsty. ?eally thirsty@ Ean you sense $wanting$ beginning to build8 :ow, imagine drinking a nice, cool glass o re reshing water. Did you notice the $wanting$ subside, at least a little8 Eompliance with wanting generates a noticeable $aaah$ relie sensation. The greater our wanting, the more intense our $aaah.$ Kur dopamine pathways are the source o sur!i!al instinct anticipation, moti!ation and rein orcement. ,ard-wired instincts include eating ood, drinking liquids, accomplishment, companionship, group acceptance, reproduction and child rearing.A Kur brain dopamine pathways cause our compliance with wanting to be recorded in high de inition memory, in our orehead just abo!e our eyes, <our pre- rontal cortex=. 5t"s what researchers call $salient$ or $pay attention$ memories.1 &lthough still poorly understood, the intensity o dopamine pathway wanting appears to stem rom a combination o at least three actors. Those actors include a diminishing tonic dopamine le!el, the collecti!e tease and in luence o old wanting satis action memories, and sel -induced anxieties i satis action is delayed. The tease o thousands o old wanting satis action memories can be triggered by a physical bodily need, by subconscious habit conditioning, or by conscious concentration, ixation and desire. Knce their collecti!e in luence is triggered, as though bombarded by a thousand points o light, we ha!e no choice but to recall exactly what needs to be done in order to satis y wanting. 5 you elt any wanting or relie with our pretend water drinking example, it was due to old thirst and replenishment memories, not a biological need. 4es, our $pay attention$ pathways are a built-in, circular, sel -rein orcing sur!i!al training school. 7anting is triggered by our tonic dopamine le!el declining in response to a need, conditioning or desire. Kld wanting satis action memories uel wanting while constantly reminding us o exactly what needs to be done to make it end. &nticipating satis action may generate additional
A (te ano M-, et al, :icotine, alcohol and cocaine coupling to reward processes !ia endogenous morphine signaling9 the dopamine-morphine hypothesis, #edical (cience #onitor, 'une /00A, Golume 3H<F=, *ages ?&B3-30/. 1 >athleen #cMowan, &ddiction9 *ay &ttention, *sychology Today #aga)ine, :o!/Dec /00., an article re!iewing the drug addiction research o :ora Golkow, Director o the :ational 5nstitute o Drug &buseJ also see 'ay T#, Dopamine9 a potential substrate or synaptic plasticity and memory mechanisms, *rogress in :eurobiology, &pril /00H, Golume FB<F=, *ages HAI-HB0.
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anxieties which urther in lame wanting. Kbedience releases a sudden phasic burst o dopamine. 7anting ends once our need, conditioning or desire is satis ied and our tonic dopamine le!el returns to normal. The release also creates a !i!id new high de inition memory o how wanting was satis ied. (o, how does all o this relate to nicotine addiction8 Chemic l ;l "ery=$ >n$et 7hat would happen i , by chance, an external chemical so closely resembled the properties o the neuro-chemical responsible or acti!ating brain dopamine pathways <acetylcholine= that once inside the brain it was capable o generating a stolen and unearned dopamine $aaah$ wanting relie sensation8 ;n ortunately, entirely by chance, nicotine is such a chemical. :icotine"s polarities and chemical structure are so similar to acetylcholine, the brain"s natural chemical messenger responsible or initiating normal dopamine pathway stimulation, that it bonds to acetylcholine receptors. 5n those o us whose genetics or de!elopment made us susceptible to nicotine addiction, our dopamine pathways began to document and record nicotine use as though a pre-programmed species sur!i!al e!ent. Elearly, no inner $wanting$ or desire existed when we irst used nicotine. -ut i susceptible to dependency, it probably didn"t take using too many times be ore repeated acti!ation caused physical changes within our dopamine pathways. Those changes would combine with constantly alling blood serum nicotine le!els to cause our tonic dopamine le!el to decline. This would trigger subtle background wanting, wanting that would moti!ate us to use again and again and again.
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6ach new supply o nicotine would be ollowed by a phasic dopamine release. The lower our tonic dopamine le!el, the more noticeable our $aaah$ wanting relie sensation, the more !i!id our newest use rein orcement memory. (oon, an increasing number o high de inition nicotine use memories would themsel!es begin suggesting that we use early and o ten, so as to a!oid sensing the onset o wanting. &s though bars to a prison cell, our thinking, planning and day became surrounded by hundreds and then thousands o durable use memories, each orcing us to !i!idly recall how wanting gets satis ied. & had de!eloped a physical need that we couldn"t then possibly understand. 7e ound oursel!es in!enting reasons to explain and justi y our continued use. Those reasons and alse use rationali)ations would act as additional bars in our prison cell. Eollecti!ely, our wanting satis action memories quickly became more durable and !i!id than any negati!e memory o any toxic unpleasantness elt during our irst ew uses o tobacco. 5t wasn"t long be ore a growing number o high de inition use memories buried all remaining memory o what li e was like without nicotine. Try recalling the calm, quiet and relaxed mind you enjoyed be ore getting hooked. Try hard to remember going entire days and weeks without once wanting to use nicotine. 4ou can"t do it, can you@ Don"t eel alone. :one o us can. 5t"s a drug addiction hallmark. *risoners o hijacked pay-attention circuitry, wanting"s satis action became our N3 priority. B 7e quickly orgot that it was e!er possible to unction without nicotine. Kur priorities teacher had been taken hostage. 5 we resisted and delayed using, we were disciplined with anxieties or ailure to apply the lessons taught. The brain"s control room or coordinating and routing dopamine pathway unctions appears to be the right insula. 5t"s an o!al, prune-si)ed brain structure abo!e and between our ear and eye. The insula recei!es a wide range o input rom our senses, emotions, dopamine pathways and rom the pre rontal cortex,
B #cMowan, >, &ddiction9 *ay &ttention, *sychology Today #aga)ine, :o!/Dec /00., &rticle 5D9 HIA3J also see, ?osack, ', Golkow #ay ,a!e ;nco!ered &nswer to &ddiction ?iddle, *sychiatric :ews 'une ., /00., Golume HB :umber 33, *age H/.
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home to pre!iously recorded $pay attention$ memories. & /00A study ound that smokers who sustained brain damage to the right insula actually lost the urge to smoke,30 suggesting that it also routes or coordinates use urges, cra!es and anxieties. Thank goodness it doesn"t take traumatic brain injury or a stroke to make us stop cra!ing nicotine. Thank goodness that reco!ery isn"t nearly as di icult as our brain wanting disorder suggests. 7hether heroin, cocaine, methamphetamines, alcoholism or nicotine, drug addiction is about the brain"s dopamine pathways being taken hostage by an external chemical. 7e nicotine smokers didn"t suck tissue destroying tars that included ammonia, ormaldehyde, arsenic, butane, hydrogen cyanide, lead, mercury, !inyl chloride, methane or !ast quantities o carbon monoxide into our bodies because we wanted to watch each pu destroy a bit more o our capacity to recei!e and circulate li e-gi!ing oxygen. 7e did so to replenish constantly alling nicotine reser!es. :icotine is a small molecule. This allows it to cross through our protecti!e blood-brain ilter. Knce through, it docks with acetylcholine receptors and stimulates dopamine low. (moked nicotine contains at least one other as yet unidenti ied chemical that somehow diminishes dopamine cleanup en)ymes #&K & and #&K -. Diminished #&K means delay in normal dopamine clean-up ollowing a phasic release. 5t means that smoked nicotine"s wanting relie sensation is allowed to linger longer than normal. Think about how short-li!ed the $aaah$ sensation is ollowing a single potato chip or a sip o water when thirsty. %onger wanting relie is thought to make smoked nicotine possibly the most per ectly designed orm o addiction. 5t may also help explain why oral tobacco users generally ha!e higher blood nicotine concentrations than smokers. (mokeless tobacco does not inhibit #&K or normal dopamine clean-up. 5t may be that users o all non-smoked orms o nicotine require higher le!els o nicotine in order to keep their wanting at bay. 7hether smoked or oral, an endless cycle o wanting and its brie absence ollowing use le t us totally yet alsely con!inced that nicotine was essential to sur!i!al. Kur nicotine eeding cycle le t many o us belie!ing that use de ined who we were, that nicotine ga!e us our edge, helped us cope, and that li e without it would be horrible or e!en
30 :aq!i, :,, et al, Damage to 5nsula Disrupts &ddiction to Eigarette (moking, (cience, 'anuary /00A, Gol. H3I <I133=, *ages IH3-IH..
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meaningless. *unished with wanting that was satis ied by use, we quickly grew to belie!e that we could not unction com ortably without it. 7hy can"t we star!e oursel!es to death8 :ot only is wanting or ood satis ied with dopamine $aaah$ relie sensations when we anticipate eating or actually do so, we are punished with anxieties and cra!ings when we wait too long between meals. &s or nicotine le!els, like ood, what goes up must come down. &s our body slowly metaboli)ed and rid itsel o nicotine, we gradually experienced increasing mood deterioration and escalating distress, punctuated by anxiety, anger and depression. 5n act, it"s work li!ing li e as a nicotine addict. 7e endured greater extremes in daily mood swings than non-users, greater problematic anger, 33 and the greater our dependency the more unstable our moods.3/ Kur hijacked priorities teacher was ooled and started teaching a alse lesson, that bringing a new supply o nicotine into the bloodstream was e!ery bit as important as eating. 6xtensi!e dopamine circuitry o!erlap,3H nicotine cra!ings became as real as ood cra!ings. :icotine $aaah$ wanting relie sensations became as important as ood $aaah$s. :early indistinguishable, we experienced the same anxiety beatings, and similar dopamine wanting relie sensations upon surrender. -ut there is one massi!e di erence between dependency upon ood and dependency upon nicotine. 7ithout ood we star!e, without nicotine we thri!e@ ;n ortunately, our hostage dopamine circuitry is incapable o distinguishing act rom iction. -y design, it has buried and suppressed the beauty o ne!er wanting or needing that existed prior to nicotine"s arri!al. 7ould coming home to your calm and quiet yet orgotten mind be a good thing or bad8 5 good, what sense does it make to ear it8 The problem is that attempts to end nicotine use are o ten met with a rising tide o anxieties.
33 Eougle '?, Delineating a ?elationship -etween *roblematic &nger and Eigarette (moking9 & *opulation--ased (tudy, :icotine and Tobacco ?esearch, #ay 3H, /03/ 3/ *arrott &E, Eigarette-deri!ed nicotine is not a medicine, The 7orld 'ournal o -iological *sychiatry, &pril /00H, Golume .</=, *ages .B-II. 3H -lum >, et al, ?eward circuitry dopaminergic acti!ation regulates ood and drug cra!ing beha!ior, Eurrent *harmaceutical Design, /033J Golume 3A<3/=, *ages 33I1-33FAJ also >elley &6, et al, :eural systems recruited by drug- and ood-related cues9 studies o gene acti!ation in corticolimbic regions, *hysiology + -eha!ior. /00I (eptember, Golume 3IJ1F<3-/=933-3..
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(oon, our thousands o old nicotine use $aaah$ relie memories begin looking like li e jackets. 7hile we only needed to remain nicotineree and stay a loat or a maximum o three days in order to na!igate the roughest seas and mo!e beyond peak withdrawal, hungry or calm, most o us took the hook and bit on our $aaah$ memory bait. 7e obeyed the alse lessons generated by our chemically hijacked teacher. 5n doing so, we abandoned the only path home in exchange or a ew minutes o relie . 7hen trying to stop using, it isn"t unusual to ind our mind"s addiction chatter insanely trying to con!ince us that things will be ine i we just ha!e a little more nicotine now, that we can stop using while using more. 5 hate to think about how many times 5 told mysel during a prior attempt that using just once more was my reward or ha!ing brie ly succeeded in going without. Kb!iously, this quick ix isn"t a solution at all. 5t shows a total lack o understanding as to the purpose and unction o brain dopamine pathways, to make circuitry acti!ating acti!ities nearly impossible, in the short term, to orget or ignore. -ut bondage is more than a rising tide o anxieties being ostered by a diminishing tonic dopamine le!el, in response to constantly declining blood-serum nicotine reser!es. &nd it"s more than thousands o old use memories screaming the wrong way out.
/oler nce
&s i nicotine taking our dopamine pathways capti!e wasn"t enough, imagine the brain physically needing and requiring more nicotine o!er time. De initions o tolerance include9 3. Decreased responsi!eness to a stimulus, especially o!er a period o continued exposure /. Diminution in the response to a drug a ter prolonged use, or H. *hysiological resistance to a poison.3. The brain attempts to ight back against its toxic intruder. &s i somehow knowing that too much unearned dopamine is lowing, it attempts to diminish nicotine"s in luence by more widely disbursing it. 5t does so by growing or acti!ating millions o extra nicotinic-type acetylcholine receptors in as
3. tolerance. <n.d.=. The &merican ,eritage (tedman"s #edical Dictionary. ?etrie!ed (eptember 3., /001, rom Dictionary.com website9 http9//dictionary.re erence.com/browse/tolerance
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many as ele!en di erent brain regions.3I &lthough you"ll generally see the a!erage nicotine intake per cigarette stated as being about 3mg <milligram=, in truth it !aries signi icantly. Dor example, a!erage intake is H0C greater in & rican &mericans at 3..3 milligrams o nicotine per cigarette, as compared to 3.0B milligrams in Eaucasians. &lthough o ten stated that the a!erage user"s body depletes and eliminates <metaboli)es= nicotine at the rate o roughly one-hal e!ery two hours, there"s !ariation there too. Dor example, nicotine"s elimination hal -li e is 3/B minutes in Eaucasians and 3H. minutes in & rican &mericans.3F Tolerance e!er so gradually pulls us deeper and deeper into dependency"s orest. 7hile nicotine"s elimination hal -li e remains ixed, o!er time we gradually ind oursel!es sucking a wee bit harder, holding the smoke a bit longer, or using more nicotine in order to a!oid wanting or achie!e relie rom it. Two a day, three, our, our smoked hard, our brain gradually grew additional nicotinic-type acetylcholine receptors. K!er the years, we gradually required a bit more nicotine to maintain our sense o nicotine-normal. #y $aaah$ relie sensations were no more power ul smoking i!e cigarettes a day at age i teen than when smoking sixty per day at age orty. 5 needed that much more in order to keep pace with wanting. 5 know, you"re probably thinking, you"!e been at the same nicotine intake le!el or some time now and it"s likely !astly less than the three packs-a-day 5 was smoking. 7hile we don"t yet ully understand wide !ariations in le!els o nicotine use, we know that genetics probably explains most di erences.3A There is also the act that some o our mothers, like mine, smoked during pregnancy. 5 was born with a brain already wired or nicotine. 5 came into this world as nicotine"s sla!e and likely spent my irst ew days in withdrawal.31 Dor me, those irst ew cigarettes at age 3I were not about initial addiction. They were about
3I #ugnaini # et al, ;pregulation o OH,Pmethyllycaconitine binding sites ollowing continuous in usion o nicotine, without changes o alphaA or alphaF subunit m?:&9 an autoradiography and in situ hybridi)ation study in rat brain, The 6uropean 'ournal o :euroscience, :o!ember /00/, Golume 3F, *ages 3FHH-3F.F. 3F *Qre)-(table 6' et al, :icotine metabolism and intake in black and white smokers, 'ournal o the &merican #edical &ssociation, 'uly 3BB1, Golume /10</=, *ages 3I/-3IF. 3A -errettini 7, et al, &lpha-I/alpha-H nicotinic receptor subunit alleles increase risk or hea!y smoking, #olecular *sychiatry, &pril /001, Golume 3H<.=, *ages HF1-HAH. 31 %aw >%, et al, (moking during pregnancy and newborn neurobeha!ior, *ediatrics, 'une /00H, Golume 333<F *t 3=9 *ages 3H31-3H/H.
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relapse to a condition my brain had known since ormation and creation o my !ery irst acetylcholine receptor. That irst receptor almost immediately became occupied by nicotine that was smoked by mom. 5t was an e!ent that occurred three to our weeks ollowing conception. 3B The problem is that receptors are being acti!ated be ore ormation o the brain cell to which the receptor will e!entually be attached. &s Duke ;ni!ersity *ro essor (lotkin puts it, $nicotine alters the de!elopmental trajectory o acetylcholine systems in the immature brain, with !ulnerability extending rom etal stages through adolescence.$/0 5n addition to genetics and prenatal nicotine exposure, the younger we were when we started using, the more pro ound the altered de!elopment trajectory experienced by our still de!eloping brain.. ?esearch suggests that nicotine in licted damage to dopamine and serotonin pathways is signi icantly greater in males than emales, but that this emale ad!antage disappears i the emale brain is exposed to both prenatal and adolescent nicotine./3 The dependent mind is capable o using a low le!el o nicotine tolerance as justi ication or continued chemical ser!itude. 5t"s easy or those who use less o ten to rationali)e that they are somehow superior or better able to control their addiction than hea!y users. 5n reality, they"re hooked solid too. Their sla!ery is just as permanent and just as real. The smoker smoking i!e times a day may also ace health risks as great or greater than hea!ier smokers. This too may be due to genetic actors, to di ering toxin and cancer causing chemical le!els ound in di erent brands o tobacco, or to how intensely each cigarette was smoked. 5t may also be due in part to en!ironmental actors that subject us to other chemical agents such as radon, or to employment or hobby chemical exposures, or due to the quality o the water we drink and the air we breathe.
3B (lotkin T&, 5 nicotine is a de!elopmental neurotoxicant in animal studies, dare we recommend nicotine replacement therapy in pregnant women and adolescents8 :eurotoxicology and Teratology, 'anuary /001, Golume H0, 5ssue 3, *ages 3-3B. /0 (lotkin T&, et al, &dolescent nicotine treatment changes the response o acetylcholine systems to subsequent nicotine administration in adulthood, -rain ?esearch -ulletin, #ay 3I, /001, Golume AF <3-/=, *ages 3I/-3FI. /3 'acobsen %>, et al, Mender-speci ic e ects o prenatal and adolescent exposure to tobacco smoke on auditory and !isual attention, :europsychopharmacology, December /00A, Golume H/<3/=J *ages /.IH-/.F..
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K!er the years 5"!e met many smokers, mysel included, who experienced a signi icant increase in the number o cigarettes smoked and higher nicotine tolerance ollowing relapse a ter a ailed attempt. 7hy8 7e don"t know. (moking more cigarettes harder, it was almost like binge eating a ter dieting, as i my brain was trying to make up or missed nicotine eedings. -ut seeing increases in the le!el o smoking ollowing relapse is becoming less common. %ike a hurricane requiring warm water to strengthen, the uel or a nicotine tolerance increase is additional time and opportunities to use. The smoke- ree indoor-air mo!ement is gradually sweeping the globe. (moking is also increasingly being prohibited in and around parks, playgrounds, beaches, hospitals, schools and college campuses, and in the presence o children. (mokers ace ewer replenishment opportunities as non-smokers become increasing less tolerant o smoking in their presence, homes or !ehicles. 5 suspect that the smoker"s nicotine tolerance le!el will increasingly be associated with trying to obtain more nicotine by smoking ewer cigarettes harder. -ut the opposite is o ten seen in smokers trans erring their dependency to oral tobacco or :?T products, where around-the-clock use becomes possible. $5 started out with about F pieces a day and now chew about 3I pieces o /mg per day. *robably more nicotine than when 5 smoked,$ asserts a .1 year-old, three-year emale gum user. $There is one in my mouth /. hours a day, A days a week ... yes or real,$ claims a H/ year-old, three-year male gum user who chews .0-I0 pieces a day and thinks he may $chew more than anyone in the world.$// ?egardless o method o deli!ery or le!el o nicotine tolerance, the millions o extra acetylcholine receptors grown by the addicted brain desensiti)ed it to its own natural sense o neuro-chemical normal. 7e became wired to unction with a precise amount o nicotine in our blood stream. :ot too much, not too little, we worked to maintain and remain within our )one o nicotine-normal. &ny attempt to stop using brought potential or a brie emotional train wreck, as we ound oursel!es not only desensiti)ed to nicotine but brie ly to li e as well. $Dependent human smokers ha!e decreased dopamine acti!ity during withdrawal$ and
// *olito '?, %ong-Term :icorette Mum ;sers %osing ,air and Teeth, 7hyLuit.com, December 3, /001.
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withdrawal is accompanied by $a decrease in tonic dopamine acti!ity.$/H -ut the brain makes substantial progress in re!ersing tolerance-induced de-sensiti!ities within A/ hours o ending all nicotine use. 5t"s primarily a matter o patience as withdrawal anxieties peak within three days, putting the worst behind us. 7ithin three weeks the brain will restore the number o receptor to le!els seen in non-smokers. &lthough eeling physically normal again, nicotine"s tolerance wiring paths ha!e been permanently burned and etched into our brains. &lthough we can arrest our chemical dependency we cannot cure, eliminate or destroy it. 7e each remain wired or relapse or li e. 7hile this may sound like a curse, it can become our greatest peace o mind. Knce con ident o !ictory, this time we know exactly what it takes to both stay ree and ail. -ut arri!al here on 6asy (treet in!ol!es more than simply arresting a chemical need and le!el o tolerance.
4$e Conditioning
The term $addiction$ is generally !iewed as being broader than $dependency.$ &mong other actors, it includes the consequences o years o nicotine eedings that in!ol!ed replenishment patterns and habits that did not go unnoticed by our subconscious mind. ;se habits were athered by endless compliance with our brain"s chemical dependence upon nicotine. &lthough co!ered in detail in Ehapter 33 <(ubconscious ?eco!ery=, a basic understanding o nicotine addiction must include mention o use conditioning. Kur subconscious mind became conditioned to associate !arious acti!ities, locations, times, people, e!ents and emotions with using nicotine. 5t learned to expect arri!al o a new supply when speci ic situations or circumstances occurred. 5nsula routed urges, cra!es and anxieties alerted us when conditioned use cues were encountered. :ormally the bell ringing use cue and urge was so subtle that it went unnoticed. &lmost as i on autopilot, we"d reach or nicotine to satis y it nonetheless. 4ou"!e likely heard o *a!lo!, who actually used the ringing o a bell to induce classical conditioning in dogs. ,e conditioned them to expect ood upon hearing a bell. The dogs
/H Mrieder T6 et al, *hasic D3 and Tonic D/ dopamine receptor signaling double dissociate the moti!ational e ects o acute nicotine and chronic nicotine withdrawal, *roceedings o the :ational &cademy o (cience ; ( &. /03/ Deb /3J30B<1=J pages H303-H30F. 6pub /03/ 'an /0.
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would actually begin sali!ating when he rang the bell, e!en as he started to delay ood"s arri!al longer and longer. 4our unique patterns o nicotine use ha!e conditioned your subconscious too. 6ncountering a nicotine eeding cue can trigger a response ranging rom a barely notice urge to a ull blown anxiety episode, depending upon your tonic dopamine le!el. Teased by thousands o old wanting satis action memories, i allowed the anxiety episode can become emotionally in lamed. (el -induced anxieties and ears can build, e!entually triggering the body"s ight or light panic response. 5t happens when stress associated with a need, conditioning or desire escalates to the point o registering within the deep inner primiti!e mind as a threatening e!ent. During panic, normal cessation time distortion is made worse, as time seemingly stands still. 5t can make a less than three minute cra!e episode eel like three hours, and entirely unmanageable. Eontrary to what is then elt, those three minutes are extremely short li!ed in comparison to acti!e dependency"s ne!er ending cycle o want, urge, use and satis y. :icotine addiction is about li!ing alse priorities, needless conditioning, dishonest use justi ications, and denial o all o the abo!e. 5t"s about use o a tiny molecule called nicotine becoming the most requent lesson taught by a highjacked sur!i!al instincts teacher. Think about it. 7hile we might orget to take our !itamin or medicine, procrastinate regarding work, skip meals, interrupt quality time with amily or riends, how o ten would we ail to respond to the bell or that next mandatory nicotine eeding8
.icotine
5 was surprised to learn that all nicotine comes rom the tobacco plant, including nicotine in
nicotine replacement products such as the patch, gum and lo)enge. &lthough creation o synthetic nicotine is possible, imagine the regulatory hoops that the industry would need to jump through in order to be allowed to market synthetic nicotine or human consumption. 5nstead, the pharmaceutical industry competes with the tobacco industry in purchasing tobacco rom tobacco armers and extracting nicotine rom it. :icotine is a colorless, odorless, liquid organic-based alkaloid in the same amily as cocaine, morphine, quinine and strychnine. 5t slowly yellows when exposed to air, is bitter tasting and
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gi!es o a slight ishy odor when warmed./. 7hen holding dry tobacco in your hand, the weight nicotine within it will !ary depending upon the type tobacco. 7hile nicotine"s weight a!erages about HC cigarettes/I and moist snu , it comprises 3.FC o tobacco plug"s weight and about 3C o the weight chewing tobacco./F o o in a o
Kne o the most toxic o all poisons,/A nicotine is a etal teratogen that damages the de!eloping brain./1 & natural insecticide ormed in the roots o the tobacco plant, it helps protect the plant"s roots, stalk and lea!es rom being eaten by insects and animals. :icotine was originally sold as an alkaloid insecticide in &merica under the brand name -lack %ea .0, a mixture that was .0C nicotine sul ate./B ;se o similar nicotine products continues to be touted in organic gardening as a means or killing insects. :eonicotinoids are synthetic orms o the natural insecticide nicotine, and likely the most widely used insecticides worldwide. (old under brand names such as 5midacloprid and Thiamethoxam <T#R=, neonicotinoids attach to the insect"s acetylcholine receptors. The insect then exhibits leg tremors, rapid wing motion and disoriented mo!ement ollowed by paralysis and death. There is growing concern that widespread use o neonicotinoids may be responsible or killing bees and colony collapse disorder.H0
/. Eornell ;ni!ersity, :icotine <-lack %ea .0= Ehemical *ro ile, &pril 3B1I. /I -lakely T et al, :ew Sealand *ublic ,ealth ?eport on :icotine, #ay /A, 3BBA. /F Tilashalski, > et al, &ssessing the :icotine Eontent o (mokeless Tobacco *roducts, 'ournal o the &merican Dental &ssociation, #ay 3BB., Golume 3/I, *ages IB0-IB.. /A de %andoni, ',, :icotine, 5*E( 5:E,6#, #arch 3BB3. /1 ?oy T(, et al, :icotine e!okes cell death in embryonic rat brain during neurulation, The 'ournal o *harmacology and 6xperimental Therapeutics, December 3BB1, Golume /1A<H=, *ages 33HF-33... /B Eornell ;ni!ersity, nicotine <-lack %ea .0= Ehemical *ro ile, *esticide #anagement 6ducation *rogram <*#6*=, &pril 3B1I. H0 7hitehorn *?, et al, :eonicotinoid pesticide reduces bumble bee colony growth and queen production, (cience, &pril /0, /03/, Golume HHF<F0AB=, pages HI3-HI/
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,ow deadly is nicotine8 5t"s nearly twice as deadly as black widow spider !enom <.I mg/kg !ersus .Bmg/kg= and at least three times deadlier than diamondback rattlesnake !enom <.I mg/kg !ersus 3.1Bmg/kg=. %DI0 is an abbre!iation or the lethal dose o a toxic chemical. 5t represents the amount o the chemical needed to kill I0C o humans weighing 3F0 pounds. :icotine"s minimum adult %DI0 is H0mg <milligrams= and i ingested in liquid orm death can occur within I minutes.H3 Drop or drop, that makes nicotine as deadly as strychnine, which also has a minimum adult %DI0 o H0mg,H/ and more deadly than arsenic <I0mg=,HH or cyanide <I0mg=.H. :icotine kills by e!entually paraly)ing breathing muscles. *rior to death, symptoms include sali!ation, nausea, !omiting, abdominal pain, diarrhea, di))iness, weakness and con usion progressing to con!ulsions, hypertension and coma.HI &lthough the a!erage &merican cigarette contains 1 to B milligrams o nicotine, HF some is burned, some escapes through cigarette !entilation and the ilter traps some. The lungs absorb nearly B0C o inhaled nicotine.HA 5t results in the a!erage smoker introducing 3.3A to 3.HA milligrams o nicotine into their bloodstream with each cigarette smoked. H1 &!erage intake can !ary signi icantly rom smoker to smoker, ranging rom 0.H to H./ mg o nicotine per cigarette.HB *icture the largest rat you ha!e e!er seen. 5t would weigh about a pound. The 3mg o nicotine that entered your bloodstream rom your last nicotine ix would be su icient to kill that rat. & smoker smoking H0 cigarettes per day is, o!er an entire day, bringing enough nicotine into their body to ha!e killed a 3F0-pound human, i the entire H0 milligrams had arri!ed all at once. Two to three drops o nicotine in the palm o the hand o someone weighing 3F0 pounds or less and he or she is dead. Those pushing a growing array o nicotine products o ten alsely assert that they are as sa e as ca eine. Dar rom it. :icotine is at least 3FF times more toxic than ca eine. Ea eine"s lethal
H3 H/ HH H. HI HF Eornell ;ni!ersity, :icotine <-lack %ea .0= Ehemical *ro ile, &pril 3B1I. -orges, & et al, (trychnine <*5# I0A=, #arch 3B1B, 5*(E 5:E,6#. -enedetti, '%, &rsenic <*5# M0./=, 'uly 3BBF, 5*(E 5:E,6#. !an ,eijst, &:*, Eyanides <*5# M00H=, Debruary 3B11, 5*(E 5:E,6#. de %andoni, ',, :icotine <*5# HAH=, #arch 3BB3, 5*E( 5:E,6#. -enowit) :%, et al, 6stablishing a nicotine threshold or addiction. The implications or tobacco regulation, :ew 6ngland 'ournal o #edicine, 'uly 3., 3BB., Golume HH3</=, *ages 3/H-3/I. HA *hilip #orris, #emorandum, #edia *resentation - Dra t Kutline, &pril A, 3BB1, -ates :umber9 /0F.HH./BF. H1 'ar!is #', et al, :icotine yield rom machine-smoked cigarettes and nicotine intakes in smokers9 e!idence rom a representati!e population sur!ey, 'ournal o the :ational Eancer 5nstitute, 'anuary 3A, /003, Golume BH</=, *ages 3H.3H1. HB -enowit) :%, et al, 6stablishing a nicotine threshold or addiction. The implications or tobacco regulation, :ew 6ngland 'ournal o #edicine, 'uly 3., 3BB., Golume HH3</=, *ages 3/H-3/I.
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dose is 30 grams or 30,000 milligrams, compared to H0 milligrams or nicotine. *icture a substance more toxic than rattlesnake or black widow !enom being ed to your brain day a ter day a ter day. 5s it any wonder that a /00. study using brain #?5 imaging ound that $smokers had smaller gray matter !olumes and lower gray matter densities than nonsmokers8$.0 Eontrary to indings rom studies examining the short-term <acute= e ects o nicotine, .3 studies o the long-term <chronic= e ects o smoking nicotine report decline and impairment o attention, concentration, and the accuracy o working and !erbal memory../ Gisuali)e nicotine"s neuro-toxic e ects upon the human brain slowly destroying it, .H while damaging what remains... *ossibly the most rightening o all the risks posed by our addiction is its ability to destroy all memory o why we need to stop. &s or those selling a growing array o nicotine products, their marketing ploys and the research backing their sales pitch will always micro- ocus upon the e ects o just a ew o the more than /00 neuro-chemicals that nicotine controls <usually the stimulants=, while ignoring the big picture. Their goal is to make money by selling us nicotine, not to ree us rom requiring it. Their marketing will ne!er !alue the loss o personal reedom to a ne!er-ending need to eed, nor discuss in a air and honest manner the harms in licted by nicotine upon those addicted to it. Do you know o any alcoholic rehabilitation program that recommends switching rom whiskey to pure alcohol, and then trying to slowly wean yoursel o o!er a period o B0 days8 7ho bene its rom such a treatment method when it takes just H days to rid the body o all nicotine and mo!e beyond peak withdrawal8
!$ !ddicti"e $ 7eroin?
Kn #ay 3A, 3B11, the ;.(. (urgeon Meneral warned that nicotine is as addicti!e as heroin and
.0 -rody, &% et al, Di erences between smokers and nonsmokers in regional gray matter !olumes and densities, -iological *sychiatry, 'anuary 3, /00., Golume II<3=, *ages AA-1.. .3 'ubelt %6, et al, 6 ects o transdermal nicotine on episodic memory in non-smokers with and without schi)ophrenia, *sychopharmacology, 'uly /001, Golume 3BB<3=, *ages 1B-B1. ./ 'acobsen %>, et al, 6 ects o smoking and smoking abstinence on cognition in adolescent tobacco smokers, -iological *sychiatry, 'anuary 3, /00I, Golume IA<3=, *ages IF-FFJ also see also see Eounotte D(,et al, %ong-%asting Eogniti!e De icits ?esulting rom &dolescent :icotine 6xposure in ?ats, :europsychopharmacology, 'une /I, /001 O6pub ahead o printPJ also see, .H Mallinat ', et al, &bnormal hippocampal neurochemistry in smokers9 e!idence rom proton magnetic resonance spectroscopy at H T, 'ournal o Elinical *sychopharmacology, Debruary /00A, Golume /A<3=, *ages 10-1.. .. Mallinat, ', et al, (moking and structural brain de icits9 a !olumetric #? in!estigation, 6uropean 'ournal o :euroscience, (eptember /00F, Gol. /., pp. 3A..-3AI0.
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cocaine..I Eanada"s cigarette pack addition warning label reads, $7&?:5:M - E5M&?6TT6( &?6 ,5M,%4 &DD5ET5G6 - (tudies ha!e shown that tobacco can be harder to quit than heroin or cocaine.$ -ut how on earth can nicotine possibly be as addicti!e as heroin8 5t"s a legal product, sold in the presence o children, near candies, sodas, pastries and chips at the neighborhood con!enience store, drug store, supermarket and gas station. ,eroin addicts describe their dopamine pathway wanting satis action sensation as being ollowed by a warm and relaxing numbness. The methamphetamine or speed addict"s wanting satis action is engul ed by racing energy, excitement and hyper ocus. (atis action o the alcoholic"s wanting is ollowed by the gradual depression o their central ner!ous system. &nd euphoria <intense pleasure= is the primary sensation elt when the cocaine addict satis ies wanting. The common link between drugs o addiction is their ability to stimulate and capti!ate brain dopamine pathways. (hould the act that nicotine"s dopamine pathway stimulation is accompanied by alert central ner!ous system stimulation blind us as to what"s happened, and who we"!e become8 :icotine is legal, openly marketed, taxed and e!erywhere. 5ts acceptance and a!ailability openly in!ites denial o a super critical reco!ery truth, that we had become $real$ drug addicts in e!ery sense. De initions o nicotine dependency !ary greatly. Kne o the most widely accepted is the &merican *sychiatric &ssociation"s as published in the Diagnostic and (tatistical #anual o
.I The ,ealth Eonsequences o (moking9 :icotine &ddiction9 & ?eport o the (urgeon Meneral, #ay 3A, 3B11.
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#ental Disorders, .th edition <D(# 5G=..F ;nder D(# 5G, a person is dependent upon nicotine i at least H o the ollowing A criteria are met9 3. Di iculty controlling nicotine use or unable to stop using it. /. ;sing nicotine more o ten than intended. H. (pending signi icant time using nicotine <note9 a pack-a-day smoker spending I minutes per cigarette de!otes 3.I hours per day, 30.I hours per week or 3H.F ortyhour work weeks per year to smoking nicotine=. .. &!oiding acti!ities because they might inter ere with nicotine use or cutting acti!ities short so as to enable replenishment. I. :icotine use despite knowledge o the harms tobacco is in licting upon your body. F. 7ithdrawal when attempting to end nicotine use. A. Tolerance - o!er the years gradually needing more nicotine in order to achie!e the same desired e ect. & /001 study ound that B1C o chronic smokers ha!e di iculty controlling use. .A &lthough o ten critici)ed, the problem with D(# nicotine dependency standards is not its se!en actors. 5t"s getting those hooked upon nicotine to be honest and accurate in describing its impact upon their li e. 5t isn"t unusual or the ensla!ed and rationali)ing mind to see lea!ing those we lo!e in order to smoke nicotine as punctuating li e, not interrupting it. The capti!e mind can in!ent a host o excuses or a!oidance o acti!ities lasting longer than a couple o hours. 5t can explain how the ashtray sitting be ore them became illed and their cigarette pack empty without reali)ing it was happening. 5n Debruary /001, 5 inished presenting FH nicotine cessation seminars in /1 (outh Earolina prisons that had recently banned all tobacco. 5magine paying T1 or a hand-rolled cigarette. 5magine it being illed with tobacco rom roadside cigarette butts, tobacco now wrapped in paper torn rom a prison -ible. 6ight dollars per cigarette was pretty much the norm in medium and maximum-security prisons. The price dropped to about T/ in less secure pre-release acilities. 5magine not ha!ing T1. 5 heard horri ic stories about the lengths to which inmates would go or a ix. Two inmates housed in a smoke- ree prison near 'ohnson Eity, Tennessee ended a six-hour stando in Debruary /00A when they traded their hostage, a correctional o icer, or cigarettes. &ccording to a prison o icial, $They got them some cigarettes, they smoked them and went back to their cell and locked themsel!es back in.$
.F &merican *sychiatric &ssociation, Diagnostic and (tatistical #anual o #ental Disorders, .th edition, 7ashington, D.E. 3BB.. .A ,endricks, *. et al, 6!aluating the !alidities o di erent D(#-5G-based conceptual constructs o tobacco dependence, &ddiction, 'uly /001, Golume 30H, *ages 3/3I-3//H.
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5"!e stood be ore thousands o inmates whose chemical addictions to illegal drugs landed them behind bars. During each program 5 couldn"t help but comment on the irony that those caught using illegal drugs ended up in prison, while we nicotine addicts openly and legally purchase our drug at neighborhood stores. The irony is that, according to the EDE, during 3BB1 tobacco killed /I times more &mericans than all illegal drugs combined <.31,FB0 !ersus 3F,B/F=. &s discussed in the intro, 'oel (pit)er may well be the world"s most insight ul nicotine cessation educator. #y mentor since 'anuary /000, he tells the story o how during a /003 two-week stop smoking clinic, a participant related that he was brie ly tempted to smoke a ter inding a single cigarette and lighter setting atop a urinal in a men"s bathroom. 7hat made it so tempting was that the cigarette was his brand. ,e thought to himsel how easy it would ha!e been to smoke it. 'oel then asked the man, $7hen was the last time you e!er saw anything else atop a urinal in a men"s room that you elt tempted to put in your mouth8$ &t that, the man smiled and said, $*oint well taken.$ K!er the years, ex-users ha!e shared stories o lea!ing hospital rooms where their lo!ed one lay dying o lung cancer so they could smoke, o smoking while pregnant, o lighting their car, clothing, hair or dog on ire, o smoking while battling pneumonia, and o sneaking rom their hospital room into the staircase to light-up while dragging along the stand holding their intra!enous medication bag. &nother story shared by 'oel relates how one clinic participant had long kept secret how his still smoldering cigarette butt on the loor had lit the bride"s wedding dress on ire. 7e each ha!e our own dependency secrets. &s a submarine sailor, 5 went to sea on a A/-day underwater deployment in 3BAF thinking that stopping would be a bree)e i 5 didn"t bring any cigarettes or money along. 5 was horribly, horribly wrong. 5 spent two solid months begging, bumming and digging through ashtray a ter ashtray in search o long butts. 6!en worse was losing both o my dogs to cancer. Kne o them, -illy, died at age i!e o lymphoma. 5t wasn"t until a ter breaking ree that 5 read studies suggesting that smoke rom my cigarettes may ha!e contributed to their deaths. .1 5 so, all this now reco!ered addict can do now is to keep them ali!e in his heart while begging orgi!eness.
.1 ?o)a #?, et al, The dog as a passi!e smoker9 e ects o exposure to en!ironmental cigarette smoke on domestic dogs, :icotine and Tobacco ?esearch, :o!ember /00A, Golume B<33=, *ages 33A3-33AFJ also see, -ertone 6?, 6n!ironmental tobacco smoke and risk o malignant lymphoma in pet cats, &merican 'ournal o 6pidemiology, /00H, Golume3IF <H=, *ages /F1-/AHJ also -ra)ell ?( et al, *lasma nicotine and cotinine in tobacco smoke exposed beagle dogs, Toxicology and &pplied *harmacology, 3B1., Golume AH, *ages 3I/-3I1, also -ertone-'ohnson 6? et al, 6n!ironmental tobacco smoke and canine urinary cotinine le!el, 6n!ironmental ?esearch, #arch /001, Golume 30F<H=, *ages HF3-HF..
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&gain, the primary di erence between the illegal drug addict and us is that our chemical is legal and our dopamine high accompanied by alertness. 4es, there are social smokers called $chippers.$ &nd yes, their genetics may allow them to use yet always retain the ability and autonomy to simply turn and walk away. .B -ut, 5"m clearly not one o them. &nd odds are, neither are you, as you wouldn"t be reading a book about how to arrest your dependency. 5 o ten think about the alcoholic"s plight, in ha!ing to watch B0C o drinkers do something the 30C who are alcoholics cannot themsel!es do, control their alcohol intake. The dependency igures or nicotine are almost the exact opposite o alcohol"s. ?oughly B0C o daily adult smokers are chemically dependent under D(#-555 I0 standards, while 1AC o students smoking at least 3 cigarette daily are already dependent under D(#-5G standards. I3
!ddiction .ot .ew$ to /o' cco <ndu$try

:early I0 million pages o once secret tobacco industry documents are today reely a!ailable and ully searchable online.I/ Eollecti!ely, they paint a disturbing picture o an industry ully aware that its business is drug addiction. The industry cannot ignore that, historically, roughly /AC o new smokers ha!e been age 3H or younger, F0C age 3I or under, 10C age 3A or younger, and B/C under the age o 3B.IH Eontrary to $corporate responsibility$ image campaigns, with nearly i!e million annual tobacco related deaths worldwide,I. the industry knows that it must either ace inancial ruin, or somehow entice each new generation o youth to experiment and get hooked on nicotine. &s a %orillard executi!e wrote in 3BA1, $The base o our business is the high-school student.$ II *hilip #orris ;(& <*#= is &merica"s largest tobacco company, holding a .BC share o the ;.(. retail cigarette market in /033. IF -ased in ?ichmond, Girginia and ounded in 31I., *#
.B >endler >(, et al, & population-based twin study in women o smoking initiation and nicotine dependence, *sychological #edicine, #arch 3BBB, Golume /B</=, *ages /BB-H01. I0 ,ughes, '?, et al, *re!alence o tobacco dependence and withdrawal, &merican 'ournal o *sychiatry, Debruary 3B1A, Golume 3..</=, *ages /0I-/01. I3 >andel D, et al, Kn the #easurement o :icotine Dependence in &dolescence9 Eomparisons o the mDTL and a D(#5G -ased (cale, 'ournal o *ediatric *sychology, 'une /00I, Golume H0<.=, *ages H3B-HH/. I/ %egacy Tobacco Documents %ibrary, ;ni!ersity o Eali ornia, (an Drancisco, http9//legacy.library.ucs .edu/J also see TobaccoDocuments.org at http9//tobaccodocuments.org IH *olito, '?, 7hyLuit"s (moking 5nitiation (ur!ey, 'une H, /00I, www.7hyLuit.com I. 7orld ,ealth Krgani)ation. 7,K report on the global tobacco epidemic, /001, Mene!a, (wit)erland9 7orld ,ealth Krgani)ationJ /001. II %orillard, #emo, &ugust H0, 3BA1, -ates :umber9 B.FA33IHJ http9//legacy.library.ucs .edu/tid/nlt3Hc00. IF *hilip #orris ;(&, #arket 5n ormation, 'uly /03/, http9//www.philipmorrisusa.com
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brands include &lpine, -asic, -enson + ,edges, -ristol, Eambridge, Ehester ield, Eommander, Da!e"s, 6nglish K!als, %+#, %ark, #erit, *arliament, *layers, (aratoga and Girginia (lims. Today, *hilip #orris" website openly proclaims, $*# ;(& agrees with the o!erwhelming medical and scienti ic consensus that cigarette smoking is addicti!e$ and $smokeless tobacco products are addicti!e.$IA ?emember that ate ul $what the heck$ moment when you surrendered and ga!e tobacco that irst serious try8 7hat you probably don"t recall are the thousands o in!itations to surrender and experiment that tobacco industry marketing had by then burned into your subconscious. &s shown by the ollowing quotes rom once secret *hilip #orris corporate documents, it was ully aware that it was in the drug addiction business while pounding your brain with those in!itations.
3BA/ - $The cigarette should not be construed as a product but a package. The product is nicotine. Think o a pu o smoke as the !ehicle or nicotine. The cigarette is but one o many package layers. There is the carton, which contains the pack, which contains the cigarette, which contains the smoke. The smoke is the inal package. The smokers must strip o all these package layers to get to that which he seeks.$I1 #ay 3BAI - $... decline in #arlboro"s growth rate is due to ... slower growth in the number o 3I-3B year-olds ... changing brand pre erences among younger smokers.$ $#ost o these studies ha!e been restricted to people age 31 and o!er, but my own data, which includes younger teenagers, shows e!en higher #arlboro market penetration among 3I-3A year-olds.$ $The teenage years are also important because those are the years during which most smokers begin to smoke, the years in which initial brand selections are made, and the period in the li e-cycle in which con ormity to peer-group norms is greatest.IB
IA *hilip #orris ;(&, *roducts, 'une /001, http9//www.philipmorrisusa.com I1 *hilip #orris ?esearch Eenter, 7illiam %. Dunn, 'r., Eon idential9 #oti!es and 5ncenti!es in Eigarette (moking, 3BA/, -ates :umber9 /0/./AHBIBJ http9//legacy.library.ucs .edu/tid/txyA.e00. IB *hilip #orris ;.(.&. memo9 The Decline in the ?ate o Mrowth o #arlboro ?ed, #ay /3, 3BAI, -ates :umber9
3-
:o!ember 3BAA - $5 was ama)ed at the trend that the OEouncil or Tobacco ?esearchP work is taking. Dor openers, Dr. Donald ,. Dord, a new sta member, makes the ollowing quotes9 "Kpiates and nicotine may be similar in action" ... "There is a relationship between nicotine and the opiates." ... 5t is my strong eeling that with the progress that has been claimed, we are in the process o digging our own gra!e.$ F0
-ased in 7inston-(alem, :orth Earolina, ?.'. ?eynolds" Tobacco Eompany <?'?= has been around since 31A.. -e ore ?'?"s /00. merger with -rown and 7illiamson, its cigarette brands included Eamel, Doral, 6clipse, #onarch, #ore, :ow, (alem, Gantage and 7inston. 7hile ?'? cigarette store marketing screams suggestions that smokers smoke its brands or a host o reasons < la!or, pleasure, ad!enture, price, to be true, make new riends, ha!e un, great menthol or to look more adult=, its once secret documents tell a di erent story. & nine page 3BA/ con idential memo by a senior ?'? executi!e is entitled $The :ature o the Tobacco -usiness and the Erucial ?ole o :icotine Therein.$ F3 The next se!en paragraphs share direct quotes rom this now amous and extremely in ormati!e memo. $5n a sense, the tobacco industry may be thought o as being a speciali)ed, highly rituali)ed and styli)ed segment o the pharmaceutical industry. Tobacco products, uniquely, contain and deli!er nicotine, a potent drug with a !ariety o physiological e ects.$ $,is choice o product and pattern o usage are primarily determined by his indi!idual nicotine dosage requirements and secondarily by a !ariety o other considerations including la!or and irritancy o the product, social patterns and needs, physical and manipulati!e grati ications, con!enience, cost, health considerations, and the like.$ $Thus a tobacco product is, in essence, a !ehicle or deli!ery o nicotine, designed to deli!er the nicotine in a generally acceptable and attracti!e orm. Kur 5ndustry is then based upon design, manu acture and sale o attracti!e dosage orms o nicotine ...$ $5 nicotine is the sine qua non o tobacco products and tobacco products are recogni)ed as being attracti!e dosage orms o nicotine, then it is logical to design our products -and where possible, our ad!ertising -- around nicotine deli!ery ...$
/0AA1F.AIIJ http9//legacy.library.ucs .edu/tid/srs1.a00. F0 *hilip #orris ;.(.&. 5nter-K ice Eorrespondence, (eligman to Ksdene, :o!ember /B, 3BAA, -ates :umber9 /0AABBH10J http9//legacy.library.ucs .edu/tid/ggyAIc00. F3 ?'? Eon idential ?esearch *lanning #emorandum, The :ature o the Tobacco -usiness and the Erucial ?ole o :icotine Therein, Elaude 6. Teague, 'r., ?'? &ssistant Director o ?esearch, &pril 3., 3BA/, -ates :umber9 I031AA3/3, http9//legacy.library.ucs .edu/tid/sjw/Bd00.
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$,e does not start smoking to obtain unde ined physiological grati ications or relie s, and certainly he does not start to smoke to satis y a non-existent cra!ing or nicotine. ?ather, he appears to start to smoke or purely psychological reasons -- to emulate a !alued image, to con orm, to experiment, to de y, to be daring, to ha!e something to do with his hands, and the like.$ $Knly a ter experiencing smoking or some period o time do the physiological $satis actions$ and habituation become apparent and needed. 5ndeed, the irst smoking experiences are o ten unpleasant until a tolerance or nicotine has been de!eloped.$ $This lea!es us, then, in the position o attempting to design and promote the same product to two di erent types o markets with two di erent sets o moti!ations, needs and expectations.$ $Eritics o tobacco products increasingly allege that smoking is dangerous to the health o the smoker. *art o this alleged danger is claimed to arise rom ingestion o nicotine and part is claimed to arise rom smoke components or smoke $tar.$ $5 , as proposed abo!e, nicotine is the sine qua non o smoking, and i we meekly accept the allegations o our critics and mo!e toward reduction or elimination o nicotine rom our products, then we shall e!entually liquidate our business.$ $5 we intend to remain in business and our business is the manu acture and sale o dosage orms o nicotine, then at some point we must make a stand.$ $5 our business is undamentally that o supplying nicotine in use ul dosage orm, why is it really necessary that allegedly harm ul "tar" accompany that nicotine8$ $There should be some simpler, $cleaner$, more e icient and direct way to pro!ide the desired nicotine dosage than the present system in!ol!ing combustion o tobacco or e!en chewing o tobacco ...$
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$5t should be possible to obtain pure nicotine by synthesis or rom high-nicotine tobacco. 5t should then be possible, using modi ications o techniques de!eloped by the pharmaceutical and other industries, to deli!er that nicotine to the user in e icient, e ecti!e, attracti!e dosage orm, accompanied by no "tar", gas phase, or other allegedly harm ul substances.$ $The dosage orm could incorporate !arious la!orants, enhancers, and like desirable additi!es, and would be designed to deli!er the minimum e ecti!e amount o nicotine at the desired release-rate to supply the "satis action" desired by the user.$ &s shown, ?'?"s 3BA/ memo accurately predicts both the arri!al o nicotine replacement products <:?T= and the combustion ree electronic or e-cigarette. The lines between the tobacco and pharmaceutical industry nicotine are now blurring horribly. & /00H nicotine gum study ound that HAC o gum users were hooked on the cure, each being chronic long-term gum users o at least F months.F/ 5t"s a trend that will continue. -rown + 7illiamson <-+7= was a cigarette company that merged with ?'? in /00.. -+7"s brands - now owned by ?'? - included -arclay, -elair, Eapri, Earlton, M*E, >ool, %aredo, %ucky (trike, #isty, :orth (tate, *all #all, *ri!ate (tock, ?aleigh, Tareyton and Giceroy. ,ere are a ew quotes rom once secret -+7 corporate documents9 'uly 31, 3BAA9 $,ow to market an addicti!e product in an ethical manner8$FH 'une /., 3BA19 $Gery ew consumers are aware o the e ects o nicotine, i.e., its addicti!e nature and that nicotine is a poison.$F. #arch /I, 3B1H9 $:icotine is the addicting agent in cigarettes. 5t, there ore, seems reasonable that when people switch brands, i they ha!e a certain smoking pattern <i.e. number o sticks/day=, they will switch to a brand at the same nicotine le!el.$FI Dounded in 3AF0, %orillard Tobacco Eompany is the oldest ;.(. tobacco company. 5ts brands include >ent, #a!erick, #ax, :ewport, Kld Mold, (atin, Triumph and True. The ollowing telling quotes are rom once secret %orillard documents9 &pril 3H, 3BAA9 $Tobacco scientists know that physiological satis action is almost totally related
F/ (hi man (, ,ughes '?, et al, *ersistent use o nicotine replacement therapy9 an analysis o actual purchase patterns in a population based sample, Tobacco Eontrol, :o!ember /00H, Golume 3/, *ages H30-H3F. FH -rown + 7illiamson &d!ertising Eon erence ?eport9 (ynectics *roblem %aboratory, 'uly 31, 3BAA, -ates :umber9 AA0303AF1J http9//legacy.library.ucs .edu/tid/mriFH 00/pd . F. -rown + 7illiamson, #emorandum9 Duture Eonsumer ?eaction to :icotine, 'une /., 3BA1, -ates :umber9 FFI0.HBFFJ http9//legacy.library.ucs .edu/tid/) i/3 00. FI -rown + 7illiamson, 5nternal Eorrespondence, *roject ?ecommendations, #arch /I, 3B1H, -ates :umber9 FA0I01.B/J http9//legacy.library.ucs .edu/tid/uly0. 00.
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to nicotine intake.$FF :o!ember H, 3BAA9 $5 don"t know o any smoker who at some point hasn"t wished he didn"t smoke. 5 we could o er an acceptable alternati!e or pro!iding nicotine, 5 am 300 percent sure we would ha!e a gigantic brand.$FA Debruary 3H, 3B109 $Moal - Determine the minimum le!el o nicotine that will allow continued smoking. 7e hypothesi)e satis action cannot be compensated or by psychological satis action. &t this point smokers will quit, or return to higher tar + nicotine brands.$F1 %ast but not least is -ritish &merican Tobacco <-&T=, which dates to 3B0/ and sells more than H00 brands worldwide. -&T"s international brands include Dunhill, >ent, %ucky (trike, *all #all, Gogue, ?othmans, *eter (tuy!esant, -enson + ,edges, 7in ield, 'ohn *layer, (tate 6xpress III, >ool and Giceroy. 5t does not own all these brands but is licensed by other companies to distribute them. ,ere are a ew -&T admissions. :o!ember 3BF39 (moking $di ers in important eatures rom addiction to other alkaloid drugs, but yet there are su icient similarities to justi y stating that smokers are nicotine addicts.$ FB 3BFA9 $There has been signi icant progress in understanding why people smoke and the opinion is hardening in medical circles that the pharmacological e ects o nicotine play an important part... 5t may be use ul, there ore, to look at the tobacco industry as i a large part its business is the administration o nicotine <in the clinical sense=.$A0 &ugust 3BAB9 $7e are searching explicitly or a socially acceptable addicti!e product. The essential constituent is most likely to be nicotine or a direct substitute or it.$A3 &pril 3B109 $5n a world o increased go!ernment inter!ention, -.&.T should learn to look at itsel as a drug company rather than as a tobacco company.$A/ 5n light o the abo!e tiny sampling o tobacco industry admissions, should there be any doubt in our minds as to who was sla!e and who was master, who pro ited and who lost8
FF %orillard, *resent (tatus o the :icotine 6nrichment *roject, &pril 3H, 3BAA, -ates :umber9 1H/I330HJ http9//legacy.library.ucs .edu/tid/bgm0Bc00. FA %orillard, %etter, :o!ember H, 3BAA, -ates :umber9 0HHFII.3J http9//legacy.library.ucs .edu/tid/c)eB3e00 F1 %orillard, #emorandum (ecret, ?T 5n ormation Task Dorce, Debruary 3H, 3B10, -ates :umber9 B.FA/F31J http9//legacy.library.ucs .edu/tid/ust3Hc00. FB ,onorable Mladys >essler, Dinal Kpinion, ;.(. District Eourt, ;.(. !s. *hillip #orris ;(&, *age .3F, &ugust 3A, /00F. A0 -ritish &merican Tobacco #emo, 3BFA, as stated in Dederal Eourt o &ustralia, :ew (outh 7ales, :-301B o 3BBB, (tatement o Elaim, *age HA0. A3 -ritish &merican Tobacco, #emo, >ey &reas - *roduct 5nno!ation K!er :ext 30 4ears or %ong Term De!elopment, &ugust /1, 3BAB, -ates :umber9 H/3.FBI13J http9//bat.library.ucs .edu/tid/ y)H.aBB A/ -ritish &merican Tobacco, -rainstorming 55, &pril 33, 3B10, -ates :umber9 30B11.3B0, http9//bat.library.ucs .edu/tid/oli1IaBB.
3+
:reedom ;t rt$ with !dmitting !ddiction

5t was not easy looking in the mirror and at last seeing a true drug addict looking back. 5 elt like 5 was surrendering, that a ter all those ailed attempts 5"d lost. 5 elt like a total and complete ailure. -ut as horrible as that moment elt, doing so was the most liberating e!ent in my li e. 5t was then and there 5 no longer needed the long list o lies 5"d in!ented to try to explain my capti!ity, my need or that next ix. 4es, there were countless times during my H decades o bondage where 5"d told mysel that 5 was hooked. -ut not until early 3BBB, a ter one last ailed attempt, did it hit me. %ike alcoholism, my addiction was or real. 5t was then that 5 awoke to reali)e that 5 was no di erent rom the meth or heroin addict Dr. #.&.,. ?ussell, a psychiatrist and addiction researcher at %ondon"s 5nstitute o *sychiatry had me pegged in 3BA.9 $There is little doubt that i it were not or nicotine in tobacco smoke, people would be little more inclined to smoke than they are to blow bubbles or to light sparklers.$ $Eigarette-smoking is probably the most addicti!e and dependence-producing orm o object-speci ic sel -administered grati ication known to man.$AH K!er the years, millions o nicotine addicts ha!e tried pro!ing Dr. ?ussell wrong. 5n 'anuary /00H, a #iami based company, the Gector Mroup %td., began marketing a nicotineree cigarette called Luest in se!en northeastern ;.(. states. & no!elty item, thousands o smokers rushed out to purchase their irst pack o nicotineree smokes. -ut locating any smoker who returned to purchase a second pack pro!ed nearly impossible. 7e would no more smoke nicotineree cigarettes than we"d smoke dried lea!es rom the backyard. ,ello@ #y name is 'ohn and 5"m a com ortably reco!ered nicotine addict. 5t is not normal or humans to light things they place between their lips on ire and then intentionally suck the ire"s smoke deep into their lungs. :or is it normal to chew or suck a highly toxic non-edible plant, hour a ter hour, day a ter day, year a ter year. 7e rationali)ed irrational beha!ior because o the neuro-chemical relie rom wanting it generated. 7hat we didn"t reali)e that each use rein orced uture wanting by creation o yet
AH ?ussell, #&, The (moking ,abit and 5ts Elassi ication, The *ractitioner, 'une 3BA. Golume /3/ <3/A/=, *ages AB3-100.
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another high de inition use memory. Euddling up to the warm, co)y rationali)ation that, at worst, all we ha!e is some $nasty little habit$ ser!es the tobacco industry well. 7hile habits can be manipulated, modi ied, toyed with and controlled, nicotine addiction is an all or nothing proposition. The industry knows that so long as its adult ree-choice marketing continues to brainwash nicotine addicts into belie!ing that they"re in ull control, that they are likely to continue to hand the industry their money until the day they die. ?egardless o the deli!ery de!ice or method used to introduce nicotine into the bloodstream, ully accepting that nicotine dependency has permanently altered our brain not only simpli ies the rules o reco!ery, it pro!ides the key to staying ree. %et"s re!iew the only rule that we each need ollow in order to spend the balance o li e on the ree side o dependency"s bars. 5t"s called the $%aw o &ddiction.$
-0
:reedom 1rom .icotine & /he Journey 7ome
Ch pter 2
/he 0 w o1 !ddiction
"Administration of a drug to an addict will cause re-establis ment of c emical dependence upon t e addictive substance!" /he 0 w #e1ined
&ccording to the 7orld ,ealth Krgani)ation, $5n the /0th century, the tobacco epidemic
killed 300 million people worldwide. During the /3st century, it could kill one billion.$A. 4ear a ter year, at least A0C o sur!eyed smokers say they want to stop, AI and each year .0C make an attempt o at least one day.AF There is no lack o desire or e ort. 7hat"s lacking is know-how. >ey to breaking and staying ree is understanding the $%aw o &ddiction.$ 7hether users know it by name or simply understand the basic premise, ailure to sel disco!er or to be taught this law is a horrible reason to die. The $%aw o &ddiction$ is not man-made law. 5t"s as undamental as the law o gra!ity and re usal to abide by it will result in injury or death. The %aw is rather simple. 5t states, $&dministration o a drug to an addict will cause reestablishment o chemical dependence upon the addicti!e substance.$ #astering it requires acceptance o three undamental principles9 <3= That dependency upon using nicotine is true chemical addiction, capti!ating the same brain dopamine wanting relie pathways as alcoholism, cocaine or heroin addictionJ </= That once established we cannot cure or kill an addiction but only arrest itJ and <H= That once arrested, regardless o how long we ha!e remained nicotine ree, that just one hit o nicotine creates an extremely high probability o ull relapse. 7e need not guess as to what happens inside a brain that attempts to $cheat$ and use nicotine during reco!ery. The e!idence seen on brain *6T scans is undeniable. 'ust one pu o nicotine and up to I0 percent o the brain"s nicotinic-type acetylcholine receptors
A. 7orld ,ealth Krgani)ation, 7,K ?eport on the Mlobal Tobacco 6pidemic, /001, The #*K76? *ackage, Dresh and &li!e, Dorward by 7,K Director Meneral, /001. AI ;.(. Eenters or Disease Eontrol, Eigarette (moking &mong &dults - ;nited (tates, /000, 7eekly ##7?, 'uly /F, /00/, Golume I3</B=, *ages F./-F.I. AF ;.(. Eenters or Disease Eontrol, Eigarette (moking &mong &dults - ;nited (tates, /00A, 7eekly ##7?, :o!ember 3., /001, Golume IA<.I=, *ages 3//3-3//F.
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become occupied by nicotine.AA During relapse, while the smoker"s conscious mind may ind itsel struggling with tobacco toxin tissue burning sensations and carbon monoxide induced di))iness, well-engineered dopamine pay-attention pathways are recording the e!ent and will make the resulting dopamine $aaah$ wanting relie sensation nearly impossible, in the short-term, to orget. 5n act, most actually walk away rom their relapse experience thinking that they ha!e gotten away with cheating and using just once. -ut it won"t be long be ore their awakened dependency is wanting and begging or more. ?eco!ery isn"t about battling an entire pack, pouch, tin or box. 5t"s about that irst bolus o nicotine striking the brain, a hit that will end our journey, cost us liberty, and land us back behind bars. ;n ortunately, con!entional reco!ery wisdom in!ites relapse with statements such as $Don"t let a little slip put you back to smoking.$ &s 'oel says, it"s like telling the alcoholic, $Don"t let a sip put you back to drinking$ or the heroin addict, $Don"t let shooting-up put you back to using.$ 6xperts are ond o stating that $on a!erage, it takes between H-I serious reco!ery attempts be ore breaking ree o tobacco dependence,$ and that $e!ery time you make an e ort you"re smarter and you can use that in ormation to increase the likelihood that your subsequent attempt is success ul.$ 7hat these so called experts ail to re!eal is the precise lesson e!entually learned. 7hy8 &nd why can"t that lesson be taught and mastered be ore a user"s irst attempt e!er8 They don"t teach it because most don"t understand it themsel!es. 5nstead they excuse ailure be ore it occurs, as i trying to protect the particular smoking cessation product they are pushing rom being blamed or de eat. The lesson e!entually gleaned rom the school o hard-reco!ery-knocks is that $i 5 take so much as one pu , dip or chew 5 will relapse.$ 'ust one, just once and de eat is all but assured. $The idea that you can"t stop the irst time is absolutely wrong,$ teaches 'oel. A1 $The only reason it takes most people multiple attempts is that they don"t understand their addiction to nicotine. ,ow could they, no one really teaches it.$ $*eople ha!e to learn by screwing up one attempt a ter another until it inally dawns on them that each time they lost it, it happened by taking a pu . 5 you understand this concept rom the get-go, you don"t ha!e to go through chronic Ostopping and startingP.$
AA -rody &% et al, Eigarette smoking saturates brain alpha . beta / nicotinic acetylcholine receptors, &rchi!es o
Meneral *sychiatry, &ugust /00F, Golume FH<1=, *ages B0A-B3I. A1 (pit)er ', 5s this your irst time quitting8 http9//www. n.yuku.com/topic/33F/H , December /B, /003.
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/he 0 w Re1lected in ;tudie$

4es, once all nicotine use ends, a single subsequent use is extremely accurate in predicting ull and complete relapse. The 3BB0 -randon lapse/relapse study ollowed 3/B smokers who success ully completed a two-week stop smoking program or two additional years.AB %apse was de ined as any tobacco use regardless o how much. &mong those who lapsed, the mean number o days between the end o the smoking cessation program and lapse was two months <I1 days=, with nearly all lapsing within the irst three months. 7hile 3.C took only one or two pu s, ./C smoked the entire cigarette, while the a!erage smoked about two-thirds. & second cigarette was smoked by BH.IC who had lapsed. :early hal <.AC= smoked that second cigarette within /. hours, with one in i!e smoking it within an hour </3C=. (till, a mean a!erage o nine days passed between subjects sampling their irst and second cigarette. Elearly, most o them likely thought they"d gotten away with it, that they were controlling the uncontrollable. The -randon study ound that F0C who lapsed $asked or$ the cigarette <bummed it=, /HC purchased it, BC ound it, FC stole it, and /C were o ered it. &lso o note, .AC who lapsed drank alcohol be ore doing so. K!erall, the study ound that 11C who $tasted$ a cigarette relapsed. 5n discussing the inding -randon wrote9 $The high rate o return to regular smoking <11C= once a cigarette is tasted suggests that the distinction between an initial lapse and ull relapse may be unnecessary.$ $5n our study, high initial con idence le!els may ha!e reduced subjects" moti!ation to acquire skills and engage producti!ely in treatment.$ The -randon study"s inding was echoed by the 3BB0 -oreland study, which ollowed callers to an &ustralian telephone stop smoking line. There, among HHB participants who lapsed <3/H who didn"t make it an entire day and 3A/ who stopped or at least /. hours= /BI or 1AC experienced relapse within B0 days.10 The 3BB/ Mar!ey study ollowed /HI adult smokers or one ull year a ter attempting to quit. 5t ound that, $Those who smoked any cigarettes at all in the post-cessation period
AB -randon, T, et al, *ostcessation cigarette use9 the process o relapse, &ddicti!e -eha!iors, 3BB0J 3I</=, pages 30I-33.. 10 -orland ?., (lip-ups and relapse in attempts to quit smoking, &ddicti!e -eha!iors, 3BB0, Golume 3I<H=, *ages /HI-.I.
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<i.e. lapsed= had a BIC probability o resuming their regular pattern o smoking subsequently.$13 &lthough the challenges o reco!ery ha!e ended or hundreds o millions o now com ortable ex-users, each li!es with nicotine dependency"s imprint permanently burned into their brain. 6!en a ter 30, /0 or H0 years o reedom we remain wired or relapse. 7e"re not stronger than nicotine but then we don"t need to be. 5t is only a chemical. %ike the salt or pepper in our shakers, it has an 5.L. o )ero. %ike the sugar in our sugar bowl, it cannot plot, plan, think or conspire. &nd it is not some big or little monster that dwells inside us. Kur blood serum becomes nicotineree and withdrawal peaks in intensity within three days o ending all use. -ut just one power ul jolt o nicotine and the deck gets stacked against us. The odds o us ha!ing the stamina to withstand and endure nicotine"s in luence upon the brain without relapsing are horrible. -randon, -oreland and Mar!ey teach us that while relapse isn"t 300C guaranteed, that the odds are so high, that to not treat lapse as relapse is a recipe or de eat, disease and death. Kur greatest weapon has always been our in initely superior intelligence. &s taught by Mar!ey, the most important reco!ery lesson our intelligence can master is that being BBC success ul at not using nicotine produces up to BIC odds o de eat. &s 'oel (pit)er"s lessons ha!e burned deeply into my brain, there"s just one controlling principle determining the outcome or all. 5t"s that total adherence to a personal commitment to not !iolate the law o addiction pro!ides a 300C guarantee o success. &lthough obedience may not always be easy, the law is clear, concise and simple - no nicotine today, not one pu , dip or chew@
Mi$$ed 0e$$on$
5n 3B1. 'oel wrote an article with the heartless sounding title, $The %ucky Knes Met ,ooked.$1/ Drankly, it"s anything but callous. 5t makes the important point that those who experience ull relapse within a ew days o taking a pu , dip or chew are ortunate in that the experience o ers potential to sel -teach them the most critical reco!ery lesson o all, $The %aw o &ddiction.$ ?ecall that in the -randon study, while nearly hal who
13 Mar!ey &' et al, *redictors o smoking relapse among sel -quitters9 a report rom the :ormati!e &ging (tudy, &ddicti!e -eha!iors, 3BB/, Golume 3A<.=, *ages HFA-HAA.
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lapsed experienced ull relapse within one day, that the study"s mean a!erage rom lapse to relapse was nine days. Those who quickly experience ull relapse increase the likelihood o learning, right away, the critical lesson o the power o using nicotine just once. -ut the more time and distance between that irst use and ull dependency resumption, the greater likelihood there is o learning the wrong lesson, a lesson that or ar too many smokers pro!es deadly. $The ex-smoker who takes a drag and doesn"t get hooked gets a alse sense o con idence,$ writes 'oel. $,e thinks he can take one any time he wants and not get hooked. ;sually, within a short period o time sneaking a drag here and there, he will become hooked.$ $Kne day he too may try to stop and actually succeed. ,e may stop or a week, month, or e!en years. -ut always in the back o his mind he eels, "5 know 5 can ha!e one i 5 really want to. & ter all, 5 did it last time and didn"t get hooked right away."$ $Kne day, at a party or under stress or just out o boredom he will try one again. #aybe this time he will get hooked, maybe not. -ut you can be sure that there will be a next time. 6!entually he will become hooked again.$ %i!ing a series o perpetual relapses, trying to break ree again and again and again, each time enduring withdrawal and reco!ery is no way to li!e. $Taking the irst drag is a no-win situation,$ cautions 'oel. K!er the years, hundreds o millions o ex-users ha!e disco!ered the power o one pu , dip or chew totally on their own. -ut o!er the years, with arri!al o each new magic cure, sel disco!ery o the %aw o &ddiction has become increasingly di icult. 5 old enough, think back to 3B10, be ore arri!al o nicotine replacement therapy <:?T= and nicotine gum. ?emember the tra!eling smoking cessation hypnotist coming to town8 There really wasn"t much else. The only real alternati!es to cold turkey were gradual weaning or tapering schemes, with extremely dismal results <roughly hal as e ecti!e as abrupt cessation - 7est /033=. The likelihood o any particular attempt being cold turkey was substantial. Thus, the odds o sel -disco!ering the %aw o &ddiction were good. &bsent was the negati!e in luence o pharmaceutical company marketing, marketing designed to intentionally shatter con idence in our natural reco!ery instincts. Eold turkey had cornered the reco!ery market. 7hen :?T arri!ed the industry saw no
1/ (pit)er, ', 'oel"s %ibrary, The %ucky Knes Met ,ooked, 3B1., http9//whyquit.com/joel
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alternati!e but to attack it. Three decades o industry brainwashing has alsely painted cold turkey as nearly impossible with ew succeeding. Eold turkey is ree yet poor. 5t has no bank account, economic muscle or political clout. The industry"s attacks, alse representations and gradual takeo!er o go!ernment cessation policy went largely unnoticed and unchallenged.1H Today, pharmaceutical industry inancial in luence has played a major role in authoring o icial national cessation policy in nearly e!ery de!eloped nation on earth. 1. ;nopposed, by 'une /000 the industry"s muscle had grown so power ul here in the ;.(. that cessation policy was rewritten so as to make use o pharmaceutical industry cessation products mandatory unless the user"s medical condition prohibited it.1I 5nstead o teaching the %aw o &ddiction and the power o nicotine to oster relapse, the pharmaceutical industry teaches that nicotine is $medicine$ and its use is $therapy.$ 5t has ne!er made a commercial announcing to smokers that it rede ined $stopping smoking$ rom its traditional meaning o ending both smoking and nicotine use, to just a single method o nicotine deli!ery, smoking it. The industry has yet to re!eal that its more than /00 $medication$ studies were not about drug addicts arresting their chemical dependency upon nicotine. 4ou see, those studies did not test body luids to see i any participant actually became nicotine ree. 5nstead, they tested the breath o participants or expired carbon monoxide, to see i participants had stopped smoking it. Kne o the best kept industry secrets is the percentage o ormer smokers who continued to remain dependent upon replacement nicotine at study"s end or who turned to oral tobacco. That"s why it"s so important that each o us teach the %aw o &ddiction to users within our sphere o in luence. 7hy8 -ecause jumping rom product to product while earing your natural reco!ery instincts, it"s getting hard to sel -disco!er the %aw, and that"s a horrible reason to die.
Ju$t one rule & 2.o .icotine /od y@2

7hile there are scores o stop smoking books and quick- ix magic cures promising near painless and sure- ire success, there is but one principle that a ords a 300C guarantee to all adhering to it ... $no nicotine today.$
1H *olito, '?, Dlawed research equates placebo to cold turkey, 7hyLuit.com, #arch 3/, /00A. 1. ,elliker, >, :icotine Dix - -ehind &ntismoking *olicy, 5n luence o Drug 5ndustry, 7all (treet 'ournal - Debruary 1, /00A, *age &3J also see, *olito '?, ;.(. quit smoking policy integrity drowns in pharmaceutical in luence, 7hyLuit.com, #ay 3H, /001. 1I *olito, '?, Does updated tobacco treatment $Muideline$ re lect sham science8 7hyLuit.com, #ay I, /001.
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7hile the -randon, -oreland and Mar!ey studies a ord the junkie mind a tiny sli!er o junkie thinking wiggle-room in belie!ing that the $%aw o &ddiction$ can be cheated, it"s impossible to ail by li!ing the $%aw$ as an absolute. 7hy test the ability o our dopamine pathways to make pathway acti!ating e!ents extremely di icult to orget or ignore8 7hy challenge our brain"s design8 7hy toy with disastrous odds8 Kne hit will be too many, while a thousand ne!er enough. 7e cannot ail so long as all nicotine remains on the outside. 'ust one rule to staying ree, none today@
-,
Quitting 23ou2
The real $you$ ne!er, e!er

needed nicotine. 4ou were ine on your own. The real $you$ didn"t need the sense o wanting satis action that arri!ed with each new supply, or the anxieties associated with needing more. The real us typically unctioned more towards the center, without nicotine"s eeding cycle mood swings. (o what i you ne!er, e!er needed to inhale or juice nicotine again8 7hat i your mind was once again allowed to be itsel , illed with a rich sense o calm while stimulating its dopamine pathways the natural way, !ia great la!ors, big hugs, cool water, a sense o accomplishment, riendship, nurturing, lo!e and intimacy8 7hat i days, weeks or e!en months passed com ortably, without once thinking about wanting to use nicotine8 7ould that be a good thing or bad8
Quitting "$. Reco"ery

Luitting is a word that tugs at emotion. -y de inition it associates itsel with departing, lea!ing, orsaking and abandonment. -ut the real abandonment took place on the day nicotine dependent pathways suppressed all remaining memory o the beauty o li e without nicotine, when no longer able to recall how antastic we unctioned without it. This book isn"t about quitting. 5t"s about reco!ering a person long ago orgotten, the real and wonder ul $you@$ The word $quitting$ tends to paint nicotine cessation in gray and black, in the doom and
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gloom o bad and horrible. 5t breeds anticipatory ears, inner demons, needless anxieties, external enemies and !isions o su ering. 5t osters a natural sense o sel -depri!ation, o lea!ing something !aluable behind. :ow, contrast quitting with reco!ery. ?eco!ery doesn"t run or hide rom our addiction. 5nstead, it boldly embraces who we became, and e!ery aspect o this temporary journey o re-adjustment. 7hen knowledge based, we"re looking or reco!ery symptoms, emotions, conditioning and junkie thinking, and !iew each encounter as an opportunity to reclaim another piece o a nicotineree li e. :icotine dependency reco!ery presents an opportunity to experience what may be our richest period o repair and sel -disco!ery e!er. Tissues are allowed to heal, senses awaken and the brain"s neuro-chemicals again low in response to li e not nicotine. 5t"s a period where each challenge o!ercome awards us another piece o our pu))le, a pu))le that once complete re lects a li e reclaimed. 5t is not necessary that we delete the word $quit$ rom our thinking, !ocabulary or this book <at least not entirely=. -ut it might be help ul to re lect upon when the real $quitting$ took place, when reedom ended and that next ix became li e"s primary objecti!e. &lthough probably impossible to belie!e right now, you won"t be lea!ing anything o !alue behind. :othing@ 6!erything done while under nicotine"s in luence can be done as well as or better as $us.$
Auried !li"e 'y .icotine 2! h2$

&gain, try to remember. 7hat was it like being you8 7hat was it like to unction e!ery morning without nicotine, to inish a meal, tra!el, talk on the phone, ha!e a disagreement, start a project or take a break without putting nicotine into your body8 7hat was it like be ore nicotine took control8 7hat was it like residing inside a mind that did not want or nicotine8 *ossibly the most ascinating aspect o drug addiction is just how quickly all remaining memory o li e without the drug gets buried by high-de inition wanting-relie memories. &s explored in Ehapter ., how can we claim to like or lo!e something when we ha!e almost no remaining memory o what li e without it was like8 7hat basis exists or honest comparison8 7hy be a raid o returning to a calm and quiet place where you no longer cra!e a chemical
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that today, e!ery day, you cannot seem to get o your mind, a chemical that is a mandatory part o e!ery day"s plan8 7hy ear arri!ing here on 6asy (treet with nearly a billion com ortably reco!ered nicotine addicts8 5s reedom o thought and action a good thing or bad8 5 good, why ear it8 ,ow wonder ul would it be to again reside inside a quiet mind where our addiction"s chatter gradually becomes in requent and then rare8 (la!e to our world o nicotine-normal, we were each pro!ided a new identity. Eapti!e brain dopamine pathways did their designed job and did it well. They le t us con!inced that our next nicotine ix was central to sur!i!al, as important as water or ood. 5 recently read disturbing comments posted by more than one hundred long-term nicotine gum addicts. Kne, a HF year-old woman, wrote, $5 ha!e to say, 5 traded one problem or another. 5 chew . mg /./A and can go through 3A0 pieces in less than F days. 5 ha!e been chewing :icorette now or 3/ years. 5 5 run out or a short time my mood becomes irrational. 5t is costing me more money than 5 ha!e. 5 ha!e chosen :icorette o!er ood many times.$1F 7e can only hope that such honesty leads her to ask and answer the bigger question, $why8$ ,ope ully someday soon she"ll eel what it"s like to com ortably engage her entire day without once wanting or nicotine. Eontrary to the alse sur!i!al training lesson constantly being pounded into her brain by her hijacked priorities teacher, she"d be lea!ing nothing o !alue behind. 6!en the lo!e in her heart, she"d get to bring it with her.
!n <n1ected 0i1e
7hether a closet user who hides their addiction, a low tolerance le!el addict whose twice daily use has them denying it, or a hea!y and open addict like 5 was, our dependency in ected ar more o li e than we care or cared to admit. Knce we permit oursel!es to begin looking closely, it becomes hard to ind any aspect o li e that wasn"t, to some degree, touched by our addiction. Kur endless eeding cycle was a perpetual interruption. &side rom the time de!oted to use, there was non-stop use planning, the need to re-supply, clean-up and returning to the acti!ity use had pre!iously interrupted, or to a new one. &s smokers, how many times daily did we suck 3 milligram o nicotine into our lungs8 &s snu users, how many times did a /.I gram pinch stay in your mouth until generating H.F milligrams o pure nicotine juice8 5 a chewer, how many times daily was A.B grams o
1F &sk&*atient.com , :icorette ;ser Database, 'anuary /I, /001 comments by a HF year-old emale user. &lso see *olito '?, %ong-term :icorette gum users losing hair and teeth, 7hyLuit.com, December 3, /001.
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loose tobacco jawed until letting go o ..I milligrams81A &nd then we"d wait or nicotine"s two-hour elimination hal -li e and a alling tonic dopamine le!el to command us to start again, or we"d accelerate elimination by encountering stress, drinking alcohol or consuming !itamin E.11 :icotine"s presence altered our body"s natural sensiti!ities, diminished our ability to relax, highjacked our priorities and consumed precious time. (moking it diminished lung unction while gradually destroying our body"s ability to recei!e and transport oxygen. 7hether smoked, chewed or sucked, tobacco diminished the accuracy o our smell and taste, while making us home to smoke"s more than .,000 chemicals or oral tobacco"s more than /,II0.1B 5 a smoker, we introduced up to 13 cancer causing chemicalsB0 and up to /1 carcinogens i an oral tobacco user.B3 %ike a mouse on an exercise wheel, there can be no end to this endless cycle o madness unless we get o , unless nicotine"s arri!al ends.
:orgotten Rel B tion

Two million years o e!olution prepared us to ight or lee the now extinct saber tooth tiger. Kur body"s response to sensing danger or sudden stress is acti!ation o the $ ight or light$ pathways o the sympathetic ner!ous system. :icotine also acti!ates these pathways.B/ :icotine"s arri!al in the brain causes the release o noradrenaline <nor-epinephrine=, which in turn causes more than 300 neuro-chemicals to prepare the body to run or its li e or ight. 5s it normal to spend the balance o li e under the in luence o an adrenaline releasing central ner!ous system stimulant8 -e ore climbing into bed to sleep, is it normal to consume a chemical that will make our heart pound up to 3A.I beats per minute aster,BH that ele!ates blood pressure, restricts
1A -enowit) :%, (ystemic &bsorption and 6 ects o :icotine rom (mokeless Tobacco, &d!ances in Dental ?esearch, (eptember 3BBA, Golume 33<H=, *ages HHF-H.3. 11 (pit)er, ', :e!er Take &nother *u , 7hyLuit.com, /00H. 1B ;.(. (urgeon Meneral, ?educing the ,ealth Eonsequences o (moking9 /I 4ears o *rogress9 & ?eport o the (urgeon Meneral9 3B1B, *age AB. B0 (mith E' et al, 5&?E carcinogens reported in cigarette mainstream smoke and their calculated log * !alues, Dood and Ehemical Toxicology, 'une /00H, Golume .3<F=, *ages 10A-13A. B3 5&?E #onographs on the 6!aluation o Earcinogenic ?isks to ,umans, (mokeless Tobacco and (ome Tobaccospeci ic :-:itrosamines, /00A, Golume 1B. B/ ,aass #, et al, :icotine and sympathetic neurotransmission, Eardio!ascular Drugs and Therapy, 'anuary 3BBA, Golume 30<F=, *ages FIA-FFI. BH *arrott &E et al, :icotine chewing gum </ mg, . mg= and cigarette smoking9 comparati!e e ects upon !igilance and heart rate, *sychopharmacology <-erlin=. 3B1B, Golume BA</=, *ages /IA-/F3 </ mg gum a!erage increase o I beats per minute ObpmP, . mg gum 30 bpm, smoking nicotine 3A.I bpm=,oulihan #6, et al, & double blind study o the e ects o smoking on heart rate9 is there tachyphylaxis8 *sychopharmacology <-erlin=, #ay 3BBB Golume 3..<3=, *ages H1-.. <max increase o 3I bpm=J also, :ajem -, et al, &cute cardio!ascular and sympathetic e ects o nicotine replacement therapy, ,ypertension, 'une /00F, Golume .A<F=, *ages 33F/-33FA <a!erage increase o A bpm=.
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extremity blood low causing the temperature o our ingers to drop up to se!en degrees, B. that accelerates breathing, dilates our pupils, perks our senses, shuts down digestion, and that triggers the release o glucose and ats rom our body"s energy stores8 &s acti!e addicts, most o us claimed that nicotine helped us relax. -ut acti!ating our ight or light response shows just how neuro-chemically con used we became regarding nicotine"s impact upon us. Try to imagine what it is like to go hours or an entire day without ha!ing adrenaline being pumped into your bloodstream. 7hat would it eel like to stop endlessly beating yoursel as i whipping a tired horse, to stop responding to non-existent saber tooth tigers, to again know and bask in ull and complete relaxation or extended periods o time8
:orgotten C lm #uring Cri$i$

,a!e you e!er noticed what you reach or during crisis8 That"s right - as just re!iewed - a ner!ous system stimulant. & ne!er-smoker and a smoker both experience lat tires while dri!ing in a ree)ing rain. They stop, get out and look at the lat. The ne!er-smoker sighs then immediately reaches or a jack to change the tire. &nd the smoker reaches or a ....8 That"s right, a cigarette. -ut why8 ,a!e you e!er watched the oaming that occurs when a liquid baking soda solution <a base or alkaloid=, is poured o!er an acid co!ered car battery terminal8 ,a!e you e!er seen a child create a !olcano by mixing baking soda with lemon juice or !inegar <both acids=8 4ou are watching ioni)ation, the mo!ement o hydrogen atoms as an acid and a base neutrali)e each other. :icotine is an alkaloid. (tress, anger, worry and ear cause the body"s luids to become more acidic, including our urine. (tress generated acids accelerate elimination o the alkaloid nicotine rom the bloodstream. The more stress ul the situation, the aster nicotine is eliminated. The urther rom your last nicotine replenishment when stress occurs, the greater the decline in tonic dopamine, the sooner and more intense the wanting that"s elt. The stressed nicotine addict is orced to reach or a central ner!ous system stimulant in order to battle the sudden onset o early nicotine withdrawal, be ore turning their attention to the underlying stress ul e!ent <the lat tire=.
B. %orillard Tobacco Eompany, >illian ?esearch %aboratories, 5nc., 3B.B-3BII,
http9//tobaccodocuments.org/lor/BIH0BIAB-BI1B.html
62
The measure o the acidity or base <alkalinity= o a solution is known as its p, <the $power o hydrogen$=. The p, scale ranges rom 0 to 3., with 0 being the strongest acid, 3. the strongest base, and A being neutral. & luid with a p, o I is ten times more acidic than a luid ha!ing a p, o F. -oth human bloodBI and nicotineBF are weak bases <alkaloids= ha!ing a p, o about A... Kn the acid side, cranberry juice has a p, o /.H to /.I, !inegar a p, o H, orange juice H.H to ..3,BA table wine H.H to H.A,B1 beer H.A to ..3,BB and whiskey a p, o about I. *ure drinking water has a p, o A and resh milk about F.A. 7hether caused by sudden emotional turmoil, !itamin E or alcohol use, the more acidic our urine, the greater the rate o nicotine depletion.300 &lthough it sounds totally backwards, the literature suggests that the rate o elimination has to do with how the kidneys unction. 5n one study, an increase in urine acidity rom a p, o I.F to a p, o ..I <making it 33 times more acidic= caused a /0FC increase in the rate nicotine was eliminated rom the bloodstream by the kidneys, and a .3C increase in the rate o total nicotine clearance rom the body.303 7hile we cannot a!oid all stress ul situations or pre!ent them rom causing chemical interactions within body luids, there would be )ero impact upon nicotine reser!es i nicotine was no longer present in our bloodstream. %i e as a nicotine addict is hard. 7e compounded stress ul situations by adding the onset o withdrawal to them. 5n battling withdrawal, we acti!ated our body"s ight or light response. Knce done ser!icing our addiction the tire was still lat. 7hat would it be like to no longer add the onset o early nicotine withdrawal to e!ery stress ul situation li e throws your way8 5magine being ar calmer during crisis. 7hat was it like being you8
:orgotten Are thing 9 %ndur nce

(mokers not only su er rom nicotine addiction but the ra!aging e ects o thousands o
BI The #erck #anuals Knline #edical %ibrary, Disorders o :utrition and #etabolism, &cid--ase -alance,
Debruary /00H, http9//www.merck.com/ BF 5nternational *rogramme on Ehemical (a ety, 5:E,6#, :icotine, #arch 3BB3, http9//www.inchem.org BA DD&, &pproximate p, o Doods and Dood *roducts, &pril /00A. B1 *andell, &', The &cidity o 7ine, 3BBB. BB #urphy and (on %imited, The p, o -eer, http9//www.murphyandson.co.uk, 'uly ., /001 300 (chachter, ( et al, (tudies o the interaction o psychological and pharmacological determinants o smoking9 55. 6 ects o urinary p, on cigarette smoking, 'ournal o 6xperimental *sychology9 Meneral, #arch 3BAA, Golume 30F<3=, *ages 3H-3B. 303 -enowit) :% et al, :icotine renal excretion rate in luences nicotine intake during cigarette smoking, 'ournal o *harmacology and 6xperimental Therapy, 'uly 3B1I, Golume /H.<3=, *ages 3IH-3II.
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inhaled chemicals upon their lungs and respiratory system. 7hat was it like to run like the wind, to engage in an extended period o brisk physical acti!ity without becoming seriously winded8 7hat was it like to climb light a ter light o stairs, to play ull-court basketball, or to chase a child or the amily pet without ending up gasping or air8 6!ery now and then 5 meet a current smoker who proudly boasts that they enjoy running. 7hat they don"t seem to appreciate is the tremendous strain they subject their heart and body to when doing so. 5t"s a matter o the a!ailability o su icient oxygen to keep !igorously working muscle well ueled and ali!e. Earbon monoxide is a colorless, odorless toxic gas produced when any carbon-based material is burned, including tobacco. 7hen smoking, the amount o carbon monoxide entering the bloodstream !aries greatly <up to /Img per cigarette= depending upon such actors as how intensely the smoker smokes, whether or not they co!er the ilter !entilation holes with their lips, and the particular brand smoked. 7ithout oxygen the body"s cells su ocate and die. The primary unction o our lungs is to allow the entry o li e-gi!ing oxygen rom the atmosphere into our bloodstream, and to then trans er carbon dioxide rom our bloodstream back out into the atmosphere. This exchange o gases takes place within an estimated .10 million thinly walled air sacs called al!eoli.30/ -ut sucking large quantities o carbon monoxide into our lungs changes the playing ield. ,emoglobin is the portion o each red blood cell that transports a new supply o oxygen rom the al!eoli in our lungs to our more than I0 trillion li!ing cells throughout the body. Kne hemoglobin molecule can transport up to . oxygen molecules. The problem is, when smoking, i both an oxygen molecule and a carbon monoxide molecule arri!e at an air sac at the same time, the carbon monoxide molecule always wins and the oxygen molecule is always le t behind.
30/ Kchs # et al, The number o al!eoli in the human lung, &merican 'ournal o ?espiratory and Eritical Eare
#edicine, 'anuary 3, /00., Golume 3FB<3=, *ages 3/0-3/..
6-
The chemical attraction between carbon monoxide and hemoglobin is /00-/I0 times greater than with oxygen.30H 7hat"s worse, once attached to hemoglobin, carbon monoxide"s long chemical bloodstream hal -li e o / to F.I hours30. destroys the ability o red blood cells to engage in transporting oxygen. Think about that last pu . Kne-hal o the carbon monoxide in it will still be circulating inside your bloodstream roughly our hours later. 5s it any wonder that our heart and body rebelled when we attempted !igorous exercise, hours a ter smoking8 7e don"t just depri!e our heart and muscles o oxygen. 7e daily paint the inside o our lungs with the .,000 chemicals that the tobacco industry collecti!ely re ers to as tar. 5t"s too little oxygen and too much gunk. 7e like to think that most o what we suck into our lungs is exhaled but it just isn"t so. :inety-se!en percent o ::: <possibly the most potent lung cancer causing chemical o all= is not exhaled but remains inside. 5t"s the same absorption rate as nicotine. :inetyse!en percent o inhaled nicotine isn"t exhaled.30I 5magine tra!eling through li e with lungs so marinated and caked in toxic tars that it signi icantly diminishes lung unction. 7hat would it be like to allow nearly destroyed bronchial tube sweeper brooms to re-grow <our cilia= and begin the process o sweeping gunk rom air passages8 5magine allowing all still unctioning air sacs <al!eoli= time to clean and heal. 7hat would it be like to experience a signi icant increase in o!erall lung unction8 5magine gi ting yoursel the ability to build cardio!ascular endurance again, to ha!e nearly all o your hemoglobin transporting li e-gi!ing oxygen.
:orgotten ;en$iti"itie$
7here is the real neuro-chemical you8 5s it normal to administer a stimulant that makes the heart pound 3A beats per minute aster when trying to relax8 5s it normal to use an external chemical to induce a dopamine $aaah$ wanting relie sensation upon hearing that a riend has been hurt or a lo!ed one has died8 Kur dependency robs us o our emotional sel -identity and sensiti!ities. The millions o extra acetylcholine receptors it grew inside our brain not only created a barrier to eeling nicotine"s ull e ects but an insensiti!ity to li e itsel .
30H #eredith T et al, Earbon monoxide poisoning, -ritish #edical 'ournal, 'anuary 3B11, Golume /BF, *ages AAAB.
30. 7orld ,ealth Krgani)ation. 6n!ironmental ,ealth Eriteria /3H - Earbon #onoxide <(econd 6dition=. 7,K,
Mene!a, 3BBBJ 5(-: B/ . 3IA/3H / <:%# classi ication9 LG FF/=. 5((: 0/I0-1FHR. 30I Deng (, & new method or estimating the retention o selected smoke constituents in the respiratory tract o smokers during cigarette smoking, 5nhalation Toxicology, Debruary /00A, Golume 3B</=, *ages 3FB-3AB.
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5t isn"t that the basic person and personality underlying nicotine dependency is signi icantly di erent. 5t"s that their addiction has disrupted their sensiti!ities, and has the wrong chemicals lowing at the wrong times. &side rom dopamine, nicotine has command and control o serotonin, our stress busting neurotransmitter with ties to mood, impulse control, anger and depression.30F 5ncluded among the estimated /00 neuro-chemicals that nicotine controls, mediates or regulates are acetylcholine, arginine !asopressin,30AM&-&,301 glucose,30B glutamate,330 neuropeptide (,333 anti-apoptotic R5&*,33/ epinephrine and nor-epinephrine. 7hat is it like to na!igate nicotine dependency reco!ery, arri!e home and or the irst time in a long time allow li e, not nicotine, to decide which neuro-chemicals your awareness will sense8
:orgotten ;en$e$
7e sometimes hear tobacco users tell us that they smoke, chew, dip or !ape or the la!or or aroma. 5 you ha!en"t heard others say it, you"!e certainly seen tobacco industry marketing suggest it. Truth is, power ul tobacco toxins rob users o the ability to accurately smell and taste. 5 used to barely get through the bank door to make the daily deposit when one cashier, without looking up, would say, $,i 'ohn@$ Kne day 5 made the mistake o
30F ?ausch '% et al, 6 ect o nicotine on human blood platelet serotonin uptake and e luxm, *rogress in
:europsychopharmacology + -iological *sychiatry, 3B1B, Golume 3H<F=, *ages B0A-B3F. 30A 4u M, et al, :icotine sel -administration di erentially regulates hypothalamic corticotropin-releasing actor and arginine !asopressin m?:&s and acilitates stress-induced neuronal acti!ation, 'ournal o :euroscience, #arch 3/, /001, Golume /1<33=, *ages /AAH-/A1/. 301 Shu *', et al, :icotinic receptors mediate increased M&-& release in brain through a tetrodotoxin-insensiti!e mechanism during prolonged exposure to nicotine, :euroscience, /00/, Golume 33I<3=, *ages 3HA-3... 30B #organ T#, et al, &cute e ects o nicotine on serum glucose insulin growth hormone and cortisol in healthy smokers, #etabolism, #ay /00., Golume IH<I=, *ages IA1-I1/. 330 %iechti #6, ?ole o the glutamatergic system in nicotine dependence, E:( Drugs, /001, Golume //<B=, *ages A0I-A/.. 333 %age ?, et al, :icotine treatment regulates neuropeptide ( system expression in the rat brain, :eurotoxicology, :o!ember /00A, Golume /1<F=, *ages 33/B-33HI. 33/ Shang ', et al, :icotine 5nduces ?esistance to Ehemotherapy by #odulating #itochondrial (ignaling in %ung Eancer, &merican 'ournal o ?espiratory Eell and #olecular -iology, &ugust 3,/001, O6pub ahead o printP.
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asking how she knew it was me. $7hen the door closes behind you,$ she said, $a rush o air that smells like smoke announces your arri!al.$ 5t hurt. 5 didn"t know whether to change banks or brands. (ensory ner!e endings in the mouth and nasal passages begin healing within three days o ending tobacco use. Does e!erything smell and taste better8 :o. &s my mentor 'oel puts it, you smell and taste e!erything more accurately, but that does not necessarily mean better. &s 'oel notes, that irst spring will bring the aroma o lowers that will likely be ar more intense than you percei!ed while smoking. -ut wait until you dri!e by a garbage dump or sewage treatment plant. The same is true o taste. 7ith an accurate sense o taste, there may be la!ors you thought you liked that no longer appeal to you, or oods you were con!inced were horrible that now become wonder ul. 7hat is it like to smell co ee brewing more than a hundred eet away8 5magine being able to identi y e!ery smoker you meet by the thousands o chemicals which coat their hair, skin and clothing. Dlour isn"t just white and rain just wet. They both o er subtle yet distinct aroma experiences. Think about ha!ing missed out on the natural smell o those you lo!e, the scent o a new baby, the aromas that tease as we walk past a bakery, or eeling compelled to stop and smell e!ery lower, as i planted just or you. 7hat is it like to li!e with healed senses8 $Eome to where the la!or is.$ Eome home to you@
:orgotten Me ltime
5 almost ne!er ate break ast and usually skipped lunch. ,owe!er, that"s not entirely accurate. 4ou see, nicotine was my spoon. :icotine was my spoon. 7ith each pu , nicotine acti!ated my body"s light or light response, which would almost instantly dump stored ats and sugars <glucose= rom my li!er into my bloodstream. 5"d normally eat just one large meal at the end o each day. & portion o that meal was stored and the next day 5"d use nicotine to release it.
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The consequences o torturing my body this way were many, including a ..C increase in the risk o de!eloping type 55 diabetes </BC or light smokers and F3C or hea!y smokers o more than /0 cigarettes per day=.33H 5 had long ago orgotten how to properly uel my body. (moking F0 cigarettes per day, about one e!ery 3I minutes, 5 had ew hunger cra!ings and little experience satis ying them. 5 repeatedly tried to na!igate early reco!ery without awareness that nicotine had become my spoon. :ot only did 5 endure nicotine cra!ings, 5 added hunger cra!ings. 5 endured a number o hypoglycemic-type symptoms including mind og and an inability to concentrate. &n utter mess, 5 tried to eat my way out o ood cra!es. 5t made reco!ery !astly more challenging than it needed to be. The result was always the same9 needless cra!ings, anxieties, extra pounds, relapse and ailure. -ut back to our theme, what was it like to eed yoursel , to uel your body on a regular basis, to sit with riends and eat like a normal person8 7hat would it be like to no longer make excuses to lea!e the meal early in order to replenish missing nicotine, to stay and com ortably sa!or the a ter dinner con!ersation or as long as possible8
%Btr Wor(wee($
& 3/ cigarette per day smoker who spends an a!erage o I minutes per cigarette de!otes one hour per day to smoking. That"s HFI smoking hours per year. -roken down into .0hour workweeks, that"s B ull workweeks per year spent ser!icing their addiction. 6!en while spitting, oral tobacco users easily blend in and hide where bellowing smoke cannot. ;sually they require ewer nicotine ixes, each deli!ering substantially more nicotine than inhaled rom a cigarette. -ut honest calculation o the total time each day spent ser!icing the oral user"s addiction is likely to show as much or more than or smokers. %ocating a spit container, your tin, can, pouch, bag or box, tapping the lid, packing the can or opening the package, sni ing or otherwise packing or loading up, working the dip, wad, pouch, orb, strip, gum or lo)enge, sucking or chewing while waiting or nicotine to slowly penetrate mouth tissues and enter the bloodstream as anxieties gradually build, spitting or swallowing juices, parking periods, and disposing o spit, used tobacco or gum, it all adds up. 5magine gi!ing yoursel a two-month !acation rom work each year. 7hat would it be like
33H 7illi E et al, &cti!e smoking and the risk o type / diabetes9 a systematic re!iew and meta-analysis, 'ournal o
the &merican #edical &ssociation, December /00A, Golume 3/J/B1<//=, *ages /FI.-/FF..
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to reclaim such a massi!e chunk o li e8 7hat would it be like or your days to be entirely yours8 7hat i your mouth, hands and time were again yours without precondition8 7here would you go, what would you do, and what would you become i not chained to mandatory eedings8
:orgotten Prioritie$, :or$ (en 0i1e

5t is entirely normal or drug addicts to truly and deeply belie!e that drug use enhances li e, that it punctuates rather than interrupts it. -ut rarely do they stop and re lect upon the realities o capti!ity and ull price o bondage. :icotine"s two-hour elimination hal -li e in human blood serum is a eeding clock without eeling or conscience. 5t cannot respect li e, time or priorities. 7hen nicotine reser!es and tonic dopamine begin alling, it will not matter i the moment being interrupted is the most wonder ul o our entire day, year or li e. The mind"s sur!i!al instincts moti!ator is capti!e to nicotine. The lesson this circuitry"s design now compels it to !i!idly and irmly implant within our brain is that nicotine use is core to sur!i!al, as important as ood. 5n act, nicotine use becomes more requent and trumps eating instincts. *art o our body"s ight or light response is to shut down digestion, so as to di!ert more blood to large muscles. &ny acti!ity lasting longer than the time we could com ortably go between nicotine eedings became a sacri icial lamb. 7here might we ha!e gone, what might we ha!e done and whom might we ha!e met8 7hat learning was missed8 Ehemical dependency onset did more than simply modi y our core sur!i!al instincts. 5t became ele!ated abo!e amily, riends, ood, work, accomplishment, romance, lo!e and concentration. 4ou"d think we would ha!e immediately questioned such a massi!e shi t in priorities. ,ow could we not notice the amount o time de!oted to nicotine and its impact upon our senses, sensiti!ities, relaxation, crisis management, meals and moods8
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7e didn"t notice because nicotine had our ocus di!erted elsewhere. &ll we could think about was that next ix, satis ying that next urge, and eeling nicotine-normal again. Knce bra!e enough to !enture beyond nicotine"s in luence, hidden truths become ob!ious. $?eal choice$ gets introduced into the equation. 7e become the jailer, and our dependency the inmate. Knce home, the ull la!or o li e can be sa!ored and celebrated. 7hat"s there to lose by coming home or a !isit8 &nd there"s just one rule to arri!ing ... none today.
80
Ch pter -
4$e R tion li5 tion$ & #eni l=$ W ll o1 <llu$ion
7hat i
you truly belie!ed that there was absolutely nothing good about spending the balance o li e as nicotine"s sla!e8 :othing@ 5magine being totally una raid to let go entirely o your chemical relationship to nicotine. 7illing to let go, imagine reco!ery in!ol!ing ar ewer ear dri!en anxieties than during any prior attempt. 5nstead o ighting reco!ery, imagine welcoming and embracing it. The chapter will aid in recogni)ing, analy)ing and destroying common use justi ications, i that be your desire. &nd 5 hope it is. 5magine how much easier letting go would be i totally con!inced that absolutely nothing o !alue was being le t behind. <n"enting 4$e R tion li5 tion$ ,ow many times did we tell oursel!es that we needed to use nicotine because we were happy or sad, to stimulate or relax us, to accompany a thrill or because we were bored, to help us concentrate or to take our mind o things, or because we were around other smokers or alone, lonely and bored8 7e in!ented a reason as to why this was the per ect time to use or nearly e!ery situation imaginable. To $rationali)e$ is to attempt to explain or justi y our actions or belie s, o ten with little or no regard or truth. ?ationali)ations are de ense mechanisms or making threatening conduct non-threatening. They are a means by which we attempt to justi y or make tolerable eelings, beha!iors and moti!es that would otherwise be intolerable.33. ?ationali)ations are o ten personal and compelling. 7hile a young smoker, 5 looked upon my chainsmoking mother with her emphysema-riddled lungs and non-stop cough and rationali)ed to mysel , $5"m still young, ar younger than she is.$ $5 ha!en"t hurt mysel yet, so it"s still sa e or me to smoke, at least or now.$ %ittle did 5 then appreciate that 5 was already just as addicted as mom. 5 also couldn"t oresee how
33. Knline #edical Dictionary, ?ationali)ation, Department o #edical Kncology, ;ni!ersity o :ewcastle upon
Tyne, 'uly /, /001
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emphysema would so weaken her that it would diminish her cancer treatment options, and that she"d die just two years a ter her own mother"s death. 5t"s normal to think that plenty o time remains to get serious about breaking ree. 5t"s logical to think that we"ll get serious at the irst sign o a serious tobacco related health concern. ;n ortunately, when truth slaps such rationali)ations hard, most simply in!ent new ones. 7hat percentage o the roughly hal o ;.(. adult smokers who"ll lose an a!erage o 3H to 3. years o li e will ride the $there"s still time$ rationali)ation until it collides with $it"s too late now$ hopelessness8 ,ow many will journey rom $5"ll stop soon$ to $you ha!e to die o something$8 7ill seriousness arri!e once the doctor diagnoses you with your irst smoking related disease, once told that you ha!e chronic bronchitis, circulatory disease, adult onset diabetes or emphysema8 5 an oral user, will that irst precancerous leukoplakia or that irst root canal be enough8 The problem is, while ear can and o ten does moti!ate action, it has little sustaining power. 7e can only stay a raid or so long be ore growing numb to it. & /00/ study ound that only //C o lung cancer patients who attempted to stop smoking by enrolling in the #ayo Elinic :icotine Dependence Eenter were smoke- ree six months a ter the program.33I 5magine the birth o hundreds o additional use rationali)ations between $5"m still young$ and $5t"s too late.$ 5magine each being in!ented by a mind that knows ama)ingly little about nicotine dependency or reco!ery rom it. 5magine being the user who always justi ied today"s nicotine purchase <always only a single day"s supply= by promising yoursel that tomorrow you"d stop. &lternati!ely, imagine being the user who always purchased a multiple day"s supply, in!iting the rationali)ation that now isn"t the right time to stop because your remaining supply would go to waste. Tobacco industry marketing is designed to support the addict"s need or alternati!e use explanations. *leasure, taste, a / or 3 sale, impro!ed menthol, a coupon, your store"s new $come to where the la!or is$ sign, a antastic price on cartons, ;.(. tobacco companies spend at least T3. billion annually to keep us con!inced that we use their products or e!ery reason imaginable, except the truth. 7e use them because we must. 7e do so because tonic dopamine declines and anxieties rise when we don"t. (tated another way, the tobacco industry spends billions each year to
33I (anderson E%, et al, Tobacco use outcomes among patients with lung cancer treated or nicotine dependence,
'ournal o Elinical *sychology, &ugust /00/, Gol. /0, 5ssue 3F, *ages H.F3-H.FB.
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keep you brainwashed and belie!ing that there"s !alue in using, to make you ear letting go. 6!en the names o most brands, a name repeated each time we purchased more, burned into our brain a sense that we"d lose something i we stopped. Think about the emotional sense o loss in breaking strong sel -identity ties to such brand names as9 &lpine, &pple 'ack, -asic, -eech :ut, -elair, -elmont, -est Galue, -ig #ountain, -lack Kwl, -lu, -ond, -ucks, -uglar, Eambridge, Eamel, Eannon -all, Eapital, Eaptain -lack, Ehampion, Ehester ield, Elass &, Eopenhagen, Eleopatra, Eloud B, Eougar, Dark ,orse, Derby, 6agle, 6clipse, 6n!y, Docus, Mold Eoast, Mold ?i!er, Molden Mate, Mrand *rix, Mreen (moke, Mri))ly, ,al + ,al , ,usky, 'ade, >ayak, >ent, >ing 6dward, >iss, >odiak, >ool, >nights, % + #, %ady, %ark, %iberty, %ucky (trike, #ain (treet, #arlboro, #arshal, #a!erick, #erit, #ild (e!en, #isty, #onarch, #ontecristo, #ore, #ustang, :atural &merican (pirit, :ewport, :joy, :ow, *alace, *aladin, *arliament, *assion, *assport, *eachy, *layers, *ride, *rince, *rince &lbert"s, *ure :atural, *yramid, Luality, ?a!e, ?ed #an, ?ed ?i!er, ?ich, ?i!iera, ?omeo y 'ulieta, ?ooster, ?osebud, ?osetta, (amson, (atin, (a!annah, (ignature, (il!er Ereek, (ir 7alter ?aleigh, (ky Dancer, (onic, (outh -each (moke, (outhern ,ar!est, (port, (pringwater, (tyle, (undance, (wisher (weets, Tempo, Top, Tourney, Triumph, True, ;(& Mold, Gantage, Gel!et, Giceroy, Girginia (lims, Gogue, 7a!e, 7hite Eloud, 7ild Meese, 7ild ire, 7ildhorse, 7ind, 7indsail, 7inston, 7orkhorse, 4ours and Sig Sag. Elearly, the industry ully understands chemical dependency upon nicotine and intentionally plays upon the wanting within in keeping users hooked. Kur lack o dependency understanding made us rather in!enti!e when trying to explain our continuing need to eed. %et"s look at a ew common use rationali)ations that were bred and ueled by our lack o understanding. &s we re!iew common use rationali)ations, notice that there are three basic types9 <3= alternati!e use explanations that aid in denying dependencyJ </= rationali)ations that minimi)e the costs and harms o useJ and <H= reco!ery a!oidance or relapse justi ications.
Chemic l to :riend
5magine the illness inside a mind that looks upon nicotine as a $ riend.$ 5t was always there, ne!er let us down, calmed us during crisis <or so we thought=, ne!er argued, a loyal and trusted companion more dependable than a dog. *retending that our addiction is human comes easily, at least until honesty arri!es. %ike table salt, nicotine can"t talk. :ot one word. ;nlike a dog, it ne!er, e!er demonstrates a ection or is happy to see us. &nd nicotine"s most dependable attribute is its ability to keep us dependent upon it.
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$#y Eigarette, #y Driend$ is the most amous $ riend$ rationali)ation buster e!er.33F 7ritten by my mentor 'oel (pit)er, in it he asks, $,ow do you eel about a riend who has to go e!erywhere with you8 :ot only does he tag along all the time, but since he is so o ensi!e and !ulgar, you become unwelcome when with him. ,e has a peculiar odor that sticks to you where!er you go. Kthers think both o you stink.$ &s 'oel notes, nicotine addiction is about surrendering control. 5t"s about putting li e on pause come replenishment time. 5t compels smokers to ind an acceptable place to eed, e!en during bad weather. 5t"s about being orced to go buy more, spending thousands upon thousands during our years as users. &s a nicotine smoker it depri!es us o engaging in prolonged !igorous acti!ities. $4our riend won"t let you,$ writes 'oel. $,e doesn"t belie!e in physical acti!ity. 5n his opinion, you are too old to ha!e that kind o un. (o he kind o sits on your chest and makes it di icult or you to breathe. :ow you don"t want to go o and play with other people when you can"t breathe, do you8$ Kur $ riend,$ notes 'oel, $does not belie!e in being healthy. ,e is really repulsed by the thought o you li!ing a long and producti!e li e. (o e!ery chance he gets he makes you sick. ,e helps you catch colds and lu.$ $,e carries thousands o poisons with him, which he constantly blows in your ace. 7hen you inhale some o them, they wipe out cilia in your lungs which would ha!e helped you pre!ent these diseases.$ $-ut colds and lu are just his orm o child"s play. ,e especially likes diseases that slowly cripple you - like emphysema. ,e considers this disease great. Knce he gets you to ha!e this, you will gi!e up all your other riends, amily, career goals, acti!ities - e!erything. 4ou will just sit home and caress him, telling him what a great riend he is while you desperately gasp or air.$ $-ut e!entually your riend tires o you,$ 'oel reminds us. $,e decides he no longer wishes to ha!e your company. 5nstead o letting you go your separate ways, he decides to kill you. ,e has a wonder ul arsenal o weapons behind him. 5n act, he has been plotting your death since the day you met him. ,e picked all the top killers in society and did e!erything in his power to ensure you would get one o them. ,e o!erworked your heart and lungs. ,e
33F (pit)er, '., $#y Eigarette, #y Driend,$ 7hyLuit.com, 'oel"s %ibrary, 3BB0.
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clogged up the arteries to your heart, brain, and e!ery other part o your body. 5n case you were too strong to succumb to this, he constantly exposed you to cancer causing agents. ,e knew he would get you sooner or later.$ Kur cigarette, e-cig, cigar, pipe, chew, dip, snus, gum or lo)enge was the means by which nicotine entered our bloodstream. 5t is no more a riend than is a stainless steel spoon. $Driend,$ asks 'oel8 Eigarettes are $expensi!e, addicti!e, socially unacceptable and deadly.$ 6xpense, time demands, and increasing social unacceptability are common to all orms o nicotine deli!ery. 7hile each poses di erent le!els and types o risks, the orm o deli!ery does not alter the super-toxin nicotine"s risks, including its ability to keep us its sla!e. 5t"s increasingly common to see those hooked on nicotine replacement products or ecigarettes treat their orm o deli!ery as though their sa!ior or hero. Elearly, the risks posed by nicotine alone are !astly less than smoking"s. ,owe!er, nicotine"s continued use, in any orm, is :KT sa e. 5 you ha!e 5nternet access, go to www.*ub#ed.go!. *ub#ed is the ;.(. go!ernment"s medical study search engine. (earch the word $nicotine.$ #y search on &ugust /B, /001, produced 30,/0I journal articles ha!ing nicotine in the title. 5n the ootnote below 5 cite titles to a ew o the papers published during &ugust /001. 33A &s you can see, it isn"t necessary or anyone to resort to scare tactics or exaggeration regarding nicotine"s e ects upon the body. The truth is bad enough. 7hile personi ying any chemical arti icially in lates emotional bonds and attachments to it, it"s still just a chemical. 7hile nicotine cannot think or eel, just one pu will acti!ate up to hal o our brain"s dopamine pathway receptors. Kne sure ire way to end the need to in!ent chemical riends is to make sure all nicotine stays on the outside.
33A Gagleno!a ', %ong-lasting teratogenic e ects o nicotine on cognition9 Mender speci icity and role o &#*& receptor unction, The :eurobiology o %earning and #emory, &ugust 3/, /001 O6pub ahead o printPJ also see, (omm 6, et al, *renatal :icotine 6xposure &lters 6arly *ancreatic 5slet and &dipose Tissue De!elopment with Eonsequences on the Eontrol o -ody 7eight and Mlucose #etabolism %ater in %i e, 6ndocrinology, &ugust A, /001 O6pub ahead o printPJ also see ,uang 44, et al, Ehronic nicotine exposure induces a long-lasting and pathway-speci ic acilitation o %T* in the amygdala, %earning + #emory, &ugust F, /001, Golume FJ3I<1=, *ages F0H-F30J also see, Shang ', et al, :icotine 5nduces ?esistance to Ehemotherapy by #odulating #itochondrial (ignaling in %ung Eancer, &merican 'ournal o ?espiratory Eell + #olecular -iology, &ugust 3, /001 O6pub ahead o printPJ also see, -aykan &, et al, The protecti!e e ect o melatonin on nicotine-induced myocardial injury in newborn rats whose mothers recei!ed nicotine, &nadolu >ardiyol Dergisi, &ugust /001, Golume 1<.=, *ages /.H/.1J also see, #archei 6, et al, ;ltrasensiti!e detection o nicotine and cotinine in teeth by high-per ormance liquid chromatography/tandem mass spectrometry, ?apid Eommunications in #ass (pectrometry, &ugust /001, Golume //<3F=, *ages /F0B-/F3/.
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2< li(e it2 & 2< lo"e it2

Think hard. 7hat, i anything, do you lo!e about smoking, !aping or about using oral tobacco or :?T8 5 a smoker, what"s so wonder ul that we were willing to destroy this body, creating a I0/I0 chance o departing earth I,000 days early8 5 an oral tobacco user, how much lo!e does it take to permanently expose your mouth to unadulterated tobacco"s /,II0 chemicals8 &s dependent users we li!ed a constant struggle to maintain a narrow range o nicotine in our bloodstream, so as to remain in our nicotinenormal )one o com ort. 6ach time our blood serum nicotine le!el ell below our minimum limit, our tonic dopamine le!el declined and we starting sensing the onset o urges and wanting. 7e grew tense, anxious, irritable and depressed, and the only path to immediate relie was more nicotine. Knce replenished, we were le t totally con!inced that we $enjoyed smoking,$ $liked chewing,$ $relished !aping,$ or $lo!ed our snus.$ Kn the other end, we also had to be cautious not to use too much nicotine and exceed our upper limit o tolerance, or risk su ering !arying degrees o nicotine poisoning. 6arly symptoms can include eeling sick, nauseous and di))y. &s 'oel notes, being a success ul user is like being an accomplished tightrope walker, constantly maintaining a balance between these two pain ul extremes o too much or too little.331 &ccording to *hilip #ichels, *hD, a ;(E (chool o #edicine pro essor and cessation acilitator, it is normal or us to look to our own beha!ior in order to obtain clues about our attitudes and belie s. 7e tend to draw conclusions about what we must like, by watching what we see oursel!es doing. (uch sel -analysis goes like this9
0ogic l 3et : l$e Re $oning

< don=t do thing$ < don=t li(e to do. < $mo(e lot$ nd lot$ o1 cig rette$.
331 (pit)er, ', $5 smoke because 5 like smoking,$ an article in 'oel"s ree *DD book :e!er Take &nother *u ,
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/hu$, < mu$t re lly lo"e $mo(ing.
5gnorance is bliss. :ow let"s look at how in ormed analysis might low9
0ogic l 9 /rue Re $oning

< don=t do thing$ < don=t li(e to do. < $mo(e lot$ nd lot$ o1 cig rette$. % ch pu11 de$troy$ more o1 my 'ody. <=m ctu lly $lowly (illing my$el1. <="e le rned nicotine i$ highly ddicti"e. <="e tried 're (ing 1ree 'ut 1 iled. /hu$, <=m pro' 'ly 2re l2 drug ddict.
The most compelling argument supporting like or lo!e re!ol!es around the undeniable dopamine $aaah$ wanting relie sensation that arri!es with replenishment. -ut e!en here the rationali)ation relies hea!ily upon selecti!e memory. 7hen !aluing replenishment, is it air to ignore the urges and anxieties that preceded our $aaah$ relie sensation8 5 we had waited longer prior to using, wouldn"t e!ery wanting relie sensation ha!e had a corresponding anxiety and depression riddled low preceding it8 Tanking up early and o ten allowed us to a!oid the downside. (till, most nicotine addicts know that $where are my cigarettes8$ eeling, and the emotions that accompany the $5 need a nicotine ix ... &:D :K7$ eeling@@@ &t 'oel"s clinics he identi ies the two pack-a-day smokers who insist that they smoke because o the $good cigarettes$ or because they $like$ smoking. $Dirst 5 ask them to tell me which cigarettes stand out in their mind as being really great cigarettes on any gi!en day. ;sually they will o er up the irst one or two they ha!e when they wake up, the ones a ter meals and maybe one or two others that they ha!e on certain breaks.$ 'oel watches as they try to think o other good ones but none seem to come to mind.33B $5 simply point out that we ha!e a mathematical problem occurring here. They ha!e come up with i!e to se!en good cigarettes yet they are smoking orty or more cigarettes a day. 7here are those other cigarettes8$ &s 'oel points out, a ew were smoked and tasted nasty while others were marginal but as soon as they were snu ed out they can"t e!en be recalled. $(o here we ha!e a ew good cigarettes, a ew lousy cigarettes and a whole bunch o what now seem to be insigni icant cigarettes.$
33B (pit)er, ', $5 smoke because 5 like smoking,$ Debruary /3, /003, http9//www. n.yuku.com/topic/3A3HA
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&s 'oel notes, while there may be some good ones, they ha!e to be accompanied by all o the mediocre and miserable ones, and when it comes down to it, $all o them, e!en the good ones, are killing them.$ ?egarding the ew identi ied as $good cigarettes,$ 'oel poses a ollow-up question. $,ow much do you like smoking8 Do you like smoking more than you like something like, oh, 5 don"t know...something like maybe ... breathing8$ 5 we say we $like smoking$ are we also saying we like the morning phlegm in our lungs and the need or water or a $horribly dry throat$8 7hat about the nasty taste it lea!es in our mouth and how it makes oods taste bland8 5 a pack-a-day smoker, do we like de!oting an hour and a hal each day to eeding our addiction8 7hat about o ten eeling hurried, the dirty brown ilm on the inside o the car windshield, rush hour anxieties depleting nicotine reser!es quicker, being unable to smoke while at work, attempting to run and being le t with a throbbing heart that wants to explode, or standing in line to buy more nicotine, are we saying we like them too8 3/0 ,ow can we claim to like or lo!e something when we ha!e no legitimate basis or comparison8 5 no longer able to remember and explain what it elt like to reside inside our mind be ore nicotine took control, i we cannot recall the calm and quiet mind we once called home, then what basis exists or asserting that we lo!e using nicotine more than we miss the prenicotine us8 ,ow can we talk about lo!e i we cannot remember who we were be ore climbing aboard an endless roller-coaster ride o nicotine-dopamine-adrenaline highs and lows8 &s real drug addicts in e!ery sense, with blind obedience to the wanting within, $what"s lo!e got to do with it$8
3/0 (pit)er, ', $-oy, do 5 miss smoking@$ #arch B, /003. http9//www. n.yuku.com/topic//0FFI
8+
2<t relie"e$ $tre$$ nd nBiety2

5t is normal and natural to belie!e that smoking is a stress buster, that it calms us during crisis. ,ow could we not belie!e it8 7e elt it happen hundreds or maybe e!en thousands o times. &s re!iewed in Ehapter H <$Dorgotten Ealm During Erisis$=, stress relie is one the most relied upon yet easily debunked use rationali)ations o all. &nd it isn"t news to the nicotine addiction industry. &ccording to a once secret 3B1H -rown + 7illiamson research memo, $*eople smoke to maintain nicotine le!els$ and $stress robs the body o nicotine, implying a smoker smokes more in times o stress due to withdrawal, not to relax.$3/3 &s we learned, stress ul e!ents turn body luids more acidic, which accelerates depletion o blood serum reser!es o the alkaloid nicotine. Mlaxo(mith>line"s :icorette website warns nicotine gum chewers that, $6ating or drinking e!en mildly acidic oods and be!erages directly be ore using or during use o :icorette inhibits nicotine absorption into your bloodstream.$3// 7hether inhaled or juiced, nicotine does not relie!e anxiety but only its own absence. %ike taking the time to calm oursel!es by counting to ten, the time needed or replenishment combines with the arri!al o a new supply o nicotine to lea!e us totally yet alsely con!inced that nicotine was an emotional solution to crisis. Think about it, when did nicotine e!er once resol!e the underlying crisis8 5 the tire was lat, it was still lat. 5 some e!ent made us angry, escape into ser!icing our addiction totally ignored the e!ent. The physiological e ects o stress cause urine to turn more acidic. ;rine acidi ication accelerates elimination o nicotine rom the bloodstream, orcing early replenishment. 3/H 5t"s more stress ul li!ing li e as a nicotine addict. 7e made e!ery stress ul e!ent li e threw our way ar more stress ul than it is or ne!er-users and ex-users. They only need to endure the stress ul e!ent, not withdrawal"s onset too. 5 the lat tire or other stress ul situation is tackled and resol!ed without using, the nicotine addict is still not going to eel good or satis ied. 7hy8 -ecause addressing the initial cause o stress does not ease withdrawal. Knly re3/3 -rown + 7illiamson Tobacco Eorporation, 5nternal Eorrespondence, #arch /I, 3B1H, -ates :umber9 FA0I01.B/J http9//legacy.library.ucs .edu/tid/uly0. 00 3// Mlaxo(mith>line, :icorette9 Drequently &sked Luestions, http9//nicorette.com/ aqs.aspx, #ay /H, /03/ 3/H -enowit) :%, 'acob * Hrd, :icotine renal excretion rate in luences nicotine intake during cigarette smoking. 'ournal o *harmacology and 6xperimental Theraputics, 'uly 3B1I, Golume /H.<3=, *ages 3IH-3II.
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administration o nicotine, or na!igating withdrawal and the up to A/ hours needed to eliminate nicotine rom the body and mo!e beyond peak withdrawal, can bring relie . ;nlike total nicotine elimination, replenishment"s relie is temporary. 7hile it calms or the moment, the user will again soon be orced to con ront the chemical clock go!erning their li e <nicotine"s two-hour chemical hal -li e=, or witness accelerated depletion brought on by encountering stress, consuming alcohol or by drinking or eating acidic oods. 'oel makes one inal yet important point here. :icotine"s alse calming e ect quickly becomes a rationali)ation crutch reached or during stress ul situations. The crutch and nicotine"s impact upon the user"s li e is $more ar-reaching than just making initial stress e ects more se!ere.$ &ccording to 'oel, $it a ects how the person may deal with con lict and sadness in a way that may not be ob!ious, but is nonetheless serious. 5n a way, it a ects the ability to communicate and maybe e!en in some ways, to grow rom the experience.$ 3/. 'oel shares an example. $%et"s say you don"t like the way a signi icant other in your li e squee)es toothpaste. 5 you point out how it"s a problem to you in a calm rational manner, maybe the person will change and do it in a way that is not disturbing to you. -y communicating your eelings you make a minor annoyance basically disappear.$ $-ut now let"s say you"re a smoker who sees the tube o toothpaste, gets a little upset, and is about to say something, again, to address the problem. -ut wait. -ecause you are a little annoyed, you lose nicotine, go into withdrawal, and be ore you are able to deal with the problem, you ha!e to go smoke.$ $4ou smoke, alle!iate the withdrawal and, in act, you eel better. &t the same time, you put a little time between you and the toothpaste situation and on urther e!aluation, you decide it"s not that big o a deal, and you orget it.$ $(ounds like and eels like you resol!ed the stress. -ut in act, you didn"t. 4ou suppressed the eeling. 5t is still there, not resol!ed, not communicated. :ext time it happens again, you again get mad. 4ou go into withdrawal. 4ou ha!e to smoke. 4ou repeat the cycle, again not communicating and not resol!ing the con lict,$ explains 'oel. $K!er and o!er again, maybe or years this pattern is repeated.$ $Kne day you stop smoking. 4ou may in act be o or weeks, maybe months. &ll o a sudden, one day the exact problem presents itsel again, that annoying toothpaste. 4ou don"t ha!e that automatic withdrawal kicking in and pulling you away rom the situation. 4ou see it, nothing else a ecting you and you blow up. 5 the person is within earshot, you may explode.$ $7hen you look back, in retrospect, you eel you ha!e blown up inappropriately, that your
3/. (pit)er, ', :ew ?eactions to &nger as an 6x-smoker, an article in 'oel"s ree *DD book :e!er Take &nother *u ,
,0
reaction was greatly exaggerated or the situation. 4ou aced it hundreds o times be ore and nothing like this e!er happened. 4ou begin to question what happened to you, to turn you into such a horrible or explosi!e person.$ $;nderstand what happened,$ writes 'oel. $4ou are not blowing up at what just happened. 4ou are blowing up or what has been bothering you or years. &nd now, because o the build up o rustration, you are blowing up much more se!erely than you e!er would ha!e i you had addressed it early on. 5t is like pulling a cork out o a shaken carbonated bottle9 the more shaken, the worse the explosion.$ &s 'oel explains it, years o nicotine use stopped us rom properly dealing with eelings early on. 5nstead, we allow them to ester and grow to a point where when they do come out, it is ar more se!ere than i initially addressed. (ooner or later, e!en i we ail to break ree rom nicotine, that unresol!ed stress will most probably result in either a blowup or onset o one or more anxiety related diseases. Don"t or a second think that hiding rom li e by escaping into a central ner!ous system stimulated dopamine $aaah$ relie sensation is an answer or solution. 5t"s our problem. &s we climb back into our mind"s dri!er"s seat we need to listen to our eelings and emotions. 7e may disco!er that we need to learn to address the root causes o once suppressed anxiety or anger in positi!e and healthy ways. The only lasting solution to anxieties brought on by rapidly alling nicotine reser!es anxieties that inter ere with healthy con lict resolution - is to bring acti!e nicotine dependence to an end.
<=m Cu$t
little 'it ddicted2
:icotine dependency diagnostic standards are re lected by o icial looking acronyms such as D(#-5G, DT:D, #:7(, #-:?L and ,K:E. These standards claim to measure the onset, existence or depth o nicotine dependency. -ut being a little bit addicted is like being a little bit pregnant. 5t"s normal to want to rationali)e that we don"t ha!e a problem, or i we do that it"s just some $nasty little habit,$ or i not and we really are addicted that we"re just a little bit addicted. 5t"s normal to compare our situation with that o other drug or nicotine addicts and rationali)e that it isn"t nearly as bad.3/I The easiest such minimi)ation is to compare how requently we use nicotine, our le!el o tolerance. -ut let"s stop kidding oursel!es. 7hether our brain demands a single nicotine ix daily or twenty, ha!ing lost the autonomy to simply turn and walk away, why pretend superiority once a ull- ledged addict8
3/I Eraig, >athleen, :ot #uch o a (moker, Kriginally posted at #(:"s Dreedom rom Tobacco"s on Debruary /B, /00., and today shared on 4uku"s Dreedom rom :icotine orum on the site"s ?ationali)ations message board.
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*retending superiority is a dependency minimi)ation rationali)ation that keep millions trapped behind bars.
2< do it 1or 1l "or nd t $te2

Dla!or8 Taste8 ,ow many taste buds are inside human lungs, the place we suck and brie ly hold all smoke8 &nswer9 )ero, none@ 5magine blaming continuing use on what we describe as tobacco"s wonder ul smells and tastes. This rationali)ation also ignores the hundreds o additi!es used by the tobacco industry to engineer a !ast spectrum o sensory sensations. 5t also ignores the act that hundreds o other plants, products and people smell good too but ne!er once did we ind it necessary to light any o them on ire and suck their smoke deep into our lungs in order to complete the experience. -ut i soaked in nicotine, stand back. 7e"ll likely try chewing or lighting them abla)e too. & 3BA/ memo rom -rown + 7illiamson consultants entitled $4outh Eigarette - :ew Eoncepts$ recommends the company use a $sweet la!or cigarette... 5t"s a well-known act that teenagers like sweet products. ,oney might be considered.$ 5t also recommends applela!ored cigarettes. $&pples connote goodness and reshness and we see many possibilities or our youth-oriented cigarette with this la!or.$3/F (ince 3BA/, almost A00 industry tobacco la!or additi!es ha!e been identi ied including9 &l al a extract, allspice extract, anise, angelica root extract, apple ructose, apricot extract, balsam oil, banana ructose, bark oil, basil oil, bay lea , beet juice, black current buds, blackberry ructose, beeswax, bergamot oil, brandy, ca eine, cajeput oil, camphor oil, cananga oil, carob bean extract, caramel, caraway oil, carrot seed oil, cassia cocoa, cedarwood oil, celery seed extract, chocolate, chicory extract, cinnamon lea oil and extract, citric acid, clary sage oil, clo!e oil, co ee extract, cognac oil, coriander oil, corn oil, corn syrup, corn silk, costus root oil, cubeb oil, cypress oil, dandelion root extract, date ructose, da!ana oil, dill seed oil, ennel sweet oil, enugreek, ig juice, ginger oil, geranium rose oil, gentian root extract, grape ructose, honey, hops oil, jasmine, lactic acid, juniper berry oil, leucine, la!andin oil, kola nut extract, lemon oil, la!ender oil, licorice, lemongrass oil, lime oil, linaloe wood oil, lo!age oil, longosa oil, locust bean gum, linden lowers, menthol, mandarin oil, maple syrup, milk solids, wild mint oil, garden mint oil, mullein lowers, nutmeg, oak moss, oak bark extract, olibanum oil, oli!e oil, orange lea , orange blossoms, orange peel oil, orris root, palmarosa oil, peach extract, pear extract, plum extract, peru!ian oil, patchouli oil, parsley seed oil, peach kernel oil, pectin, pepper oil, peppermint oil, plumb juice, pimenta lea oil, pine needle oil, pineapple extract, pipsissewa lea extract, prune extract, quebracho bark, raisin extract, raspberry extract, rose water, rose oil, rosemary oil, rum, saccharin, sa ron,
3/F #arketing 5nno!ations 5nc., *roject9 4outh Eigarette - :ew Eoncepts, (eptember 3BA/, -rown + 7illiamson Document, -ates :umber9 3A00./03.
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sage oil, sandalwood oil, sclareolide, sherry, smoke la!or, sodium, spearmint oil, spike la!ender oil, snakeroot oil, starch, star anise oil, strawberry extract, styrax gum, sucrose syrup, tamarind extract, solanone, tangerine oil, sugar alcohols, sugars, tarragon oil, thyme oil, rye extract, thymol, toasting la!ors, tobacco extracts, tolu balsam gum, tagetes oil, tuberose oil, turpentine oil, urea, !inegar, !aline, wild cherry bark, xanthan gum, !alerian root, !anilla beans and extract, !anillin, !eti!er oil, !iolet lea oil, walnut extractables, wheat extract, wine, whiskey, yeast and ylang ylang oil. Tobacco"s smells and la!ors are highly engineered. The ew brands that do not use additi!es use lue curing or sweetness, genetic engineering, blending and/or aster nicotine deli!ery <more ree-base nicotine= in order to make tobacco"s natural harshness more acceptable to the senses. 5 you like one or more additi!es in your brand such as licorice or chocolate, then purchase licorice or chocolate and sa!or their la!ors. 5 doubt you"ll eel a need to light them on ire. &gain, there are )ero taste buds inside our lungs. &d!ertising that suggests that la!or or taste is the reason smokers suck nicotine laden smoke deep into their lungs is an insult to our intelligence. %ikewise, it"s pathetic or oral tobacco product marketing to suggest that taste is the reason users cannot stop putting taste bud damaging and sensiti!ity destroying tobacco toxins into their mouth.
2My co11ee won=t t $te the $ me2

There"s some truth here but probably not or the reason you"re thinking. Toxins in tobacco smoke seriously impair our ability to accurately smell both co ee and cigarettes. 5t also increases the risk o taste impairment <an inability to detect !ery small amounts o one or more o the our basic tastes9 sweet, salty, sour and bitter= by A3C in smokers smoking /0 or more cigarettes per day. 3/A &s 'oel teaches, smells and la!ors may not be better a ter ending tobacco use but will certainly be more accurate. Knce our senses heal, many ind that co ee"s smell and taste actually impro!es. 4our morning co ee experience can be ar richer than when smoking. 5magine smelling the aroma o brewing co ee when the pot is more than I0 eet away.
2<t help$ me concentr te2

&lthough nicotine is undeniably a stimulant that acti!ates ight or light pathways and
3/A Gennemann ##, et al, The association between smoking and smell and taste impairment in the general population, 'ournal o :eurology, 'uly /1, /001 O6pub ahead o printP.
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excites certain brain regions, it"s also a super toxin, !asoconstrictor, and promotes hardening o the arteries through angiogenesis. (moked nicotine introduces !ast quantities o carbon monoxide into the brain which ob!iously doesn"t aid concentration. 7hile true that nicotine is a stimulant, so are i!e minutes o physical acti!ity. &nd i truly concerned about concentration, continuing use will diminish such concerns a bit more each day as the super toxin nicotine slowly destroys remaining brain gray and white matter. &nd don"t orget that concentration can be eliminated entirely by a nicotine-induced stroke, early dementia or a tobacco induced death. *rotect your ability to concentrate. Dresh air and acti!ity are ar healthier stimulants. &s you na!igate early reco!ery, keep in mind the role nicotine played in regulating blood sugar by causing release o stored ats and sugars !ia our ight or light response. :icotine"s absence can temporarily impair concentration and clear thinking. %ow blood sugar concentration impairment may be a!oided by sipping on natural ruit juice during the irst three days. Eranberry juice is excellent. &lso, try not to skip meals or the irst ew weeks. 5t isn"t necessary to eat more ood but to learn to spread our normal calorie intake out more e!enly o!er the day, so as to keep blood sugars as stable as possible.
2< do it to relie"e 'oredom2

5t"s easy to relate nicotine use to boredom. ,owe!er, as acti!ely eeding addicts we needed to replenish constantly alling nicotine reser!es whether bored to death, ha!ing the time o our li e, and at all points in-between. :icotine use is more noticeable, and thus more memorable when bored. 5 doing nothing, it"s hard not to notice when eeding time arri!es. 4et, i busy, thinking or excited, we o ten didn"t notice our re ueling. &lthough nicotine"s hal -li e is roughly / hours, a alling tonic dopamine le!el would get our attention long be ore serious depletion anxieties arri!ed. 7e learned to tank up early and o ten, whether bored or not. ,a!e you e!er noticed the minor anxieties that occur when bored8 5t"s why we talk o $relie!ing$ boredom. -oredom is thought to be a means by which the mind moti!ates action. 5t causes us to seek
,-
accomplishment and the dopamine $aaah$ wanting relie sensation that come with anticipating completion or completing each task. 7hat"s sad is a mind that !iews success ul nicotine replenishment as itsel an important accomplishment. #aybe that"s why we make such a power ul association between not using nicotine and boredom. 5nstead o earning the phasic burst o dopamine that boredom"s anxieties attempt to moti!ate, we"d steal it, o!er and o!er and o!er again. ?eco!ery presents a substantial increase in opportunities to experience boredom and to blame it on reco!ery. 5 we normally used nicotine 3/ times per day, and each replenishment a!eraged I minutes, we now ha!e an extra hour each day to either ill with some new acti!ity or to sense boredom"s anxieties. -ut don"t kid yoursel . 7e didn"t smoke, chew, dip or !ape due to boredom. :e!er-users get horribly bored too but the thought o nicotine replenishment ne!er once crosses their mind. :icotine depletion anxieties attempt to moti!ate replenishment. -oredom anxieties attempt to moti!ate acti!ity. ;n ortunately, the nicotine addict"s act o replenishment satis ied both. -oredom can be a producti!e emotion. ?eco!ery will clearly add additional ree time to each day. ,ope ully, we"ll learn to spend it in healthy, producti!e and satis ying ways.
2< do it 1or ple $ure2

$5 smoke or pleasure.$ *leasure8 5t"s the :ewport sales cry and it"s highly e ecti!e. *leasure is de ined as a state o grati ication, a source o delight, satis action or joy. 7anting is de ined as eeling a need, strong desire, su ering rom the lack o something, or requiring it. Ealling the satis action o wanting pleasure is akin to saying that it eels good to stop pounding your thumb with a hammer. (till, it"s high quality bait, one o the most power ul use rationali)ations o all, and the industry lo!es it. The tobacco industry knows how easy it is to con use wanting with pleasure. %ook around. 5ndustry pleasure marketing is e!erywhere, subliminal and constantly assaulting the subconscious mind. 5ntentionally substituting joy or need, i pleasure marketing wasn"t e ecti!e it wouldn"t be there.
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,a!e you e!er seen an ad!ertisement showing a smoker badly in need o a smoke8 &nd you won"t. 7hen photos or pictures are used with pleasure marketing they show smokers laughing, care ree and ha!ing the time o their li e. Kur pleasure rationali)ation sinks its teeth into nicotine"s dopamine induced $aaah$ while totally ignoring the wanting, urge and anxiety which proceeded it. 7e are true drug addicts. This isn"t about pleasure but about the mind"s sur!i!al instincts teacher teaching another alse lesson a ter ha!ing again been acti!ated by nicotine. *leasure8 Try to imagine anything more intellectually dishonest than suggesting that smokers smoke or pleasure. Try to imagine anything more criminal than to hang signs along public streets that alsely teach children that smoking is about pleasure.
2<t=$ my choice nd < choo$e to u$e2

$Luitters ne!er win and 5"m no quitter.$ $5t"s my choice and 5 choose to continue using@$ Truth is, we lost $choice$ the day nicotine took control. -ut that doesn"t stop the tobacco industry rom spending billions building mighty neighborhood store marketing acades that each scream the message $smoking is an adult ree-choice acti!ity.$ Think about the message and collecti!e tease o hundreds o color ul and neatly arranged boxes, packs and tins behind the checkout counter. 6ach time we stepped-up to buy a new supply, our senses were looded with the subconscious message that using is all about choice, lots and lots o choices. &pparently, ew tobacco executi!es are buying the $choice$ lie. & ormer 7inston #an, Da!id Moerlit), asked ?.'. ?eynolds executi!es, $Don"t any o you smoke8$ Kne executi!e answered, $&re you kidding8 7e reser!e that right or the poor, the young, the black and the stupid.$3/1 Knce hooked, our only real alternati!e is the up to A/ hours needed to purge nicotine rom our system and mo!e beyond peak withdrawal. Ehoice8 The only choice made while still using is to a!oid withdrawal. 5t isn"t that we like using nicotine but that we don"t like what happens when we don"t. Then there are those who claim to smoke knowing ull well that it"s killing them. They suggest that they don"t care what happens, that they don"t want to get old, that we ha!e to die o something, so why not smoking8 This sel -destruction $choice$ rationali)ation can be used to hide ears born o a history o
3/1
:ew 4ork Times, 5n &merica, Tobacco Dollars, by -ob ,ebert, :o!ember /1, 3BBH.
,8
ailed attempts. 5t"s o ten rooted in a alse belie that they are somehow di erent rom those who succeed, that they"ll ne!er be able to stop. -ut try to ind any user who isn"t shocked upon arri!al o lung cancer, emphysema, a heart attack or stroke. &s 'oel writes, $no one e!er called me enthusiastically proclaiming, "5t worked, it"s killing me@" Kn the contrary, they were normally upset, scared and depressed.$3/B Truth is, my name is 'ohn and 5"m a reco!ered nicotine addict. 6 ortlessly and com ortably, 5 li!e just one pu away rom three packs a day. 5 5 want to stay ree, and to stay me, all 5 ha!e to do is to ... ne!er take another pu , dip or chew@
2<t=$ Cu$t
n $ty little h 'it2
$:asty little habit8$ 7e are true drug addicts in e!ery sense. That"s right, look in the mirror and you"ll see an honest to goodness drug addict looking back. Kne o the most harm ul rationali)ations o all is pretending that all we ha!e is nasty $habit.$ 5t con uses children and encourages experimentation. Ehildren and teens belie!e that it takes time and repetition to de!elop a habit. -ut research shows that $experimenting$ with smoking nicotine just once may be su icient to begin ostering the loss o autonomy to stop using it. it.3H0 &doption o the $habit$ rationali)ation is also disabling to those already ensla!ed. 5magine pretending that someday, we"ll awaken and at last disco!er how to mold, modi y, manipulate and control our nicotine use, so as to allow us to use, or not use, as o ten as we please. 5magine pretending that someday, we"ll disco!er how to $ha!e our cake and eat it too.$ The phrase $nasty little habit$ is simply more junkie thinking. (uch so t u))y words minimi)e the hard cold reality o being chemically married to and dependent upon nicotine. 5t"s much easier to tell oursel!es that all we ha!e is some $nasty little habit.$ The warmth o the phrase is akin to the cute and cuddly word $slip,$ the addict"s tool or sugarcoating relapse. Dailing to use turn signals while dri!ing is a $habit$ and so is using too many cuss words, cracking our knuckles or losing our temper too o ten. -ut we will not experience physical withdrawal i we start using turn signals, stop cussing or cracking our knuckles, or learn to keep our temper in check. Ehemical addiction does oster habits. -ut it does so by orcing us to select patterns or the
3/B
(pit)er, ', $5 (moke -ecause 5"m (el -Destructi!e,$ an article in 'oel"s ree *DD book :e!er Take &nother *u , http9//whyquit.com/joel 3H0 DiDran)a '?, ,ooked rom the irst cigarette, (cienti ic &merican, #ay /001, Golume /B1<I=, *ages 1/-1A.
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regular deli!ery o nicotine. Kur addiction athers our drug eeding habits, not the other way around. Ealling nicotine addiction a habit is like calling a young child a parent. 4es, it was almost always nearing time or another ix. &nd yes, we de!eloped habits, but not just or the sake o ha!ing habits. There were only two choices - use again or prepare or withdrawal. 5 wish it were just a $nasty little habit,$ 5 truly do. There would be no need or this book and ar ewer deaths. Truth is, my name is 'ohn and 5"m a reco!ered nicotine addict. Eom ortably, 5 li!e just one pu away rom three packs a day. 5 5 want to stay ree, and to stay me, all 5 ha!e to do is to ... ne!er take another pu , dip or chew@
2<=ll lo$e my 1riend$2

5magine con!incing oursel!es that i we arrest our chemical dependency that our riends won"t want to be around us, or that we won"t be able to be around them. 4es, it takes a bit o practice getting com ortable around users. -ut extinguishing all use conditioning is a necessary part o healing. &ccording to *hilip #orris research, o!er 1IC o smokers strongly agree with the statement, $5 wish 5 had ne!er started smoking.$3H3 (ecretly, most o our riends who use eel the same. They wish they knew how to stop. 5magine them ha!ing a riend who is both knowledgeable and skilled regarding nicotine dependency reco!ery. Through use conditioning and association, most o us became con!inced that nicotine use was central to our li e, including riendships with other users. 7hile reco!ery means that we"ll no longer use while with riends who do, no relationship whose oundation is broader than shared drug use need be ad!ersely a ected by nicotine"s absence. (uccess ul reco!ery need not depri!e us o a single riend or lo!ed one. Kn the contrary, tobacco use has likely cost us relationships. Dewer and ewer non-users are willing to tolerate being around the smells, smoke and stink. &nd oral tobacco use can be a major turn-o . &side rom no longer using nicotine, our current li!es do not need to change at all unless we want them to change. #ine did. 5 no longer sought situations that allowed me to eel com ortable smoking.
3H3
*hilip #orris, The Eigarette Eonsumer, #arch /0, 3B1., -ates :umber9 /0AA1F.1HIJ http9//legacy.library.ucs .edu/tid/wos1.a00
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Dellow nicotine addicts don"t normally try to make each other eel guilty or being hooked and using. 5n act, there can be a !ery real sense o dependency camaraderie. 7e also ser!e as a orm o $use$ insurance or each other on those occasions when our supply runs out. Kb!iously, 5 no longer requented community ashtrays. 5n act, or the irst time in my adult li e 5 ound mysel totally com ortable sitting beside non-users and ex-users or extended periods o time. Mradually, yet increasingly, my circle o riends and acquaintances grew to include ar more non-users and ex-users. 5t was as i my addiction had been picking relationships or me.
2<=m $till he lthy2

#illions and millions ride the $5"m still healthy$ rationali)ation until it collides with a massi!e heart attack, stroke, or until diagnosed with incurable cancer. 6ach nicotine use acti!ates the body"s ight or light response. That response releases extra uel. 4ou can"t hear or see it but stored energy is released into the bloodstream, including cholesterol, the bad kind, %D%. This energy was supposed to be burned and used leeing or ighting to sa!e our li e. 5nstead, we sit or stand around doing little or nothing. 5nstead, the %D% cholesterol begins orming deposits within artery walls. ;se a ter use, the plaques build, gather and grow and become hardened by nicotine through a process known as angiogenesis. 6!entually, the artery becomes totally blocked. &ll tissues ser!iced with oxygen !ia the artery su ocate and die. 7hether the result is a heart or stroke, there may ha!e been little warning that disaster was about to strike. Kn the outside, your body mass or si)e may ha!e looked normal or e!en thin. 4et, on the inside an artery started acting as a gathering spot and roadblock or cholesterol, dead cells, waste and other ats. &nd we ne!er once used tobacco without introducing more cancer causing chemicals into our body. There"s no eeling, sensation or warning be ore a house alls on you and that irst cancerous cell begins to di!ide and multiply. $5 eel antastic.$ $5"m as healthy as a horse@$ $5 do aerobics.$ $5 eat healthy.$ $5 walk and run.$ $5"m athletic.$ 7hat does any o that ha!e to do with pre!enting the scores o cancer causing chemicals that you daily introduced into your body rom e!entually causing cancer8 7ish ul thinking8
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%et"s turn our attention to three common reco!ery rationali)ation9 <3= that we can"t stopJ </= that i we try, internal orces will plot against usJ and <H= that using $just once$ won"t hurt.
2< c n=t $top2

5"!e made no secret o!er the years about which 'oel (pit)er article is my a!orite. 3H/ 5t"s about a woman who enrolled in one o 'oel"s two-week clinics. *rior to the start o the irst session, she came up to 'oel and told him, $5 don"t want to be called on during this clinic. 5 am stopping smoking but 5 don"t want to talk about it. *lease don"t call on me.$ 'oel said, $(ure. 5 won"t make you talk, but i you eel you would like to interject at anytime, please don"t hesitate to.$ (he grew angry. $#aybe 5 am not making mysel clear, 5 don"t want to talk@ 5 you make me talk 5 will get up and walk out o this room. 5 you look at me with an inquisiti!e look on your ace, 5 am lea!ing@ &m 5 making mysel clear8$ (urprised by the orce o her reaction, 'oel said he"d honor her request. &lthough he still hoped she"d change her mind and share her experiences with the group, 'oel was no longer expecting it. 7ith approximately /0 participants, it was a good group except or two women in back who $gabbed constantly.$ Kthers were orced to turn around and ask them to be quiet. The women would stop or a ew seconds and then were right back at it. (ometimes, when other people were sharing sad, personal experiences, they"d be laughing at some humorous story they"d shared with each other, obli!ious to surrounding happenings, recalls 'oel. Kn the third day o the clinic it happened. The two women in the back were talking away as usual when a younger participant asked i she could speak to the group irst because she had to lea!e. The two in the back continued their pri!ate con!ersation as i she wasn"t there. The young woman said, $5 can"t stay, 5 had a horrible tragedy in my amily today, my
3H/
(pit)er, ', 5 Ean"t Luit or 5 7on"t Luit, 7hyLuit.com, 'oel"s %ibrary, 3B1F.
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brother was killed in an accident. 5 wasn"t e!en supposed to come tonight. 5 am supposed to be helping my amily making uneral arrangements. -ut 5 knew 5 had to stop by i 5 was going to continue to not smoke.$ (he"d remained nicotineree or two days and not smoking was ob!iously important. 'oel recalls that the group $ elt terrible, but were so proud o her. 5t made what happened in their days seem so tri!ial. &ll except the two ladies in the back o the room. They actually heard none o what was happening,$ recalls 'oel. $7hen the young woman was telling how close she and her brother were, the two gossips actually broke out laughing. They weren"t laughing at the story, they were laughing at something totally di erent not e!en aware o what was being discussed in the room.$ The young woman excused hersel to return to her amily, said she"d keep in touch and thanked the group or their support. & ew minutes later 'oel was relating a story to the group when all o a sudden the woman who had requested anonymity interrupted him. $6xcuse me 'oel,$ she said loudly. $5 wasn"t going to say anything this whole program. The irst day 5 told 'oel not to call on me. 5 told him 5 would walk out i 5 had to talk. 5 told him 5 would lea!e i he tried to make me talk. 5 didn"t want to burden anyone else with my problems. -ut today 5 eel 5 cannot keep quiet any longer. 5 must tell my story.$ The room went quiet. $5 ha!e terminal lung cancer. 5 am going to die within two months. 5 am here to stop smoking. 5 want to make it clear that 5 am not kidding mysel into thinking that i 5 stop 5 will sa!e my li e. 5t is too late or me. 5 am going to die and there is not a damn thing 5 can do about it. -ut 5 am going to stop smoking.$ $4ou may wonder why 5 am stopping i 5 am going to die anyway. 7ell, 5 ha!e my reasons. 7hen my children were small, they always pestered me about my smoking. 5 told them o!er and o!er to lea!e me alone, that 5 wanted to stop but couldn"t. 5 said it so o ten they stopped begging.$ $-ut now my children are in their twenties and thirties, and two o them smoke. 7hen 5 ound out about my cancer, 5 begged them to stop. They replied to me, with pained expressions on their aces, that they want to stop but they can"t.$ $5 know where they learned that, and 5 am mad at mysel or it. (o 5 am stopping to show them 5 was wrong. 5t wasn"t that 5 couldn"t stop smoking, it was that 5 wouldn"t@$ $5 am o two days now, and 5 know 5 will not ha!e another cigarette. 5 don"t know i this will make anybody stop, but 5 had to pro!e to my children and to mysel that 5 could stop smoking. &nd i 5 could stop, they could stop, anybody could stop.$ $5 enrolled in the clinic to pick up any tips that would make stopping a little easier and because 5 was real curious about how people who really were taught the dangers o smoking
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would react. 5 5 knew then what 5 know now - well, anyway, 5 ha!e sat and listened to all o you closely.$ $5 eel or each and e!ery one o you and 5 pray you all make it. 6!en though 5 ha!en"t said a word to anyone, 5 eel close to all o you. 4our sharing has helped me. &s 5 said, 5 wasn"t going to talk. -ut today 5 ha!e to. %et me tell you why.$ (he turned to the two women in the back who had listened to her e!ery word. $The only reason 5 am speaking up now is because you two -5TE,6( are dri!ing me cra)y. 4ou are partying in the back while e!eryone else is sharing with each other, trying to help sa!e each other"s li!es.$ (he told them about the young woman whose brother was killed and how they laughed, totally unaware o her loss. $7ill you both do me a a!or, just get the hell out o here@ Mo out and smoke, drop dead or all we care, you are learning and contributing nothing here.$ 'oel recalls they sat stunned. ,e had to calm the group as things had become $quite charged.$ :eedless to say, recalls 'oel, $that was the last o the gabbing rom the back o the room or the entire two-week clinic.$ &ll present that night were success ul in remaining nicotineree. The two women who had earlier talked only to each other were applauded by all during graduation, e!en by the woman with lung cancer. $&ll was orgi!en,$ recalls 'oel. The woman who"d lost her brother was also present, nicotineree and proud. $&nd the lady with lung cancer proudly accepted her diploma and introduced one o her children. ,e had stopped smoking or o!er a week at that time. &ctually, when the lady with cancer was sharing her story with us, she had not told her amily yet that she had e!en stopped smoking.$ (ix weeks later his mother was dead. 7hen 'oel telephoned to see how she was doing her son answered. ,e thanked 'oel or helping her stop at the end, and told him how proud she was and how proud he was o her. $(he ne!er went back to smoking, and 5 will not either,$ he said. (he"d taught her children a alsehood and as her inal lesson she corrected it. 5t wasn"t that she couldn"t stop but that she wouldn"t. 5 too was once totally con!inced that 5 couldn"t. -ut it was a lie, a lie born inside a hostage mind, a mind con!inced that that next ix was more important than li e itsel .
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Chemic l to #emon
Knce we decide to make an attempt, imagine turning our imaginary $ riend$ into an imaginary $ oe.$ 5magine in!enting destiny controlling monsters and demons who make success ul reco!ery all but impossible. The most amous smoking rationali)ation book is $The 6asy 7ay to (top (moking$ by the late &llen Earr o 6ngland.3HH 7e lost &llen to lung cancer on :o!ember /B, /00F at age A/. %ike me, &llen was a ormer thirty-year smoker. 6nding his i!e pack-a-day dependency clearly contributed to buying him another /F years o li e. &llen"s book ocuses almost exclusi!ely on a single aspect o reco!ery, using honesty to demolish and destroy smoking rationali)ations. 4et, more than .0 times he teaches readers that success ul reco!ery in!ol!es killing $monsters$ that reside within. 5 wrote a smoking rationali)ation article in early /000 that 5 entitled $:icodemon"s %ies.$ The title clearly suggesting demon in!ol!ement. 5t wasn"t long be ore 'oel set me straight. 5 irst read &llen"s book in #ay /00F and ound mysel chuckling at all the re erences to monsters. 5magine two ex-smokers, an ocean apart, in!enting and blaming continuing capti!ity on demons and monsters. 7hile &llen"s work has helped millions to critically analy)e their smoking justi ications, there are no monsters and there is no :icodemon There ne!er was. :icotine is simply a chemical. %ike table salt, it cannot think, plan, plot or conspire and is not some monster or demon that dwells within. The act that nicotine has an 5.L. o )ero is reason or celebration. &lthough nicotine acti!ates brain dopamine pathways, causes up-regulation o receptors and creates durable memories o how wanting gets satis ied, reco!ery is not some strength or willpower contest. 5n act, we will ne!er be stronger than nicotine. 7e don"t need to be. Kur greatest weapon has always been our in initely superior intelligence but only i we put it to work. &s 'oel puts it, although nicotine is the addicti!e chemical, it is $no more e!il than arsenic or carbon monoxide or hydrogen cyanide - all chemicals ound in tobacco smoke.$ 3H. 5t is the mind"s design that generates cra!e episodes, not some e!il orce. &ccording to 'oel, terms such as :icodemon or monster $make nicotine seem to ha!e more power than it actually does. The personi ication gi!en to it can make an indi!idual eel that
3HH Earr, &llen, The 6asy 7ay to (top (moking, 3B1I, /00. 6dition, (terling *ublishing Eompany, 5nc.
3H. (pit)er, ', Knce and or all, there is no :icodemon, 'une B, /00., http9//www. n.yuku.com/topic/3/1/B
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nicotine has the potential o tricking him or her into smoking. &n inanimate object such as a chemical has no such power.$ $*eople do not o!ercome the grip o chemical addictions by being stronger than the drug but rather by being smarter than the drug.$ $%ets not gi!e nicotine more credit than it is due,$ writes 'oel. $%ets not make it some cute and cuddly or e!il and plotting entity. 5t is a chemical that alters brain chemistry. 5t is no di erent than heroin, cocaine or alcohol.$ $These drugs don"t ha!e cute names gi!en to them and gi!ing cute names to nicotine can start to make it seem di erent than these other substances -- more tri!ial or less serious in a way. :icotine is not more tri!ial than other drugs o addiction and in act kills more people than all other drugs o addiction combined.$ #onsters and demons are in!entions o the uneducated mind. 7e needed them to help explain a want and yearning we couldn"t understand. :icotine is just a chemical. (o long as it does not enter our bloodstream, there will be no need to in!ent explanations or its continued presence. &dherence to just one guiding principle which pre!ent the need to in!ent demons ... no nicotine today.
Ju$t >ne, Ju$t >nce

5t"s a basic tenet o drug addiction that $one is too many and a thousand ne!er enough.$ 4et ixating upon the thought o $just one, just once$ is the most common cessation torturing tease o the unschooled mind. 5t isn"t honest either to say that we don"t really $want$ one i we do. 7hat we don"t want are the thousands that ollow it. 5t"s antasy !ersus reality, iction !ersus truth. &s 'oel says, $Don"t say that we don"t want one when we do. ?ather, acknowledge the desire but then ask yoursel , do 5 want all the others that go with it8$ The $%aw o &ddiction$ declares that we can"t ha!e just one. (o why torment yoursel with such an extremely destructi!e tease8 7hen the thought o $just one$ or $just once$ enters your mind, try to picture all o them, the thousands upon thousands that would ollow.
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Ch pter 6
P c(ing 1or the Journey 7ome

When to ;t rt 7ome & .ow or 0 ter?
(hort answer8 :ow@

?egrettably, both smoking cessation product and tobacco industry websites continue to proclaim that a $key$ to success is to not stop using today or tomorrow but to pick some uture date such as our birthday, :ew 4ears or your nation"s national stop smoking day, and then plan around it. (uch ad!ice isn"t just wrong but is depri!ing millions o signi icantly greater odds o success. & /00F study ound that about hal o all smokers attempt to stop smoking without any planning whatsoe!er. That"s right, no planning and no packing at all. The study"s authors were shocked to learn that unplanned attempts were /.F times more success ul in lasting at least six months than attempts planned in ad!ance. 3HI ?esults rom a /00B study were nearly identical, also generating increased odds o /.F. 3HF &ccording to 'oel (pit)er, the real experts on this question are millions o long-term success ul ex-users, and this isn"t news to them. $?arely do those with the longest initials or credentials do real research on how people stop smoking,$ he says. $Eon!entional wisdom in smoking cessation circles says that people should make plans and preparations or some unspeci ied uture time,$ writes 'oel. $#ost people think that when others stop smoking that they must ha!e put a lot o time into preparations and planning, setting a date and ollowing stringent protocols until the magic day arri!es. 7hen it comes down to it, this kind o action plan is rarely seen in real-world OcessationP.$3HA 5n an email to me 'oel wrote, $#y gut eelings here, 5 think the di erence between planned and unplanned is that a person who is planning to stop isn"t really committed.$ $5 he were committed to it he would just do it - not plan it.$
3HI 7est ?, et al, $Eatastrophic$ pathways to smoking cessation9 indings rom national sur!ey, -ritish #edical 'ournal, Debruary /00F, Golume HH/<AIHB=, *ages .I1-.F0. 3HF Derguson (M, et al, ;nplanned quit attempts--results rom a ;.(. sample o smokers and ex-smokers, :icotine + Tobacco ?esearch, 'uly /00B, Golume 33<A=, *ages 1/A-1H/. 3HA (pit)er, ', (etting Luit Dates, 7hyLuit.com/joel, /00F
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7aiting on some uture day to arri!e in!ites silly and exaggerated ears and anxieties about ending use, to gradually erode con idence and destroy core moti!ations. 5magine being emotionally drained and physically whipped be ore e!er getting started. &ccording to 'oel, most success ul ex-users all into one o three groups9 <3= Those who awoke one day and were suddenly sick and tired o smoking, who threw their cigarettes o!er their shoulder and ne!er looked backJ </= Those gi!en an ultimatum by their doctor - $stop smoking or drop dead$ and <H= Those who became sick with a cold, the lu or some other illness, went a ew days without smoking and then decided to try to keep it going. $&ll o these stories share one thing in common - the technique that people use. They simply stop smoking one day. The reasons !aried but the technique used was basically the same.$ $5 you examine each o the three scenarios you will see that none o them lend themsel!es to long-term planning. They are spur o the moment decisions elicited by some external circumstance.$ 5 !isited the *hilip #orris ;(& website during the initial dra t o this book. *hilip #orris is the company that then held a I0C share o the ;.(. cigarette market. 5ts $Luit &ssist$ pages told those hooked on nicotine to9 ""lan and prepare#t at$s t e first %ey to &uit-smo%ing success!" Choose a s@eci-ic Fuit dateG@erha@s your birthday or anniversary< or your child's birthdayGand mar: it on your calendar. I- you )ive yoursel- at least a month to @re@are< you're more li:ely to succeed than i- you decide #e( Aear's 8ve to Fuit the ne6t day. ;ic: a (ee: (hen your stress level is li:ely to be lo(. ;hili@ /orris =SA'() Delay reco!ery or at least a month8 ;ntil your next birthday8 7ait or li e to become nearly stress ree8 'oel wrote an article attacking such insanity back in 3B1..3HB 5t opens with the ollowing rather lengthy list o cessation delay rationali)ations that it snuggly with *hilip #orris" ad!ice to continue using. $5 will stop when my doctor tells me 5 ha!e to.$ $5 can"t stop now, it"s tax season.$ $#aybe 5 will stop on !acation.$ $(chool is starting and 5"m too ner!ous to stop.$ $5 will stop in the summer when 5 can exercise more.$ $7hen conditions impro!e at work 5"ll stop.$ $(top
3H1 *hilip #orris ;(&, Luit &ssist, Met ?eady, web site !isited 'uly H3, /001. 3HB (pit)er, ', $5 will quit when ...$ www.7hyLuit.com/ 'oel"s %ibrary, 3B1I, note that article re erences to the word $quit$ ha!e been here been replaced with the word $stop$ in hopes o diminishing any sense o ha!ing le t something behind.
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now, during midterms, you must be nuts@$ $#aybe a ter my daughter"s wedding.$ $#y ather is in the hospital. 5 can"t stop now.$ $5 5 stop now it will spoil the whole trip.$ $The doctor says 5 need surgery. 5"m too ner!ous to try now.$ $& ter 5 lose 3I pounds.$ $5"m making too many other changes right now.$ $5"!e smoked or years and eel ine, why should 5 stop smoking now8$ $5"m in the process o mo!ing, and it"s a real headache.$ $5t"s too soon a ter my new promotion, when things settle down.$ $7hen we ha!e a !eri iable bilateral disarmament agreement, 5"ll consider stopping.$ $5t is too late. 5"m as good as dead now.$ $The best time to stop is :K7. :o matter when now is. 5n act, many o the times speci ically stated as bad times to stop may be the best.$ $5 actually pre er that people stop when experiencing some degree o emotional stress. 5n most cases, the more stress the better. This may sound harsh, but in the long run it will !astly impro!e the chances o long term success in abstaining rom cigarettes,$ suggests 'oel. ,e knows that i success ul during a period o signi icant stress, that stress would ne!er again be the mind"s excuse or relapse. 'oel is care ul to distinguish real-world cessation rom the 5nternet phenomenon where some spend substantial time at 7hyLuit.com reading, planning and watching many o his more than 300 ree !ideo stop smoking lessons be ore taking the plunge. 7hile 5nternet use is tremendous in industriali)ed nations, only about 3 in H humans were 5nternet users in /03/ <H/.AC=.3.0 5 suspect that the percentage o the world"s nicotine addicts turning to the 5nternet to master their dependency, who ha!e e!er heard o the %aw o &ddiction, 'oel (pit)er or 7hyLuit.com is probably less than 3 percent. 6!en with 5nternet access, while knowledge is power, time de!oted to studying incorrect or alse lessons can pro!e deadly. ?egrettably, the primary lessons shared at the majority o websites are about replacement nicotine and garbage. 7e wish it wasn"t so but it is. 7hen to get started8 ;nless delay is associated with quality learning that is diminishing needless ears and anxieties, the sooner the better. -ut e!en then, you can pack and learn as you go. &sk yoursel , when will there e!er be a more per ect time to take back control o your mind than when wanting lowing rom hijacked dopamine pathways is again commanding you to use8 This book"s lessons are presented in an order which parallels reco!ery"s sequencing and priorities. (o, don"t worry about inishing it be ore departure.
3.0 5nternet 7orld (tats, 5nternet ;sage (tatistics - The 5nternet -ig *icture, www.internetworldstats.com - 0A/3A/3/.
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P c( 1or Reco"ery
?eady or day N3 packing8 Dor starters, are you packing or quitting or reco!ery8 5nstead o lea!ing wiggle room or mind games such as $quitters ne!er win, winners ne!er quit,$ why not start by adopting a positi!e !ision o what"s about to happen8 (ynonyms or the word $quit$ include9 abandon, break-o , chuck, desert, orsake, gi!e-up, lea!e, push-out, relinquish, resign, surrender and terminate. &bandoning us8 Mi!ing up8 Dorsaking, terminating or quitting oursel!es8 &s re!iewed in Ehapter H, the real $quitting$ took place on the day that nicotine took control o our mind, not the day we decide to take it back. 7hy not pack a healthy mental image o what happens during this temporary journey o readjustment8 The taking back o control, $reco!ering$ the real us@ &lthough it"ll eel a bit awkward at irst, try replacing the phrase $5"m quitting$ with $5"m reco!ering.$ 4ou"ll be pleasantly surprised at the calming e ect upon needless anxiety generating ears by thinking in terms o taking back, returning and getting, instead o abandoning, orsaking and quitting.
#ocument 3our Core Moti" tion$

7hat is the inner source that allows us to end once mandatory nicotine eedings8 (trength, willpower or desire8 5t"s natural to think that it"s some combination. ,owe!er, none o us are stronger than nicotine"s in luence upon brain dopamine pathways, as clearly e!idenced by our inability to li!e the addict"s greatest desire, to control the uncontrollable. 4es, we can temporarily muster mountains o willpower. -ut can willpower make any o us endure a challenge that we lack the desire to complete8 Knce nicotine gets inside, all the strength and willpower on earth cannot stop it rom tra!eling to the brain and acti!ating acetylcholine receptors. 7e cannot beat our dependency into submission. :or can we handle one hit o nicotine without stimulating brain circuitry designed to make acti!ating e!ents nearly impossible to orget, pathways engineered to generate wanting or more. 5 incapable o using strength to control our addiction and we cannot $will$ it into hibernation or submission, what remains8
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&s simple as it may sound, dreams and desire ha!e always been the uel o human accomplishment. -orn o the honest recognition o nicotine"s negati!e impact upon our li e, desire is the uel or change. -ut it takes keeping those moti!ations !ibrant and on center-stage, so that they can both consciously and unconsciously stimulate, moti!ate and uel our journey home. Those success ul in na!igating reco!ery ound creati!e ways to protect and sa eguard their dreams and desires. They somehow kept them robust, in!igorated and a!ailable at a moment"s notice. Kur core moti!ations aid in ostering the patience needed to transition an up to H minute subconsciously triggered cra!e episode. They pro!ide resistance to the nicotine addict"s romantic ixations. Desire"s energy, they stand up to junkie thinking that at times may linger inside the reco!ering mind. This temporary period o re-adjustment is about ul illing reco!ery"s dreams and desires. 7e enhance our chances by protecting desire"s juices. Those juices are accurate and !i!id memories o the daily nightmare o li!ing li e as nicotine"s sla!e. (uccess is about well-protected and remembered reco!ery moti!ations. 5t"s about uniting the realities o use with an understanding o the %aw o &ddiction <Ehapter /=. 7hat will you do during the heat o battle <i there is any - as cakewalk reco!eries can and do occur= to remind yoursel o the importance o !ictory8 7hich desires will control8 7ill you be able to !i!idly recall the ull price o li e as nicotine"s sla!e8 7hat will aid you in recalling dependency"s prison cell, your lost pride and sel -esteem, and the increasing sense o eeling like a social outcast8 7hat will help you remember standing at the counter and handing o!er your money to purchase a chemical that you knew would orce you to return to buy more8 During moments o challenge, how do we bring honesty and the desire lowing rom it, to the ore ront o our mind8 Dreams and desire embrace reco!ery as reedom"s stepping-stone. Eonsider allowing honest dependency memories to keep desire excited and stimulated. %et honesty transport you home. &llow it to gi t you the inner quiet and calm that arri!es once addiction"s daily chatter goes silent. 7hen packing, bring along the thousands o negati!e nicotine use memories that moti!ated you to begin reading this book. Doing so will pro!ide all the wind your dream"s wings will
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need. Kne way to do so is to sit down and write yoursel a caring <or e!en lo!ing= letter in which you list your reasons or wanting to be ree. Then, carry it with you, pull it out during challenge and use as a ront-line de ense. 5 admit, it sounds rather silly or a ully grown man or woman to write themsel!es a letter, carry it, and then reach or it when threatened. -ut when your greatest moment o challenge is upon you and an anxiety riddled mind is seriously considering throwing it all away, it won"t seem so silly then. 4ou"ll reach or one inal resource -- $you$ -- to remind yoursel why !ictory here and now is oh so important. Dear and panic may at times suggest that you lee toward your dependency"s grasp, that you lea!e reco!ery behind. Dailure to document and recall dependency"s bad and ugly makes saying $no$ to it more challenging. 7hy allow your core reco!ery moti!ations and the dreams they uel to be absent, erode or die8 The human mind suppresses negati!e memories. 7hile daily chemical dependency kept dependency"s memories !i!id and ali!e, it"s ama)ing how quickly they begin to erode once nicotine use ends. &s impossible as this may be to belie!e, it won"t be long be ore you"ll ind it extremely di icult to picture yoursel ha!ing e!er used nicotine. 7hy allow time, challenge and memory suppression to destroy reedom"s dreams8 *ack su icient uel to get you home. Eonsider spending a ew minutes now to document li e as an addict. Take a glance now at the &ppendix at the end o this book. 5t"s a simple journal orm that you can copy, complete and carry with you. Kr, make your own@
P c( #ur 'le Moti" tion$

#o thi$ 1or 2you,2 not other$ - 5t"s wonder ul that we"d be willing to attempt reco!ery because some other person wants us to. -ut na!igating battle a ter battle or someone who isn"t in there ighting with us, and who isn"t there a terward expressing thanks or our sacri ice, naturally osters a sense o sel -depri!ation that can quickly eat away and destroy moti!ation.

$#y husband can"t stand it when 5 smoke. 5"m stopping or him.$ $#y dentist is constantly nagging me about my dip causing gum disease. 5"ll stop be ore my next appointment.$ $5"m hooked on nicotine gum and my two teenagers are telling e!eryone that dad is a drug addict. 5 can"t take it. 5"ll stop i they stop.$ $5"m pregnant and stopped or the baby.$
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$Kur pediatrician claims that my smoking is causing our daughter"s illnesses. 5"m stopping or her.$ $#y doctor says that she won"t do surgery i 5"m still smoking. (he lea!es me no choice.$ $#y neighbor said my cat smells like cigarettes. #y cat deser!es better.$
7hile each is making an attempt, they are doing so or the wrong reasons. $7hile they may ha!e gotten through the initial withdrawal process, i they don"t change their primary moti!ation or abstaining, they will ine!itably relapse,$ wrote 'oel in 3B1..3.3 6nding nicotine use or someone else pins our success to him or her. (hould they do something wrong or disappoint us we ha!e at our disposal the ultimate re!enge, relapse. $5 depri!ed mysel o my cigarettes or you and look how you pay me back@ 5"ll show you, 5"ll smoke a cigarette@$ &s 'oel notes rom this example, $,e will show them nothing. ,e is the one who will return to smoking and su er the consequences. ,e will either smoke until it kills him or ha!e to stop again. :either alternati!e will be pleasant.$ 7e can"t stop or our doctor, religious leader, parents, spouse, children, grandchildren, best riend, employer, insurance company, support group, pet, some guy who wrote a nicotine cessation book, or or the de!eloping li e inside a woman"s womb. &s or pregnancy, imagine the thinking, while gi!ing birth, o a woman who stopped or the baby. 5magine each contraction making her ixate upon relapse as she con!inces hersel that she"s sacri iced long enough, that danger o harming the baby is about to pass. (adly, the new baby may ne!er know its mother"s natural smell. The mother may ind it curious that her baby seems extremely content in the arms o smokers, especially those who smoke her brand. ,er own sense o smell deadened, she probably won"t make the connection. &pproximately hal o women who stop smoking during pregnancy relapse within six months o gi!ing birth.3./ 7hile all with whom we share our li!es will clearly inherit the ruits o our reco!ery, it must irst and oremost be our gi t to us. Journey 1or 'etter he lth, not 1e r o1 1 iling he lth - 7hile ear o bad or e!en ailing health can be a power ul moti!ator in causing us to contemplate reco!ery, the human body is a healing machine. 5 allowed, it mends and repairs.
3.3 (pit)er, ', 'oel"s %ibrary, Luitting or Kthers, 3B1., http9//whyquit.com/joel 3./ Eolman M', et al, Trends in smoking be ore, during, and a ter pregnancy in ten states, &merican 'ournal o
*re!enti!e #edicine, 'anuary /00H, Golume /.<3=, *ages /B-HI.
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7hat i the primary orce dri!ing our reco!ery is an escalating ear lowing rom noticeable dependency related harms8 7hat will happen to those ears i nearly all-noticeable harms quickly impro!e a ter stopping8 7hat will happen to our determination and resol!e8 5 an oral nicotine user, imagine a white spot on your gum that quickly disappears. 3.H 5 a smoker, picture dramatic impro!ement in your sense o smell and a noticeable change in taste. 5magine a chronic cough or whee)e that !anishes in a couple o weeks. ,ealing is normally an extremely positi!e thing. -ut i reco!ery is dri!en almost exclusi!ely by ear o ailing health, it can eel like our moti!ational rug is being pulled out rom under us as our primary concerns e!aporate be ore our eyes. 5magine healing breeding such thoughts as, $5 guess smoking hadn"t hurt my body as much as 5"d thought. 5 guess it"s sa e to go back to smoking.$ Kb!iously, we don"t correct years o mounting damage to lungs and blood !essels within a ew months. %ong-term cancer and circulatory disease risks take years to re!erse. -ut to a mind that commenced reco!ery primarily due to worries about declining health, disappearance o a chronic cough or a noticeable increase in lung unction may uel erroneous thinking about the impact o smoking upon the body. The lip side o ear o declining or poor health is hope or impro!ed health. 7hile it may seem like word games, when packing durable and sustaining moti!es the distinction could pro!e critical. 5nstead o using ear o ailing health as a moti!ator, imagine recasting those ears into a dream o seeing how healthy your body can once again become. 7hat i instead o each new health impro!ement reali)ation eating away at our primary moti!ation, we looked upon it as a reward that le t us wanting to celebrate8 5magine the disappearance o each concern stirring our imagination about the limits o possible impro!ement8 &gain, initially, ear can be an extremely positi!e orce. 5t may ha!e been what moti!ated you to start reading this book. -ut ear su ers rom a lack o sustainability. 7e can only remain a raid or so long. 7e can only look at so many photographs o diseased lungs or mouth cancers be ore growing numb to them. &s to noticeable tobacco related health concerns, why not use their potential or healing and some degree o noticeable impro!ement as a means o re ueling core dreams and desires8 These bodies are built or healing. 5 gi!en the opportunity, all tissues not yet destroyed will
3.H *olito '?, %ong-Term :icorette Mum ;sers %osing ,air and Teeth, 7hyLuit.com, December 3, /001.
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mend and repair. 7hy not put your body"s ability to heal to work or you8 #o it 1or tot l $ "ing$, not d ily co$t & The inal moti!ation we may want to consider shi ting and recasting is cost. The cost o satis ying the brain"s demand or nicotine continues to rise as go!ernments increasingly turn to tobacco tax increases as moti!ation to induce cessation, or so they say. Dewer smokers mean that the tobacco industry must charge remaining smokers more money in order to satis y pro it seeking shareholders. (till, i the cost o today"s supply o nicotine is our primary reco!ery moti!ation, what"s the actual price o relapse8 ,ow much does it cost to bum or be o ered a cigarette, cigar, pinch, wad or piece8 7hat"s the cost o a single pack, tin, pouch or box8 & ew dollars8 -ut i we ocus upon total sa!ings instead o the cost o our daily or weekly supply, our core moti!ation is allowed to grow instead o ser!e as a source o increasing temptation. 5 just glanced and according to my computer"s desktop reco!ery calculator, at TH.00 per pack o cigarettes <an addict"s paradise, (outh Earolina continues to ha!e almost the cheapest nicotine in &merica=, during my 3H years o healing 5"!e sa!ed TI/,.F/.03 <;.(.= by skipping /1I,A.B once mandatory nicotine eedings. -ut in reality, my sa!ings ha!e been ar greater. 7hen calculating sa!ings don"t orget the price o uel i tra!el was necessary to re-supply. &nd what about the !alue o our time8 &nd don"t orget tobacco use related doctor and dentist !isits. 7hen smoking H packs a day, 5 li!ed with chronic bronchitis and respiratory illness, including being diagnosed with early emphysema. 5 had pneumonia two years in a row and six root canals in the two years prior to my inal attempt. &ma)ingly, the madness o paying the tobacco industry to destroy this body ended a ter arresting my dependency. 5 can"t begin to guess at my medical sa!ings but clearly they"!e been substantial, including being ali!e here today to type these words. Dream about the big picture and total sa!ings, not just what you"d spend or tomorrow"s or
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next week"s supply.
P c( P tience) >ne 7our, Ch llenge nd # y t /ime

Deri!ed rom the Drench word $pati,$ which means to su er or endure, patience is the $quality o being patient in su ering,$3.. 5ronically, nicotine users su er rom the act that stimulation o dopamine pathways by use o an external chemical osters impulsi!eness, 3.I the opposite o patience. The speed with which we were each able to introduce a new supply o nicotine conditioned us to de!elop !arying degrees o impatience when it came to satis ying the wanting within. &s you embark upon this temporary journey o re-adjustment, practice de!eloping patience as an aid to na!igating any moments o challenge. %et"s look at measuring !ictory irst. /od y "er$u$ 1ore"er - $Kne Day at a Time$ is both a patience de!elopment skill and a means or measuring ull and complete !ictory. &lthough 5"!e remained 300C nicotineree since #ay 3I, 3BBB, i we both remain 300C ree today, your day"s worth o reedom will ha!e been no longer, shorter or less real than mine. 7e"ll remain equals in being just one hit o nicotine away rom relapse. &nd when our head hits our pillow, we"ll both ha!e achie!ed ull and complete !ictory o!er today. #any ail at breaking ree because they con!ince themsel!es that the mountain is just too big to climb. (till, it doesn"t stop them rom trying. 6!ery ew years they"ll likely take a ew steps up it, stop and decide that it"s still too big. 7e can"t build a beauti ul wall with just one brick, recei!e a new baby a ter only one month o pregnancy, obtain a college degree with just one class, or cook a delicious holiday dinner in a ew short minutes8 5magine getting hal the meal cooked and then leeing the kitchen, or building hal a wall and walking away. Moing the distance in li e is normal. (wimming hal way across the ri!er and stopping is not. (o how do we build a wall8 'ust one brick at a time. Take pride in each brick that"s laid. #anaging impatience can be as simple as making each task smaller and sa!oring each !ictory sooner. 5 we only see !ictory in terms o $stopping ore!er,$ then on which day do we allow oursel!es to celebrate8
3.. *atience. <n.d.=. Knline 6tymology Dictionary. ?etrie!ed 'uly /A, /001, rom Dictionary.com website. 3.I !an Maalen ##, et al, Eritical in!ol!ement o dopaminergic neurotransmission in impulsi!e decision making,
-iological *sychiatry, 'uly /00F, Golume 3JF0<3=, *ages FF-AH.
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7hy wait until dead to celebrate8 7ho is coming to that party8 5nstead, consider adopting a reco!ery philosophy that celebrates e!ery day that we remain ree and healing. 2>ne # y t /ime,2 1und ment l 1ocu$ $(ill - &s 'oel notes in his article entitled $Kne Day at a Time,$ $this concept is taught by almost all programs which are de!oted to dealing with substance abuse or emotional con lict o any kind. The reason that it is so o ten quoted is that it is uni!ersally applicable to almost any traumatic situation.$3.F $Kne day at a time$ is a ocus skill. 5t allows us to declare total !ictory within /. hours, while ocusing on tomorrow"s concerns once tomorrow arri!es. 5t encourages abandonment o all !ictory standards that ail to permit celebration today. Think about the needless anxiety and delayed satis action o those who insist that !ictory can only occur i they stop using or the rest o their li!es. Dorget about tomorrow. 7hy not end use just or one day, today@ Truth is, any worry or concern about tomorrow is wasted emotion unless we succeed today. 7hen we take reco!ery just one day at a time, it isn"t long be ore so many aspects o li e are reclaimed that we ha!e no choice but to accept the simple truth that e!erything done while nicotine"s sla!e can be done as well as or better without it. &s 'oel notes, we"ll be orced to reali)e that our thoughts o what li e would be like as an ex-user were all wrong, that there is li e a terwards and that $it is a cleaner, calmer, uller and most importantly, a healthier li e.$ Knce residing here on $6asy (treet,$ occasional thoughts o wanting to use may become so brie and mild that they become laughable. 5t may eel like our $one day at a time$ reco!ery philosophy has done its job and outli!ed its use ulness. -ut 'oel cautions us not to abandon it. ,e warns that like ne!er-users, now and then ex-users ha!e horrible days too, including stress at home or work. & growing sense o complacency could also lea!e us toying with temptation in social situations. Ch llenge p tience - 7hether con ronting a physical withdrawal symptom, struggling with a reco!ery emotion, encountering an un-extinguished subconscious cra!e trigger, or ixating on conscious thoughts about using, i you are to remain ree you must muster the patience needed to na!igate challenge. -ut how8 *atience is the ability to na!igate anxieties when con ronted by challenge. 5t may be associated with our thinking rational mind <our pre rontal cortex= learning to say
3.F (pit)er, ', Take it Kne Day at a Time, 7hyLuit.com, 'oel"s %ibrary, 3B1I.
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$no$ to our primiti!e impulsi!e mind <our limbic mind or li)ard brain=. 5t may in!ol!e an internal debate and the need to summons the patience to allow honesty and reason to pre!ail. Ehapter 33 is loaded with coping techniques or handling subconscious cra!e episodes. Ehapter 3/ shares tips associated with na!igating periods o conscious thought ixation. %earning to say $no$ to the impulse to use and enduring up to three minutes o anxiety may be the most important reco!ery skill o all. 7e smokers became conditioned to expect to sense satis action o nicotine urges and cra!es within 1-30 seconds o inhaling a pu o smoke. 5s it any wonder then that it may take a ew !ictories be ore growing com ortable, con ident and skilled at saying $no$ to use impulses8 4ou are climbing back into your mind"s dri!er"s seat and taking o!er the wheel. 5t"s likely been a while since you were in ull control. ,a!e patience@ The next ew minutes are all that are within your immediate control and each is entirely doable. The decisions, i any, made during those minutes are yours to command. Journey p tience - ?eco!ery is a journey not an e!ent. Knline at support group message boards such as Dreedom and Turkey!ille we o ten see those in early reco!ery growing impatient. $7hy am 5 still cra!ing8$ $7hen will com ort come8$ (ome endure a substantial degree o sel -in licted anxiety by intense ocus upon the question o how long it will take be ore able to go an entire day without wanting to use. 5 like to think o it in terms o the time needed to heal a broken bone, but with greater !ariation rom person to person. 6!ery reco!ery is di erent. 5n regard to psychological reco!ery, some will let go and put their relationship with nicotine behind them ar sooner than others. (ome will cling to !arying use rationali)ations or months. (ome e!en longer. Dind contentment in today"s reedom and healing. 5t took years to walk this deeply into dependency"s orest. 5s it realistic to think we can walk out o!ernight8 *atience@ 4ou"ll soon be doing easy time. $-ig bite$ anxieties occur when we percei!e that the task be ore us is bigger than our ability to na!igate or endure it. $Kne day at a time$ is a patience de!elopment skill that once mastered causes $big bite$ anxieties to e!aporate. 7hen cli climbing, it"s wise to ocus on gaining a solid hold upon the rock beneath our hands, not looking up ahead at the remaining mountain to be climbed. 5t"s wise to ocus on
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where we"ll next place our oot, not repeatedly looking down at the ground ar below. 7hy intentionally oster needless anxieties8 $Kne day at a time,$ $baby steps,$ and $one hour$ or $one challenge at a time$ <when irst starting out= are patience ocus techniques that break large tasks down into entirely manageable e!ents. ,ow many times ha!e we said, $This time 5"m stopping ore!er@$ $Dore!er$ is an aw ully big psychological bite that can make any task appear larger than li e, or all but impossible. *icture yoursel sitting down at the dinner table and ha!ing to eat FA pounds o bee . 5magine the anxieties associated with thinking we need to eat a large portion o a cow. 5t sort o destroys the image o a nice juicy steak, doesn"t it8 4et the a!erage &merican consumes FA pounds o bee annually.3.A 5 start each seminar with the same two questions. $5 need an honest show o hands. ,ow many o you deeply and honestly belie!e that you"ll ne!er, e!er smoke another cigarette or the rest o your li e8$ ?arely will a hand go up. 5 then ask e!eryone to look around and to ne!er orget what he or she is seeing. :ext 5 ask, $,ow many o you deeply and honestly belie!e that you can go one hour without smoking nicotine8$ 7ithout exception, e!ery hand goes up. 7hy adopt a reco!ery philosophy that we don"t belie!e will succeed when we already ha!e a building block in which we deeply belie!e8 'ust one hour or challenge at a time, allow the hours to build into an day. ,ow does a person reco!er rom a broken bone or nicotine addiction8 -y allowing time to heal, just $one day at a time.$ ?egardless o our emotions or the situation, i con ronted by a desire to introduce nicotine back into your bloodstream there"s one guiding principle that i embraced will guarantee that your healing continues ... no nicotine today.
P c( Po$iti"e !ttitude
Ean we make oursel!es miserable on purpose8 :o doubt about it. Throughout our li!es we"!e experienced worry, ear, anger and irritability, only to ind out later that our emotions were totally unnecessary, that our concerns didn"t occur. The single greatest source o sel -in licted anxiety in my li e lowed rom my ailure to understand my addiction. ,ow could 5 seriously and intelligently con ront something that 5 didn"t understand8
3.A Da!is EM et al, Dactors & ecting ;.(. -ee Eonsumption, ;(D&, Kctober /00I, Kutlook ?eport :o.
%D*#3HI0/.
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&lthough 5 o ten dreamed about reedom, 5"d always end up reaching or that next ix instead. Eombining intelligence with attitude can destroy baseless ears. 7hy not reassure your impulsi!e mind that there is absolutely nothing to ear, that coming home is good not bad. *icture a board on the ground that"s 30 inches wide and I0 eet long. *icture yoursel easily and repeatedly walking its entire length, o!er and o!er. :ow, picture the same board suspended between two skyscrapers, i ty stories o the ground. 7hat are the odds o you walking its length without alling8 :ot good.3.1 ?eco!ery is grounded. 7hy allow alse ears to destroy your will8 &ttitude can either escalate and uel ears or ser!e as a calming in luence that relaxes and reassures. 7hy not choose reedom o!er bondage, happy o!er depressed, success o!er ailure8 7hy not in!ite your subconscious to pick honesty, healing and sa ety o!er lies, toxins and disease8 7hy allow resol!e, commitment and success to be controlled by dependency induced doubt, anxiety and ear8 7hy heap layer upon layer o anxiety icing on reco!ery"s cake8 Do you remember when you irst learned to swim and ound yoursel in water o!er your head8 Did you panic8 5 did. 7ould 5 ha!e panicked i 5"d been a skilled swimmer8 K course not. The more knowledgeable and skilled we become, the easier and calmer reco!ery. 4es, there may be a ew wa!es along the way. -ut why ear their arri!al8 7hy not relax and do the backstroke until your swimming skills are needed8 5magine a positi!e attitude becoming your subconscious teacher, in sharing the truth about coming home. 5magine con ident honesty enlisting it to ight on the side that"s right. Met it to take its inger o o the button controlling your body"s ight or light panic response. ,elp it understand that what needs to be eared is your dependency. Mradually destroying your body, continued use was threatening sur!i!al. 7hy adopt an attitude that resists bringing wanting to an end8 7hat harm is there in allowing this temporary journey o re-adjustment to become our most ama)ing period o sel -disco!ery e!er8 7hy pretend that the board is too high, the swim too hard, or that there are monsters or demons where none exist8 ?e lect on how repeatedly telling yoursel that reco!ery $is too hard,$ $endless$ or $nearly
3.1 EouQ, 6mily, (el #astery through Eonscious &utosuggestion, #alken *ublishing Eo., 5nc., 3B//.
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impossible$ might tend to eat away at reedom"s dreams and desires. ?e lect upon how a positi!e can-do attitude might reassure your subconscious and help diminish sel -in licted stress, worry, anxiety, panic, anger and depression. 7hy not allow our dreams to eel the in luence o celebrating each moment o reedom, each challenge o!ercome8 *icture a plugged-in lamp but without a light bulb. The power switch is turned o . *icture intentionally sticking your inger into the bulb socket and lea!ing it there. :ow picture all o your subconscious nicotine eeding cues being wired directly into the lamp"s on-o switch. 5 we know that we are going to encounter a use cue that will trigger an anxiety episode but we don"t know when, what will lea!ing our inger in the socket all day do to our ner!es8 7ill it keep us on edge8 7ill a constant sense o anticipation anxiety ha!e us lashing-out at anyone entering the room8 7ill we eel like crying8 7ill worry and concern keep us rom concentrating on other things8 7ill it wear us down and drain our spirit8 Eon!ersely, what i we know that when a shock occurs that it will always be tolerable, that no cra!e episode will e!er harm us, cut us, or make us bleed, break our bones, make us ill or kill us8 5 we expect to soon encounter another use cue and anxiety episode but don"t know when, what will lea!ing our inger in the socket all day do to our ner!es8 7ill it keep us on edge8 Ean honesty, con idence, understanding and attitude make the time and distance between challenges more relaxed8 &lternati!ely, can we allow our thinking to become so in ected by ear, doubt and negati!ism that it becomes the instrument o de eat8 5nstead o intense ocus upon any anxiety elt when the light switch is turned on, why not ocus on learning to relax during the massi!e amount o time that the switch is o 8 5 we keep eeding oursel!es the thought that reco!ery is too hard, should we be surprised when our emotions make us eel that it is8 7hy eed the mind ailure8 7hy ear the swim and worry needlessly when some o us are not e!en in the water yet8 7hy uel your impulsi!e mind in breeding power ul negati!e anxieties8 Dight back with reason, logic and dreams. %ook orward with con idence while knowing that nicotine will no longer de ine who you are. 4ou, not a chemical, will now control your remaining time here on earth.
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6mbrace reco!ery as a wonder ul journey back to the rich, deep, and tranquil inner calm that resided inside our mind be ore nicotine irst arri!ed. *ermit yoursel to grow stronger, not weaker. %et honesty answer addiction"s chatter. *icture your brain and tissues healing, extra money in your pocket, extra time to spend it, and more bounce in your step. 7hile true that only action, not thought, can rob us o !ictory, why allow a negati!e attitude to in!ite ailure8 #ar!el in the glory o taking back your mind.
/he D lue o1 #ocumenting 3our Journey

7hile $one day at a time$ is an excellent !ictory yardstick, imagine the !alue o being able to look back and see what each day was like. Eonsider jotting down a ew calendar notes or diary entries about what early reco!ery was like and the challenges o!ercome. &lthough not necessary to success, doing so could pro!e !aluable later. -ut why would anyone want to !i!idly recall the irst ew days o reco!ery, days which could re lect a blend o rustrations, anxieties, cra!e episodes, anger, bargaining and sadness8 The same reason we need to remember, in as much detail as possible, daily li e as an acti!ely eeding nicotine addict. 7e"!e all heard that $those who orget the past are destined to repeat it.$ 5t"s hard to imagine a situation where it rings truer than with drug reco!ery and relapse. ,umans tend to repress and inhibit negati!e emotional memories, and emotional experiences in general.3.B 5nstead, we remember and replay the good times while orgetting the bad. 5magine i it were otherwise. & !i!id picture o all the pain, anxiety and hurt o all our yesterdays would be a hea!y burden to bear. 7hile your mind will quickly suppress memories o the challenges o!ercome, ink on paper or words typed into a computer are durable. The best way to protect against complacency isn"t by orgetting what bondage or reco!ery was like, but by accurately recalling them. 5t"s wise to make a record o both our reco!ery justi ications and what the irst couple o weeks were like. Eonsider sending yoursel an e-mail be ore bed. &nd here"s an example o why.
3.B Da!is *', et al, ?epression and the inaccessibility o a ecti!e memories, 'ournal o *ersonality and (ocial
*sychology, 'anuary 3B1A, Golume I/<3=, *ages 3II-3F/J also see Depue -6, et al, *re rontal regions orchestrate suppression o emotional memories !ia a two-phase process, (cience 'uly 3H, /00A, Golume H3A<I1HI=, *ages /3I-/3B.
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5magine hitting what eels like a reco!ery plateau, where you no longer sense impro!ement. 5magine eeling stuck and wondering i it"s going to remain this way or good, as i a rose bud had stopped opening. :ow imagine being able to look back and read your own progress notes. %ike ha!ing a medical chart during a hospital stay, your record can pro!ide accurate perspecti!e o how ar you"!e come. 5t can help calm concerns that reco!ery has stalled. &lthough at times nearly impossible to see, 5 assure you, reco!ery"s rose bud continues to slowly un old. Eonsider a present gi t o uture memory. Eonsider it ree relapse insurance. & ew memory-jogging notes when starting out could become in!aluable during challenge, lulls or once complacency arri!es.
Re1ueling
7hile challenge, time and negati!e memory suppression erode dreams and desires, opportunities abound to rein!igorate the wind beneath our wings. %B&u$er$ - 6x-users can be an excellent source o support. #ost already reside here on 6asy (treet. -ut a word o caution about ex-users. &s just discussed, their memories o the challenges o early reco!ery ha!e likely been suppressed. 7hile most will ha!e orgotten the bad, some ha!e continued to cling tight to a ew old nicotine use rationali)ations. Doing so has likely kept tantali)ing $aaah$ wanting relie memories associated with those remaining rationali)ations teasingly ali!e. Kthers will look back upon their years o use as ha!ing been $!ile, disgusting, expensi!e, stupid, cra)y$ or insane.3I0 Dor them, breaking ree is now seen as ha!ing been common sense, no big deal, a non-e!ent or easy. &sk the next ex-user you meet how long it has been since their last signi icant challenge. Try to get them to put a date on it. &sk how long the challenge lasted and what it elt like. ,ow intense was it8 Then ask about the challenge prior to that. &gain, try to get them to be accurate in dating and describing it. & ew ollow-up questions and 5 think you"ll disco!er that the e!ent was really a non-e!ent, that it le t !ery little impression. &sk what they like most about being ree. ,ow has it changed their li e8 Did their success in luence others still using8 7hat do they think about while watching others use8
3I0 (pit)er, ', $5 don"t know i 5 ha!e another quit in me$, http9//www. n.yuku.com/topic/33.0F, #arch H, /00/.
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7hat do they most miss8 Try to identi y any lingering romantic ixations. ?e lect upon the honesty o each. ?e lect on how this ex-user succeeded e!en though they re used to let go o this rationali)ation. 5magine i they had. Think about how it places them at greater risk or relapse. Current&u$er$ - 5 questioned, riends or lo!ed ones still using may not be as open and honest as >atie about their dependency, or about their dream o someday being ree. -ut, words are not necessary. Their dependency will speak or them. Eare ully watching users can be moti!ational. K ten you"ll identi y them by smell e!en be ore they light up. 7atch that irst deep pu . 7atch their reaction to it, their eyes as 1-30 seconds later nicotine strikes their brain. 7hile doing so, keep in mind that they are not replenishing to tease you. They are doing so because they must. 7hile stopped in tra ic, look or windows rolled down when rain, heat or cold suggest they should be up. ;pon spotting the smoker, look closely. 7hat moti!ated this nicotine eeding8 Do they e!en reali)e that they"re smoking or are they replenishing while on autopilot8 %ike *a!lo!"s dogs, did they conditioned their subconscious to expect replenishment when dri!ing8 Did tra ic anxieties turn their urine more acidic, thus accelerating depletion o remaining reser!es o the alkaloid nicotine8 5t"s the same acid-alkaloid interaction seen with stress or when consuming alcohol. Do they extend their arm out the !ehicle"s window in order to keep tobacco toxins rom burning their eyes8 &nd once replenishment is complete, what do they do with their non-biodegradable cigarette butt, with its 3/,000 plastic-like cellulose acetate ibers83I3 (ociety is increasingly treating those still in bondage as social outcasts. :otice the smokers standing around outside o buildings in the cold, heat, night, wind or rain.
3I3 *olito '?, Eigarette -utts, 7hyLuit.com, 'uly ., /00/.
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Eare ully watch their gestures and posture. 5t"s almost as i they want all who see them to belie!e that the only reason they are outside is to enjoy the wonder ul health bene its o the great outdoors. -ut the need to return e!ery thirty minutes betrays them. 7atch at the store counter when they re-supply. &re they buying a one-day supply or more8 &re you witnessing a daily e!ent in their li e8 ?e lect on their choices. 5 already in reco!ery yoursel , what are the odds that this person is en!ious o you8 &ccording to a /00A Mallop *oll o ;.(. smokers, A.C o those polled said they would like to stop smoking, while FAC consider themsel!es addicted.3I/ The beauty o using unsuspecting current-users to recharge our moti!ational batteries is that they won"t disappoint us. They wear their chemical addiction, or more appropriately, it wears them. :one awoke this morning and decided to put it on. 5n act, we"ll ne!er in our li etime encounter any now dependent user who awoke one day and said, $,ey, today 5"m going to addict mysel to nicotine@$ Kn a personal note, 5 hope that none o us e!er orget that not long ago that was us. .e"er&u$er$ - 7hen irst starting out, i not a closet smoker and bra!e enough to share your decision, you"ll likely ha!e amily, riends and possibly co-workers o ering support and encouragement. Their simple words o praise can inspire and make us look orward to more o the same. -ut be extremely care ul not to de!elop support expectations, to lean upon them, to trans orm their praise or comments into a crutch. Knce teenagers, my daughters constantly nagged about my smoking. They were both excited the irst ew days o inal ailed attempt. 7hile their encouragement was extremely upli ting, it abruptly ended. 5 suddenly elt abandoned. 7here was my support8 5"d leaned upon them ar too hea!ily. 5"d made them my crutch. 5"d made their desire that 5 stop my primary moti!ation. 5t was a mistake, a mistake that le t me eeling depri!ed, resent ul and wanting to use. & ter relapsing 5 con ronted them. $Dad, we didn"t want to bring it up any more because we could see you were succeeding.$ $7e didn"t want to remind you and make you keep thinking about smoking.$ 5s it air to expect a person who has ne!er been chemically addicted to anything, to appreciate the reco!ery process8 5n!ite ne!er-users to be part o your support team but be sure to educate them. %et them
3I/ (aad, %, ;.(. (moking ?ate (till Eoming Down, Mallup, 'uly /., /001, http9//gallop.com
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know that helping you stay ocused or the next B0 days would be antastic. -ut don"t count on them being there. (ee their support as dessert, ne!er the main meal. <ndu$try m r(eting - (tore tobacco marketing becomes sadly laughable to the trained eye. 6xtremely e ecti!e, it"s a multi-purpose acade through which the dependency sa!!y brain can easily see. 6 ecti!e industry marketing accomplishes three objecti!es. 5t encourages youth experimentation, pro!ides use justi ication, and is bait or relapse. %ook closely. 7hen is your mind irst assaulted by use in!itations8 &re there roadside signs, signs on top o gas pumps, tied to lamp posts, window signs, exterior building wall signs, signs hanging abo!e candy racks or on the door as you both enter and lea!e8 7hether noticed or not, almost e!ery aspect o marketing is designed to encourage starting, continued use and discourage stopping. 6ach time we returned to purchase more, our mind was ed justi ications as to why we"d returned. &nd when trying to stop, it proclaims why we shouldn"t. 5t wraps around us while trying to purchase gas, ood and medicine. 5ts aim is simple9 to orce our subconscious to notice it, to stir desire, in lame wanting and contribute to relapse. Dla!or, pleasure, to be true, cool, our gateway to riendship, or ad!enture, rebellion or unbelie!able prices, it suggests that we stand at that counter or e!ery reason except the truth, because we must, because our brain is chemically dependent upon nicotine. Think like a tobacco company. %ook closely. 7hat subliminal message is each ad or display attempting to pound into your mind8 7here is the $responsible$ merchant"s message stating that smoking nicotine may be more addicti!e and harder to beat than
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heroin or cocaine8 7here"s the message warning students that they may only need to use nicotine a couple o times be ore becoming hooked or li e8 Deel the industry"s economic muscle as it purchased your subconscious ocus at the checkout counter. 7hat tobacco company won the bidding war at your neighborhood sales location8 %ook at row a ter row o the same packs or cartons. The winner"s products are the ones on top and most !isible. (ee the winner"s sign8 &nd what"s the real purpose o the giant yellow $7e Eard$ or other similar sign abo!e the checkout counter8 Don"t you ind it strange that there isn"t one or alcohol8 5t"s teen bait. Knce secret industry documents suggest that the carding sign"s primary purpose is to torment neighborhood youth with the ongoing tease that tobacco use is a sign o adulthood, a rite o passage, that it"s what $real$ grown-ups do.3IH %ook at the hundreds o brightly colored packs, boxes, cartons, tins, cans, bags, pouches and tubes. Eollecti!ely this power wall oo)es the impression that users can"t wait to awaken each day so that they can run down to the store and try a new la!or. 4ou"re looking at the biggest tobacco ib o all. The entire color ul acade is orchestrated to scream the lie that use is a ree-choice acti!ity, that e!eryone"s doing it. 5n your mind, strip away the rainbow o color, the ancy packaging and the almost A00 documented tobacco la!or additi!es.3I. 5nstead, see a !ast array o di erent doses o nicotine, each engineered to penetrate tissues at !arying rates o speed. Turn store marketing on its head. 5nstead o being used by it, use it as moti!ation or staying ree and keeping your money. ;oci l control$ - ,ow did you react to anti-smoking news stories or to stories about new tobacco health concerns8 Did you instantly change the channel, turn the page or otherwise tune out8 5 did. :ews stories that once ostered anxieties can now be used as a source o moti!ation in helping keep us clean and ree. 5n case you ha!en"t noticed, there"s a mo!ement sweeping the globe as workers and nonsmokers demand smoke- ree air. 7e"re seeing stories o smoking being banned on all hospital property, in parks, playgrounds, outdoor sporting e!ents, on beaches, in hotel rooms, and e!en in company or go!ernment owned !ehicles.
3IH *olito, ', Eon!enience (tores - :icotine &ddiction Eentral, 7hyLuit.com, #arch 31, /00F. 3I. *olito, ', Eigarette &dditi!es, Earcinogens and Ehemicals, 7hyLuit.com, Debruary A, /00I.
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7e"re also seeing proposed legislation attempt to ban smoking in all !ehicles transporting a child. &nd smoking is now beginning to actor into amily court child custody, !isitation and child abuse decision-making. (cience is awakening to the reali)ation that there may not be any li!ing cell in the entire human body that isn"t touched and a ected by tobacco toxins. 7here allowed by law, employers are beginning to discriminate in re using to hire anyone testing positi!e or nicotine. (ome employers are threatening to ire all current employees who test positi!e or nicotine a ter being a orded a reasonable period o time to break- ree. Duel and li!ing costs are now rising aster than income in most nations. #illions o hooked parents are increasingly con ronted with the choice o buying ood or their child or nicotine or their addiction. 5t"s a situation made worse by cash strapped go!ernments that ha!e become increasingly dependent on tobacco taxes, and nicotine"s grip upon the taxpayer"s brain. *ersonally, it"s o ensi!e that most politicians either accept tobacco industry campaign contributions or see those still ensla!ed as a highly dependable source o tax re!enue. They just don"t seem to get it, or maybe they do. 7hether we accept or deplore the way society treats those still in bondage, news o the latest assault upon them can be used as moti!ation to pre!ent any more assaults upon us. 3ou@ - Elearly, your most dependable source o support is $you$@ 4our three most !aluable moti!ational assets will be9 3. #emories o li e as an acti!ely eeding nicotine addictJ /. 4our reasons or wanting to be reeJ and H. #emories o early reco!ery. &gain, the early part o this journey can be emotional. 5t"s wise to anticipate and prepare or signi icant negati!e memory suppression. 4ou will also suppress use memories. Dind quality ways to preser!e those memories. #ake them a!ailable both as a reco!ery progress report and later as an aid in ending o complacency. Doing so will be like owning the best and quickest battery re-charger the world has e!er known. 7hether your nicotine use was hea!y or light, long or short, out in ull !iew or the world to see or the best kept secret on earth, your intelligence and conscious thinking mind is your N3 moti!ational tool. Clo$et u$er$ - *retend or a second that you are a closet nicotine addict. 5 a secret user, your amily and riends either ne!er knew you were hooked, or were told that you
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success ully broke ree long, long ago. &side rom all the lies we told oursel!es to rationali)e that next mandatory eeding, the closet user li!es and breathes the need to constantly decei!e the world too. 5 a reco!ering closet-user, in addition to celebrating sel -honesty, there"s tremendous relie in at last being honest with those we lo!e. ,a!ing li!ed in almost constant ear o being exposed, whether or not we come totally clean and share our secret, the emotional rewards o no longer li!ing a lie can themsel!es be extremely supporti!e. 5 a closet ex-user, where can you turn or support when your world thinks that you didn"t use8 <nternet re1ueling - 5 you don"t own a computer or are not online, consider dropping by your local library, as most now o er ree 5nternet access. 6!en i you ha!e ne!er touched a computer in your entire li e, there is hope ully a library sta member who delights in teaching library patrons how to explore the 5nternet and print their disco!eries. Knce online, a keyboard and mouse will allow you to explore a !ast array o empowering reco!ery tools. Gisit 7hyLuit.com. (imply type whyquit.com in the address window at the top and then press $enter$ or $return.$ 7elcome to 7hyLuit@ &s this partial screen shot shows, 7hyLuit"s home page is broken down into three categories. The le t column contains links to moti!ational articles, the center contains links to educational materials and the right column is the gateway to ree online support.
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The site is totally ree, sells nothing, declines donations and is sta ed entirely by !olunteers. 7hyLuit"s moti!ation column includes stories o the ordeals endured by young tobacco !ictims and their amilies. Elearly, 7hyLuit intentionally shares horri ic stories about the youngest o the young. 5t
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does so in an attempt to get !isitors to appreciate that predicting whom tobacco will harm and at what age is like playing ?ussian roulette. The center education column is home to all o 'oel"s materials and my articles. ,ere you"ll ind e!ery lesson shared in 'oel"s book, more than 300 short articles on nearly e!ery reco!ery topic imaginable. 4ou"ll also ind links to his ree electronic e-book $:e!er Take &nother *u $ and to 'oel"s 300U !ideo counseling lessons <most ormatted as audio iles or listening as well=. The right column pro!ides support links and transports !isitors to $Dreedom,$ the 5nternet"s most serious and ocused peer support group and to Turkey!ille, 7hyLuit"s Dacebook group. &t both, education always comes irst. 5t must. 7e disco!ered !ery early that a orum"s ability to support and sustain reco!ery in a purely pep-rally type en!ironment is dismal at best. 7hile the initial excitement o interacting with other ex-users is o ten tremendous, it e!entually begins to wane. &s it does, the orum"s !alue and e ecti!eness in supporting success ul reco!ery diminishes. 5 no education to all back upon, group relapse rates become horrible. Gisitors to Dreedom don"t need to join in order to read the orum"s materials. 5n act, most don"t. -ut we still treat them like part o the amily. Dreedom unctions as a !irtual classroom with enormous windows. #aintaining positi!e control o!er admissions ensures a classroom type learning experience, pre!ents chaos, and makes sure that the orum"s seasoned !olunteer educators are not o!erwhelmed. 6!ery message posted at Dreedom must relate to reco!ery. Meneral sociali)ation is not permitted, including celebration o birthdays, anni!ersaries or holidays. Elearly, Dreedom isn"t or those seeking to sociali)e or make new riends. 7ith millions o tobacco related deaths annually, the orum takes its mission seriously. 5ts goal is simple9 to aid !isitors in remaining nicotineree today. 7e igure there must be at least one place on planet earth where nicotine has no !oice. Those applying or membership must certi y that they stopped cold turkey without use o any product or procedure and that they"!e remained 300C nicotineree or A/ hours. &lthough it may sound harsh, applicants must agree to abide by Dreedom"s relapse policy. That policy states that should any member relapse that they will permanently lose message board posting pri!ileges. 5t encourages members to take reco!ery seriously.
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Kne inal point deser!es mention. The orum"s posting rules prohibit mention o any commercially sold book, product, diet or procedure. The orum was built around the concept that e!ery reco!ery lesson is made reely a!ailable to all without cost or obligation. &s such, the orum will not permit any suggestion that any reader need spend any money or make any purchase in order to succeed. (upport is also a!ailable at 7hyLuit"s Dacebook site, Turkey!ille. %ike Dreedom, it"s exclusi!ely a cold turkey reco!ery group. ;nlike Dreedom there"s no A/ hour nicotineree waiting period be ore you can join and no relapse policy. The group"s primary ocus is in helping those just starting out in na!igating early reco!ery. Reco"ery meter$ - 7hyLuit and Dreedom o er !isitors links to ree stop smoking meters. These are small computer programs that are either downloaded to and installed on our computer, or designed or use while online. 5n either case, once we type in our tobacco use history <how o ten we smoked, the purchase price and the day we stopped=, most will calculate the number o days, months and years we"!e remained ree, the amount o money we"!e sa!ed, and i a smoker the total number o cigarettes not smoked and the amount o li e expectancy so ar reclaimed. #ost meters allow you to copy their calculations to your computer"s clipboard or transporting and pasting into e-mails, documents created with your word processing program or or sharing on 5nternet message boards. %ike a car"s odometer, they"re a un way o tracking, marking and measuring our journey home. %inks to ree meters can be ound at both 7hyLuit and Dreedom. ;upport limit$ - The abo!e reco!ery support suggestions will hope ully stir your thinking. The only limit to identi ying additional ways o keeping our reco!ery dreams ueled and !ibrant is the limits o our imagination. Kur objecti!e is simple. 5t"s to stay su iciently moti!ated long enough to allow the time needed to success ully na!igate reco!ery"s challenges, i any. -ut whether today is good or bad, whether we eel moti!ated or not, our reedom and healing will continue so long as we stick to one guiding principle ... no nicotine today@
#e$troy !ll Rem ining .icotine

&s nicotine addicts, many o us engaged in mind games while pretending to arrest our addiction. Kne such game
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was to keep nicotine on hand a ter stopping, or the purported purpose o pro!ing that we were in ull control, stronger than our addiction ... or just in case we need it. This practice makes as much sense as someone on suicide watch carrying a loaded gun, while ighting the urge to use it. (ome carry their nicotine deli!ery de!ices with them while others knowingly keep a stash within quick and easy reach. 7e"ll ne!er be stronger than nicotine but then we don"t need to be. Kur weapon is our intelligence. Deeling a need to tempt and toy with impulsi!eness in order to pro!e conscious strength re lects abandonment o intelligence. 7hy treat quick access to nicotine as though a li e jacket8 5t"s a jacket all right but not one that sa!es, one that ensla!es. The smart mo!e is to destroy all remaining nicotine. 7hether in the pocket o a coat hanging in a closet, in your other purse, hidden in the yard, on the balcony, in the garage, in a !ehicle, under a seat, or at work, destroy it. &nd don"t orget to empty the ashtrays too. 5t"s time to get serious. Eheck or cigarettes that may ha!e allen under urniture, beneath a cushion or under the car seat. &nd throw out all old nicotine replacement products and e-cigarettes tools too. >eeping nicotine handy is contrary to learning to li!e li e without it. Metting rid o all nicotine buys you precious seconds during challenge. 7ith cue triggered cra!e episodes peaking within three minutes, a bit o delay may be all that"s needed to sense anxieties peak and begin to diminish. $Don"t e!er orget how cigarettes once controlled your beha!iors and belie s,$ reminds 'oel. $7hen you stopped smoking you admitted cigarettes controlled you. 4ou were literally a raid that one pu could put you back. That was not an irrational ear. Kne pu today will lead to the same tragic results as it would ha!e the day you quit.$ $Eigarettes were stronger than you be ore, and, i gi!en the chance, will be stronger than you again, warns 'oel. $5 you want to show you are now in control, do it by admitting you can unction without ha!ing cigarettes as a worthless and dangerous crutch.$ 3II 4ou"ll do just ine e!en i your employment requires you to be near or handle nicotine products, or i you li!e with someone who insists upon lea!ing their cigarettes, cigars, dip, chew or :?T lying around. 5t simply means that you"ll extinguish use cues
3II (pit)er, ', $5"m going to ha!e to carry cigarettes with me at all times or me to quit smoking,$ 3B11, 'oel"s %ibrary, www.7hyLuit.com.
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associated with those situations more quickly than most. -ut mind games in!ol!ing conscious temptation are ully within our ability to control. -e smart. Erush, throw-out or lush all remaining nicotine. 5t"s an excellent means o proclaiming that the time or games is o!er, that you"re serious about coming home@
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Ch pter 8
Prep ring 1or Common 7 5 rd$ 9 Pit1 ll$

% rly !lcohol 4$e
& 3BB0 study
ound that nearly hal who relapsed to smoking <.AC= consumed alcohol be ore doing so. 5t also ound that another IC had been under the in luence o $recreational$ drugs.
3IF
6arly alcohol use is clearly the most a!oidable relapse risk o all. ;sing an inhibition diminishing substance while in the midst o early physical withdrawal is in!iting relapse. Ehapter 33 pro!ides insights in how to con ront and extinguish alcohol related nicotine use cues once peak withdrawal has passed. 7e"re ar too !ulnerable during withdrawal to chance using a substance that relaxes resol!e and inhibits judgment. 5 strongly recommend reading the Ehapter 33 topic entitled $Eon ronting alcohol related cra!e triggers$ be ore attempting alcohol use. ,ere, 5 want to alert you as to the danger o early alcohol use, why post-cessation alcohol use is di erent, and to your cessation options i you ha!e alcohol or other drug abuse or dependency concerns. Why eB&u$er$ m y 1eel lcohol e11ect$ $ooner - There are a number o nicotine/alcohol interactions. #ost ob!ious is the combined e ects <or synergy= o both alcohol and nicotine stimulating our brain dopamine pathways and satis ying wanting.3IA
3IF -randon, T,, et al, *ostcessation cigarette use9 the process o relapse, &ddicti!e -eha!iors, 3BB0, Golume
3I</=, *ages 30I-33.. 3IA Ti)abi 4, et al, Eombined e ects o systemic alcohol and nicotine on dopamine release in the nucleus accumbens shell, &lcohol and &lcoholism, (ept-Kct. /00A, Golume ./<I=, *age .3H-.3F.
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&dditionally, as re!iewed in Ehapter H <$Dorgotten Ealm During Erisis$=, alcohol use causes our urine to turn more acidic, thus more rapidly depleting reser!es o the alkaloid nicotine. & third interaction may lea!e us eeling intoxicated sooner. :icotine stimulates the body"s central ner!ous system while alcohol depresses it. &lcohol stimulates M&-& production <gamma-aminobutyric acid=, which produces a sedating e ect3I1 while impairing muscle <motor= control.3IB :icotine stimulates our ight or light pathways, causing release o adrenaline and noradrenaline.3F0 This is why alcohol induced eelings o becoming sedated or e!en sleepy can be diminished by stimulating the body with nicotine.3F3 7hen drinking, we soon begin noticing alcohol"s gradual sedation and anesthesia type e ects. The more we drink, the more sedated our ner!ous system becomes. The more we drink, the more acidic our urine becomes and the quicker our kidneys eliminate the alkaloid nicotine rom our bloodstream. :ot only are we starting to eel tipsy, our nicotine reser!es are declining aster than normal. -ut just one power ul hit o nicotine and, in addition to an alcohol exaggerated $aaah$ wanting relie sensation, nicotine kicks in our automatic in-born $ ight or light$ neurochemical response. The mind has been ooled into belie!ing that danger is present and begins to stimulate an alcohol-sedated body. &drenaline, noradrenaline and cortisol are released into the bloodstream. Kur heart pounds aster and our rate o breathing increases. Digestion is suspended so that extra blood can be di!erted to our muscles. Kur pupils dilate, ocus impro!es, hearing perks and stored ats and sugars are pumped into our bloodstream to pro!ide an instant source o energy. &n alcohol-depressed ner!ous system has just experienced some degree o stimulation. :o saber tooth tiger to ight or lee, our new ound sense o alertness instead emboldens us ask or another round. $-artender, 5"m ready or another drink@$ The cycle can be repeated again and again, with an increasingly sedated body gradually becoming less responsi!e to nicotine-induced stimulation.
3I1 >oob MD, & role or M&-& mechanisms in the moti!ational e ects o alcohol, -iochemical *harmacology,
Kctober /00., Golume F1<1=, *ages 3I3I-3I/I. 3IB ,anchar ,', et al, &lcohol-induced motor impairment caused by increased extrasynaptic M&-&<&= receptor acti!ity, :ature :euroscience, #arch /00I, Golume 1<H=, *ages HHB-H.I. 3F0 >enneth '. >ellar, >', &ddicted to :icotine, :europharmacology and -iology o :euronal :icotinic ?eceptors, :ational 5nstitute on Drug &buse website, www.Drug&buse.go!, article updated #ay 3B, /00F. 3F3 #c>ee (&, 6 ect o transdermal nicotine replacement on alcohol responses and alcohol sel -administration, *sychopharmacology <-erlin=, Debruary /001, Golume 3BF</=, *ages 31B-/00.
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7hat signi icance does this ha!e to a reco!ering addict8 5t may mean that without nicotine periodically slapping you awake, that you may eel alcohol"s e ects sooner or a ter ewer drinks. %ook on the bright side. 5t may be less expensi!e being an ex-user because you may not need to drink as much to eel the same e ects. The solution can be as simple as learning to drink a bit more slowly, spacing drinks a bit urther apart or simply drinking less. Co&#ependency Concern$ - &ma)ingly, roughly eighty percent o alcoholics smoke nicotine.3F/ ,as alcohol become central to your li e8 &re you chemically dependent upon it8 5 not an alcoholic, ha!e you conditioned your mind to use and expect alcohol too o ten or too much8 6!en social drinkers need to take extreme care when attempting to extinguish alcohol related nicotine use cues. (o, what can we do i alcohol use and its inhibition diminishing e ects seem to be key actors in pre!enting us rom breaking nicotine"s grip upon our mind and li e8 5 unable to drink in a controlled manner or i drinking is ad!ersely a ecting our li e, work, relationships or health, you may be dealing with problem drinking or e!en alcoholism. &s 'oel sees it, $5 a person says that they know that their drinking will cause them to take a cigarette and relapse back to smoking, and i they then take a drink and relapse, they are in e ect problem drinkers, or they ha!e now put their health on the line in order to drink.$3FH 5s alcohol use your reco!ery roadblock8 5 so, while many mental health pro essionals are remain reluctant to suggest simultaneous dual alcohol-tobacco withdrawal,3F. multiple studies suggest that smoking cessation may actually enhance the likelihood o long-term alcohol sobriety.3FI & /033 study re!iewed 3,31I subjects who B years earlier had entered substance use treatment, A3F o whom had also smoked at the time, among which 3.C had success ully stopped smoking within a year o substance use treatment. 5t ound that those who had stopped smoking within a year o entering substance use
3F/ DiDran)a '?, &lcoholism and smoking, 'ournal o (tudies on &lcohol, #arch 3BB0, Golume I3</=, *ages 3H03HI. 3FH (pit)er, ', Ean people quit smoking and still drink alcohol8 'oel"s %ibrary, 7hyLuit.com, Kctober /00I. 3F. 'acques D, et al, Luit smoking8 Luit drinking8 7hy not quit both8 &nalysis o perceptions among -elgian postgraduates in psychiatry, *sychiatra Danubia, :o!ember /030, // (upplement 39(3/0-H. 3FI Mulli!er (-, et al, (moking cessation and alcohol abstinence9 what do the data tell us8 &lcohol ?esearch + ,ealth, /00F Golume /B<H=, *ages /01-/3/.
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treatment had /.0C greater odds o both remaining abstinent rom drugs, drugs plus alcohol, or alcohol alone within the past year, than those who had continued smoking. 3FF The basic insights and skills needed to arrest any chemical dependency are ama)ingly similar. ?eco!ering alcoholics schooled by quality treatment programs are already skilled in their use. ?esearch shows that while those with alcohol problems make ewer smoking cessation attempts they are $as able to stop on a gi!en attempt as smokers with no problems.$3FA ;n ortunately, alcohol reco!ery programs ha!e a tendency to actually destroy nicotine cessation attempts. $#any i not most alcohol reco!ery programs will inad!ertently or !ery purposely push a new ex-smoker entering the program to smoke,$ writes 'oel. $K!er the years 5 ha!e in act had acti!ely drinking alcoholics in smoking clinics - people who made it abundantly clear that they knew they had drinking problems and smoking problems but wanted to treat the smoking irst.$ $5 really do try to get them into alcohol treatment concurrently but cannot orce them to do it. Kn more than one occasion 5 ha!e seen the person success ully stop smoking, stay o or months and sometimes longer, and inally get into &&, only to be assigned a smoking sponsor who tells the person that he or she can"t get o smoking and drinking at once, and who actually encourages the person to smoke again.$ $:ote the sequence here,$ says 'oel. $The ex-smoker has been o nicotine or an extended time period but the smoking sponsor says that the person can"t stop both at once. 5t is un ortunate that most alcohol and drug treatment programs just don"t recogni)e smoking as another drug addiction.$ 'oel uses heroin to show the insanity o such ad!ice. $4ou will not o ten see an && sponsor say that you can"t gi!e up drinking and heroin at once, so i you ha!e been o heroin or six months and now want to stop drinking, you should probably take heroin or a while until you get alcohol out o your system.$3F1 #any o the lessons in this book can be applied to arresting alcohol dependency. 5n act, a number o them, such as a $one day at a time$ reco!ery philosophy ha!e deep roots in alcohol reco!ery programs.
!"oiding Alood ;ug r ;wing ;ymptom$

,ypoglycemia is a big word or what occurs when our $blood sugar <or blood glucose= concentrations all below a le!el necessary to properly support the body"s need or energy
3FF Tsoh '4, et al, (topping smoking during irst year o substance use treatment predicted B-year alcohol and drug treatment outcomes. Drug and &lcohol Dependence, &pril 3, /033, Golume 33.</-H=, *ages 330-3311. 3FA ,ughes '?, et al, Do smokers with alcohol problems ha!e more di iculty quitting8 Drug and &lcohol Dependence, &pril /1, /00F, Golume 1/</=, *ages B3-30/. 3F1 (pit)er, ', Ean people quit smoking and still drink alcohol8 'oel"s %ibrary, 7hyLuit.com, Kctober /00I.
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and stability throughout its cells.$3FB Eauses o low blood sugar in non-diabetics include skipping or delaying meals, eating too little, increased acti!ity or exercise and excessi!e alcohol. 3A0 7arning signs include an inability to concentrate, anxiety, hunger, con usion, weakness, drowsiness, sweating, trembling, warmness, nausea, di))iness, di iculty speaking and blurred !ision.3A3 6ach hit o nicotine ser!ed as a spoon pumping stored glucose into our bloodstream !ia our body"s ight or light pathways. 5t allowed us to skip break ast and possibly lunch without experiencing low blood sugar or hypoglycemic type symptoms. Kne o reco!ery"s greatest challenges is learning to again properly eed and uel our body. 5t"s not a matter o consuming more calories but learning to spread them out more e!enly o!er our entire day, by eating smaller portions o healthy oods more requently. &s an aid in blood sugar stabili)ation, unless diabetic or otherwise prohibited by your health or diet, we recommend de!oting the money you would ha!e spent in purchasing nicotine toward purchase and use o some orm o natural ruit juice or the irst A/ hours. 'uice will not only help stabili)e blood sugar le!els, it will aid in accelerating remo!al o nicotine rom our blood. -ut don"t o!er do it or go beyond three days as juice tends to be rather attening. #ake sure it"s 300C natural juice, no sugar added and a!oid ruit soda drinks and aides. Eranberry juice is excellent. 7hile grape ruit juice speeds elimination too <by nearly I0C !ersus drinking water=, a study o grape ruit juice use in non-smokers gi!en /mg o oral nicotine ound that accelerated elimination was o set by a decrease in the rate that the li!er metaboli)es nicotine and cotinine.3A/ 7hile grape ruit juice comes with the metabolite concern mentioned, a /001 study examined the e ects o drinking .10 milliliters or 3F ounces o unsweetened, normalcalorie cranberry juice </10 calories= upon blood sugar. &nalysis ound that while low-calorie cranberry juice <H1 calories= and water produced no signi icant changes in blood sugar le!els, that normal-calorie cranberry juice resulted in signi icantly higher blood glucose concentrations within H0 minutes, which were no
3FB hypoglycemia. <n.d.=. Dorland"s #edical Dictionary or ,ealth Eonsumers. </00A=. ?etrie!ed &ugust // /001
rom http9//medical-dictionary.the reedictionary.com/hypoglycemia
3A0 :ational 5nstitutes o ,ealth, ,ypoglycemia, :ational 5nstitute o Diabetes and Digesti!e and >idney
Diseases, :5, *ublication :o. 0H-HB/F, #arch /00H. 3A3 ,epburn D&, et al, (ymptoms o acute insulin-induced hypoglycemia in humans with and without 5DD#. Dactor-analysis approach, Diabetes Eare, :o!ember 3BB3, Golume 3.<33=, *ages B.B-BIA. 3A/ ,ukkanen ', et al, 6 ect o grape ruit juice on cytochrome *.I0 /&F and nicotine renal clearance, Elinical *harmacology and Therapeutics, :o!ember /00F :o!, Golume 10<I=, *ages I//-IH0.
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longer signi icant a ter 310 minutes.3AH &s or ruit juices accelerating nicotine remo!al, the heart pumps about /0C o our blood through our kidneys. Kur kidneys ilter approximately I0 gallons or 31B liters o blood daily. This results in remo!al o about two quarts o waste products and extra water, which pass to the bladder as urine.3A. The word $renal$ means $o or relating to the kidneys.$ $?enal clearance$ is de ined as the !olume o blood rom which a chemical such as nicotine is completely remo!ed by the kidney in a gi!en amount o time <usually a minute=.3AI & controlling actor in determining renal clearance rate is the p, le!el o urine produced by our kidneys.3AF The more acidic our urine, the quicker nicotine is remo!ed rom the bloodstream. & /00F study ound that drinking one liter o ull-strength grape ruit juice <H. ounces or about / pints= will increase the rate by which the kidneys remo!e nicotine rom blood plasma by 11C, as compared to when drinking 3 liter o water </H3 milliliters o nicotineree blood produced per minute using grape ruit juice !s. 3/H milliliters o blood when drinking water=.3AA The study ound that e!en i the grape ruit juice was hal -strength that nicotine"s renal clearance rate increased by A1C </3B milliliters per minute=. The p, scale ranges rom 0 to 3. with A being neutral. The urther below A a substance is, the greater its acidity. The higher a substance is abo!e A, the greater its alkalinity. &ccording to the DD&,3A1 the below luids ha!e the ollowing p, ranges9

Eranberry juice Mrape ruit juice *ineapple juice Krange juice &pple juice *rune juice Gegetable juice
/.H - /.I /.B - H.H H.H - H.F H.H - ../ H.. - ..0 H.B - ..0 H.B - ..H
3AH 7ilson T, et al, ,uman glycemic response and phenolic content o unsweetened cranberry juice, 'ournal o
#edicinal Dood, #arch /001, Golume 33<3=, *ages .F-I.. 3A. :ational 5nstitutes o ,ealth, 4our >idneys and ,ow They 7ork, :>;D5E, :ational 5nstitute o Diabetes and Digesti!e and >idney Diseases, :5, *ublication :o. 0A-H3BI, &ugust /00A. 3AI renal clearance. <n.d.=. The &merican ,eritage Dictionary o the 6nglish %anguage, Dourth 6dition. ?etrie!ed &ugust /0, /001, rom Dictionary.com website. 3AF Tucker MT, #easurement o the renal clearance o drugs, -ritish 'ournal o Elinical *harmacology, December 3B13, Golume 3/<F=, *ages AF3-AA0. 3AA ,ukkanen ', et al, 6 ect o grape ruit juice on cytochrome *.I0 /&F and nicotine renal clearance, Elinical *harmacology and Therapeutics, :o!ember /00F, Golume 10<I=, *ages I//-IH0. 3A1 ;.(. Dood + Drug &dministration, &pproximate p, o Doods and Dood products, Eenter or Dood (a ety + &pplied :utrition, &pril /00A.
11+

Tomato juice #ilk
..3 - ..F F.. - F.1
Depending upon urinary low rate, renal clearance o nicotine may be as high as F00 milliliters per minute in acidic urine ha!ing a p, o ..., to as low as just 3A milliliters per minute in alkaline urine ha!ing a p, o A.0.3AB &side rom juices, adding extra ruit and !egetables to your diet will aid in helping stabili)e blood sugars, and may aid in helping diminish weight gain. & /03/ study ound that the odds o success ul smoking cessation or 3. months among the one-quarter o study participants consuming the greatest amount o ruits and !egetables daily was three times greater than among the one-quarter consuming the least.310 7hat we don"t know is i most within the greater ruit and !egetable group were simply more health conscious to begin with, and thus more moti!ated. -ut don"t o!erdo it. ?emember, our primary objecti!e is stabili)e blood sugar during the most challenging portion o reco!ery, so as to a!oid needless symptoms.
3our Alood C 11eine 0e"el Will #ou'le

Ea eine is a mild central ner!ous system stimulant ound in co ee beans, tea lea!es and cocoa beans. The question during early reco!ery is, can you handle a doubling o your normal daily ca eine intake without experiencing $ca eine jitters$ or other symptoms o o!er-stimulation8 :icotine somehow doubles the rate by which the body depletes ca eine. 7hat"s that mean8 5t means that i we were drinking two cups o co ee while using nicotine, once nicotine use ends, that the stimulant e ect o those two cups might now eel like our. &ccording to a 3BBA study, $continuous ca eine consumption with smoking cessation has been associated with more than doubled ca eine plasma le!els. (uch concentrations may be su icient to produce ca eine toxicity symptoms in smoking abstinence conditions.$ The study ound $a signi icant linear increase in ca eine sputum le!els across H weeks post cessation,$ and that $three weeks a ter cessation, concentrations reached /0HC o baseline or the ca eine user.$313 &n earlier study ound that the clearance rate o ca eine rom blood plasma a!eraged 33.
3AB -enowit) :%, et al, :icotine chemistry, metabolism, kinetics and biomarkers, ,andbook o 6xperimental *harmacology /00BJ Golume 3B/=, *ages /B-F0. 310 ,aibach '*, et al, & %ongitudinal 6!aluation o Druit and Gegetable Eonsumption and Eigarette (moking. :icotine + Tobacco ?esearch, #ay /3, /03/. O6pub ahead o printP 313 (wanson '&, et al, The impact o ca eine use on tobacco cessation and withdrawal, &ddicti!e -eha!ior, 'anDeb 3BBA, Golume //<3=, *ages II-F1.
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milliliters per minute in nicotine smokers and F. milliliters per minute in non-smokers.31/ (ymptoms o ca eine intoxication ha!e been seen with as little as 300 milligrams o ca eine daily, and may include restlessness, ner!ousness <anxiety=, excitement, insomnia, a lushed ace, increased urination and gastrointestinal complaints. 5ntoxication symptoms seen when more than 3 gram o ca eine is consumed per day include muscle twitching, rambling low to thoughts and speech, irregular or rapid heartbeat, irritability and psycho-motor agitation.31H #ost o us can handle a doubling o our daily ca eine intake without getting the jitters. -ut how can we tell whether the anxieties we eel are related to nicotine cessation or to too much ca eine8 5t isn"t easy. 6xperiment with an up to I0C reduction in daily ca eine intake i at all concerned. -e care ul not to reduce normal ca eine intake by more than I0C unless you want to add the symptoms o ca eine withdrawal to those o nicotine withdrawal. Ea eine withdrawal symptoms can include headache, atigue, decreased energy, decreased alertness, drowsiness, decreased contentedness, depressed mood, di iculty concentrating, irritability, and a oggy mind. (ymptoms typically begin 3/ to /. hours a ter ca eine use ends, reach peak intensity at /0 to I3 hours, and normally last / to B days.31. The ollowing is a sampling o the number o milligrams <mg= o ca eine $typical$ in !arious substances931I

1Img 10mg AImg .0mg .0mg /1mg /Fmg /Img
co ee - 1 ounces drip brewed $energy drinks$ co ee - 1 ounces percolated espresso - 3 ounce ser!ings tea - 1 ounces brewed tea - 1 ounces instant baker"s chocolate - 3 ounce iced tea - 1 ounces
31/ 'oeres ?, 5n luence o smoking on ca eine elimination in healthy !olunteers and in patients with alcoholic
li!er cirrhosis, ,epatology, #ay-'une 3B11, Golume 1<H=, *ages IAI-IAB. 31H &merican *sychiatric &ssociation, Ea eine 5ntoxication, Diagnostic and (tatistical #anual o #ental Disorders, Dourth 6dition, Text Gersion, *age /H/. 31. 'uliano %#, et al, & critical re!iew o ca eine withdrawal9 empirical !alidation o symptoms and signs, incidence, se!erity, and associated eatures, *sychopharmacology, Kctober /00., Golume 3AF<3=, *ages 3-/B. 31I :ational 5nstitute o ,ealth, Ea eine, :ational Toxicology *rogram, webpage updated 0.//H/01, http9//cerhr.niehs.nih.go!/common/ca eine.html
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/.mg /0mg Fmg Img .mg Hmg
some so t drinks - 1 ounces dark chocolate - semi sweet - 3 ounce cola be!erage - 1 ounces chocolate mild be!erage chocolate la!ored syrup co ee - deca einated
The stimulant e ects o a /.mg so t drink be ore bed or a /0mg chocolate bar could now eel like two sodas or two chocolate bars. Eonsider a modest reduction o up to one-hal i experiencing di iculty alling to sleep. %ook at it this way, i we were a big ca eine user, it"s cheaper now. 7e get twice the stimulation or hal the price.
Weight E in
-e ore going urther, it"s important to understand that you would need to gain at least AI additional pounds to equal the health risks associated with smoking one pack o cigarettes a day. &s 'oel teaches, reco!ery"s battle line is extremely easy to see. &s a nicotine addict, $you can"t administer any nicotine. There is no gray area here. 6ating is more complicated. 4ou will ha!e to eat or the rest o your li e.$31F Dor many, weight gain associated with nicotine cessation is o critical concern. 5t isn"t unusual to see up to I pounds o water retention weight gain during the irst week, 31A pounds that can be shed as quickly as they arri!ed. :icotine increases release o antidiuretic hormone <&D, or !asopressin=. &D, pre!ents us rom dehydrating by increasing water retention. &ccording to 'oel, during withdrawal some people experience a rebound type e ect, where the normal e ect o the drug is actually exacerbated when the drug is stopped. $That temporary increase is likely what is causing the water retention <bloating= e ect that many people notice when they irst stop smoking, writes 'oel. $The e ect can go a ew days and at times, e!en into the second week.$ 5t"s normal to notice ood starting to taste better as early as day three. 5t is also normal to think about or attempt to use ood as a replacement crutchJ to try to replace missing nicotine generated dopamine $aaah$ wanting relie sensations with $aaah$s rom extra ood. 5t is also entirely normal to experience a minor metabolism change associated with our body no longer needing to expend energy in attempting to expel scores o tobacco toxins,
31F (pit)er, ', *atience in weight control issues, http9//www. n.yuku.com/topic/33FHF &pril /., /00H. 31A 7eight Eontrol 5n ormation :etwork, :5DD>, :ational 5nstitute o ,ealth, &ugust /00F.
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and no longer eeling nicotine"s stimulant e ects in making our body"s organs work harder <primarily our heart=. #etabolism is all the chemical processes that occur within a li!ing cell that are necessary to keep it ali!e. (ome substances are broken down to create ood energy while other substances necessary or li e are synthesi)ed or created. 311 These processes themsel!es consume energy. $-asal #etabolic ?ate$ or -#? is the rate at which the body expends energy while at complete rest. 5t is expressed as $the calories released per kilogram o body weight O3 kilogram equals 3,000 grams or /./ poundsP or per square meter o body sur ace per hour.$31B 7ere we e!er really at complete rest while addicted to a stimulant8 Does addiction"s impact upon -#? account or nicotine cessation weight gain8 #ost studies examine short-term weight gain with little or no attempt to determine i the gain is due to diminished -#?, extra ood or less exercise. Kne long-term study ollowed weight change and body mass index <-#5= or HF months. 5t ound that the $contribution o smoking cessation to the -#5 increase was practically negligible with $no considerable long-term weight gain.$3B0 #ost shorter studies report weight change results similar to those shared by the ;.(. (urgeon Meneral in his 3BB0 report on $The ,ealth -ene its o (moking Eessation.$3B3 That report examined 3I studies in!ol!ing /0,000 people and although $ our- i ths o smokers gained weight during reco!ery, the a!erage weight gain was only I pounds </.H kg=.$ $The a!erage weight gain among subjects who continued to smoke was 3 pound. Thus, smoking cessation produced a our pound greater weight gain than that associated with continued smoking.$ The (urgeon Meneral also ound that less than .C gained more than /0 pounds. & 3BB3 study which ound slightly greater weight increases than reported by the (urgeon Meneral </.1 kg or F./ lbs in men and H.1 kg or 1.H lbs in women=. 5t also ound that while smokers weighed less than ne!er-smokers be ore commencing reco!ery, $they weighed nearly the same$ at one-year ollow-up.3B/ 5 true, and the end result is nearly the same body weight as a comparable ne!er-smoker, is
311 metabolism. <n.d.=. The &merican ,eritage Dictionary o the 6nglish %anguage, Dourth 6dition. ?etrie!ed &ugust 0F, /001, rom Dictionary.com 31B basal metabolic rate. <n.d.=. The &merican ,eritage Dictionary o the 6nglish %anguage, Dourth 6dition. ?etrie!ed &ugust 0F, /001, rom Dictionary.com 3B0 'ohn ;, et al, :o considerable long-term weight gain a ter smoking cessation9 e!idence rom a prospecti!e study, 6uropean 'ournal o Eancer *re!ention, 'une /00I, Golume 3.<H=, *ages /1B-/BI. 3B3 ;.(. (urgeon Meneral, The ,ealth -ene its o (moking Eessation, a report o the (urgeon Meneral, 3BB0. 3B/ 7illiamson DD, et al, (moking cessation and se!erity o weight gain in a national cohort, :ew 6ngland 'ournal o #edicine, #arch 3., 3BB3, Golume H/.<33=, *ages AHB-A.I.
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weight gain ine!itable8 &re we simply returning to our $natural$ body weight8 Theories as to potential causes are many3BH including genetics,3B. hand to mouth oral grati ication replacement, impro!ed senses o smell and taste <most notably sweets and salts=, diminished exercise <isolation=, changes in diet, and binge eating. 5t isn"t easy pinpointing the cause or consuming or burning an extra calorie, especially when our metabolism slows as we age. &lso keep in mind that study weight indings re lect a!erages. &s seen abo!e, up to .C clearly went o!erboard with ood during reco!ery. &lso not re lected by a!erages is the act that body weight remained unchanged or many, while actually declining or some. 7hile natural or the rationali)ing $junkie mind$ in its quest or relapse justi ications to want to blame cessation weight gain entirely on metabolic changes or genetics, actors totally beyond our ability to control <not increased eating or lack o acti!ity=, the math associated with cessation weight gain usually doesn"t add up. &s a general rule it takes H,I00 extra calories to add one pound o body weight and it takes burning H,I00 to shed one pound. & study o F,IFB middle-aged men who stopped smoking ound that at one year they had consumed an a!erage o 30H ewer calories per day, which the study attributed to metabolic change.3BI ;sing that igure, with )ero change in diet or acti!ity, it would take H. days without nicotine be ore metabolic changes could be blamed or one pound o weight gain <H. x 30H V H,I0/=. &ccording to the (urgeon Meneral, about hal o smokers belie!e that smoking nicotine aids in controlling weight. The ob!ious question becomes, do $weight-concerned smokers endorse exaggerated belie s in the ability o smoking to suppress body weight8$ ?esearch suggests they do.3BF 5t also suggests that education may help correct exaggerated weight control belie s, making reco!ery more in!iting. 7ow to g in lot$ o1 eBtr weight - ?eco!ery heralds an end to both nicotine"s arri!al and to the $aaah$ wanting relie sensations it generated. (ome ind themsel!es camping
3BH 7ack 'T, et al, (moking and its e ects on body weight and the systems o caloric regulation, The &merican 'ournal o Elinical :utrition, Debruary 3B1/, Golume HI</=, *ages HFF-H10. 3B. *ietilainen >,, et al, *hysical inacti!ity and obesity9 a !icious circle, Kbesity <(il!er (pring=, Debruary /001, Golume 3F</=, *ages .0B-.3.J also see, 7aller >, et al, &ssociations between long-term physical acti!ity, waist circum erence and weight gain9 a H0-year longitudinal twin study, 5nternational 'ournal o Kbesity, Debruary /001, Golume H/</=, *ages HIH-HF3J also see, 7aller >, et al, &ssociations between long-term physical acti!ity, waist circum erence and weight gain9 a H0-year longitudinal twin study, 5nternational 'ournal o Kbesity, Debruary /001, Golume H/</=, *ages HIH-HF3. 3BI ,all >D, 7hat is the required energy de icit per unit weight loss8 5nternational 'ournal o Kbesity, #arch /001, Golume H/<H=, *ages IAH-IAF. 3BF 7hite #&, et al, (moke and mirrors9 magni ied belie s that cigarette smoking suppresses weight, &ddicti!e -eha!iors, Kctober /00A, Golume H/<30=, *ages //00-//30.
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out inside the re rigerator or inside a potato chip bag where they $aaah$ themsel!es sick with ood. Turning to and adopting ood as an $aaah$ relie replacement crutch is a sure ire means o adding pounds. 7hy do up to . percent who engage in nicotine cessation continue such destructi!e beha!ior to the point o outgrowing their entire wardrobe8 Dew had any understanding o the dopamine pathway relationship between ood and nicotine. 7hile normal healthy eating stimulates dopamine, during the irst ew days o reco!ery stimulation rom normal eating ob!iously won"t be su icient to satis y all wanting being elt. -ut o!er-eating cannot replace the stimulation e ects o missing nicotine, at least not without lea!ing us as big as a house. Think about it. #ost o us used nicotine to satis y wanting e!ery waking hour o e!ery single day. (till, some try. 5nstead o allowing the brain time to restore natural dopamine pathway receptor counts and sensiti!ities,3BA it"s as i the up to . percent gaining more than /0 pounds attempt to make their brain"s dependency wiring operate on taste"s $aaah$ in luence instead o nicotine"s.3B1 & /03/ study re!iewed brain imaging studies in!ol!ing ood and smoking. 5t ound that $ ood and smoking cues acti!ate comparable brain networks$ and $there is signi icant o!erlap in brain regions responding to conditioned cues.$3BB 7hile signi icant o!erlap in how ood and nicotine a ect brain dopamine wanting, there"s one massi!e distinction. The brain does not die without nicotine, it thri!es@ The sad part about attempting $aaah$ relie replacement using large quantities o additional ood is that, once the demorali)ing weight increases are adopted as the addict"s relapse justi ication, the extra pounds usually remain ollowing relapse. That /0U pound bag o rocks they are carrying makes daily exercise more di icult, and thus less likely. :ow, instead o the ormer smoker"s bloodstream being illed with oxygen reser!es su icient to allow prolonged !igorous physical acti!ity, the signi icantly hea!ier relapsed smoker eels the e ects o an oxygen-star!ed bloodstream that is once again occupied by
3BA *icciotto #?, et al, 5t is not $either/or$9 acti!ation and desensiti)ation o nicotinic acetylcholine receptors both
contribute to beha!iors related to nicotine addiction and mood, *rogress in :eurobiology, &pril /001, Golume 1.<.=, *ages H/B-H./. 3B1 de &raujo 56, et al, Dood reward in the absence o taste receptor signaling, :euron, #arch /A, /001, Golume IA<F=, *ages BH0-B.3. 3BB Tang D7, et al, Dood and drug cues acti!ate similar brain regions9 & meta-analysis o unctional #?5 studies, *hysiology and -eha!ior, 'une F, /03/, Golume 30F<H=, *ages H3A-H/..
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large quantities o toxic carbon monoxide. 5nstead o extra pounds being counterbalanced by greater sel -esteem and sel -worth at ha!ing broken ree, the relapsed addict is hea!ier, less healthy and likely more depressed. 7orst o all, they are again engaged in the gradual sel -destruction o their body"s ability to recei!e and transport oxygen. Ainge e ting - -inge eating re lects a loss o control, that is, being unable to stop eating or control what or how much is consumed./00 The primary psychological binge-eating cue is waiting too long be ore eating and sensing the onset o hunger./03 &lthough it may eel like the only way to satis y a hunger cra!ing is to eat as much ood as quickly as possible, repeatedly doing so could result in binge eating becoming hunger"s conditioned response. -inge eating is an attempt to satis y hunger with a sho!el. &s nicotine addicts, we used nicotine as a spoon. 5t pumped stored ats and sugars into our bloodstream !ia our body"s ight or light response. 5t allowed us to eat one or two larger meals each day and then use nicotine to release stored calories. (o, what happens when nicotine is no longer there8 Ean the addition o hunger cra!ings atop early nicotine withdrawal result in binge eating8 ?esearch suggests that it may be more o a concern or those ha!ing a high -#5./0/ The problem is that the acti!e nicotine addict was able to instantly satis y the onset o hunger by using nicotine to release stored energy. :on-users who get hungry can"t do that. They ha!e to eat ood and then wait or digestion to turn o the body"s hunger switch. Knce we become non-users, whether we eat with a toothpick or sho!el we will need to wait or digestion to satis y hunger. 5t is critical that we quickly re-learn how to properly uel our body. &nd we should ully expect to con ront hunger i we insist upon skipping meals. 7hen eating, we need to chew our ood well, into small pieces. Doing so allows a mouth en)yme <sali!ary amylase= to begin breaking down carbohydrates. This will speed digestion and aid in satis ying hunger sooner. Try to make a habit o eating more slowly. Turn o and tune out distractions. #aintain
/00 Eolles (%, et al, %oss o control is central to psychological disturbance associated with binge eating disorder,
Kbesity, #arch /001, Golume 3F<H=, *ages F01-F3.. /03 Ganderlinden ', 7hich actors do pro!oke binge-eating8 &n exploratory study in emale students , 6ating -eha!iors, (pring /003, Golume /<3=, *ages AB-1H. /0/ (aules >>, et al, 6 ects o disordered eating and obesity on weight, cra!ing, and ood intake during ad libitum smoking and abstinence, 6ating -eha!iors, :o!ember /00., Golume I<.=, *ages HIH-FH.
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your ocus on the act o eating and chewing and you"ll eat less. ?emember, satis ying hunger is more about allowing time or digestion to satis y hunger than it is about how much or how quickly we eat. :e r=$ un'urned c lorie$ - 5magine being so consumed by ear o ailure that you withdraw rom li e. ,ow many calories are burned while lying in bed watching tele!ision or setting at a computer and clicking a mouse8 4es, some nicotine addicts take the term $quitting$ literally and withdraw rom li e entirely. -ody weight will climb i the amount o daily energy expended substantially declines, while the number o calories consumed remains the same or increases. Demorali)ing weight gain is ertile ground or destroying reedom"s dreams. The only acti!ity we need end during reco!ery is nicotine use. Don"t allow ear to trans orm reco!ery into a prison. Re ching 1or Fero C lorie G! hH - (ome researchers classi y increased eating as a symptom o nicotine withdrawal./0H 5 true, it"s clearly one within our ability to minimi)e. Eonsider reaching or a non- at $aaah$ sensation. Take a slow deep breath. Do you eel the $aaah$ while exhaling8 Take a sip o a glass o cool water. Deel the $aaah$8 Mi!e your a!orite person a big, big hug. &re you eeling it now8 Take your normal walk, e!en i just around the yard but this time go a little urther or a little quicker than normal. Do you eel accomplishment"s $aaah$8 Dopamine $aaah$ wanting relie sensations are the mind"s way o moti!ating beha!ior. %i etimes o li!ing our priorities teacher"s lessons, we each ha!e a he ty collection o durable $aaah$ wanting relie memories. ?each or the healthy )ero calorie $aaah$ i seeking wanting relie without gaining weight. Pic(ing me ltime - :icotine no longer our spoon, increasing the requency o meals while decreasing the amount eaten may be all that"s needed to a!oid mixing hunger and withdrawal. 5nstead o eating large meals, consider eating little and o ten as a means to enhance appetite control. Kne study ound that eating more requently resulted in /AC ewer calories being consumed./0.
/0H -enowit) :%, :eurobiology o nicotine addiction9 implications or smoking cessation treatment, The
&merican 'ournal o #edicine, &pril /001, Golume 3/3<. (uppl 3=, *ages (H-30. /0. (peechly D*, et al, Mreater appetite control associated with an increased requency o eating in lean males, &ppetite, December 3BBB, Golume HH<H=, *ages /1I-/BA.
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Eonsider ueling your body with small healthy ood portions at least i!e times daily during the irst two weeks. Doing so should diminish blood-sugar swings and hunger pains, thus reducing risk o eating binges. %nding Me ltime - #any o us conditioned our mind to belie!e that eating was complete and mealtime was o!er by putting a cigarette between our lips or oral tobacco into our mouth. :ow, without a new cue, there may be no clear signal to our brain that our meal is complete. 5t could result in reaching or additional ood. ,ealthy meal completion cues may be as simple as pushing away or getting up rom the table, standing and stretching, clearing the table, reaching or a toothpick, taking a slow deep breath, doing the dishes, gi!ing a hug or kiss, stepping outside, or brushing our teeth. #imini$hing 'ody weight & & $diet$ is a temporary program or losing weight, which by de inition ends. The key to sustained weight control isn"t dieting. 5t"s in committing to minor changes in our daily calorie intake or acti!ity le!el that become part o the abric o our li e. 5 the remo!al o one pound o body weight requires the expenditure o H,I00 calories, attempting to burn all H,I00 during a single session o acti!ity or exercise may lea!e us tired and sore. 5t can discourage us rom being acti!e again tomorrow. 5nstead, consider a small yet deliberate increase in today"s le!el o physical acti!ity o!er yesterday"s, or i today"s le!el seemed su icient, maintaining that le!el tomorrow. 5t can be exercise or a bit more o any physical acti!ity that we lo!e and enjoy. Eonsider gardening, walking your a!orite path, !isiting or caring or a neighbor, extra house or yard work, a lap around the block, a bike ride or any other acti!ity that expends energy. &lthough a minor daily acti!ity adjustment may seem insigni icant, burning just I1 extra calories per day will cause our body weight to decline by hal a pound per month <3,A.0 ewer monthly calories=. 7hat i we add a minor change in eating patterns to a minor acti!ity adjustment8 5 we consume I1 ewer calories per day we would experience a total monthly decline o roughly H,I00 calories and the loss o one pound per month. %earning to sustain these minor li estyle adjustments could mean 3/ ewer pounds within a year@ ,ow do we lose 3/ pounds8 -aby steps ... another moment o acti!ity, a ew less calories, just one ounce at a time@ (mall adjustments can be made anytime. &s mentioned, we can eat more o ten while consuming the same or less, ocus upon, sa!or and chew each bite longer, take just one less bite, get com ortable lea!ing something on our plate, use a tad less butter, choose baked o!er ried, portion control or cooking less ood, one cookie !ersus two, eliminating
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e!ening snacks, or trading empty carbohydrates or long lasting ones./0I Met excited about climbing rom the deep ditch in which our addiction orced us to li!e. (a!or the richness and la!or o li e beyond. -e bra!e and explore the world that obedience to our dependency"s wanting kept hidden rom !iew. 6!en i already disabled by smoking, our physician will likely be able to assist us in de!eloping an increased acti!ity or exercise plan that"s appropriate, e!en i done while on oxygen, in a wheelchair or bed. (hould you ind yoursel gaining extra pounds during reco!ery don"t beat yoursel up. 4our breathing and circulation will impro!e with each passing day. 7hether reali)ed or not, your endurance potential will slowly increase. 5n a way, we are turning back the clock to a time when we had greater ability to engage in prolonged !igorous physical acti!ity. &s smokers, most o us lacked the ability to build cardio!ascular endurance. :ot any more@ &ging grace ully does not require $dieting.$ Kur slowing metabolism simply requires a minor calorie or acti!ity adjustment, which o!er time maintains desired body weight.
Crutche$
& crutch is any orm o reliance that is leaned upon so hea!ily in supporting or moti!ating reco!ery, that i suddenly remo!ed would signi icantly ele!ate risk o relapse. 7hy lean hea!ily upon any person, place, thing or acti!ity8 7hy risk sudden remo!al8 7hy allow our reedom, healing and possibly our li e to rest upon the presence o a source o support whose reliability is beyond our ability to control8 Reco"ery 'uddie$ - *eople can ser!e as crutches. Ereating and leaning hea!ily upon the expectation that some other person will beha!e in a supporti!e manner is dangerous. 7hile great when our expectations are ul illed, what happens when they"re not8 7hy tie our ate to the actions or inactions o others, to their sympathies, time demands, comments, emotions, lack o dependency reco!ery understanding or indi erence8 7hile there"s nothing wrong with enjoying their support when it"s there, picture your reco!ery standing entirely on its own. *icture your core moti!ations and resol!e actually strengthening during moments when those who we thought would be supporti!e are not. Take pride in the act that you are standing and saying $no$ to wanting without use o any crutches.
/0I The Mlycemic 5ndex, glycemicindex.com, ;ni!ersity o (idney, /00/, website accessed &ugust B, /001.
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7aiting or another nicotine dependent person to join us in reco!ery is a delay tactic. 7e"re waiting or a crutch. 7hile wonder ul when able to share coming home with a spouse, signi icant other, amily member, riend or co-worker, serious drug reco!ery programs ne!er partner two new exusers together. (uch programs understand that risk o relapse during early reco!ery remains high. *artnering newbies with newbies increases likelihood that should one relapse that the other will ollow suit. 5nstead, e ecti!e programs partner new ex-users with stable longterm ex-users. (uccess ul reco!ery isn"t about learning rom someone who may know less about success ul cessation than we do. 5t isn"t about coming together to commiserate or share addiction war stories. (uccess is not dependent on being able to lean on a person who ended nicotine use with us, but understanding what"s required to stand on our own. 5t"s about abiding by the %aw o &ddiction <Ehapter /=. 7hile obedience to the %aw pro!ides 300 percent odds o success, how many smokers ha!e e!er heard o it8 (tatistically, only 3 in 1.A who attempt reco!ery succeed in remaining nicotineree or six months./0F That doesn"t mean that two new ex-users na!igating reco!ery together can"t both succeed. 7e see it all the time. 5n act, it is impossible or either to relapse so long as neither allows nicotine back into their body. ?omeo and 'uliet is the tragic tale o a lo!e so great that it would rather be dead than apart. 6ach year millions surrender li e itsel rather than stop smoking. -ut this isn"t ?omeo and 'uliet being played out on some grand scale. 5t isn"t lo!e reaching or a deadly chemical but physical dependence upon one. 7hat are the odds that nicotine addiction won"t be the cause o ending a marriage or other long-term relationship in which both are smokers and both re use to stop unless the other stops too8 (tatistically, roughly hal o adult smokers smoke themsel!es to death. The death toll is staggering. (moking is blamed or /0C o all deaths in de!eloped nations./0A ,ere in the ;.(., the a!erage emale claimed by smoking loses 3..I years o li e expectancy, while the
/0F *olito, '?, Does the K!er-the-counter :icotine *atch ?eally Double 4our Ehances o Luitting8 7hyLuit.com, &pril 1, /00/. /0A 7ald :' and ,ackshaw &>, Eigarette smoking9 an epidemiological o!er!iew, -ritish #edical -ulletin, 'anuary 3BBF, Golume I/<3=, *ages H-33.
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a!erage males loses 3H././01 7aiting on our partner to be our $reco!ery buddy$ o ten pro!es deadly. Kne partner needs to be bra!e, go irst, and bla)e a trail home that the other can e!entually ollow. There were a number o times during my thirty-year struggle where 5 wanted others to pick me up and carry me home. 5 waited, and waited and waited or dear riends to stop with me. Dinally, 5 got my wish. #y best riend and 5 became $reco!ery buddies$ in 3B1.. 5 recall two things about that experience. 5t was the only time during our riendship that we"d e!er yelled at each other. 5 also recall that within an hour o learning that he had relapsed, that 5 relapsed too. -ut the story had a healthy ending. 'im attended a /00/ reco!ery seminar 5 presented at the high school rom which my daughters graduated. (tanding on the auditorium stage, 5 shared this crutch and $buddy system$ lesson and our mutual ailure 31 years earlier. 5 recall hoping that as a seasoned ex-user that 5 could now lend a hand in showing 'im the way home. ,e succeeded. &nd he"s still ree today. &s 'oel"s $-uddy (ystems$ article proclaims, $Take heart ... your primary ocus needs to be on your own OsuccessP now.$ $(oon you will be the seasoned !eteran.$ $#any programs use the phrase, "To keep it, you ha!e to gi!e it away,"$ writes 'oel. $:o where is this more true than when dealing with addictions.$/0B !lcohol or other drug$ - 'oel"s crutches article tells the story o one o his clinic participants turning to alcohol. $-oy did 5 e!er drink my brains out, today,$ she enthusiastically proclaimed, $-ut 5 did not smoke@$ $(he was so proud o her accomplishment,$ recalls 'oel. $Two whole days without smoking a single cigarette, to her being bombed out o her mind was a sa e alternati!e to the deadly e ects o cigarettes.$ $'ust /. hours earlier 5 had made a special point o mentioning the dangers o replacing one addiction with another,$ writes 'oel. $5n OstoppingP smoking one should not start using any other crutches which might be dangerous or addicti!e.$ ;sing alcohol, illegal drugs or addicti!e prescription medications as nicotine cessation crutches also ele!ates the risk o relapse due to diminished inhibitions while using them. 5t can oster psychological associations that can present problems when unable to obtain or use them. &nd let"s not orget the risk o establishing a chemical dependency upon them,
/01 Eenters or Disease Eontrol, &nnual (moking-&ttributable #ortality, 4ears o *otential %i e %ost, and 6conomic Eosts - ;nited (tates, 3BBI-3BBB, #orbidity and #ortality 7eekly ?eport, &pril 3/, /00/, Golume I3, :umber 3., *ages H00-H0H, at *age H03. /0B (pit)er, ', -uddy (ystems, &pril /B, /000, http9//www. n.yuku.com/topic/3/AF0
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and trading one dependency or another. &s 'oel notes, $5n many o these cases the end result will be a more signi icant problem than just the original problem, smoking. The new addiction can cause the person"s li e to end in shambles, and when it comes time to deal with the new dependence he or she will o ten relapse to cigarettes.$/30 (ome 5nternet sites teach users to $do whate!er it takes$ to stop. &d!ice such as this is disturbing. $5 guess that can be translated to taking any ood, any drug, legal or illegal, or participate in any acti!ity, no matter how ludicrous or dangerous that acti!ity might be,$ writes 'oel. $Does the comment smoke crack cocaine, or shoot up heroin, or drink as much alcohol as it takes, or administer lethal dosages o arsenic or cyanide make any sense to anyone as practical ad!ice to stop smoking,$ asks 'oel8 $5 not, the comment "do whate!er it takes" loses any real concept o credibility.$ $&s ar as stopping smoking goes, the ad!ice should not be "do whate!er it takes to stop smoking," but rather, "do what it takes to stop, "$ asserts 'oel. $7hat it takes to stop is simply sticking to your commitment to :e!er Take &nother *u @$/33 &nd to be a bit more inclusi!e, to ne!er take another pu , dip, chew, patch or lick. %Berci$e progr m$ - &t irst blush, some crutches appear harmless. Dor instance, consider an exercise program that was started on your irst day o reco!ery. -ut imagine your mind so tying the program to success ul reco!ery that you became totally con!inced that it was the primary reason you were succeeding. 7hat would happen i your exercise acility suddenly closed or i bad weather, transportation problems, illness or injury made exercise impossible8 6xercise is always bene icial and 5 am in no way trying to discourage acti!ity or exercise. ,owe!er, while bene icial, exercise is not a nicotine dependency reco!ery requirement. Giew your program in terms o the direct bene its it pro!ides, not as a primary source o reco!ery moti!ation. 5n your mind, see your reco!ery remaining strong with or without it, and your ability and willingness to exercise as a bene it rather than a requirement. <nternet $upport - The 5nternet can also become a crutch. 7hile online support groups such as Dreedom rom :icotine/3/ or 7hyLuit"s Dacebook group/3H can be extremely supporti!e, take care not to lean too hea!ily upon them.
/30 (pit)er, ', ?eplacing Erutches, 7hyLuit.com, 'oel"s %ibrary, 3B1A. /33 (pit)er, ', $Do whate!er it takes to quit smoking$ #arch 3B, /00H,
http9//www. n.yuku.com/topic/3/1II /3/ Dreedom rom :icotine - http9//www. n.yuku.com/ /3H 7hyLuit"s Dacebook Mroup - http9//www. acebook.com/N@/groups/whyquit/
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7hat i your computer crashes and you can"t a ord a new one8 7hat i your 5nternet ser!ice pro!ider has problems and its ser!ers crash or a week8 7orse yet, what i the company hosting your online support site goes bankrupt or abruptly discontinues ser!ice8 *icture your reco!ery and resol!e remaining strong e!en without a computer. ,ope or the best yet prepare or the worst. Eonsider printing your a!orite articles. 5 keeping an online reco!ery journal, diary or log, be sure to print or sa!e a copy e!ery now and then. ?emo!e as much risk as possible rom all sources o support. Ereate dependability and longe!ity by preser!ing what you deem !aluable. %Btr 1ood - &s discussed earlier, ood can become an $aaah$ wanting satis action crutch, as can other oral hand-to-mouth substitutes or cigarettes, e-cigarettes, cigars, pipes, oral tobacco or replacement nicotine products. 5n act, any new emotion producing acti!ity or signi icant li estyle change can be leaned upon as a crutch. $5 you are going to de!elop a crutch,$ writes 'oel, $make sure it is one which you can maintain or the rest o your li e without any interruption, one that carries no risks and can be done anywhere, anytime.$ $&bout the only crutch that comes close to meeting these criteria is breathing. The day you ha!e to stop breathing, smoking will be o little concern. -ut until that day, to stay ree rom cigarettes all you need to do is - :e!er Take &nother *u @$ Eonsider building your reco!ery so as to enable it to stand entirely on its own. 5 you now reali)e that you ha!e de!eloped a crutch, picture continuing on and succeeding e!en i it"s suddenly remo!ed. 4ou"ll be ine. The next ew minutes are all we can control and each is entirely do-able.
Ce$$ tion Product$

>pen lie$ nd hidden truth$ - K!er the years 5"!e written much on this topic. Two key points that need making. Dirst, any smoking cessation product manu acturer whose marketing suggests that ew smokers succeed in stopping on their own has already lied to us. Truth is, each year more smokers succeed by going cold turkey than by all other methods combined./3. Truth is, while appro!ed cessation products clobber placebo inside clinical trials, that they get clobbered just as badly by cold turkey in real-world use. /3I (econd, what logic is there in paying money to extend nicotine withdrawal or weeks or
/3. *olito, '?, &re those who quit smoking paying with their li!es because o :?T"s ailure8 -ritish #edical 'ournal, Debruary A, /03/, *age H.., e1FF. /3I *olito, '?, ?eplacement :icotine"s >illing Dields, 7hyLuit.com, Debruary 33, /03/, http9//whyquit.com/pr/0/333/.html
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months when it takes less than A/ hours to rid the body o all nicotine8 7hat sense does it make to buy and use a prescription product which poses risk o death when our objecti!e is longer li e8 Cold tur(ey i$ 1 $t, 1ree, e11ecti"e nd $m rt - 7e nicotine addicts ha!e been lied to by so many or so long that it"s growing harder and harder to belie!e anyone. Elearly, the most damaging and deadly lie o all is being told by those seeking to increase their product or procedure"s market share by alsely suggesting that ew nicotine addicts succeed in going cold turkey, that you"d need to be a super-hero to do so. -illions in marketing ha!e been spent during the past three decades in getting us to ear our natural reco!ery instincts. 5 submit that it has already cost millions their li!es. -oth direct and indirect cold turkey bashing not only results in diminished reco!ery odds or population le!el product users, but a cessation con idence crisis or all still using. :e!er in history ha!e a greater array o appro!ed smoking cessation products promised to double success rates. (kyrocketing cigarette taxes and prices, the smoke- ree air mo!ement sweeping the globe, and a steady stream o new studies on the negati!e e ects o smoking, ne!er in history ha!e the coerci!e pressures upon smokers to stop been greater. 4et, during the six years between /00. and /030 decline in the ;.(. adult smoking rate was just one percentage point, rom /0 percent to 3B percent./3F, /3A, /31 Ehantix was appro!ed by the DD& in /00F and millions ha!e gi!en it a try. &lso, according to the EDE, more than /.I million ;.(. smokers smoked themsel!es to death between /00. and /030. Today, up to three quarters o all smokers continue to stop entirely on their own without use o any product, procedure, website or book./3B &nd that"s despite billions spent trying to get them to purchase :?T, rather risky Ehantix or Ehampix pills,//0 stop smoking shots in!ented by a quack now doing hard time or raud, magic herbs or undergo hypnosis, acupuncture or lasers therapy. & /00F &ustralian study ollowed smoking patients o 3,000 amily practice physicians. 5t ound that 11C o all success ul ex-smokers succeeded by going cold turkey, and that those going cold turkey were twice as likely to succeed as those using the nicotine patch, nicotine gum, nicotine inhaler or Syban <bupropion=.//3
/3F *olito, '?, 5s the ;.(. Mo!ernment"s Luitting *olicy >illing (mokers8 7hyLuit.com, Kctober /F, /00F.
/3A EDE, Eigarette (moking &mong &dults - ;nited (tates, /00A, :o!ember /1, /001, ##7? GolIA, :o. .I. /31 EDE, Gital (igns9 Eurrent Eigarette (moking &mong &dults &ged W31 4ears --- ;nited (tates, /00I--/030 /3B Ehapman (, #ac>en)ie ?., The global research neglect o unassisted smoking cessation9 causes and consequences, *%o( #ed. /030 Deb BJA</=9e3000/3F. //0 *olito, '?, $7ill Ehantix really help me quit smoking8$ 7hyLuit.com, &ugust /I, /00F. //3 *olito, '?, Eold Turkey Twice as 6 ecti!e as :?T or Syban, 7hyLuit.com, #ay 3B, /00F.
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7e nicotine addicts make extremely easy prey. 7hile normal to dream o painless cures, we must not close our eyes to actual results in an arena where the most ridiculous or e!en raudulent cessation scheme imaginable should statistically generate success testimonials rom 30-33C o users at six months and IC at one year./// These igures re lect the generally accepted odds o success ul smoking cessation by those stopping entirely $on-their-own.$ 5t"s why so many o us are e!entually claimed by our addiction. 5t"s the reason or this book, to share basic reco!ery insights that hope ully turn darkness to light. *retend that together we concoct a new magic cessation product that we name -illy -ob"s %ima -ean -utter. ;nless our product somehow undercuts natural cessation <as seen with :?T=, 30-33 percent who use it should succeed and still be smoke- ree at F months. :early all who succeed will deeply belie!e that our butter was responsible or their success. 5n act, we won"t be able to con!ince them otherwise. 5t would be a waste o breath to try. The trick is, we can dramatically in late our butter"s 30-33 percent success rate by testing it in conjunction with high quality reco!ery inter!entions, pro!en to double or e!en triple success rates.. Dor example, we could combine our butter"s use with coping skills de!elopment, beha!ioral therapy, or indi!idual or group counseling, all o which ha!e their own pro!en e ecti!eness Eombining high quality counseling or support with use o -illy -ob"s %ima -ean -utter would guarantee newsworthy results. ;n ortunately, this success rate in lation tactic has been used in nearly all :?T, bupropion Syban= and !arenicline <Ehantix or Ehampix= clinical studies to date. 5magine regular && meetings where alcoholics come together to educate and support mutual success ul ongoing reco!ery. 5magine the group"s support
/// *olito, '?, Does the K!er-the-counter :icotine *atch ?eally Double 4our Ehances o Luitting8
7hyLuit.com, &pril 1, /00/.
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dynamics achie!ing a rather impressi!e reco!ery rate o HI percent at six months. :ow imagine someone trying to package and sell the program o!er-the-counter to alcoholics or T/00 as a stand-alone, in-home, personal reco!ery tool, while suggesting that users would experience similar odds. ,ow long would it take or allegations o consumer raud to begin lying once it was noticed that BHC buying and trying the program were relapsing to alcohol within six months <o!er-the-counter :?T"s six month rate is AC=8 * i)er"s i!e original !arenicline studies <Ehantix and Ehampix= broke records or the number o counseling sessions, with up to twenty- i!e. To this day, * i)er marketing continues to award ull credit to !arenicline.//H 7hile appro!ed smoking cessation products clobber placebo users inside clinical trials rich in support and counseling, real-world per ormance has been a disaster. Eali ornia,//. #assachusetts,//I #innesota,//F Luebec,//A %ondon,//1 7estern #aryland,//B :ottingham,/H0 &ustralia,/H3 the ;nited (tates,/H/ and 6ngland,/HH it should bother all o us that a ter nearly three decades o widespread use that real-world cessation sur!eys continue to show that those buying and using appro!ed products ail to per orm better than those stopping entirely on-their-own. (uch cessation method sur!eys are relati!ely inexpensi!e, quick and easy to generate. &nd success ul ex-users ha!e absolutely no reason to lie about how they inally achie!ed success. -ut :?T stakeholders quickly dismiss such sur!eys as $unscienti ic.$ They argue that we
//H Ehantix %isa commercial - 4ou Tube http9//youtu.be/(uwx/d0,AR# $5n studies, ..C o Ehantix users were quit during weeks B to 3/ o treatment compared to 31C on sugar pill.$ //. *ierce '*, et al, 5mpact o K!er-the-Eounter (ales on 6 ecti!eness o *harmaceutical &ids or (moking Eessation, 'ournal o the &merican #edical &ssociation, (eptember 33, /00/, Golume /11, *ages 3/F0-3/F.. //I &lpert, ,?, Eonnolly M:, -iener, %, & prospecti!e cohort study challenging the e ecti!eness o populationbased medical inter!ention or smoking cessation, Tobacco Eontrol, Knline Dirst, 'anuary 30, /03/. //F -oyle ?M, et al, Does insurance co!erage or drug therapy a ect smoking cessation8 ,ealth & airs <#illwood=, :o!-Dec /00/ Golume /3<F=, *ages 3F/-3F1. //A Mome)-Samudio, #, et al, ?ole o pharmacological aids and social supports in smoking cessation associated with Luebec"s /000 Luit and 7in campaign, *re!enti!e #edicine, #ay /00., Golume H1<I=, *ages FF/-FFA. //1 (mokeDree %ondon, Tobacco 5n %ondon, Dacts and 5ssues, Osee Digure 3.P, :o!ember /F, /00H. //B &lberg &', et al, :icotine replacement therapy use among a cohort o smokers, 'ournal o &ddicti!e Diseases, /00I, Golume /.<3=, *ages 303-33H. /H0 Derguson ', et al, The 6nglish smoking treatment ser!ices9 one-year outcomes, &ddiction, &pril /00I, Golume 300 (uppl /, *ages IB-FB Osee Table FP. /H3 Doran E#, et al, (moking status o &ustralian general practice patients and their attempts to quit, &ddicti!e -eha!iors, #ay /00F /H/ ,artman &#. 7hat does ;( national population sur!ey data re!eal about e ecti!eness o nicotine replacement therapy on smoking cessation8 *aper presented at 7orld Eon erence on Tobacco or ,ealth, 3/-3I 'uly /00F, 7ashington, DE. Dull Text a!ailable http9//whyquit.com/:?T/studies/,artmanX:E5X:?T.pd /HH ;> :,(, (tatistics on :,( (top (moking (er!ices in 6ngland, &pril to December /00A Osee Table FP, &pril 3F, /001.
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can"t trust smokers and ex-smokers to correctly remember the method they used, and whether or not it brought them success. Drankly, what should be dismissed as unscienti ic is any smoking cessation clinical trial whose !alidity is grounded in use o placebo controls. Pl ce'o i$n=t reco"ery method nd i$n=t cold tur(ey - %et me ask you this. 5 5 hand you a piece o nicotine gum or a nicotine lo)enge, how long will it take you to tell me whether or not it really contains nicotine or is instead a nicotineree placebo8 :ot all can do it, but H to . times as many will be correct as guess wrong. /H. *retend or a moment that while still hooked and using, that we hear about a new nicotine gum study at a nearby medical school that is o ering participants three months o ree nicotine gum. There"s just one catch. ,al signing up or the study will be randomly assigned to recei!e nicotineree placebo gum instead. 7ould we stick around and allow oursel!es to be toyed with or the next H months i con!inced that we had been assigned to recei!e placebo gum instead o the real thing8 :either did they. :ormally, 10 to B0 percent o study participants report a history o prior stop smoking attempts. Those attempts taught them to recogni)e the onset o their withdrawal syndrome. The more prior attempts they had made, the more expert they had become at recogni)ing withdrawal"s onset. 5 true, what !alidity would there be in the study"s ultimate inding that twice as many nicotine gum users succeeded in stopping smoking as those chewing placebo gum8 5magine the lack o intellectual integrity required to label !ictory by de ault, !ictories rooted in rustrated expectations, as ha!ing been $science-based.$ 5t"s why use o placebo controls in smoking cessation studies ha!e ser!ed as a license to steal. &s 5 wrote in a letter to the Eanadian #edical &ssociation 'ournal published in :o!ember /001, $pharmacologic treatment o chemical dependency may be the only known research area in which blinding is impossible.$/HI
/H. Dar ?, et al, &ssigned !ersus percei!ed placebo e ects in nicotine replacement therapy or smoking reduction in (wiss smokers, 'ournal o Eonsulting and Elinical *sychology, &pril /00I, Golume AH</=, *ages HI0-HIH <H.H times as many correctly determined assignment=J also see ?ose '6, *recessation treatment with nicotine patch signi icantly increases abstinence rates relati!e to con!entional treatment, :icotine + Tobacco ?esearch, 'une H0, /00B, where . times as many placebo patch users correctly determined placebo assignment as were wrong. /HI *olito '?, (moking cessation trials, Eanadian #edical &ssociation 'ournal, :o!ember /001, Golume 3AB, *ages 30HA-30H1J also see original online e-letter selected or publication, *olito '?, #eta-analysis rooted in
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4ou cannot ool cessation sa!!y nicotine addicts as to whether or not brain dopamine pathway wanting is being satis ied or not. & 'une /00. study was entitled $The blind spot in the nicotine replacement therapy literature9 &ssessment o the double-blind in clinical trials.$/HF 5t teaches that anyone asserting that :?T studies were blind is not being honest, as ar more study participants correctly determine their assignment as guess wrong. This might surprise you, but those wanting to stop smoking cold turkey ha!e ne!er been in!ited to compete in clinical trials against sel -selecting smokers seeking months o ree replacement nicotine, bupropion or !arenicline./HA ;nlike those going cold turkey, those seeking ree $medicine$ joined the study in hopes o diminishing, not enduring, their withdrawal syndrome. 7hy are there no head-to-head clinical studies pitting medicine against cold turkey8 -ecause i honest competition had occurred there would be no need or this explanation. :early all cessation researchers ha!e accepted unding and/or personal payments rom the pharmaceutical industry. 5t is not reasonable to expect researchers to bite the hand that eeds them. The industry cannot permit intellectually honest studies as they would cost it billions in pro its. (moking cessation clinical trial research is increasingly !oid o scienti ic integrity. #ost calling themsel!es researchers are now little more than glori ied salesmen. 7e ha!e now seen more than /00 placebo-controlled smoking cessation :?T, bupropion and !arenicline studies, when nearly all agree that placebo a ords study participants the worst possible odds o success. Today, the :ational 5nstitute o ,ealth"s clinical trials registry identi ies more than /00 new smoking studies that are using placebo controls./H1 7hy8 5t"s simple. 5t"s all about money. ,ow many study participants assigned to placebo are acing their inal cessation
expectations not science, 6-%etter, Eanadian #edical &ssociation 'ournal, 'uly 3A, /001J and a ollow-up e-letter rebutting pharmacology meta-analysis editors" suggestion that blinding issues in drug addiction studies are no di erent than concerns seen in other studies, *olito '?, 7hy cessation blinding concerns di er rom other clinical trials, 6-%etter, Eanadian #edical &ssociation 'ournal, :o!ember B, /001. /HF #ooney #, et al, The blind spot in the nicotine replacement therapy literature9 &ssessment o the double-blind in clinical trials, &ddicti!e -eha!iors, 'une /00., Golume /B<.=, *ages FAH-F1.. /HA *olito, '?, Dlawed research equates placebo to cold turkey, 7hyLuit.com, #arch 3/, /00A. /H1 :ational 5nstitute o ,ealth, www.ElinicalTrials.go!, !isited December /001, search9 placebo U smoking
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opportunity be ore experiencing a smoking induced heart attack, stroke, or being diagnosed with terminal cancer or emphysema8 7hy not o er them the most e ecti!e pro!en treatment as a study"s control, and then see how the newest method compares8 *rinciple H/ o the 7orld #edical &ssociation"s <7#&= Declaration o ,elsinki commands that the $bene its, risks, burdens and e ecti!eness o a new inter!ention must be tested against those o the best current pro!en inter!ention$ and that placebos should not be used unless $compelling and scienti ically sound methodological reasons$ are demonstrated./HB ,ow many desperate study participants who were down to their inal opportunity ha!e smoking cessation researchers needlessly, hoodwinked, bamboo)led and killed8 Do they care8 Kne reason researchers use placebo instead o the $best current pro!en inter!ention$ is that placebo promises the greatest margin o !ictory possible, the biggest news headlines. &lso, in pitting cessation products against each other, unless a tie, one must win and one must lose. Think about Mlaxo(mith>line, maker o :icorette gum, the Eommit nicotine lo)enge, the :icoderm EL patch and Syban. 7ould you want any o your products losing to another8 *harmaceutical companies a!oid risk o de eat in meaning ul head-to-head product competition by use o a control that isn"t a real cessation method. This way, no company economic interest gets harmed. ;n ortunately, the li!es o clinical trail participants are being sacri iced by a near ethicless headline seeking smoking cessation research industry that"s powered by ambition and dollars. Wh t Aig Ph rm doe$n=t w nt u$ to (now - Elinical smoking cessation studies re lect the worst junk-science e!er perpetrated upon humans. ?egret ully, real scientists turned their heads as inancial stakeholders rede ined $cessation$ rom ending nicotine"s arri!al to continuing its use. They remained silent as the pharmaceutical industry re-labeled a natural poison $medicine$ and termed its use $therapy.$ &nd why total silence when seeing apples compared to oranges8 7hat sense does it make to compare the accomplishment o someone who has stopped
/HB 7orld #edical &ssociation, Declaration o ,elsinki, 6thical *rinciples or #edical ?esearch 5n!ol!ing ,uman (ubjects, &dopted by the 31th 7#& Meneral &ssembly, ,elsinki, Dinland, 'une 3BF., and last amended by the IBth 7#& Meneral &ssembly, (eoul, Kctober /001.
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using nicotine to stimulate brain dopamine pathways, to someone who continues stimulation by use o :?T, Syban, Ehantix or Ehampix8 -ut who has greater ault, those paid or pro iting by knowingly engaging in nicotine shell games, or go!ernment agencies that continue to hide population le!el cessation method indings, indings that would aid users in making in ormed, intelligent and reasoned decisions8 -ut who has greater ault, those paid or pro iting by knowingly engaging in nicotine shell games, or go!ernment agencies that continue to hide population le!el cessation method indings, indings that would aid users in making in ormed, intelligent and reasoned decisions8 ;ntil recently, 5 struggled trying to understand why go!ernment health o icials actually discourage natural cessation. Dor years, 5 toyed with the possibility that health bureaucrats grow la)y, don"t read cessation studies, are generally stupid or simply don"t care. 5t wasn"t until 'uly /03/ that 5 learned about the EDE Doundation. 6stablished by Eongress in 3BBI, it"s a non-pro it organi)ation in which corporations such as Mlaxo(mith>line and * i)er partner with the EDE, by making inancial donations towards projects that they want the EDE to study. Knline documents at www.cdc oundation.org suggest that the amounts paid by cessation product makers is secret. 7hat isn"t secret is the partnership between the EDE and the industry. 7hat percentage o o!er-the-counter <KTE= :?T users are still not smoking at six months8 7ould this be important to know8 5 challenge you to locate an answer to this question on any go!ernment, commercial or health website ad!ocating :?T use. & #arch /00H study, conducted by paid :?T industry consultants, combined and a!eraged all se!en KTE :?T patch and gum studies./.0 KTE studies are important because their design is as close as possible to the way these products get used in the real world. (tudy participants simply walk into the pharmacy, purchase or are gi!en the product, and use it without any ormal counseling, education or support. ?esearchers ound that only AC o KTE study participants were still not smoking at sixmonths. That"s right, a product with a BHC ailure rate. 5t"s actually worse. The same industry consultants conducting this study also published a :o!ember /00H study that ound that as many as AC o success ul gum users were still hooked on the gum
/.0 ,ughes, '?, (hi man, (, et al., & meta-analysis o the e icacy o o!er-the-counter nicotine replacement,
Tobacco Eontrol, #arch /00H, Golume 3/, *ages /3-/A.
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at six months./.3 Kb!iously these were two entirely di erent studies. 6!en so, the math lea!es you wondering i anyone actually breaks ree rom nicotine by chewing it. 7hat are the odds o success during a second or subsequent :?T attempt8 Do the user"s odds impro!e or get worse the second time around8 &gain, 5 challenge you to locate any go!ernment or health organi)ation sharing an answer to this rather important yet elementary question. The pharmaceutical industry, go!ernment health agencies and health non-pro its ha!e known since as early as 3BBH that i you ha!e already tried and ailed while using the nicotine patch, that your odds during a second patch attempt drop to near )ero percent. /./ ;nlike cold turkey, where each ailed attempt actually increases the odds o e!entually sel -disco!ering the %aw o &ddiction, the odds o success or the repeat :?T user dramatically decline with each ailure. 7hy would anyone hide this data8 :icotine addicts are also not being told that at least HF.FC o all current nicotine gum users are chronic long-term users o greater than F months./.H ;nlike the gum, which traps some nicotine, the nicotine lo)enge ully dissol!es, deli!ering up to /IC more nicotine. 7e ha!e no reason to belie!e that the percentage o current :?T users who became hooked on the cure isn"t climbing. %et me share the irst paragraph o an email 5 recei!ed. $5"m a /. year old male who smoked cigarettes or about F years until stopping / years ago. ;n ortunately, 5 did so by switching to :icorette. 5n a horror story that 5"m sure you"!e heard do)ens o times, 5"m now horribly addicted to the gum.$ 5 able to get our brain"s dopamine pathways adjusted to unctioning without nicotine while at the same time continuing to use it, we should be extremely proud o oursel!es because we are in act super-heroes.
The * m). nicotine lo>en)e
/.3 (hi man (, et al, *ersistent use o nicotine replacement therapy9 an analysis o actual purchase patterns in a
population based sample, Tobacco Eontrol, (eptember /00H, Golume 3/<H=, *ages H30-H3F. /./ Tonnesen *, et al, ?ecycling with nicotine patches in smoking cessation, &ddiction, &pril 3BBH, Golume 11<.=, *age IHH-IHBJ also see Mourlay (. M., et al, Double blind trial o repeated treatment with transdermal nicotine or relapsed smokers, -ritish #edical 'ournal, 3BBI Golume H33, *ages HFH-HFF. /.H (hi man (, et al, *ersistent use o nicotine replacement therapy9 an analysis o actual purchase patterns in a population based sample, Tobacco Eontrol, (eptember /00H, Golume 3/<H=, *ages H30-H3FJ also see -artosiewic), *, & Luitter"s Dilemma9 ,ooked on the Eure, :ew 4ork Times, #ay /, /00..
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-ut i among the BH out o 300 irst time KTE :?T users who quickly relapse, or among the nearly 300C who ail during a second or subsequent attempt, your brain dopamine pathways are unctioning as designed. They made a circuitry acti!ating e!ent <nicotine"s arri!al= extremely di icult, in the short term, to orget or ignore. ,ence, the need to na!igate withdrawal once use ends. ?eplacement nicotine use de ies the !ery purpose o withdrawal and reco!ery, the time needed to mo!e beyond nicotine"s in luence. :?T users are not breaking ree because o weeks or months spent toying with replacement nicotine, but in spite o ha!ing done so. 5t"s testimony to their dri!e and determination. Eore dreams and desires or reedom are not altered by standing in ront o any weaning product or e!en -illy -ob"s %ima -ean -utter. 5t is $us$ doing the work. (o long as we keep our day N3 dreams !ibrant and ali!e long enough to become entirely com ortable within nicotineree skin, we"ll e!entually be ree to award ull credit to any product or procedure we desire. -ut should this book ser!e as a tool in aiding your reco!ery, do understand that it was $you$ who put its lessons to work, you who did all the li ting, and the glory is 300 percent yours@ D renicline & Ch ntiB 9 Ch mpiB - & ew words o caution about !arenicline <Ehantix and Ehampix=. :e!er in the history o cessation products ha!e we seen such a wide array o serious side e ects, including death. 7e cannot accurately predict who will and will not sustain harm. 7hat can be asserted with con idence is that !arenicline is not the magic cure or nearly as e ecti!e in real-world use as marketing suggests. (o ar, only three studies ha!e pitted !arenicline against :?T, &ubin /001, Tsukahara /030 and Dhelaria /03/. 5n all three, !arenicline ailed to show statistical signi icance o!er :?T quitters when assessing the percentage o users within each group who were not smoking at /. weeks./..
/.. &ubin ,', et al, Garenicline !ersus transdermal nicotine patch or smoking cessation9 results rom a randomi)ed open-label trial, Thorax, &ugust /001, Golume FH<1=, *ages A3A-A/.J Tsukahara ,, et al, & randomi)ed controlled open comparati!e trial o !arenicline !s nicotine patch in adult smokers9
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The study notes that two !arenicline users experienced se!ere depression, with suicidal ideation causing one to be hospitali)ed 33days a ter ending Ehantix use. 5t ound that among HAF Ehantix users and HA0 patch users that the likelihood o a Ehantix users experiencing !omiting was I.I times greater, that decreased sense o taste was I.H times greater, abdominal pain xI, disturbances in attention x..I, nausea x., latulence x., constipation xH, headaches x/, di))iness x/, diarrhea x/, with /.H times as many Ehantix users complaining o atigue. Does it make any sense to assume signi icantly increased risks, including risk o death, without signi icantly o setting bene its8 6ngland"s (top (moking (er!ices may o er the highest caliber go!ernment sponsored cessation ser!ices o any nation. (er!ices include ree indi!idual or group counseling and support. & /001 study analy)ing program per ormance ound that at our weeks a ter starting !arenicline use <Ehampix in the ;>= that FHC o !arenicline users were still not smoking as compared to .1C using nicotine replacement products <:?T= such as the nicotine patch, gum or lo)enge, and I3C who stopped smoking without use o any product./.I 7hile at irst blush it might appear that !arenicline has the lead, keep in mind that these are our-week results and that both !arenicline and :?T users still ace another .-1 weeks o treatment be ore trying to adjust to li!ing and unctioning with natural brain dopamine stimulation. The only long-term 6nglish e!idence is rom an &pril /00I study that examined one-year success rates. /.F That study did not include !arenicline as it wasn"t yet on the market. 5t ound that while /I.IC o those who attempted to stop without using any pharma product were still smoke- ree at one year, that only 3I./C o :?T users and 3...C o bupropion <Syban= users were still not smoking. -ringing together all we so ar know suggests that when examining one year rates, that !arenicline will likely per orm similar to :?T but well behind cold turkey. Don"t expect any researcher to e!er include a copy o this book or 'oel"s as part o any air,
e icacy, sa ety and withdrawal symptoms <the G:-(66(&7 study=, Eirculation 'ournal, &pril /030, Golume A.<.=, *ages AA3-AA1J and Dhelaria ?>, 6 ecti!eness o !arenicline or smoking cessation at / urban academic health centers, 6uropean 'ournal o 5nternal #edicine, 'uly /03/, Golume /H<I=, *ages .F3.F..
/.I ;> :,(, (tatistics on :,( (top (moking (er!ices in 6ngland, &pril to December /00A Osee Table FP, &pril
3F, /001. /.F Derguson ', et al, The 6nglish smoking treatment ser!ices9 one-year outcomes, &ddiction, &pril /00I, Golume 300 (uppl /, *ages IB-FB Osee Table FP.
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open-label study pitting cold turkey against !arenicline or :?T. Doing so would produce a cold turkey !ictory that would destroy the industry"s golden goose. &ny researcher bold enough to conduct such a study would ne!er recei!e pharma industry study unding again. Joel=$ poll $ugge$tion - 'oel has also written extensi!ely on pharma industry cessation products. &s early as 3B1. he was warning about nicotine gum"s ability to oster relapse or become a crutch./.A ,e encourages those contemplating using pharma products to take their own poll o all success ul long-term ex-users who ha!e remained nicotineree or at least a year. /.1 ,e encourages us to belie!e our own sur!ey indings. 'oel reminds us that smoking declined rom ./C to /HC o!er the past .0 years, but that the drop-o stalled in the 3BB0s. ,e inds it curious because that"s when pharma industry :?T started experiencing widespread use. $:icotine gum was irst appro!ed or use in &merica in 3B1., by prescription only. 5n 3BB3 and 3BB/, our patches were appro!ed or prescription use. 5n 3BBF all controls broke loose as the gum and two o the our patches went o!er-the-counter and Syban <bupropion= was just coming into the ray.$/.B $%ets hope not too many miracle products or smoking cessation get introduced in the uture as it may result in skyrocketing smoking rates,$ cautions 'oel. 7hy delay and extend withdrawal and neuronal re-sensiti)ation or weeks or months8 >eep in mind that a Amg. nicotine patch deli!ers the nicotine equi!alent o smoking se!en cigarettes a day. 5n the end, all drug addicts who success ully reco!er must gi!e-up their drug. 5n act, all who success ully arrest their dependency e!entually go cold turkey. 5t is then and there that the rule or staying ree becomes the same or all ... no nicotine just one day at a time.
.eg ti"e ;upport

"*ou$re suc a bas%et case+ you s ould ,ust give up-" ".f t is is w at you are li%e not smo%ing+ for /ods sa%e+ go bac%-"
/.A (pit)er, ', *harmacological Erutches, 'oel"s %ibrary, 3B1.. /.1 (pit)er, ', Luitting #ethods - 7ho to -elie!e8 'oel"s %ibrary, /00H. /.B (pit)er, ', .0 4ears o *rogress8 'oel"s %ibrary, /00..
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".$m trying but my smo%ing friends laug + tell me .$ll fail and offer me smo%es!" :o person"s comment, look, laugh, stare or o er can destroy our reedom. Knly we can do that. &ccording to 'oel, most o the time the person making comments or o ers such as these has not considered their implications./I0 5t"s comparable to telling someone on chemotherapy and in a really bad mood due to hair loss, nausea, and other horrible side e ects, that they should get o that stu because they are so irritable that they are ruining your day, suggests 'oel. $K course, i analy)ed by any real thinking person, the comment won"t be made, because most people recogni)e that chemotherapy is a possible last ditch e ort to sa!e the other person"s li e.$ $The decision to stop the treatment is a decision to die. (o we put up with the bad times to help support the patients e ort to sa!e his or her li e,$ he explains. 7hat"s o ten o!erlooked, reminds 'oel, is that stopping smoking too is an e ort to sa!e their li e. $7hile others may not immediately appreciate that act, the person stopping has to know it or him or hersel . Kthers may ne!er really appreciate the concept, but the person stopping has to.$ &s 'oel notes, such comments are $usually rom a spouse, a child o the smoker, a riend, a co-worker or just an acquaintance. 5t is much more uncommon that the person expressing it is a parent or e!en a grandparent. 5 think that says something.$ $*arents are o ten used to their kids outbursts and moods, they ha!e experienced them since they were in ants. The natural parental instinct is not to hurt them when they are in distress and lash out, but to try to protect them. 5 think it o ten carries into adulthood, a pretty positi!e statement about parenthood.$ -ut 'oel has seen where people ha!e encouraged riends or lo!ed ones to relapse and then months or years later the smoker died rom a smoking related disease. $(ometimes the amily member then eels great guilt and remorse or putting the person back to smoking,$ he says. $-ut you know what8 ,e or she didn"t do it. The smoker did it him or hersel . -ecause in reality, no matter what any person said, the smoker had to stop or him or hersel and stay o or him or hersel .$ $,ow many times did a amily member ask you to stop smoking and you ne!er listened8
/I0 (pit)er, ', :egati!e (upport rom Kthers, Debruary 3I, /003, http9// n.yuku.com/topic//H03B
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7ell i you don"t stop or them, you don"t relapse or them either. 4ou stop or yoursel and you stay o or yoursel .$ ". can$t stop! 0y usband still smo%es and leaves is cigarettes lying around!" ".$m a bartender! 1ow can . stop surrounded by smo%e and smo%ers at every turn2" 5 recall attempts where 5 hoped smoking riends would be supporti!e in not smoking around me, and not lea!e their packs lying around to tempt me. 7hile most tried, it usually wasn"t long be ore they orgot. 5 recall thinking them insensiti!e and uncaring. 5 recall grinding disappointment and intense brain chatter that more than once sei)ed upon rustrated support expectations as this addict"s excuse or relapse. 5nstead o expecting them to change their world or me, the smart mo!e would ha!e been or me to want to extinguish my brain"s subconscious eeding cues related to being around them and their addiction. The smart mo!e would ha!e been to take back my world, or as much o it as 5 wanted. &s 5 sit here typing in this room, around me are a number o packs o cigarettes9 Eamel, (alem, #arlboro %ights, and Girginia (lims. 5 use them during presentations and ha!e had cigarettes within arms reach or years. Don"t misconstrue this. 5t is not a smart mo!e or someone struggling in early reco!ery to keep cigarettes on hand. -ut i a amily member or best riend smokes or uses tobacco, or our place o employment sells tobacco or allows smoking around us, we ha!e no choice but to work toward extinguishing tobacco product, smoke and smoker cues almost immediately. &nd we can do it@ Thousands o com ortable ex-users handle and sell tobacco products as part o their job. 4ou may ind this di icult to belie!e but 5"!e ne!er cra!ed or wanted to smoke any o the cigarettes that surround me, e!en when holding packs or handling indi!idual cigarettes during presentations. 7orldwide millions o ex-smokers success ully na!igated reco!ery while working in smoke illed nightclubs, restaurants, bowling alleys, casinos, con!enience stores and other businesses historically linked to smoking. &nd millions broke ree while their spouse, partner or best riend smoked like a chimney.
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5nstead o ighting or hiding rom the world, take it back. 7hy allow our circumstances to wear us down8 (mall steps, just one moment at a time, embrace challenge. 6xtinguish use cues and claim your pri)e once you do, another slice o a nicotineree li e. ?eco!ery is about taking back li e. 7hy ear it8 5nstead, sa!or and relish reclaiming it. #aybe 5"ll ha!e a cra!e tomorrow. -ut it"s been so many years <since /003= that 5"m not sure 5"d recogni)e it. 7hy ear our circumstances when we can embrace them8 They cannot destroy our glory. Knly we can do that.
Are thing ;econd&7 nd ;mo(e

". ave to breat e smo%e anyway so w y not ,ust go bac% to smo%ing!" $Eontrary to popular opinion or misconceptions, the risks o second-hand smoke exposure are nothing compared to actually smoking yoursel ,$ writes 'oel. $&s ar as causing a relapse to needing nicotine, it can"t do that. The trace amount o nicotine that can be absorbed rom second hand smoke exposure is usually under 3C o what a smoker gets rom smoking.$ The primary metabolite that nicotine breaks down into is called cotinine. The bene it o researchers looking at cotinine le!els in sali!a, blood and urine, instead o nicotine, is that nicotine has a relati!ely short elimination hal -li e o about / hours. Eotinine"s 3A hour hal -li e makes it a more stable indicator that nicotine was present. The a!erage o three studies reporting cotinine le!els in the sali!a o smokers was /F0 ng/ml in women and HHA ng/ml in men./I3 :g/ml stands or nanograms per milliliter. & nanogram is one billionth o a gram and a milliliter is one thousandth o a liter. & /00F study used spectrometry <a scope that measures wa!e lengths or requency= to analy)e cotinine le!els o non-smokers a ter spending H hours in a smoke illed bar. &lthough they experienced an 1- old increase in cotinine le!els, their total a!erage increase was still only 0.FF ng/ml or a little more than hal o a nanogram./I/ %et me quote rom a 3BAB (urgeon Meneral report9 $(e!eral researchers ha!e attempted to measure the amount o nicotine absorbed by nonsmokers in in!oluntary smoking situations. Eano, et al. studied urinary
/I3 7ells &', et al, #isclassi ication rates or current smokers misclassi ied as nonsmokers. &merican 'ournal o
*ublic ,ealth, Kctober 3BB1, Golume 11<30=, *ages 3I0H-3I0B. /I/ Dowles ', et al, (econdhand tobacco smoke exposure in :ew Sealand bars9 results prior to implementation o the bar smoking ban, The :ew Sealand #edical 'ournal, &pril /3, /00F, Golume 33B, *age ;3BH3.
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excretion o nicotine by persons on a submarine. Despite !ery low le!els measured in the air <3I to H/ug/ma=, nonsmokers showed a small rise in nicotine excretionJ howe!er, the amount excreted was still less than 3 percent o the amount excreted by smokers. ,arke measured nicotine and its main metabolite, cotinine, in the urine o smokers and nonsmokers exposed to a smoke illed en!ironment and reported that nonsmokers excreted less than 3 percent o the amount o nicotine and cotinine excreted by smokers. ,e concluded that at this low le!el o absorption nicotine is unlikely to be a ha)ard to the nonsmoker.$/IH -reathing secondhand smoke is !astly di erent rom inhaling a pu rom a lit cigarette or e!en taking a pu into one"s mouth without inhaling. 5n both cases, the quantity o nicotine absorbed by the lungs or oral mucosa is su icient to acti!ate brain dopamine pathways and oster relapse./I. & critical act that bears repeating is that just one pu o mainstream nicotine is su icient to stimulate up to I0 percent o the brain receptors that sustain nicotine addiction./II Knce we ring that bell it cannot be un-rung. &ccording to 'oel, $as ar as second-hand smoke and nicotine goes, you would ha!e to be in a smoke illed room, non-stop or 300 hours, yes 5 am saying o!er . days to get the equi!alent dose o nicotine deli!ered to a smoker rom one cigarette.$ $Kther chemicals in second-hand smoke can reach some pretty toxic le!els much quicker than that, in minutes not days. The side e ects elt rom being exposed to secondhand smoke are rom carbon monoxide, hydrogen cyanide and some other noxious chemicals that can reach le!els that are well abo!e K(,& standards or sa ety,$ explains 'oel. -ut as many newbies disco!er, being orced to breathe secondhand smoke during reco!ery can be demorali)ing. -reathing it can become a source o junkie thinking during times o challenge. $5 ha!e to breathe it anyway so why not just go back to smoking.$ 7hat this addict is really saying is, $5"m so concerned about the lesser harms o secondhand smoke and the damage it in licts that $5"m going to suck main-stream smoke into my lungs and bloodstream, smoke that 5 know will cause ar greater harm.$ 7hat they"re saying is, $5"m so concerned about a risk that is many times less than 5 used to ace, that 5"m going to relapse back to the greater risk and take a I0C chance that 5"ll smoke mysel to death 3H to 3. years early./IF
/IH ;( (urgeon Meneral, (moking and ,ealth9 & ?eport o the (urgeon Meneral, 3BAB, Ehapter 33, *age /.. /I. (pit)er, ', 7ithdrawal again8 Luoting rom (econd ,and (moke, :o!ember /3, /003, http9//www. n.yuku.com/reply//II13.Nreply-/II13. /II -rody &% et al, Eigarette smoking saturates brain alpha . beta / nicotinic acetylcholine receptors, &rchi!es o Meneral *sychiatry, &ugust /00F, Golume FH<1=, *ages B0A-B3I. /IF 7ald :' and ,ackshaw &>, Eigarette smoking9 an epidemiological o!er!iew, -ritish #edical -ulletin, 'anuary
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(uch thinking makes you wonder why it ne!er, e!er occurs to non-smokers to take up smoking or the same reason. (uch logic could only make sense to a drug addict. 7hat such junkie-thinking is saying is that, $5"m going to again become part o the problem and at times expose others to the smoke, smells and chemicals that my once again badly damaged senses will by then no longer ind o ensi!e.$ 7hy allow negati!e support to block the path home or smoke screens to obscure it8 'ust one challenge at a time, $endea!or to perse!ere,$ stri!e to see through it@
%Btremely Di"id #re m$ o1 ;mo(ing*4$ing

(tay prepared or dynamic dreams o smoking or using tobacco products. They may be so !i!id and so real that you"ll awaken totally con!inced that you"!e relapsed to using. (uch dreams are normal, expected and are o ten a sign o physical healing. &nd it isn"t unusual to experience more than one. *icture a hori)ontal body in which mouth, throat and lung tissues suddenly begin healing and re-sensiti)ing a ter years o being marinated in toxin rich tobacco juice. *icture the sweeper brooms coating the smoker"s lung bronchial tubes <cilia= regenerating and sweeping mucus and tars up to the back o their throat. :ow throw in a rapidly healing sense taste and smell. *resto@ The tobacco smells and tastes you"ll experience are probably real. 7hat better proo could we possibly sense o the ama)ing healing happening within8 The use dream that seems to cause the most concern is the one that happens later in reco!ery, weeks or e!en months a ter ull acceptance that this time is or keeps. &lthough nearly always described as a Ynightmare,Z they are sometimes mistaken by the ex-user as a sign that they want to start using again. 5t"s here that we point out the ob!ious con lict. 5 a nightmare and not real, then why would any rational person want to in!ite their nightmare to become a real and destructi!e part o daily li e8 &s 'oel notes, seeing smoking as a nightmare is a healthy sign.
A d # y$
6x-users should expect to experience bad days. 7hy8 -ecause e!eryone has bad days, including ne!er-users. -ut when a bad day occurs early in reco!ery it can become ammunition inside a challenged mind searching or a relapse excuse. -laming a bad day on reco!ery would ne!er ha!e crossed our mind it had occurred the
3BBF, Golume I/<3=, *ages H-33.
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week be ore ending nicotine use. -ut now nicotine"s absence becomes a magnet or blame. 7ould it e!er occur to a ne!er-user to reach or nicotine i ha!ing a bad day8 5t"s a thought process peculiar to us nicotine addicts. &s 'oel teaches, i the bad day happens during the irst week a ter ending nicotine use then blame reco!ery as $it is probably the reason.$ $-ut as time marches on you need to be a little more discriminating.$ &cknowledge bad days but allow your gi t o reedom and healing to li!e on. $(ure there are some tough times,$ writes 'oel, $but they pass and at the end o the day, you can still be ree.$ (taying ree means that, $in the greater scheme o things, it was a good day.$ 5 you want to hear about a horrible day, talk to someone who relapsed a ter ha!ing remained clean or a considerable length o time. $They are ha!ing bad weeks, months and years,$ writes 'oel. 5 a smoker, unless they again break ree, they will likely ace a day when their doctor tells them they now ha!e a serious smoking related disease. &nd imagine all the bad days they"ll orce lo!ed ones to endure i among the I0C o ;.(. adult male smokers claimed an a!erage o 3H years early, or 3. years early or women. /IA ?egardless o how we eel, e!ery hour these minds and bodies are allowed to heal is good. &cknowledge the bad while sa!oring the good. &nd the good only gets better. &head are entire days where you"ll ne!er once think about wanting to use. %et the healing continue.
Men$tru l Cycle Con$ider tion$

& complex interaction o hormones cause many women o childbearing years to experience physical, psychological, and emotional symptoms related to their menstrual cycle. &n estimated 10C experience premenstrual symptoms, which may include9 irritability, tension, anxiety, depression, restlessness, headaches, atigue and cramping. The se!erity o symptoms can range rom mild to disabling. (o how does a woman experiencing signi icant menstrual symptoms success ully na!igate nicotine dependency reco!ery8 The menstrual cycle can be broken down into two primary segments, the ollicular and luteal phases. The ollicular or pre-o!ulation phase is when signi icant hormonal changes
/IA Eenters or Disease Eontrol, &nnual (moking-&ttributable #ortality, 4ears o *otential %i e %ost, and 6conomic Eosts - ;nited (tates, 3BBI-3BBB, #orbidity and #ortality 7eekly ?eport, &pril 3/, /00/, Golume I3, :umber 3., *ages H00-H0H, at *age H03.
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occur. 5t announces the irst day o a woman"s cycle, includes the period o menstrual bleeding and normally lasts in the neighborhood o two weeks. The luteal phase commences at o!ulation, normally lasts two weeks and ends the day be ore her next period. & /001 study tried to determine i the menstrual phase during which a woman attempts to stop smoking a ects the risk o smoking relapse./I1 & total o /0/ women were assigned to either commence reco!ery during the luteal phase or the ollicular phase. & ter H0 days, H.C o women who started during the luteal phase were still not smoking !ersus only 3.C o women who started during the ollicular phase. 7hile normal to ocus on the H.C, what 5 ind encouraging is the 3.C. &s they demonstrate, success is achie!able e!en i commencing reco!ery during the ollicular phase, during signi icant premenstrual symptoms. ,ormone related stress and tension might actually accelerate nicotine elimination by turning urine more acidic, thus causing the kidneys to draw the alkaloid nicotine rom the bloodstream aster <see Ehapter 1=. The question now being asked is, is addiction to smoking nicotine a cause o premenstrual syndrome <*#(=8 & ten year study published in /001 ollowed 3,0IA women who de!eloped *#( and 3,BF1 reporting no diagnosis o *#(, with only minimal menstrual symptoms./IB & ter adjustment or oral contracepti!es and other actors, the authors ound that $current smokers were /.3 times as likely as ne!er-smokers to de!elop *#( o!er the next /-. years.$ The study concludes, $(moking, especially in adolescence and young adulthood, may increase risk o moderate to se!ere *#(.$ 7hen is it best to ace challenge8 6arly on or delay it8 &s 'oel o ten states, commencing reco!ery during a period o signi icant anxiety increases the odds that excess anxiety will ne!er again ser!e as our relapse excuse. Ean hormonal related symptoms be so pro ound that it is best to na!igate the most challenging portion o reco!ery -- the irst A/ hours -- during the luteal phase8 5 concerned discuss it with your physician. >eep in mind that the smoking woman"s unconscious mind has likely been conditioned to reach or a cigarette during speci ic menstrual cycle hormonal or symptom related e!ents.
/I1 &llen (( et al, #enstrual phase e ects on smoking relapse, &ddiction, #ay /001, Golume 30H<I=, *ages 10B1/3. /IB -ertone-'ohnson 6?, et al, Eigarette (moking and the De!elopment o *remenstrual (yndrome, &merican 'ournal o 6pidemiology, &ugust 3H, /001 O6pub ahead o printP.
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The more nicotine use cues encountered and extinguished during the luteal phase, the ewer remaining to trigger cra!e episodes during the ollicular phase. The beauty o reco!ery is that next month"s cycle will not be a ected by the heightened stresses associated with rapidly declining reser!es o the alkaloid nicotine. &lso, next month"s cycle may !ery well stand on its own, una ected by either early withdrawal or cue related cra!e triggers. 'oel encourages doubters to stroll through the hundreds o thousands o indexed and archi!ed member posts at Dreedom rom :icotine, the ree message board support group where he ser!es as education director./F0 $Mo back one month and see how many o the woman at our site seem to ha!e panicking posts complaining o intense smoking thoughts month a ter month a ter month on any kind o regular pattern.$ $The act is there are no such posts on the board because a ter the irst ew months, not smoking becomes a habit e!en during times o menstruation.$ /F3 'oel closes by reminding women concerned about menstrual symptoms, that to keep their reco!ery on the course o getting easier and easier o!er time is still just as simple as staying totally committed, e!en during tough times, to their original commitment to :e!er Take &nother *u @
Pregn ncy
The awe and excitement o a new li e growing inside, the ear and horror that your chemical dependency may damage or kill it, news o pregnancy can be an emotional kaleidoscope. ;pon con irmation, o ten within minutes, the mother-to-be makes the biggest mistake o her entire pregnancy. (he decides to $stop or the baby.$ ,ow could something that sounds so right be so wrong8 Knly about hal o women claim to be success ul in ending nicotine use a ter learning they are pregnant./F/ , the real igure is probably closer to one-third. ?esearchers conducting third trimester blood tests on women claiming to ha!e succeeded ound that /IC had been untruth ul./FH 7hy do so ew succeed8
/F0 Dreedom rom :icotine - http9//www. n.yuku.com/ /F3 (pit)er, ', *#( and Luitting (eptember 3., /00., http9//www. n.yuku.com/topic/3/3H/ /F/ Tong GT, (moking patterns and use o cessation inter!entions during pregnancy, &merican 'ournal o *re!enti!e #edicine, Kctober /001, Golume HI<.=, *ages H/A-HHHJ also see, *auly '?, et al, #aternal tobacco smoking, nicotine replacement and neurobeha!ioural de!elopment, &cta *aediatrica, 'une 3/, /001, 6pub ahead o print. /FH Meorge %, et al, (el -reported nicotine exposure and plasma le!els o cotinine in early and late pregnancy, &cta Kbstetricia Mynecologica (candina!ica, /00F, Golume 1I<33=, *ages 3HH3-3HHA.
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(topping or others, including the unborn, is a ormula and recipe or relapse./F. 5t can mean an entire pregnancy spent either eeling depri!ed o nicotine or gradually growing numb to the ears o harm it would in lict, and e!entually surrendering to it. 7hat logic is there in making this $the baby"s$ reco!ery instead o its mother"s8 (top or the baby8 5s it the baby who needs help or its mom-to-be8 :o longer in harm"s way, the precious seconds a ter childbirth are o ten soured by ixation upon relapse. 5nstead o sa!oring li e"s richest moment, she"s plotting the act she knows may bring an early end to both motherhood and li e. (topping $ or the baby$ can make pregnancy cessation !astly harder than need be. Doing it $ or the baby$ may as well be an open declaration that this baby will ha!e an acti!ely eeding drug addict or a mom. ,ere"s a ew quotes rom a ew e-mails 5"!e recei!ed9 $5 am HH years old. 5 started smoking at age 3H and o course ne!er thought 5 would still be a smoker /0 years later, and a pack to a pack and a hal each day. 5 stopped or nine months while 5 was pregnant and could not wait the entire pregnancy or just one cigarette. The minute 5 was home rom the hospital 5 started again.$ $5 stopped smoking each time 5 ound out 5 was pregnant but right a ter they were born 5 was back to a pack a day.$ $5"m H1 years old with three children and ha!e smoked since 5 was 3A, stopping when pregnant only to re-light within hours o gi!ing birth.$ $5 started smoking at 3H <well 5 couldn"t draw back like all the other girls= but by the time 5 was 3. 5 was smoking at e!ery opportunity. The only time 5 stopped smoking is whilst 5 was pregnant and breast eeding. Then as soon as my babies weaned 5 started again@$ $7hen 5 was pregnant with my irst child 5 ga!e up smoking as soon as 5 ound out, the same or the second pregnancy. #y mistake is 5 started back up ... 5"m stopping smoking today e!en though 5"m about to wean my daughter.$ $#y daughter is I months pregnant and still smokes occasionally. &ctually 5 don"t know how much she smokes. Dor someone who is trying to be so protecti!e o her unborn child she isn"t. (he is an intelligent person but putting her baby at risk.$ $5 am concerned about my neighbor"s smoking. (he is pregnant again but still smokes. (he was smoking while pregnant with her 3st son who is . years-old now and dea .$
?oughly hal o women who claim to ha!e stopped smoking during pregnancy admit to relapse a ter gi!ing birth./FI &dding it all up, it means that only about 3 in I women who smoked at conception will experience the joys o smoke- ree motherhood.
/F. (pit)er, ', Luitting or Kthers, 7hyLuit.com, 'oel"s %ibrary, 3B1..

/FI >aneko &, et al, (moking trends be ore, during, and a ter pregnancy among women and their spouses, *ediatrics 5nternational, 'une /001, Golume I0<H=, *ages HFA-HAI.
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The reasons gi!en in trying to justi y relapse ollowing childbirth !ary greatly9
$5 am an attracti!e, HB year old pro essional yuppie turned new mom who has been hiding it and in the closet or many years. 5 stopped success ully when 5 ound out 5 was / weeks pregnant and then started during a brie bout o postpartum depression when my baby was F weeks old and 5 had stopped nursing. 5 was back to smoking a hal a pack to a pack a day.$ $5 am addicted to nicotine gum. 5 stopped smoking and started chewing the gum. Then 5 got pregnant with my daughter and stopped chewing the gum. #y mother died right a ter my daughter was born, so 5 started smoking again. Three months later, 5 stopped using cigarettes and started with the gum again. 5 inally ended gum use in 'anuary o /00H. 5 was totally nicotineree or about 31 months when my sister-in-law ga!e me a cigarette. 5 igured 5 could handle just one$ $5 bought a pack the next day. :ow 5"m stuck on the gum again...no pun intended.$
Dri!en by signi icant and !ery real risks, these women were able to temporarily suspend nicotine use. Then, postpartum depression and a were used as reasons or relapse. &lthough not mentioned, it"s unlikely that relapse and acti!e drug addition impro!ed either situation. *regnancy is a golden opportunity. 5t"s a period during which a mind, body and li e can be reclaimed in anticipation o the calmness and cleanliness o nicotineree motherhood. 5nstead, roughly . out o I women who smoked at conception spend their pregnancy somewhere between the grips o penetrating guilt o!er the harms that continued use in licts and a growing sense o sel -depri!ation that will be satis y soon a ter gi!ing birth. %et"s be clear, it"s normal and natural to want to stop or the baby. The risks o harm are tremendous. 5t isn"t a matter o whether or not nicotine will damage the etus but how bad the damage will be. The risks are so huge that the ears lowing rom them consume reason, logic and common sense. -e ore learning they were pregnant, most women had their own dream o someday stopping smoking, at a time, place and manner chosen by them. Mripped by worry o harm to the de!eloping li e inside, it"s a dream quickly orgotten. 5nstead o seeing here and now as the per ect time to li!e that dream, it"s abandoned it in a!or o sel -sacri ice or the growing li e inside. Their dream orgotten, some temporarily suspend use or the bene it o the baby while others do not. Those that don"t are orced to in!ent new nicotine use rationali)ations in order to suppress the harms being in licted. ,ere are more quotes rom e-mails.
$#y daughter just ound out that she is pregnant and she smokes. (he was going to
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just stop but then a midwi e told her that i she did, her etus would go into shock and that she should just taper o .$ $5 did attempt to stop when 5 ound out 5 was pregnant the irst time, but a ter thinking about all the people 5 knew who smoked while pregnant and had normal kids 5 kept right on smoking.$ $5 kept my mouth shut as 5 had lied to Dr. and the hospital about smoking.$
There"s also the rationali)ation that $stopping or the baby is just too hard.$ (he"s absolutely correct. The challenge truly is ar greater when attempting or others. Think about the day to day agony and anxiety endured by these women. 5magine the disappro!ing stares and !erbal abuse by those who notice them smoking. (ociety"s disdain only increases her ocus upon $stopping or the baby.$
$5 am 1 weeks pregnant and ha!e been struggling with stopping or some time. 6!en be ore my pregnancy 5 was trying to stop. The scariest part or me is the anxiety it creates. 5s it dangerous to go through withdrawal cold turkey8$ $5 am /F years old. 5"m B weeks pregnant. 5"!e smoked a pack a day or 33 years. 5"!e tried to stop H times now in . weeks and blown it e!ery time. 5 am down to about H-I cigarettes a day. 5 am worried about my baby and 5 ha!e smoked through the whole thing. 5 am trying to stop again. 5t has been about 3/ hours without a smoke.$ $5 am a // year-old emale who is currently H/ weeks along in my pregnancy. 5 eel that the reason why 5 ha!en"t stopped is just that@ 5 am deathly a raid o the eeling o withdrawal.$
7e can only li!e in ear or so long be ore growing numb to it. 5 this isn"t $your$ reco!ery but instead a temporary pause or the baby, how long be ore that depri!ed eeling o!erwhelms remaining ears o harm8 ,ow much anxiety and guilt would ollow8 5 the expectant mother has gone two weeks without nicotine, her brain has already substantially completed restoring neurotransmitter sensiti!ities and counts. &lthough her mind contains thousands o old nicotine replenishment memories, they belonged to an acti!ely eeding drug addict whose blood-serum nicotine reser!es were always on the decline. & ter two weeks, there is nothing missing and nothing in need o replacement. Dor her, relapse will not match expectations. There will not be an underlying $aaah$ wanting relie sensation as nothing was missing. -ut lapse will re- ire dependency"s engines. The circumstances o lapse will be documented in high de inition memory, breathing li e into thousands o old use memories that will, in the short term, make lapse nearly impossible to orget.
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,er $aaah$ missing ollowing lapse, her ocus will instead turn to the sensations elt when scores o cigarette toxins strike healing tissues, and carbon monoxide in!ades an oxygen rich mind. The toxic assault will likely compel her di))y and disrupted mind to turn its ocus to her now ailed objecti!e, $stopping or the baby.$ (he"ll wonder whether the burning sensations generated by carbon monoxide, hydrogen cyanide, arsenic, sul ur, ammonia, and ormaldehyde are also burning her unborn baby. -ut it"s too late. Knce nicotine is inside, relapse is all but assured, with more assaults and guilt to ollow.
$;n ortunately, 5 ha!e gi!en in and 5 had my irst cigarette in 30 months yesterday. 5 had another today and now 5"m eeling absolutely horrible about it. 5 am breast eeding and 5 would like to continue breast eeding without harming my child.$ $5 am .3 years-old and smoked a pack a day since 5 was 3I years old, with the exception o B months when 5 pregnant <started right up again the day a ter she was born=. 5 hated mysel or ailing. 5 hated the way 5 smelled. 5 hated $sneaking$ a smoke to get through the day. 5 hated the disgusted looks o people walking by me as 5 huddled outside my o ice building sucking on that disgusting thing, rain or shine, cold or hot. 5 hated mysel or hurting my daughter - thinking or sure, unless 5 could ind the strength and courage to stop that my daughter would lose her mother.$
&s mentioned, it isn"t a matter o whether or not nicotine will damage the etus but how noticeable the damage will be. :ot con!inced8 %et me share some o the work and indings o those who ha!e de!oted their li!es to the study o nicotine toxicology and pharmacology. -ut be ore doing so, reali)e that the primary reason these harms occur is because the woman con!inced hersel she had to $gi!e-up$ her drug or the $sake o the baby.$ 5nstead, re lect upon the truth that the only way the baby"s time with its mother will not be constantly interrupted by the need to replenish missing nicotine is i she embraces reco!ery or the $sake o the mother.$ &llow your own dreams and desires to transport you home to the reedom, calmness and beauty that"s $you@$ Dr. ,ein) Min)el is a medical doctor and retired ;ni!ersity o &rkansas pharmacology and toxicology pro essor who has de!oted decades to the study o nicotine. Dr. Min)el"s medical journal articles use language that tends to speak o!er-the-heads o most expectant women.
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They share concerns o!er $ etotoxicity and neuroteratogenicity that can cause cogniti!e, a ecti!e and beha!ioral disorders in children born to mothers exposed to nicotine during pregnancy.$/FF -ut he has also written aiming directly at pregnant women. %isten care ully to his message9 $To set the stage, one has to recogni)e that nicotine interacts with the !ery basic unctions o the peripheral and central ner!ous system, i.e., the ner!es supplying organs and tissues o the body and the !ital command stations in the brain. 7hen these systems are ormed during etal li e, the nicotine the mother is exposed to rom smoking, secondhand smoke, or :?T will impair their normal de!elopment.$ $(uch impairment can mani est itsel in a !ariety o symptoms depending on the site, time and intensity o nicotine action. ,ere are a ew examples9 The notorious $(udden 5n ant Death (yndrome$ or (5D( has been traced to prenatal and/or postnatal nicotine exposure. :icotine exposure is responsible or cogniti!e and learning de icits in children as well as a ecti!e and beha!ioral problems such as "&ttention De icit ,yperacti!ity Disorder" <&D,D=, with displays o unruliness and aggression.$ $:eonatal nicotine exposure impairs so-called auditory learning, a !ery speci ic li elong handicap. *renatal nicotine also primes the de!eloping brain or depression and or nicotine addiction in adolescence. 7rongly belie!ing or being told that :?T is risk- ree, pregnant smokers who would ha!e stopped during pregnancy may begin using :?T throughout pregnancy.$ $&s a consequence, intelligence expressed by 5.L. standards may decline in their o spring, but as larger segments o the population are a ected, this decline may not be readily discernible.$/FA 7arnings such as Dr. Min)el"s make the expectant mother"s ailure to place her own drug addiction reco!ery abo!e $stopping or the baby$ almost understandable. Duke #edical ;ni!ersity *ro essor Theodore (lotkin is probably the world"s leading nicotine toxicology researcher. ,e is deeply concerned that nicotine, including replacement nicotine, may cause as much or more harm to the de!eloping etus than crack cocaine./F1 &ccording to *ro essor (lotkin, $:?T, especially by transdermal patch, deli!ers more nicotine to the etus than smoking does.$ $(tudies ha!e ound that the brains o etal mice wound up with /.I times higher nicotine concentrations than ound in the mother"s blood
/FF Min)el >,, et al, Eritical re!iew9 nicotine or the etus, the in ant and the adolescent8 'ournal o ,ealth
*sychology, #arch /00A, Golume 3/</=, *ages /3I-//.. /FA Min)el, >,, 7hy do you smoke8 7hyLuit.com, Debruary F, /00A. /F1 (lotkin T&, Detal nicotine or cocaine exposure9 which one is worse8 The 'ournal o *harmacology and 6xperimental Therapeutics, 'une 3BB1, Golume /1I<H=, *ages BH3-B.I.
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when on a slow continuous nicotine eed, as would be the case with the nicotine patch.$ /FB The patch"s continuous deli!ery o nicotine is belie!ed to somehow o!erwhelm and saturate the ability o the placenta to per orm limited nicotine iltering. *ro essor (lotkin wrote in /001 that, $nicotine by itsel is able to reproduce the net outcome rom tobacco smoke exposureJ that is not to say that the other components are not injurious, but rather, the replacement o tobacco with :?T is likely to produce less impro!ement than might otherwise be thought, and as shown abo!e, may actually worsen some o the critical outcomes.$/A0 *onder the collecti!e regret o the millions o mothers whose intense ocus on protecting the baby actually resulted in harming them. $5 learned irst hand the results o smoking during pregnancy. 5 had taken lightly my responsibility to him and 5 will always regret it.$ $#y son was born at a comparati!ely low birth rate, and notably, his umbilical cord, instead o a healthy red color, was a sickly, puss-like shade o yellow. 5t was not thick and healthy, but tapered and became thinner toward where it was attached to him.$ $(o, now my second son is two and a hal with de!elopmental delays, and my our year old has &ttention ,yperacti!ity Disorder, with extreme emphasis on the hyperacti!ity part. 5 know in my heart that 5 probably caused these problems but 5 keep inding other excuses.$ $5 smoked !ery little during my irst pregnancy. #y child has allergies and catches bronchitis !ery easily. 7ith my second child 5 stopped smoking during pregnancy. #y husband began smoking again and so did 5. 7hen 5 began breast eeding a ter the birth it became another concern or me. 5 tell mysel that it"s not hurting the baby, but in my mind it bothers me.$ &nd what will the child say8
$5 hate, hate, hate cigarette smoking, second hand smoke and smokeless tobacco@ #y mother smoked while she was pregnant <both times= and smoked until 5 was 3A years old. 5 was born with a head tumor which continues to gi!e me trouble a ter two surgeries and more than HI years o li e.$ $#y mother smoked, e!en when pregnant with me. (o 5 guess, being born that way, 5"!e always been addicted to nicotine.$ $&t age //, my mother died o a sudden and massi!e stroke caused by hypertension, ele!ated by smoking. That"s exactly what was put on the coroner"s report. 6!en then, 5 kept smoking.$
5magine ne!er being able to ully bond with your baby because nicotine keeps coming
/FB (lotkin, T&, e-mail rom *ro essor (lotkin to 'ohn ?. *olito, 'anuary 1, /00F.
/A0 (lotkin, T&, (lotkin, 5 nicotine is a de!elopmental neurotoxicant in animal studies, dare we recommend
nicotine replacement therapy in pregnant women and adolescents8 :eurotoxicology and Teratology, 'an-Deb /001, Golume H0<3=, *ages 3-3B.
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between you. &lternati!ely, en!ision the rich calmness o nicotineree motherhood. 7hy not reach back and sei)e upon your own pre-pregnancy dream o reedom and make reco!ery your gi t o $you$ to $you$8 7hy not exchange all ears o etal harm or the celebration o using pregnancy as your time to come home to $you$8 *icture your new baby basking in liberty"s blessings.
$5 am !ery happy to say that 5 ha!e been nicotine ree or six months now. #y kids ha!e not missed any days o school this year. 5 ha!e started to workout three times a week. 5 eel better. #ost people tell me 5 look a lot better. #y house and car are cleaner. 5 am so glad 5 stopped.$ $:ow although 5 still know 5 am an addict, 5 concentrate on keeping my reco!ery ali!e by celebrating my reedom. Kne thought 5 ind !ery heartening is that 5 am doing $easy time.$ Eompared with the irst days, it is so easy or me not to smoke today - most o the costs ha!e gone, but 5 still get the bene its. (moking is expensi!e in the ;>, and so ar 5 ha!e sa!ed [3.,000 <that ;( T/A,I00=@ 5 sa!e so much 5 can easily justi y a weekend away on my annual reco!ery anni!ersary. -est o all, 5 ha!e a 30 week-old son who has a smoke- ree mom.$ $5 had stopped with my pre!ious pregnancies <three older daughters=, but 5 picked it right back up again with erocity. & ter each ailure 5 increased my nicotine intake more and more. &t / to / 3// packs a day 5 saw not much hope or an end. -ut this pregnancy scared me. :ow 5 was much older and this baby was counting on me to not just stop during my pregnancy, like with the sisters, but or the rest o my li e. 5 !isited 7hyLuit and read, and read, and read. 5 inally learned 7,4 e!ery time 5 picked them back up again in my postpartum periods. 5 was still in post acute withdrawal. ?iddled with anxiety, 5 did not approach stopping with a reco!ery mind-set but with a "suspended sentence" on smoking. Dor our i teenth anni!ersary, 5 ga!e my husband another daughter ... and a nicotineree wi e.$
?egarding postpartum depression, ready yoursel or the possibility. (tudies analy)ing how o ten it occurs !ary signi icantly depending on where the women studied li!ed, the study"s de inition o depression, and whether or not the results included women who were experiencing depression be ore gi!ing birth. &mong studies reporting new cases o depression arising a ter childbirth, F.BC o /10 new moms in 5srael reported postpartum depression at F weeks <Mlasser 3BB1=, 3/.IC among 3,I1. (wedish women at 1 weeks, which declined to 1.HC by 3/ weeks <7ickberg 3BBA=, I.1C among .FI 7isconsin women between months 3 and . <Ehaudron /003=, and H.AC o .0H #innesota woman during the irst year ollowing childbirth <-ryan 3BBB=. 5 depressed ollowing childbirth be sure and let your doctor know. *ostpartum depression is not some character law or weakness but as real as the nose on our ace. 5t"s belie!ed to be associated with a large increase in progesterone-deri!ed neuro-steroids during pregnancy, and its sharp decline ollowing childbirth, which may ha!e signi icant
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e ects on M&-& receptors./A3 6merging research suggests that these receptors could be a path to e ecti!e treatment. /A/ 7hat no physician will suggest as a treatment course is relapse to the highly addicti!e, etal teratogen nicotine. &s or replacement nicotine, e!en its most !ocal ad!ocates are orced to admit that, $there is no e!idence that :?T is actually e ecti!e or smoking cessation in pregnancy.$ /AH >eep your eye on the placebos and nicotine should some uture $placebo$ controlled pregnancy study proclaim :?T $e ecti!e.$ ?emember, placebo is not a real-world reco!ery method./A. There"s no such thing. -ut it certainly has pro!en e ecti!e in allowing the pharmaceutical industry to make mountains o money./AI &lso, look closely to see i the pregnancy pharma product cessation study examined cotinine le!els <the primary chemical nicotine breaks down into= to see i women were truly able to get o nicotine. 5 nicotine and cotinine le!els were ignored, it tells us that those conducting the study were probably more interested in selling their product not pre!enting etal harm. *regnant women would be wise to accept that knowledge is an extremely e ecti!e reco!ery tool. The highest known pregnancy cessation rates are associated with $counseling and beha!ioral inter!entions.$/AF 5t"s what we"re doing now, re!iewing the knowledge, insights and skills needed to embrace and celebrate nicotineree motherhood. %et this be your lo!ing gi t o $you$ to $you.$ 7atch the magic un old as your nicotineree body heals, mends and repairs while at the same time making a new li e. *icture your new baby bonding to its mother"s natural skin ragrance instead o the more than our thousand chemicals that cigarette smoke would ha!e deposited upon your hair,
/A3 #aguire ', et al, M&-&<&=? plasticity during pregnancy9 rele!ance to postpartum depression, :euron, 'uly
H3, /001, Golume IB</=, *ages /0A-A3H. /A/ :emero E-, ;nderstanding the pathophysiology o postpartum depression9 implications or the de!elopment o no!el treatments, :euron, 'uly H3, /001, Golume IB</=, *ages 31I-31F. /AH Eoleman T, ?ecommendations or the use o pharmacological smoking cessation strategies in pregnant women, E:( Drugs, /00A, Golume /3<3/=, *ages B1H-BBH. /A. -rewster, '#, *harmacotherapy or (moking Eessation, electronic letter, Eanadian #edical &ssociation 'ournal, 'uly /B, /001, http9//cmaj.ca/cgi/eletters/3AB///3HIN3B1AB /AI *olito, ', #eta-analysis rooted in expectations not science, electronic letter, Eanadian #edical &ssociation 'ournal, 'uly /B, /001, http9//cmaj.ca/cgi/eletters/3AB///3HIN3BA13 /AF Eraw ord 'T, et al, (moking cessation in pregnancy9 why, how, and what next..., Elinical Kbstetrics and Mynecology, 'une /001, Golume I3</=, *ages .3B-.HI.
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skin and clothing. 5 encourage you to continue reading, learning and growing. &llow yoursel to become !astly more dependency reco!ery sa!!y than your addiction is strong. 4es you can@ There"s only one rule ... no nicotine today@
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Ch pter ,
/he Ro dm p 7ome
The purpose o
3. /. H. ..
this chapter is to pro!ide a brie o!er!iew o reco!ery. 5t"s a start to inish look at our distinct yet o!erlapping phases. 5t lays a oundation or the our chapters that ollow9 *hysical ?eco!ery 6motional ?eco!ery (ubconscious ?eco!ery Eonscious ?eco!ery
:icotine addiction is the result o the introduction o a chemical into the body, which by happenstance is able to unlock and acti!ate the same brain cells and pathways as the neurotransmitter acetylcholine. :icotine"s acti!ation o acetylcholine receptors causes stimulation o the brain"s dopamine pathway, the mind"s priorities teacher. 5t is the purpose o these pathways to make e!ents that stimulate them extremely di icult to orget or ignore. -ut prior to nicotine dependency onset there was no $wanting$ or more. 5nitially, arri!ing nicotine would cause a burst o unearned dopamine, pro!iding a wanting satis action sensation or wanting that didn"t exist. -ut or those o us susceptible to dependency onset, continued use would soon end ree stealing. (oon, our tonic dopamine le!el started to decline in response to alling nicotine le!els. This resulted in $wanting.$ That wanting would soon be ampli ied by the anxiety generating tease o a growing number o wanting satis action memories. 6ach o those high de inition memories documented exactly how wanting was satis ied, by arri!al o a new supply o nicotine. &rri!al o more nicotine would generate a phasic burst o dopamine, restoring our tonic dopamine le!el and temporarily satis ying wanting. Eontinued use causes our brain to attempt to desensiti)e itsel to nicotine"s presence by increasing the number o acetylcholine receptors in multiple brain regions. Eontinued use also conditioned our subconscious mind to expect a new supply o nicotine when speci ic times, locations, people, acti!ities or emotions were encountered. :ow, any attempt to stop using nicotine could result in the same wanting related anxieties elt when depri!ed o ood or water.
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Declining by one-hal e!ery two hours, years o struggling to keep su icient nicotine in our bloodstream, so as to hold wanting at bay, le t us alsely con!inced that nicotine was core to our existence, as undamental as eating. 6ducated reco!ery is about understanding both the lie and dependency"s e ects upon us. 5t is my hope that education and understanding will make any remaining ears o li e without nicotine so insigni icant that it becomes impossible not to notice the beauty that reco!ery un olds be ore you. 5t"s my hope that you"ll sense the ull glory o again standing on our own, o engaging li e as $you.$ -ut that"s only a hope. Knce home, whether our journey is best characteri)ed as ha!ing been a cakewalk, a lo!e est, a non-e!ent, rantic or nightmarish, the only thing that matters is that each challenge and each day remains totally do-able. ;nderstanding where we now stand is the window to where we"!e been. &n awakening is at hand. &llow your mind to see the lies, the depths to which they took us, and where you now stand. (uch awareness itsel can be a bit rightening. -ut why spoil healing with ear8 7hy ear arri!al o a calm and com ortable day where not once do thoughts o using enter our mind8 7hy ear such days becoming so requent that they become your new sense o normal8
Reco"ery /imet 'le

#ost but not all bene its listed below are related to smoking. 7hy8 ,ere in the ;.(. there are ten times as many smokers as oral tobacco users. /AA -y ar, smoking re lects the greatest health risks o any orm o nicotine deli!ery. ;nderstandably, until now the !ast majority o research has ocused on smoking. -ut just because science cannot yet tell us when most oral tobacco, :?T or e-cig reco!ery bene its occur doesn"t mean they are not happening. When ending ll to' cco nd nicotine u$e, within .../A1
/AA Eenters or Disease Eontrol, Tobacco ;se &mong &dults - ;nited (tates /00I, ##7?, 7eekly, Kctober /A,
/00F, Golume II<./=, *ages 33.I-33.1. /A1 *rimary sources or this reco!ery bene its timetable are9 <3= ;.(. Department o ,ealth and ,uman (er!ices, The ,ealth Eonsequences o (moking9 & ?eport o the (urgeon Meneral, /00.J </= ,ughes, '?, 6 ects o abstinence rom tobacco9 !alid symptoms and time course, :icotine and Tobacco ?esearch, #arch /00A, Golume B<H=, *ages H3I-H/AJ <H= K"Eonnell >&, et al, Eoping in real time9 using 6cological #omentary &ssessment techniques to assess coping with the urge to smoke, ?esearch in :ursing and ,ealth, December 3BB1, Golume /3<F=, *ages .1A-.BA.
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/0 minutes - Kur blood pressure, heart rate and the temperature o our hands and eet return to normal. 1 hours - ?emaining nicotine in our bloodstream will ha!e allen to F./IC o normal peak daily le!els, a BH./IC reduction. 3/ hours - The ex-smoker"s blood oxygen le!el will ha!e increased to normal while carbon monoxide le!els ha!e dropped to normal. /. hours - &nxieties peak and within two weeks should return to near precessation le!els. .1 hours - Damaged ner!e endings ha!e started to re-grow and our sense o smell and taste are beginning to return to normal. Eessation anger and irritability peaks. A/ hours - Kur body is 300C nicotineree and o!er B0C o all nicotine metabolites <the chemicals it breaks down into= ha!e been ioni)ed or excreted !ia urine. (ymptoms o withdrawal ha!e peaked in intensity, including restlessness. The number o cue induced cra!e episodes will peak or the $a!erage$ ex-user. %ung bronchial tubes leading to air sacs <al!eoli= are beginning to relax in reco!ering smokers. -reathing is becoming easier and the lungs unctional abilities are starting to increase. I to 1 days - The $a!erage$ ex-smoker will encounter an $a!erage$ o three cue induced cra!e episodes per day. &lthough we may not be $a!erage$ and although serious cessation time distortion can make minutes eel like hours, it is unlikely that any single episode will last longer than H minutes. >eep a clock handy and time them. 30 days - The $a!erage ex-user is down to encountering less than two cra!e episodes per day, each less than H minutes. 30 days to / weeks - ?eco!ery has likely progressed to the point where our addiction is no longer doing the talking. 7e are beginning to catch glimpses o where reedom and healing are transporting us. / weeks - -lood circulation in our gums and teeth are now similar to that o a nonuser. / to . weeks - Eessation related anger, anxiety, di iculty concentrating, impatience, insomnia, restlessness and depression ha!e ended. 5 still experiencing any o these symptoms get seen and e!aluated by your physician. /3 days - -rain acetylcholine receptor counts up-regulated in response to nicotine"s presence ha!e now down-regulated and receptor binding has returned to le!els seen in the brains o non-smokers./AB / weeks to H months - 5 an ex-smoker, heart attack risk has started to drop and lung unction continues to impro!e. H weeks to H months - 5 an ex-smoker, circulation has substantially impro!ed. 7alking has become easier. &ny chronic cough has likely disappeared. 5 coughing persists contact your physician. 3 to B months - &ny smoking related sinus congestion, atigue or shortness o breath ha!e decreased. Eilia ha!e re-grown in our lungs, thereby increasing their
/AB #amede #, et al, Temporal change in human nicotinic acetylcholine receptor a ter smoking cessation9 I5& (*6ET study, 'ournal o :uclear #edicine, :o!ember /00A, Golume .1<33=, *ages 31/B-31HI.
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ability to handle mucus, keep our lungs clean and reduce in ections. The body"s o!erall energy le!el has increased. 3 year - 5 an ex-smoker, excess risk o coronary heart disease has dropped to less than hal that o a smoker. I to 3I years - 5 an ex-smoker, risk o stroke has declined to that o a non-smoker. 30 years - 5 an $a!erage$ ex-smoker <one pack per day=, our risk o death rom lung cancer has declined by almost hal . ?isk o cancer o the mouth, throat and esophagus has also decreased. 3I years - Kur risk o coronary heart disease is now that o a person who has ne!er smoked.
%nding .icotine 4$e

Eontrary to marketing suggestions o those selling smoking cessation chemicals that stimulate brain dopamine pathways, the only way to restore natural stimulation and sensiti!ities is to end nicotine"s arri!al. The speed and beauty o natural reco!ery can be seen within just one hour o remaining 300C nicotineree, as the concentration o nicotine within our blood declines by /IC. $,al -li e$ is de ined as $the time required or hal the quantity o a drug or other substance deposited in a li!ing organism to be metaboli)ed or eliminated by normal biological processes.$/10 #ost older cessation literature irmly ixes nicotine"s elimination hal -li e at about two hours./13 -ut nicotine"s hal -li e can !ary substantially based upon genetic, racial, hormonal, diet, acti!ity and age actors./1/ Dor now, let"s ignore genetic di erences as we ha!e no idea which genes we do or don"t ha!e. &s or racial !ariations, a 3BB1 study ound an a!erage nicotine hal -li e o 3/B minutes in Eaucasians and 3H. minutes in & rican &mericans./1H & /00/ study compared Ehinese-&merican, %atino and Eaucasian smokers. 5t ound that %atinos had the shortest hal -li e <3// minutes=, Ehinese-&mericans the longest <3I/ minutes=, with Eaucasians in the middle <3H. minutes=./1.
/10 hal -li e. <n.d.=. The &merican ,eritage Dictionary o the 6nglish %anguage, Dourth 6dition. ?etrie!ed
&ugust //, /001 rom Dictionary.com. /13 -enowit) :%, et al, 5nterindi!idual !ariability in the metabolism and cardio!ascular e ects o nicotine in man, The 'ournal o *harmacology and 6xperimental Therapeutics, #ay 3B1/, Golume //3</=, *ages HF1-HA/J also see Deyerabend E, et al, :icotine pharmacokinetics and its application to intake rom smoking, -ritish 'ournal o Elinical *harmacology, Debruary 3B1I, Golume 3B</=, *ages /HB-/.A. /1/ -enowit) :%, Elinical pharmacology o nicotine9 implications or understanding, pre!enting, and treating tobacco addiction, Elinical *harmacology + Therapeutics, &pril /001, Golume 1H<.=, *ages IH3-I.3. /1H *ere)-(table 6', et al, :icotine metabolism and intake in black and white smokers, 'ournal o the &merican #edical &ssociation, 'uly 1, 3BB1, Golume /10</=, *ages 3I/-3IF. /1. -enowit) :%, et al, (lower metabolism and reduced intake o nicotine rom cigarette smoking in Ehinese&mericans, 'ournal o the :ational Eancer 5nstitute, 'anuary 3F, /00/, Golume B.</=, *ages 301-33I.
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:icotine"s hal -li e is shorter in women <331 minutes= than men <3H/ minutes=, and e!en aster in women taking oral contracepti!es <BF minutes=. This is thought to be associated with estrogen./1I 5ts hal -li e is shorter during pregnancy <BA minutes= than a ter gi!ing birth <333 minutes=./1F (adly, new born babies whose mothers smoked endure a nicotine withdrawal period i!e times longer than what their mother"s would ha!e been. 5nstead o a /-hour elimination hal -li e, it increases to 33./ hours./1A 5 considering breast- eeding, nicotine"s breast milk hal -li e a!erages BA minutes./11 5nterestingly, a 3BBH nicotine patch study ound that when nicotine was administered directly into the bloodstream <intra!enously= it had a / hour elimination hal -li e but when administered through the skin !ia the nicotine patch <transdermally=, once the patch was remo!ed nicotine"s elimination hal -li e was /.1 hours./1B This inding is con irmed by a second patch study which ound it to be a minimum o H.H hours./B0 #ost nicotine is broken down into six primary metabolites by the li!er <mostly cotinine9 A0-10C=. The kidneys remo!e <eliminate or excrete= nicotine and its metabolites rom the bloodstream./B3 Thus, any acti!ity which increases blood low though the li!er <exercise or eating= accelerates nicotine depletion. Kne study reports that li!er blood low increases by H0C a ter meals, with a .0C increase in the rate that nicotine is cleared rom arri!ing blood. /B/ &s we"ll re!iew in the next chapter, acidic urine helps ioni)e <eliminate= nicotine while alkaline urine actually allows its re-absorption back into the body. &s suggested by the abo!e hal -li e data, most o us had su icient nicotine reser!es to com ortably make it through 1 hours o sleep each night <. hal li!es lea!ing us with a minimum o F./IC o our normal daily supply=.
/1I -enowit) :%, et al, Demale sex and oral contracepti!e use accelerate nicotine metabolism, Elinical
*harmacology + Therapeutics, #ay /00F, Golume AB<I=, *ages .10-.11. /1F Dempsey D, et al, &ccelerated metabolism o nicotine and cotinine in pregnant smokers, 'ournal o *harmacology 6xp Therapeautics, #ay /00/, Golume H03</=, *ages IB.-IB1. /1A Dempsey D, et al, :icotine metabolism and elimination kinetics in newborns, Elinical *harmacology Therapeutics, #ay /000, Golume FA<I=, *ages .I1-.FI. /11 %uck 7, :icotine and cotinine concentrations in serum and milk o nursing smokers, -ritish 'ournal o Elinical *harmacology, 'uly 3B1., Golume 31<3=, *ages B-3I. /1B Mupta (>, et al, -ioa!ailability and absorption kinetics o nicotine ollowing application o a transdermal system, -ritish 'ournal o Elinical *harmacology, (eptember 3BBH, Golume HF<H=, *ages //3-//A. /B0 >eller-(tanislawski -, et al, *harmacokinetics o nicotine and cotinine a ter application o two di erent nicotine patches under steady state conditions, &r)neimittel-Dorschung, (eptember 3BB/, Golume ./<B=, *ages 33F0-33F/. /B3 -enowit) :%, et al, :icotine chemistry, metabolism, kinetics and biomarkers, ,andbook o 6xperimental *harmacology /00BJ Golume 3B/=, *ages /B-F0. /B/ ,ukkanen ', et al, #etabolism and disposition kinetics o nicotine, *harmacological ?e!iews, #arch /00I, Golume IA<3=, *ages AB-33I.
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5n act, the amount o nicotine remaining a ter sleep is actually slightly higher in that the amount o blood low and nicotine passing through and metaboli)ed by the li!er decreases while sleeping. &s you can see, our remaining reser!es will become so small within /. hours o ending all nicotine use that they become di icult to detect <.0/ or just //300ths o our normal daily le!el=. 5t"s here that surgery <nicotine extraction= is nearly complete and deep dependency healing begins in earnest. 7ithin three days, with absolute certainty, you can and will inhabit a nicotineree body and mind. &s or detection, we o ten get the question, how long a ter 5 stop using nicotine will my insurance company or employer be able to detect nicotine in my system8 &s seen abo!e, unless examining hair which permanently records nicotine use, trying to measure rapidly alling nicotine le!els in blood, urine and sali!a is all but useless as a marker o use. That"s why insurance companies and employers normally test or cotinine, one o nicotine"s longer-lasting metabolites, which has a generally recogni)ed hal -li e o about 3A hours./BH 7hat"s important is that remaining le!els become so small within /. hours o ending use that re-sensiti)ation and the brain"s adjustment to unctioning without it ha!e no choice but to commence. 7ithin /. hours the mind and body will begin to experience o!erlapping reco!ery on our le!els9 physical, emotional, subconscious and conscious. >eep all nicotine on the outside and within A/ hours o ending use, regardless o your body"s nicotine hal -li e or elimination rate, you"ll stand atop withdrawal"s mountain. The most challenging portion o reco!ery will be behind you. 7hile your climb was quick, the slope o the journey down the other side, although initially brisk, is continuous yet e!er so gradual. 6asier time with ewer bumps, the balance o the journey becomes an exercise in patience. 4et, !iolate the $%aw o &ddiction$ - just one hit o nicotine - and orget about any gradual down slope or doing easy time. 5t"s called relapse. 4ou"ll either resume li e as an acti!ely eeding addict or need to again endure nicotine detox and another climb to the top. The price o each climb is urther depletion o core dreams and desires. &lthough able to rest and reju!enate once at or o!er the top, ama)ingly ew ha!e the stamina o purpose needed to make back-to-back climbs.
/BH (wan M6, et al, (ali!a cotinine and recent smoking--e!idence or a nonlinear relationship, *ublic ,ealth
?eports, :o!-Dec 3BBH, Golume 301<F=, *ages AAB-A1H.
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6xpect to be teased during both your climb and descent by those selling chemicals that stimulate brain dopamine pathways <tobacco products, cigarettes, nicotine products, bupropion and !arenicline=. 6xpect them to try to discourage you. %isten or the alse and decepti!e implication that ew succeed in stopping on our own. Truth is, it"s how the !ast majority will succeed this year. Elearly, they want your money. &nd un ortunately, most are willing to lie to get it. 6xpect their tease to alsely suggest that their product makes the climb easy or, as suggested by recent :icorette commercials, make it $suck less.$ Don"t listen. 5 the product stimulates dopamine low, physical withdrawal"s climb isn"t ully underway until product use ends. *roduct use does not aid reco!ery. 5t delays it. That"s why ad!ertising the product"s cessation results on the day product use ends, while still under the chemical"s in luence, is not about science but salesmanship. &s 'oel says, we"d only ha!e oursel!es to blame or intentionally extending what should ha!e been a ew days o withdrawal into weeks or months. :ot only do users ace the side-e ect risks posed by each product, they ace ha!ing to someday adjust to li!ing without the dopamine pathway stimulation each pro!ides.
2Wh t $hould < c ll my$el1?2

7hile the exact moment o transition rom use to non-use is clear, what we call oursel!es once use ends is not. &re we an ex-user or non-user, ex-smoker or non-smoker, an ex-dipper or non-dipper8 &nd when ha!e we earned that title8 ?egarding ormer smokers, the primary choice is between non-smoker and ex-smoker. Elearly, non-smoking applies as soon as use ends. 7e are in act non-smokers. -ut there"s a major distinction between being a ne!er-smoker and non-smoker, a distinction the term non-smoker ails to declare. :e!er-smokers don"t ha!e to worry about relapse. Ehemical dependency has not permanently groo!ed and wired their brain or nicotine. This critical distinction between non-smoker and ex-smoker applies equally to oral, nasal and transdermal nicotine users. 5 staying ree is important, remembering that we are di erent can ha!e as a protecti!e e ect as a sel -reminder o our !ulnerability.
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7hile both a non-user and ex-user, 5 always re er to mysel as an ex-smoker or ormer smoker as doing so reminds me that 5 remain just one power ul pu o nicotine away rom three packs-a-day. 5nitially, my mind rebelled against the thought that 5 wasn"t ully $cured.$ 5 wanted to be like the a!erage ne!er-smoker. 5 thought 5"d earned the right to hide among them. -ut 'oel"s online analysis compelled critical thinking. (oon resistance and disappointment passed as 5 ound mysel wanting to embrace both the term ex-smoker and the world o ex-smoker-hood. 5 lo!e my reedom. 5 lo!e residing on this side o the bars. (o why wouldn"t 5 want to remind mysel o exactly what it takes to stay here8 5 you want to consider yoursel a non-smoker or non-user that"s ine, you truly are. -ut be care ul not to totally entrench your thinking in non-smoker-hood. &lso don"t orget that certain legal documents, such as a li e or health insurance policy application, may demand disclosure that we are ex-smokers. Dailure to ully disclose our prior use status could later result in co!erage concerns. & related question is when should we see oursel!es as being an ex-user or non-user8 7hen do we cross the line rom $trying to stop$ to ha!ing done so8 5t"s one o the most wonder ul sel -reali)ations o our entire journey. 5t"s a deeply personal moment that"s di erent or each o us, the crossing o a sel -de ined threshold. Dor me, it occurred when my ears subsided to the point that 5 knew or certain that this was or keeps, that 5 wasn"t going back. 5"d already told the world 5"d stopped but the di erence now was that 5 actually belie!ed it. 5"d already surrendered three decades o control to inhaling this chemical. :ow, e!en i 5 were diagnosed with lung cancer tomorrow 5"d take com ort in one sure- ire act. 5 would not die with my true killer still circulating inside. The time be ore such con!iction arri!ed was not some preplanned dress rehearsal. (tarting out, 5 didn"t oresee some magic moment in the uture where success would become certain. 5n act, the most rightening moment o all was the decision to stop putting nicotine into my body. 5 didn"t think 5 could do it. 5 thought 5 would ail. 6!erything a ter that irst bra!e step
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was a journey o con idence that transported me rom just one moment and challenge at a time, to a deep seeded con!iction that 5 will, e!er use nicotine again@ &long the way 5 na!igated our layers o reco!ery. ,ere"s a brie o!er!iew o each.
Phy$ic l Re dCu$tment
The brain needs time to re-adjust its equilibrium or homeostasis to again unctioning without nicotine. :icotine caused both acti!ation and deacti!ation o nicotinic-type acetylcholine receptors./B. & signi icant increase in the number o receptors <upregulation= may ha!e occurred in as many as ele!en di erent brain regions. /BI The brain needs or us to de!elop the patience necessary to allow time to remo!e de enses and restore natural sensiti!ities. 5 allowed, it will work around-the-clock restoring receptor counts and neurotransmitter sensiti!ities. 7hile the bulk o physical reco!ery is generally recogni)ed as being complete within the irst two weeks, recent studies ha!e ound that some symptoms, primary emotional and possibly related to brain neuron sensiti!ity restoration, may persist or up to our weeks. &side rom the brain, the body needs time or its physiology to adjust to again unctioning without nicotine and other chemicals introduced by our method o deli!ery. &s it does, the withdrawal symptoms experienced may be none, ew, some, or many. &lthough Ehapter B pro!ides a detailed list <and discussion= o possible withdrawal symptoms, 5 encourage you to skip it. That"s right, don"t read it. 5 needed, it"ll be there. (uch lists ha!e a tendency to trans orm a sensation that may ha!e been barely noticeable into a ull-blown worry. This book"s primary goal is to destroy ears, not oster them. -oth online at Dreedom and during li!e two-week, six session clinics <each session being two hours=, we watched, read or looked into aces. &side rom expected anxieties and emotions, many report no noticeable physical symptoms at all. &lso, don"t con use the time needed or the mind to adapt to unctioning without nicotine"s in luence, with the time needed or deep tissue healing and purging o tobacco tars. &s suggested by the abo!e reco!ery timetable, it takes signi icant time to ully expel
/B. *icciotto #?, et al, 5t is not $either/or$9 acti!ation and desensiti)ation o nicotinic acetylcholine receptors
both contribute to beha!iors related to nicotine addiction and mood, *rogress in :eurobiology, &pril /001, Golume 1.<.=, *ages H/B-H./J also see, 6!en :, et al, ?egional di erential e ects o chronic nicotine on brain alpha .containing and alpha F-containing receptors, :euroreport, Kctober 1, /001, Golume 3B<3I=, *ages 3I.I-3II0. /BI *arker (%, ;p-regulation o brain nicotinic acetylcholine receptors in the rat during long-term sel administration o nicotine9 disproportionate increase o the alphaF subunit, #olecular *harmacology, #arch /00., Golume FI<H=, *ages F33-F//.
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toxins and carcinogens and heal rom their assaults.
%motion l Re dCu$tment
&lthough chemical in nature, a long and intense relationship is ending. Dor most, it was the most dependable relationship we"d e!er known. 6!en i our ix was bummed or borrowed and we hated the brand"s la!or, e!en i the cigarette was damp, wet, broken, or a week old cigarette butt, the nicotine was always there. :e!er once did nicotine let us down in pro!iding temporary relie rom wanting. Knce inside our bloodstream, within seconds we experienced replenishment9 nicotine"s stimulation o our ner!ous system accompanied by satis action o our mind"s latest cycle o wanting. -ut now that"s all behind us. 5t"s o!er, inished, done. &nd as with ending any long-term relationship we must na!igate the sense o loss emotions lowing rom it. Denial, anger, bargaining and depression are normal emotional phases associated with any signi icant loss. :a!igating each brings us closer to the inal phase marking completion o emotional reco!ery, acceptance.
;u'con$ciou$ Re dCu$tment
:icotine"s two-hour hal -li e compelled us to select replenishment times, situations and patterns. 7hile you may not ha!e recogni)ed the patterns your subconscious mind did. 7hen did you replenish, upon waking each morning, entering the bathroom, be ore or a ter a meal, in the yard or garage, while tra!eling, surrounding work, around riends, while drinking, on the telephone, be ore bed, when happy, sad, stressed or mad8 7hether or not aware o our use patterns, our subconscious recorded the times, places, circumstances and emotions during which we replenished nicotine. 5t became conditioned to expect replenishment during these e!ents. 6ncountering a use cue would trigger a gentle urge reminding us that it was time to eed. :ormally we simply obeyed. -ut i not, anxiety alarms may ha!e sounded triggering a ull-blown cra!e episode. (ubconscious reco!ery is about meeting, greeting and extinguishing each conditioned use cue. The subconscious mind does not plot, plan or conspire. 5t simply reacts to input. 5 we say $no$ during what"s normally a less than H minute cra!e episode <which time distortion may cause to eel ar longer=, in most instances a single encounter will se!er
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and break the nicotine use association, extinguishing the cue that caused it. 6ach time we extinguish a cue we are rewarded with the return o another aspect o a nicotineree li e. That"s right, cra!e episodes are good not bad@ 5t"s how we take back li e, just one extinguished use cue and slice at a time. 5n Ehapter 33 we"ll explore a host o cra!e coping techniques. Dor now, understand that9 <3= there is no orce or circumstance on planet earth that can compel us to bring nicotine into our bodyJ </= we will always be able to handle up to three minutes o wanting anxietyJ and <H= the reward at the end o each episode, use cue extinguishment, is always worth !astly more than the price o enduring it.
Con$ciou$ Re dCu$tment
-y ar, the easiest yet longest phase o reco!ery is reclaiming normal, e!eryday thinking. ;nlike a less than three-minute subconscious cra!e episode, the conscious mind can ixate upon a thought o wanting nicotine or as long as we are able to maintain concentration and ocus. ,ow long can you keep your mind ocused upon your a!orite ood8 %ook at a clock and gi!e it a try. Ean you taste it8 Does it make your mouth water8 &re you eeling an urge8 :ow think about your a!orite nicotine use rationali)ation. 7hat were your top use justi ication8 Eonscious reco!ery is the period o time needed or new nicotineree memories to gather, o!erwrite or suppress all the durable dopamine pathway memories which recorded how wanting or nicotine was brie ly satis ied <by using more=. 5t"s the time needed to mo!e beyond their conscious tease. Eonscious reco!ery is !ery much within our ability to accelerate. 5t is not necessary to destroy drug use memories in order to alter their impact upon us. 5t"s done by seeing our pile o old wanting satis action memories or the truth they re lect, that each memory was created by an acti!ely eeding addict in need o more. 5t"s also accomplished by a willingness to let go o our use rationali)ations. This is done by grabbing hold o each use justi ication, exposing it to honest light, and recasting it using truth. Ehapter 3/ is about using logic, reason and science to accelerate this inal phase o reco!ery. &s seen in Ehapter . <?ationali)ations=, some use rationali)ations can be laughed away. Kthers require a bit more distance rom acti!e dependency be ore honesty
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and clarity o thought allow us to let go. (till, other rationali)ations may be harder to release and mo!e beyond. Eontrary to industry marketing, there was only one reason we didn"t stop using nicotine long, long ago. Kur new addiction quickly conditioned us to expect anxiety, irritability, anger and depression to begin building i we waited too long between eedings. 7e didn"t continue using because we liked it. 7e did so because we didn"t like what happened when we didn"t use it./BF
!rri"ing 7ome
7hat was it like to go entire days without once thinking about wanting to smoke, dip, chew, suck or !ape nicotine8 7hat was it like being $you$8 Don"t eel alone i you can no longer recall. That"s what drug addiction is all about, quickly burying nearly all remaining memory o the beauty o li e without the chemical. Trust in your common sense and dreams. 5t"s my hope that you"re curious about what it"s like to na!igate li e without wanting to introduce nicotine back into your bloodstream. Don"t be a raid. There"s nothing to ear. 7e lea!e absolutely nothing o !alue behind. 5n act, e!ery chemical that nicotine controlled already belonged to us. &s reco!ering addicts, we can do e!erything we did while ensla!ed and do it as well as or better once ree. 7hy ight and rebel against reedom and healing when it should be sa!ored, hugged and lo!ed8 7hy see challenge as rightening when it pro!ides indisputable e!idence o just how in ected our li e had become8 #y prior attempts ailed because 5 ought reco!ery, and did so in ignorance and darkness. 4es, e!ery now and then 5"d get lucky and land a punch. -ut this time was di erent. This time 'oel and his insights e ecti!ely turned on the lights. :ow my opponent couldn"t be clearer. #y eyes and mind were opened to exactly what it takes to ail and what it takes to succeed. 'oel burned an extremely bright line into my mind, one 5"ll do my best to keep clean and clear or all my remaining days. ,e taught me that 5 get to stay and li!e here on the ree side o that line so long as it"s ne!er crossed, so long as all the world"s nicotine remains on the other, so long as complacency isn"t allowed to obscure it.
/BF (pit)er, ', $5 smoke because 5 like smoking,$ 3B1H, www.7hyLuit.com
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-aby steps to glory, just one moment, hour and day at a time. 4es you can@ There was always only one rule ... that one equals all, that lapse equals relapse@
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/he :ir$t ,2 7our$
,a!e you accepted the
act that you are a true drug addict in e!ery sense <Ehapter 3=8 Do you understand the %aw o &ddiction, the only rule that we addicts need master and ollow in order to stay ree <Ehapter /=8 ,a!e you discarded destructi!e use rationali)ations such as the alse tease o $just one, just once$ and the lie that nicotine relie!es stress <Ehapter .=8 &re you aware o common ha)ards and pit alls such as early alcohol use, blood sugar swings, how your blood ca eine le!el will double, and how extra ood become a replacement crutch <Ehapter I= 5 so, you"re ready@ (till a bit apprehensi!e8 5t"s totally understandable. (till, try to relax. Take slow deep breaths. ?emember, when going cold turkey without use o any product or procedure, nearly e!erything elt during the irst three days is e!idence o what may be the most pro ound healing your body has e!er known. 5t"s good not bad. 5 coming home cold turkey, rest assured, you will not experience any cessation product side e ect or ad!erse e!ent. 5nstead you"ll witness and experience the response o your body and mind as they na!igate a temporary period o deep and pro ound repair, cleansing and mending. 5 a smoker, this will likely be your body"s most intense healing period e!er. *icture more than I0 trillion cells,/BA each recei!ing ar more oxygen and ar ewer toxins than normal. *sychologically, that !ery irst step in getting started is the biggest hurdle o all. 5t"s here, during these early magic moments, that we re-disco!er how to breathe, mo!e about, eat and go to sleep without introducing nicotine back into our bloodstream. The minutes will pass whether we orce oursel!es to sit on pins and needles or permit oursel!es to relax and remain as calm and com ortable as the moment allows. & clock or watch will soon announce the passing o an hour. 7hen it does, celebrate@ 4ou"!e taken that irst giant step home. Eongratulations@
/BA :ational 5nstitutes o ,ealth, ,uman Eells 303, :5E,D, http9//www.nichd.nih.go! - page last updated B/31/0F.
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& new supply o the super-toxin and natural insecticide nicotine did not arri!e <Ehapter 3, :icotine=. &dditional brain gray matter was not stung and destroyed./B1 ;nhealthy cells throughout the body elt the licker o hope that nicotine would no longer orce them to li!e on, that they"d be permitted to experience natural cell death <apoptosis=./BB &nd a new round o nicotine induced angiogenesis did not riddle though and harden plaque build-up within arteries, or accelerate tumor growth rates by pro!iding them with a blood supply.H00 #ost importantly, we arrested our dependency or an entire hour. 7e traded sides o the bars. Kur dependency was now our prisoner and we its jailer. Dorget about ore!er, tomorrow or e!en two hours rom now. &ll we control are the next ew minutes, minutes during which nicotine need not and shall not enter our bloodstream. 4ou already know the only principle that need be ollowed in order to enjoy 300 percent odds o success, the %aw o &ddiction <Ehapter /=. The ollowing cold turkey tips list is a summary o key reco!ery insights. Dollowing each tip is the chapter which re!iews the tip in detail.
;umm ry o1 A $ic Reco"ery /ip$

3. 0 w o1 !ddiction - &dministration o a drug to an addict will cause re-establishment o chemical dependence upon the addicti!e substance. Dully accept chemical dependency. :icotine addiction is as real and permanent as alcoholism. The same brain dopamine pathways that make stopping eating seem nearly impossible ha!e become hostage to nicotine. 5t"s their job to make acti!ities that acti!ate them nearly impossible to ignore in the short term. 5t"s why withdrawal and reco!ery are necessary. 5t"s the time needed to get clean and mo!e beyond this brain circuitry"s in luence. 5t"s why there"s no such thing as just one, or
/B1 -rody, &% et al, Di erences between smokers and nonsmokers in regional gray matter !olumes and densities, -iological *sychiatry, 'anuary 3, /00., Golume II<3=, *ages AA-1.J also see >uhn (, et al, -rain grey matter de icits in smokers9 ocus on the cerebellum, -rain (tructure and Dunction, &pril /03/, Golume /3A</=, *ages I3A-I//. 6pub (eptember 30, /033. /BB Eucina &, et al, :icotine 5nhibits &poptosis and (timulates *roli eration in &ortic (mooth #uscle Eells Through a Dunctional :icotinic &cetylcholine ?eceptor, The 'ournal o (urgical ?esearch, :o!ember /F, /00AJ also see Shang T, et al, :icotine pre!ents the apoptosis induced by menadione in human lung cancer cells, -iochemical and -iophysical ?esearch Eommunications, &pril 3., /00F, Golume H./<H=, *ages B/1-BH.. H00 Eooke '*, &ngiogenesis and the role o the endothelial nicotinic acetylcholine receptor, %i e (ciences, #ay H0, /00A, Golume 10</.-/I=, *ages /H.A-/HI3J also see, ,eeschen E, et al, :icotine stimulates angiogenesis and promotes tumor growth and atherosclerosis, :ature #edicine, 'uly /003, Golume A<A=, *ages 1HH-1HB.
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just once. ?emember, without ood we die, without nicotine we thri!e@ <Ehapter /= /. Me $ure Dictory >ne # y t /ime - Dorget about stopping $ ore!er.$ 5t"s the biggest psychological bite imaginable. 5nstead, adopt a do-able $one day at a time$ reco!ery philosophy, or one challenge or hour at a time when needed. <Ehapter I= H. Record 3our Moti" tion$ - Knce in the heat o battle it"s normal to orget the reasons that moti!ated us to begin this journey home. 7rite yoursel a reminder letter, carry it with you, and don"t hesitate to use i challenged. <Ehapter I= .. #o .ot ;(ip Me l$ - 6ach pu o nicotine was our spoon pumping stored ats and sugars into our bloodstream. 7hy add hunger cra!es to nicotine cra!es8 6at little, healthy and o ten. <Ehapter F= I. /hree # y$ o1 . tur l Juice$ - 5 your health and diet permit, consider drinking extra acidic ruit juice the irst three days. Eranberry is excellent. 5t will both help stabili)e blood sugars and accelerate nicotine"s elimination. <Ehapter F= F. ;topping 1or >ther$ & 7e cannot stop or others. 5t must be our gi t to us. Doing it or others creates a natural sense o sel depri!ation that"s a recipe or relapse. <Ehapter I= A. !ttitude & &lthough not mandatory in staying ree, a positi!e attitude will accelerate both letting go and getting home. ?emember, your subconscious is listening. <Ehapter I= 1. Eet Rid o1 !ll .icotine - >eeping a stash handy is begging or relapse. <Ehapter I= B. C 11eine*.icotine <nter ction - :icotine doubles the rate by which the body depletes ca eine. Eonsider a ca eine reduction o up to one-hal i troubled by anxieties or poor sleeping. <Ehapter F= 30. !ggre$$i"ely %Btingui$h .icotine 4$e Cue$ - #ost use cues are extinguished by a single encounter during which the subconscious ails to recei!e the expected result nicotine. (ubconsciously triggered cra!es peak in intensity within three minutes. -ut normal cessation time distortion combining with panic can may make the minutes eel like hours. >eep a clock handy to maintain honest perspecti!e. Take back your li e one cue at a time@ <Ehapter 33= 33. Cr "e Coping /echniIue$ - Kne coping method is to practice slow deep breathing while clearing your mind o all needless chatter by ocusing on your a!orite person, place or thing. &nother is to say your &-Es while associating each letter with your a!orite ood, person or place. Dor example, the letter $&$ is or grandma"s hot apple pie. $-$ is or warm buttered biscuits. 5t"s unlikely that you"ll ne!er make it to the challenging letter L be ore the episode peaks in intensity and !ictory is yours.
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&lso, try embracing a cra!e episode"s energy by mentally reaching out inside your mind. & cra!e cannot cut us, burn us or make us bleed. -e bra!e just once. 5n your mind, wrap your arms around the cra!e"s anxiety energy and then sense as it slowly i))les and dies while within your embrace. 4es, another use cue bites the dust and !ictory is yours@ <Ehapter 33= 3/. !lcohol 4$e - &lcohol use is associated with roughly hal o all relapses. -e extremely care ul with early alcohol use. Met your reco!ery legs under you irst. Knce ready, consider drinking at home irst without nicotine around, going out with riends but re raining rom drinking during the irst outing, or spacing drinks urther apart or drinking water or juice between drinks. ,a!e an escape plan and a backup, and be ully prepared to deploy both. <Ehapter F= 3H. !"oid Crutche$ - & crutch is any orm o reliance that is leaned upon so hea!ily in supporting reco!ery that i quickly remo!ed would ele!ate risk o relapse. <Ehapter F= 3.. %Btr :ruit 9 Deggie$ - To help a!oid weight gain, eat !egetables and ruit instead o candies, chips and pastries. Eelery and carrots can be used sa ely as short-term nicotine substitutes. & /03/ study suggests that increased ruit and !egetable consumption may substantially increase H0 day cessation rates. <Ehapter F= 3I. .o 0egitim te %Bcu$e 1or Rel p$e - ?ecogni)e that using nicotine cannot sol!e any crisis. Dully accept that there is absolutely no legitimate excuse or relapse, including an auto accident, inancial crisis, the end o a relationship, job loss, a terrorist attack, a hurricane, the birth o a baby, alling stocks, or the e!entual ine!itable death o those we lo!e most. <Ehapter 3.= 3F. Rew rd 3our$el1 - Eonsider using some o the money you sa!e to be nice to you. 4ou"!e earned it@ <Ehapter I= 3A. Ju$t >ne Rule - There is only one reco!ery rule which i ollowed pro!ides a 300 percent guarantee o success9 no nicotine today@ <Ehapter /=
Reco"ery ;en$ tion$ & Eood, .ot ' d

The early days o an educated attempt will be a cakewalk or some and a challenge or others, and easier than expected or most in between. &lthough it sounds strange, within reason, e!erything elt as you climb to the point where withdrawal"s symptoms peak is bene icial and good, not bad. 7hat more honest signs o healing could we ha!e8 Does it make sense to ear healing8 7hy resist taking back the dri!er"s seat o your mind8 7hy ight the dri!e home8 7hy ear returning to a place where entire days pass without e!er once wanting to use8
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Don"t ight reco!ery, embrace it. ,ug it hard@ The balance o this book details each layer o reco!ery9 physical reco!ery <Ehapter B=, emotional reco!ery <Ehapter 30=, subconscious reco!ery <Ehapter 33=, and conscious reco!ery <Ehapter 3/=, be ore closing with homecoming <Ehapter 3H= and complacency + relapse <Ehapter 3.=. &gain, there was always only one rule. 5t"s that lapse equals relapse, that one equals all, that just one hit o nicotine will acti!ate up to hal o brain dopamine pathway receptors, orcing this circuitry to again make you belie!e that not using more is akin to star!ation.
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Ch pter 9
Phy$ic l Reco"ery
*hysical reco!ery is the layer o
healing associated with the chemical and physical changes which occur within the body and mind once use o nicotine, and the chemicals introduced with it, ends. 7hat"s important rom our standpoint isn"t the science associated with the neuro-chemical chain reactions which occur within the body once use ends, but the symptoms those changes $may$ generate. &nd the key word is $may.$ 7hile physiological cessation changes within the brain are real, most nicotine cessation symptoms are sel induced and can be diminished, corrected or eliminated. :eed proo 8 ,a!e you e!er been so tired that you slept or ten to twel!e hours8 :icotine reser!es at less than HC, why didn"t withdrawal awaken you8 ,a!e you e!er been so sick that you went a day or more without using8 ,ow8 &nd how did the single-session tra!eling hypnotist gi!e us a day or two o total cessation calm and bliss be ore reality hit home8 7hile e!ery attempt is di erent, why does a physician"s warning that smoking"s damage is now so pro ound that $it"s time to either stop or die$ so o ten result in a symptom-less reco!ery8 5"m increasingly con!inced that nearly all reco!ery symptoms are the result o sel induced ears and anxieties, correctable blood sugar issues, ca eine o!erdose, or the need or a medication adjustment or treatment o a hidden condition that appears a ter ending use o one or more o the thousands o chemicals present in tobacco. The primary anxiety culprit is a pre- rontal cortex illed with thousands o old dopamine pathway generated use memories. The greater our need at the moment be ore use, the more pro ound wanting"s satis action, and the greater that memory"s in luence upon us. :ot understanding that our mind"s priorities teacher had been hijacked, we in!ented scores o explanations as to why that next nicotine ix was so important. The common thread between extended sleep, illness, hypnotism and standing on the !erge o death is a higher priority. 7hether the higher priority is biological, a subconscious suggestion or a death threat, in each case both the lure o old use memories and the appeal o use explanations was totally o!ercome.
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&s we re!iew the ollowing physical reco!ery changes and symptoms which may ollow, with each ask yoursel , how can the symptom itsel be minimi)ed, corrected or a!oided8
.euron l Re&$en$iti5 tion

6xactly how and why the brain diminishes the number o acti!e nicotinic-type acetylcholine receptors <down-regulation= a ter nicotine use ends is still poorly understood. 7hat we do know is that once use ends we temporarily ha!e ar too many acti!e receptors. 6arly reco!ery puts us ace-to- ace with physical e!idence o nicotine"s in luence upon the brain"s hard-wired priorities control center. &gain, in terms o healing, it is normal to notice that the brain"s desire circuitry is temporarily out o whack. -ut once nicotine"s arri!al ends, the brain is works its $butt o $ to diminish the number o acti!e receptors and restore sensiti!ities. &lmost as quickly as we notice our sense o smell and taste being enhanced, our brain is working to restore natural sensiti!ities. (*6ET stands or (ingle *hoton 6mission Eomputed Tomography. 5t is a scan during which a radioacti!e substance is put into the bloodstream and ollowed as it works its way through the body and brain. & camera capable o detecting gamma radiation is then rotated around the body or head taking pictures rom many angles. & computer is then used to put the images together and create a picture o acti!ity within a speci ic slice o the body or brain. & /00A study used (*6ET scans to ollow dynamic changes in acetylcholine receptor down-regulation binding during smoking cessation. 5t compared those inding to receptor acti!ity inside the brains o non-smokers.H03 5t ound that within our hours o ending nicotine use that acetylcholine receptor binding potential had already declined by HH.I percent. The good news is that binding potential rebounded by /I.AC within ten days o ending nicotine use and then $decreased to le!els seen in non-smokers by around /3 days o smoking cessation.$ 7e don"t need to put radiation into our bloodstream or do a (*6ET scan o our brain to know that the de-sensiti)ed period experienced during reco!ery is temporary, normal and expected. 5t"s enough to know that what we are sensing and eeling is happening inside a brain working hard to readjust to unctioning without nicotine. 7hy ear it8 (a!or it.
H03 #amede #, et al, Temporal change in human nicotinic acetylcholine receptor a ter smoking cessation9 I5&
(*6ET study, 'ournal o :uclear #edicine, :o!ember /00A, Golume .1<33=, *ages 31/B-31HI.
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;ymptom$
W!R.<.E9 /he 1ollowing $ymptom$ rel te to cold tur(ey nicotine

ce$$ tion only. /hey re not intended 1or tho$e u$ing Ch ntiB, Ch mpiB, Fy' n, Well'utrin, nicotine repl cement product$ J.R/K or ny other ce$$ tion product. Reg rdle$$ o1 ce$$ tion method, <mmedi tely con$ult your he lth c re pro"ider or ph rm ci$t i1 eBperiencing ny $ymptom c u$ing concern, including ch nge$ in thin(ing, mood$ or 'eh "ior.
W!R.<.E9 /he li$t o1 $ymptom$ 'elow i$ .>/ M%#<C!0 !#D<C%

'ut $imply n outline o1 documented cold tur(ey reco"ery $ymptom$. <MM%#<!/%03 cont ct our phy$ici n $hould you eBperience ny condition or $ymptom th t c u$e$ you C>.C%R. or !0!RM, including continuing depre$$ion. 7ithin reason and common sense, i going cold turkey it is airly sa e to blame withdrawal or most e ects elt during the irst three days, but not always. *ay close attention to what your body is telling you and i at all concerned contact your doctor. 7hile re!iewing the symptoms below, keep in mind that 5 am not a physician. 5 am a nicotine cessation educator. The below in ormation is intended to support, not replace, the relationship that exists between you and your doctor. #o not rely upon ny in1orm tion in thi$ 'oo( to repl ce indi"idu l d"ice 1rom your phy$ici n or other Iu li1ied he lth c re pro"ider. 6!ery reco!ery is di erent. The !ariety and intensity o e ects experienced during reco!ery !aries rom person to person, and e!en between each person"s own cessation experiences. K!er the years we"!e seen thousands o new ex-users surprised to ind that they experience ew symptoms, i any, while others were con ronted with multiple symptoms. -y understanding some o the symptoms, how requently they occur and how long they last, it may be possible, in some instances, to minimi)e their impact by action or thought. &s we just learned, brain dopamine pathway sensiti!ities can take up to three weeks be ore ully restored. &lthough physical withdrawal symptoms normally peak within the irst three days, a /00A study re!iewed all symptom studies and ound that within two weeks they had passed or most but not all. The study suggests that i symptoms remain $slightly ele!ated$ beyond two weeks that
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they will ully resol!e within H to . weeks.H0/ 6!en so, within two weeks the ongoing process o restoring and ine-tuning natural sensiti!ities reach a point where most o us begin experiencing con idence building glimpses o the ull la!or o being ree. & serious concern with symptoms lists such as this is that $smokers with higher le!els o percei!ed risk may ind it more di icult to stop and remain abstinent due to higher le!els o anticipated or experienced withdrawal symptoms.$H0H They pro!ide a $junkie-mind$ looking or relapse justi ications a rich source o uel or accentuating or highlighting something that may otherwise ha!e remained minor, secondary, suppressed or ignored. -ut how can we not notice symptoms8 5 we ha!e a toothache at the same time as a headache, the one that will recei!e the most attention and ocus is the one generating the greatest pain or discom ort. &s soon as the discom ort rom our primary concern alls below that o our secondary concern, our ocus immediately shi ts to what was our secondary concern. 7e do the same type o primary/secondary re ocusing with the e ects o withdrawal and the phases o reco!ery. (ometimes we don"t e!en notice a particular symptom until the discom ort o a prior one subsides. &lthough the intensity o each remaining e ect is likely ar less signi icant than the one preceding it, the mind o the uneducated drug addict is impatient and on the lookout or great excuses to relapse and get their drug back. ;pon decline o initial reco!ery symptoms <i any=, reco!ery remains continuous yet at times may be so gradual that - like trying to watch a rose bud open - it almost becomes impossible to notice change. ?eading symptom lists such as this may tend to cause the mind to look or and expect symptoms to occur. 5n act, mental expectations are capable o generating physical symptoms. This phenomenon - known as psychological or unctional o!erlay - is !ery real. Dew starting home will experience the majority o the symptoms listed below. (o why e!en share this list8 4ou may !ery well experience one or more symptoms. >nowing how o ten they occur and how long they last brings potential to diminish anxieties, thus increasing odds o success.
H0/ ,ughes, '?, 6 ects o abstinence rom tobacco9 !alid symptoms and time course, :icotine and Tobacco
?esearch, #arch /00A, Golume B<H=, *ages H3I-H/A. H0H 7einberger &,, et al, ?elationship o percei!ed risks o smoking cessation to symptoms o withdrawal, cra!ing, and depression during short-term smoking abstinence, &ddicti!e -eha!iors, 'uly /001, Golume HH<A=, *ages BF0-BFH.
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This list is shared to alert you to symptoms commonly seen, how long they last, and to moti!ate you to communicate with your doctor regarding any symptom, whether listed or not, that is causing you concern. 7hy sell your mind on the belie that starting your new li e needs to be pain ul or intense8 7hy not instead learn to relax, dump irrational ears, maintain a positi!e attitude, keeping your reasons or wanting to break ree in the ore ront o your mind, while abandoning unrealistic !ictory standards such as $stopping ore!er.$ 7hy not adopt a realistic standard such as celebrating a ter the next hour, challenge or day, eating smaller and healthier portions o ood more requently, a!oiding skipping meals, sipping on some orm o natural ruit juice or the irst three days, and i a big ca eine user, consider a modest reduction o up to one-hal o normal daily ca eine intake8 5 you do, this ad!enture home may turn out to be the most deeply satis ying personal experience o your entire li e@ (ome withdrawal symptoms ha!e roots in the absence o nicotine, and the time needed or the mind to physically adapt to unctioning without it. The brain isn"t just downregulating the number o receptors associated with dopamine pathway stimulation. 5t isresuming ull control o the low o all neuro-chemicals that were in luenced by nicotine, including adrenaline and serotonin pathways. 7hile it may take science decades to untangle, measure and quanti y all cessation sensiti!ity interplays, researchers are already cataloging subjecti!e symptom reports by tens o thousands who ha!e attempted cessation. &s with the (*6ET scan, they"re also using brain-imaging studies and other non-in!asi!e exams to disco!er how the brain is physically altered by nicotine"s absence. ,omeostasis is de ined as $the ability or tendency o an organism or cell to maintain internal equilibrium by adjusting its physiological processes.$H0. Kur ensla!ed mind had adjusted to unctioning within a sphere o nicotine normal. Knce nicotine"s arri!al ends the brain"s grand design will cause it to readjust to non-nicotine normal. #aintaining homeostasis is a critical part o our ticket home. !nBiety 7hether dealing with heroin dependency, alcoholism or nicotine addiction, anxiety is a
H0. ,omeostasis. The &merican ,eritage (cience Dictionary. ?etrie!ed 'uly 3/, /001, rom Dictionary.com
website9 http9//dictionary.re erence.com/browse/homeostasis
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common reco!ery symptom among many drugs o addiction.H0I ?eco!ery anxiety can ha!e many sources. #ost ob!ious, nicotine is no longer stimulating dopamine pathways, resulting in declining le!els o background or tonic dopamine, and thus ele!ating wanting. That wanting may be teased by thousands o old replenishment memories, each sharing the alse message that the way to end wanting is to use more nicotine. Kne study suggests that much o the underlying current o anxiety elt during the irst se!en days may in part be the product o a mind preoccupied with risk o relapse. H0F ?emember, it is impossible to ail so long as no nicotine enters the bloodstream. &nd contrary to the primary message o thousands o use memories, it"s the only path home. Thinking and dreaming about nicotine use do not cause relapse. ;se does. The primiti!e limbic mind has been ooled into associating nicotine use with sur!i!al. 5t may see ending use as akin to star!ing yoursel to death. Eontinuing belie in our addiction"s primary deception can generate signi icant anxieties. 7e can also generate, uel and eed anxieties on purpose. &n addict could easily sabotage his or her own reco!ery by purpose ully ocusing on the negati!e, allowing emotions to ester and build. 7e can then intentionally crash our emotions in hopes o pro!iding su icient justi ication to relapse. :ow or the good news. &ny undercurrent o anxiety elt should peak within A/ hours. -y then you"ll reside inside a nicotine ree body. -y then you may begin noticing that both anxieties and brain unction are getting better not worse. Kh, you may still eel disconnected and oggy or a while <as discussed below= but o!erall brain unction is now on the mend. 7hile simple to sit here writing about the bene its o dumping needless anxiety generating ears, and about there being no need to be a raid o coming home a ter years or e!en decades o chemical capti!ity, 5 sincerely appreciate that it"s easier said than done. Dor some, emptying the mind o nicotine may brie ly eel like an emotional train wreck. 5 so, it"s wreckage that"s quickly cleared, as the brain works around the clock to restore
H0I ,all (#, The abstinence phobias9 links between substance abuse and anxiety, The 5nternational 'ournal o the
&ddictions, (eptember 3B1., Golume 3B<F=, *ages F3H-FH3 H0F -rown ?&, et al, &nxiety sensiti!ity9 relationship to negati!e a ect smoking and smoking cessation in smokers with past major depressi!e disorder, &ddicti!e -eha!iors, :o!-Dec /003, Golume /F<F=, *ages 11A-1BB.
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homeostasis. 5 we remain 300C nicotineree or just A/ hours, unless in the grips o sel -induced ears and anxieties, we should begin noticing the underlying current o anxieties begin easing o . -y then, billions o brain neurons are basking in nicotineree, oxygen rich blood serum. 4es, as early as three days and homeostasis sensiti!ity re-adjustments can be elt bearing ruit. 6arly healing is rapid. (low, deep breathing while intentionally working to relax and reassure a rightened mind may help diminish anxieties. 5t also can"t hurt to use physical acti!ity or exercise to stimulate blood circulation. &s re!iewed in Ehapter 1, keep an eye on ca eine intake as ca eine intoxication can oster anxieties. 7atching sugar intake may ha!e a calming e ect. 6ating small portions o healthy ood more requently should help stabili)e blood sugars and a!oid ha!ing to deal with anxieties associated with the onset o hunger wanting, urges and cra!es. & /003 study by 7ard entitled $(el -reported abstinence e ects in the irst month a ter smoking cessation,$ may be the most detailed withdrawal symptom study e!er, and pro!ides ascinating reco!ery symptom insights.H0A The 7ard study ound that, on a!erage, anxieties peak on day one <within /. hours= and, or most, within two weeks return almost to pre-cessation le!els. 5rritability <anxiety"s a termath= peaks at about .1 hours while restlessness peaks at A/ hours. &ccording to the 7ard study, both begin ho!ering back around pre-cessation le!els within two weeks. !nger Kn a!erage, anger peaks at about .1 hours <day /= and within A/ hours is beginning to return to near pre-cessation le!els. &drenaline stimulation was a non-addicti!e but now missing element o our nicotine high. The rational mind can use anger to in!oke the body"s ight or light response and stimulate an adrenaline release. &nger may also re lect the boiling point o anxiety dri!en ears, or a normal emotional phase o any signi icant sense o loss.
H0A 7ard, ## et al, (el -reported abstinence e ects in the irst month a ter smoking cessation, &ddicti!e
-eha!iors, #ay-'une /003, Golume /F<H=, *ages H33-H/A.
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The good news is that it only takes a couple o days o reco!ery patience to begin sensing impro!ement. %ook or ways to !ent rustrations that won"t cause needless hurt to amily, lo!ed ones, riends or co-workers. 7alk, run, !ent into a pillow, ind a punching bag, bend a piece o steel, or bite your lip i need be. (hare your eelings with your amily, riends or other support network. <mp tience 7hether impatience is an independent reco!ery symptom or simply an expected result o anxiety, anger and restlessness is subject to debate. 7hat isn"t debatable is the act that as nicotine addicts we were each conditioned by our dependency to be extremely impatient when it came to satis ying urges and cra!es. &s acti!e users, we were each in ull control in responding to and quickly satis ying those early urges announcing it was again time or replenishment. 7e smokers didn"t need patience. 5ncreasingly, neither do those using chewing tobacco and snu . :icotine deli!ery engineering is mastering use o alkaline p, bu ering to shorten the time needed or nicotine to penetrate oral mouth tissues and enter the bloodstream. H01 -ut impatience conditioning is clearly worst among smokers. 7e could quiet brain dopamine pathway wanting within 30 seconds o a pu . :icotine laden smoke would tra!el into our mouth and throat, past our larynx <housing our !ocal cords=, down our inches o trachea or windpipe, and then branch into our le t and right lungs !ia our two main bronchial tubes. Knce inside each lung, smoke descended down ten smaller bronchial tubes be ore striking an estimated /.0 millionH0B thinly walled air sacs called al!eoli. ,ere nicotine passed through each al!eoli membrane and into the bloodstream"s pulmonary !eins. 5nside the bloodstream, nicotine was pumped o!er to our heart where between beats it collected in the le t atrium. The next beat would pump it through the le t !entricle be ore being ejected upward into the aorta. There it branched and tra!eled up to our brain !ia either the carotid or !ertebral arteries. & small molecule, it easily passed through the brain"s protecti!e blood brain barrier.
H01 -enowit) :%, (ystemic absorption and e ects o nicotine rom smokeless tobacco, &d!ances in Dental
?esearch, (eptember 3BBA, Golume 33<H=, *ages HHF-H.3. H0B Kchs # et al, The number o al!eoli in the human lung, &merican 'ournal o ?espiratory and Eritical Eare #edicine, 'anuary 3, /00., Golume 3FB<3=, *ages 3/0-3/..
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The amount o nicotine rom that irst pu would be su icient to occupy up to I0C o our brain"s nicotinic-type acetylcholine receptors. &cti!ating these receptors would trigger a burst o dopamine which would ele!ate background dopamine, generating an $aaah$ wanting relie sensation. 7hen smoked, the entire journey takes less than 30 seconds. 5 sucked, chewed or dipped, the oral nicotine user"s impatience is satis ied in a minute or two, depending on the brand"s p, bu ers or added abrasi!es. 5s it any wonder that we nicotine addicts ha!e !ery little patience when it comes to satis ying depletion related wanting, urges, cra!es and anxieties8 (o how do we de!elop the patience to na!igate the up to three days needed to mo!e beyond peak physical withdrawal, the up to H minutes needed to outlast a cue induced cra!e episode, or the duration patience needed to allow new nicotineree memories time to bury old replenishment memories8 7e do so by staying ocused on here and now, just one moment and challenge at a time. <n 'ility to Concentr te or :oggy Mind &ccording to the 7ard study, the eeling that our concentration is not as good or that our mind now li!es in a og is experienced, to one degree or another, by almost two-thirds o reco!ering nicotine addicts. The return o our clearness o mind and concentration may seem e!er so gradual but within two weeks most begin experiencing concentration le!els !ery close to those o ne!er-smokers. *oor concentration, ocus and an inability to think clearly can be associated with low blood sugar. 5t"s important to understand that nicotine orce- ed us stored ats and sugars with each new pu or chew. 5t"s why we were able to skip break ast and/or lunch and yet not eel hungry. 5t did so by acti!ating our $ ight or light$ pathways. 6nding nicotine use ends ight or light pathway stimulation. Eontinuing to attempt to skip meals will cause decline in blood sugar <glucose= le!els, which in turn could impact concentration. :icotine is no longer our spoon. 5t isn"t necessary to eat more ood but to learn to spread our normal daily ood intake out more e!enly o!er the entire day.
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7omen would be well ad!ised to put a !ery small amount o uel into their stomach about e!ery three hours and men at least e!ery i!e. &s re!iewed in Ehapter 1, unless diabetic or our health care pro!ider recommends otherwise, consider drinking some orm o natural ruit juice during the irst A/ hours. Eranberry is excellent. :ot only will it aid in helping stabili)e blood sugar, it is acidic and may slightly accelerate elimination o the alkaloid nicotine. 6!en i unable to entirely stabili)e blood-sugar luctuations the symptom is temporary and relie on the way. 4ou may want to temporarily reduce or a!oid alcohol, which reduces brain oxygen and impairs concentration. -risk walks, other physical exercise or slow deep breathing may deli!er additional ocus by increasing oxygen to the brain. ?emember, li e-gi!ing oxygen is a ar healthier brain stimulant than a super toxin that eats brain gray matterH30 and destroys memory.H33 ; dne$$ 9 #epre$$ion
W!R.<.E - 3 e following depression discussion is not medical advice! .t is a

general overview for t ose going cold tur%ey+ not for t ose using any cessation medication or product! Regardless of met od+ see% emergency medical attention if you+ your family or your caregiver notice agitation+ depressed mood+ or c anges in be avior t at are disturbing or alarming+ or if you develop suicidal t oug ts or actions! %et"s brie ly re!iew a ew depression background acts be ore looking at sadness or depression related to ending nicotine use. Dirst, the good news or those experiencing pre-cessation depression. 7hile e!idence that adolescent nicotine use contributes to causing depression continues to build,H3/ researchers report no di erence in either short-term <less than H months= or long-term reco!ery success rates <greater than F months= between smokers with a history o depression and those without.H3H
H30 -rody, &% et al, Di erences between smokers and nonsmokers in regional gray matter !olumes and densities, -iological *sychiatry, 'anuary 3, /00., Golume II<3=, *ages AA-1.. H33 6rnst #, et al, (moking history and nicotine e ects on cogniti!e per ormance, :europsychopharmacology, (eptember /003, Golume /I<H=, *ages H3H-H3B. H3/ 5nigue) (D, et al, :icotine 6xposure During &dolescence 5nduces a Depression-%ike (tate in &dulthood, :europsychopharmacology, December 3A, /001 O6pub ahead o printPJ also see, Moodman 6, et al, Depressi!e symptoms and cigarette smoking among teens, *ediatrics, Kctober /000, Golume 30F<.=, *ages A.1-AIIJ and also -oden '#, et al, Eigarette smoking and depression9 tests o causal linkages using a longitudinal birth cohort, -ritish 'ournal o *sychiatry, 'une /030, Golume 3BF<F=, *ages ..0-..F. H3H ,itsman -, et al, ,istory o depression and smoking cessation outcome9 a meta-analysis, 'ournal o Eonsulting
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&ccording to the ;.(. :ational 5nstitute o #ental ,ealth <:5#,=, we all occasionally eel sad or blue but normally such eelings pass within a couple o days. :5#, states that symptoms o depression may include persistent sadness, anxious or $empty$ eelings, eelings o hopelessness and/or pessimism, eelings o guilt, worthlessness and/or helplessness, irritability, restlessness, loss o interest in acti!ities or hobbies once pleasurable, including sex, atigue and decreased energy, di iculty concentrating, remembering details and making decisions, insomnia, early morning wake ulness, or excessi!e sleeping, o!ereating, or appetite loss, thoughts o suicide, suicide attempts, persistent aches or pains, headaches, cramps or digesti!e problems that do not ease e!en with treatment.H3. There are many types o depression and no one single cause. 5t likely results rom a combination o actors including psychological, biochemical, en!ironmental and genetic. (adness and depression are commonly seen in association with withdrawal rom most addicti!e substances. During nicotine withdrawal, both temporary neuro-chemical desensiti)ation and normal psychological emotional loss can gi!e rise to sadness and depressi!e-type symptoms. -ut should moods ostered by a healing brain or due to normal and expected sadness be classi ied as clinical depression and mental illness8 $*robably not,$ says a leading ;.(. expert. The &merican *sychiatric &ssociation"s D(#-5G manual <Diagnostic and (tatistical #anual o #ental Disorders, Dourth 6dition= pro!ides standards or diagnosing depression. -ut e!en i a patient otherwise meets the criteria to be diagnosed with depression, they are excluded and denied the diagnosis i their depression is a normal reaction to the death o a lo!ed one, or induced by alcohol or drug use. (o why exclude drug induced depression but not depression related to ending drug use8 7hy is it normal to experience depression related to the loss o a lo!ed one, but not when the loss is associated with ending a long and intense chemical relationship8 Dr. #ichael Dirst is a physician and psychiatry pro essor at Eolumbia ;ni!ersity #edical Eenter and was editor or the D(#-5G standards.H3I Dr. Dirst did an inter!iew with :ational *ublic ?adio in &pril /00A.
and Elinical *sychology, &ugust /00H, Golume A3<.=, *ages FIA-FFH. H3. ;.(. :ational 5nstitute o #ental ,ealth, Depression, 5nternet article last re!iewed &pril H, /001, accessed 'uly 3B, /001. H3I Eolumbia ;ni!ersity #edical Eenter, Department o *sychiatry, #ichael Dirst #D, Daculty *ro ile, updated /00I, !iewed 'uly /., /001.
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During the inter!iew he discussed a new study he co-authored that sheds light on the question o whether or not the D(#-5G $berea!ement exclusion$ should extend to $other types o losses,$ where it is normal to expect temporary depression to be seen. $Dor some people a !ery messy di!orce, a loss o a job, suddenly, those can be just as traumatic as the loss o a lo!ed one,$ said Dr. Dirst. &ccording to Dr. Dirst, in order to all under the $berea!ement exclusion$ or normal, expected and temporary depression, the depression has to $last less than two months and be relati!ely mild.$ $Dor instance it would not include symptoms such as suicidal ideation or se!ere slowing down in the way you talk. (o it was a mild !ersion o depression that occurred ollowing a loss such as di!orce and other things like that.$H3F Dr. Dirst"s new study, which re!iewed a national mental health sur!ey, was able to demonstrate that $/IC o people who were diagnosed with major depressi!e disorder in the study looked just like the people who we would consider to ha!e normal grie .$H3A $(o it really raises questions about whether or not these indi!iduals should be considered normal in the same way someone who has normal grie would be considered normal.$ ,e was asked about treatment o those experiencing normal and expected sadness. $7hen a clinician makes a decision about whether to use psychotherapy or mediation or some combination, the se!erity o the symptoms play an important role,$ he notes. $&nd certainly i someone is elt to ha!e a normal reaction to the loss o a lo!ed one or a stress ul situation, probably the clinician would err on the side o being less aggressi!e with respect to treatment.$ &lthough normal sadness might bene it rom medication, Dr. Dirst reminded listeners that $medications ha!e side e ects$ and any potential bene its must be weighed against them. ?eco!ery re lects an end to a long and intensely dependent chemical relationship. &s the brain restores sensiti!ities, physiological, psychological and emotional bonds are broken. (ome degree o sense-o -loss sadness is common and expected. 5t can eel like the death o a riend or lo!ed one, but in truth is an end to a destructi!e chemical relationship. 5t is normal to eel a sense o loss and normal to na!igate grie!ing. &s with the end o any long-term relationship, the period o cessation mourning and
H3F :ational *ublic ?adio, &ll Things Eonsidered, The Elinical De inition o Depression #ay Ehange, &pril H,
/00A www.npr.org H3A 7ake ield 'E, et al, 6xtending the berea!ement exclusion or major depression to other losses9 e!idence rom the :ational Eomorbidity (ur!ey, &rchi!es o Meneral *sychiatry, &pril /00A, Golume F.<.=, *ages .HH-..0.
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grie!ing can be as long or short as we need. 5n the 7ard $abstinence e ects$ study, HBC o smokers entering the study reported experiencing depression on the day be ore commencing reco!ery. -y comparison, 3BC o ne!er-smokers in the control group were also then experiencing depression. The percentage experiencing depressi!e type symptoms during reco!ery peaked at IHC on day three, and ell to HHC <F points below their starting baseline= by day se!en. &ma)ingly, only /0C o ex-smokers were reporting depressi!e-type symptoms by day twenty-eight, just one percentage point abo!e the rate o non-smokers in the control group.H31 5t was once thought that those with depression smoked in order to sel -medicate. -ut new research is asking, $which came irst, nicotine addiction or depression.$ H3B 7e know that i nicotine replenishment is delayed, that an escalating sense o depression is part o each low elt between each nicotine ix, and accompanies increasing anxiety and rustration. 7e know that youth who take up smoking report increased le!els o anxiety, stress and depression, and ha!e reports rom adults who stop o $enduring mood impro!ements.$H/0 ,ope ully, education and sel -honesty will aid in more quickly putting any normal sense o loss blues behind you. This journey isn"t about gi!ing up anything o !alue. 5t"s about reco!ering the real us. &s re!iewed in Ehapter H, keep in mind that the real quitting took place when nicotine assumed control, when we lost the sense o normal that de ined how and what we elt while interacting with li e. 5t must also be noted that some nicotine users su er rom underlying organic depression that is both chronic <long-term= and signi icant. &s shown by 7ard, some may not sense impro!ement during reco!ery. &nd it"s possible that a ew may actually eel worse. The problem is in recogni)ing the di erence between organic depression and depression experienced a ter sensing a loss. Kne may need prompt medical treatment while the other is normal, expected and should soon pass. ,ow do we tell the di erence8
H31 7ard, ## et al, (el -reported abstinence e ects in the irst month a ter smoking cessation, &ddicti!e
-eha!iors, #ay-'une /003, Golume /F<H=, *ages H33-H/A. H3B Ru S, et al, &dolescent nicotine administration alters serotonin receptors and cell signaling mediated through adenylyl cyclase, -rain ?esearch, Kctober ., /00/, Golume BI3</=, *ages /10-/B/J also -oden '#, et al, Eigarette smoking and depression9 tests o causal linkages using a longitudinal birth cohort, -ritish 'ournal o *sychiatry, 'une /030, Golume 3BF<F=, *ages ..0-..F. H/0 *arrott &E, Eigarette-deri!ed nicotine is not a medicine, The 7orld 'ournal o -iological *sychiatry, &pril /00H, Golume .</=, *ages .B-II.
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(el -diagnoses can be dangerous. The best ad!ice 5 can gi!e is that i you sense you are experiencing depression that isn"t li ting, or your amily is noticing mood changes, get seen and e!aluated as soon as possible by your medical pro!ider or at the nearest emergency medical acility. >eep in mind that the physician"s depression treatment resources include scores o nonnicotine and non-addicti!e medications including 7ellbutrin <whose acti!e chemical is bupropion=, which is marketed as the stop smoking pill Syban. &lthough long-term results rom real-world cessation method sur!eys indicate that Syban is no more e ecti!e than reco!ery without it,H/3 including a /00F sur!ey by the ;.(. :ational Eancer 5nstitute,H// it doesn"t mean that bupropion does not bene it those experiencing depression. 5 also want to brie ly mention !arenicline, which is marketed in the ;.(. as Ehantix and elsewhere as Ehampix. &lthough we ha!e no reported case or medical journal article discussing anyone stopping cold turkey ha!ing e!er attempted suicide, on &pril 3, /001 the ;.(. Dood and Drug &dministration reported that9 $Ehantix has been linked to serious neuropsychiatric problems, including changes in beha!ior, agitation, depressed mood, suicidal ideation and suicide. The drug may cause an existing psychiatric illness to worsen, or an old psychiatric illness to recur. The symptoms may occur e!en a ter the drug is discontinued.$H/H 5 mention !arenicline or two reasons. Dirst, in arguments intended to help sal!age !arenicline rom the DD& recall chopping block, * i)er <the pharmaceutical company marketing !arenicline= has come dangerously close to suggesting that depression in those stopping cold turkey can become so great that they too commit suicide. Garenicline is what"s termed a partial agonist. 5t stimulates dopamine pathways !ia the same nicotinic-type acetylcholine receptors that nicotine would ha!e occupied, while at the same time blocking nicotine"s ability to occupy the receptor and induce stimulation. H/. -ut receptor stimulation by !arenicline is signi icantly less than with nicotine <HI to F0C=.H/I This reduced le!el o stimulation may be insu icient to keep some ha!ing certain pre-existing underlying disorders <such as depression or other mental health
H/3 Doran E#, et al, (moking status o &ustralian general practice patients and their attempts to quit, &ddicti!e
-eha!ior, #ay /00F, Golume H3<I=, *ages AI1-AFF, also see Derguson ', et al, The 6nglish smoking treatment ser!ices9 one-year outcomes, &ddiction, &pril /00I, Golume 300 (uppl /, *ages IB-FB Osee Table FP H// ;npublished /00F ;.(. :ational Eancer 5nstitute (ur!ey o 1,/00 quitters, as reported in the 7all (treet 'ournal, *age &3, Debruary 1, /00A H/H ;.(. Dood and Drug &dministration, DD& *atient (a ety :ews, :ew (a ety 7arnings &bout Ehantix, (how NA., &pril /001 H/. * i)er, Ehantix Dull *rescribing 5n ormation, #ay /001, www.Ehantix.com H/I Eoe '7, et al, Garenicline9 an alpha.beta/ nicotinic receptor partial agonist or smoking cessation, 'ournal o #edicinal Ehemistry, #ay /00I, Golume .1<30=, *ages H.A.-H.AA.
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disorders= rom experiencing the onset o serious depression and/and beha!ioral changes. The problem is that !arenicline"s elimination hal -li e is /. hours.H/F 5t means that e!en i the user reali)es that the medication is a ecting mood or beha!ior, that e!en i they stop taking !arenicline immediately that they"ll only reduce its in luence by hal a ter a ull day without it. (o long as !arenicline"s stimulation blocking e ects remain present, could it be that or some small percentage o users, that the only way they see to bring their su ering to an end is to contemplate ending li e itsel 8 5t"s only one theory. 7e don"t yet know. The :ational 5nstitute o ,ealth maintains the www.*ub#ed.go! website, which indexes and allows searching o the summaries <abstracts= o nearly all medical journal articles and studies. #y 'une 3., /03/ search o the term $smoking cessation$ returned //,0./ papers, while a search o $suicide$ identi ied IF,H.I. -ut when the two terms were combined into a single search <$smoking cessation$ U suicide= only F3 papers were returned, nearly all associated with cessation medications. 5 could not locate a single research paper documenting that anyone going cold turkey had e!er attempted suicide. The brains o those going cold turkey do not contain any chemical such as !arenicline with a /.-hour elimination hal -li e, pre!enting their nicotinic-type acetylcholine receptors rom being stimulated naturally. &lso, no chemical was present pre!enting their brain rom re-sensiti)ing receptors and down-regulating their numbers to le!els seen in non-smokers. &s an a!enue o last resort, e!en i they were to begin eeling the e ects o untreated chronic organic depression, there was no chemical pre!enting stimulation. 7hat we know with certainty is that smokers attempt to break nicotine"s grip upon their mind in order to sa!e and extend their li e, not end it. 5 eeling o!erwhelmed by eelings o depression and sadness get help immediately@ Mo to the nearest emergency medical acility i necessary. Mi!en proper treatment, there is absolutely no e!idence that anyone with a mental health condition - including chronic depression - cannot break ree rom nicotine too. 0oneline$$ or :eeling Cooped 4p
H/F * i)er, Ehantix Dull *rescribing 5n ormation, #ay /001, www.Ehantix.com
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&kin to the $sense o loss$ elt with depression, loneliness is natural anytime we lea!e behind a long-term companion, e!en i a super-toxin. 5t"s time we gi ted oursel!es a new companion, a healing and healthier $us@$ Elimb rom the deep, deep rut we once called home and taste the la!or o nicotineree li e. #any o us smokers se!erely limited the acti!ities we were willing to engage in, either because they either were too long and inter ered with our ability to smoke nicotine, or because our body could not muster the stamina needed to do them, due to carbon monoxide"s our-hour hal -li e robbing our blood o the ability to recei!e and transport oxygen. %onely8 Met to know the gradually emerging you. Elimb rom the ditch, alter your outlook and head in directions once a!oided. 5 able, consider pushing your body a bit harder than normal and sampling the healing within. Kne o the most satis ying aspects o reco!ery can be exploring li e as an ex-user. Elimb out, look around, sa!or and enjoy. <ncre $ed !ppetite, 7unger, nd Weight E in 5t"s easy to attribute a new ound desire to consume large quantities o additional ood to rapidly healing taste buds and a re!i!ed sense o smell. Truth is, most in early reco!ery reach or extra calories and or a host o reasons. 7hether using extra ood as a hand-to-mouth oral substitute crutch, an attempt to satis y wanting or nicotine by satis ying non-existent wanting or ood, or because you"re still learning to eed yoursel now that nicotine is no longer eeding you !ia your body"s ight or light response, the net e ect is the same, extra body weight. 4es, the oundation o our dependency was nicotine"s ability to release dopamine and brie ly end wanting. &nd yes, an extra mouth ul o ood will pro!ide a small and shortli!ed burst o dopamine. -ut re lect on how many times or how long each day that you used nicotine. :ow, re lect on the eating patterns and habits that using ood as a replacement crutch so many times daily might tend to establish. Disastrously, should relapse occur, the pounds are likely to remain. 7hat will remain is a larger addict in need o bigger clothing, a larger person or whom exercise will be more challenging than e!er. 5n regard to eating, it takes a bit o practice to re-learn to properly uel the body once nicotine is no longer our spoon.
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5nstant li!er to bloodstream eedings are gone. :ormal people ha!e to allow time or digestion be ore hunger ully subsides. *ractice eating a bit more slowly as mouth en)ymes are designed to accelerate digestion. &nother weight gain possibility is to intentionally in!ite weight gain in order to justi y relapse. 5t"s an addict"s ploy to get their drug back. ,a!ing outgrown their entire wardrobe and now wearing bedsheets, it"s a relapse excuse that"s easy to sell to themsel!es and their lo!ed ones. 6!en without extra ood, it is common to see H to I pounds o weight gain during the irst week due to water retention associated with physiological changes.H/A 5 so, they are pounds easily and quickly lost as water retention returns to normal within two weeks. 7hile true that minor metabolism changes can account or a ew extra unburned calories each day <a slower beating heart= they can be easily o set by enhanced cardio!ascular abilities resulting rom healing that includes a signi icant increase in o!erall lung unction. :ot smoking or using oral nicotine does not cause weight gain, eating does. #any o us reached or a cigarette or oral nicotine to mark the end o our meals. 5t was a conditioned signal to our brain that eating was o!er and our meal complete. ;pon cessation, this cue no longer exists. 5ts absence may lead to continued eating a ter our normal meal would ha!e ended. 7e may need to ind a new cue that our meal is o!er. & toothpick, walk, brushing our teeth, doing the dishes, a stick o sugarless gum, or e!en a nice extra deep breath may be all it takes. 6scalating weight gain can gradually errode reco!ery moti!ation to the point o making a I0C chance o losing 3H to 3. years o li e look more appealing than another pound. 5 you should ind yoursel reaching or ood as a temporary early oral substitute <which is :KT recommended=, reach or healthy, low calorie oods like resh !egetables. &lso consider that 3/ o 3I studies since /00F ha!e ound that exercise reduces smoking cessation cra!ings.H/1 (till, 5 encourage you to accept early on that should some initial $temporary$ weight gain occur that the extra pounds are acceptable. >eep in mind that a emale smoker who is F. inches tall <3FHcms= would need to gain BH
H/A :ational 5nstitutes o ,ealth, 4ou Ean Eontrol 4our 7eight as 4ou Luit (moking, :5DD>, Dederal Eiti)en
5n ormation Eenter o the ;.(. Meneral (er!ices &dministration, web page !isited &ugust /F, /001 http9//www.pueblo.gsa.go!/cicXtext/health/w1quit-smoke/N3 H/1 ?oberts G, et al, The acute e ects o exercise on cigarette cra!ings, withdrawal symptoms, a ect, and smoking beha!iour9 systematic re!iew update and meta-analysis, *sychopharmacology <-erlin=, 'uly /03/, Golume ///<3=, *ages 3-3I. 6pub /03/ #ay 3I.
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pounds <./kg= be ore experiencing the ele!ated risk o chronic heart disease generated by smoking <see $(moking, body weight, and E,D mortality in di!erse populations$ /00.=. &lso, while a /00B study ound a!erage cessation weight gain o H kg or women and I kg or men, it also ound $no signi icant di erences in weight gain o!er the 33-year period existed between ne!er smokers and ormer smokers who had stopped at least i!e years ago.$H/B 7ould we rather be slightly bigger and ali!e or a tad smaller but dead8 5s li e worth a ew extra pounds8 &bsolutely. There will be plenty o time later to shed them, and i you were a smoker, the bene its o enhanced physical endurance will increase your ability to do so. /rou'le ;leeping or <n$omni :icotine is a ner!ous system stimulant known to a ect subconscious thought. (ome e!idence suggests it alters 66M monitored brain wa!es during sleep,HH0 and diminishes the percentage o deep ?6# sleep <our high quality sleep= while increasing ?6# dream imagery.HH3 Kur sleep"s sense o $nicotine normal$ can become disrupted and $sleep ragmentation$ is not unusual. Mradually, new or pre-nicotine sleep patterns will emerge. K!er time we may ind that we don"t need nearly as much sleep as we did while using, or we may ind that our body requires more. Take a close look at ca eine intake i sleep is disrupted. :icotine somehow doubles the rate by which the body eliminates ca eine.HH/ During reco!ery, with no nicotine in the bloodstream to accelerate ca eine elimination, i we continue to consume the same amount o ca eine, we should expect to ind twice as much circulating in our bloodstream. 5 you normally drink a cola be ore going to bed imagine now eeling the e ects o two. 5 you can handle doubling your normal ca eine intake without disrupting sleep then this isn"t an issue.
H/B ?eas D%, et al, Do quitters ha!e anything to lose8 Ehanges in body mass index or daily, ne!er, and ormer smokers o!er an 33-year period <3BB0--/003=, (candina!ian 'ournal o *ublic ,ealth, (eptember /00B, Golume HA<A=, *ages AA.-AAAA. 6pub /00B &ug A. HH0 Shang %, *ower spectral analysis o 66M acti!ity during sleep in cigarette smokers, Ehest, Debruary /001, Golume 3HH</=, *ages ./A-.H/. HH3 *age D et al, The e ect o transdermal nicotine patches on sleep and dreams, *hysiology and -eha!ior, 'uly /00F, Golume H0J11<.-I=, *ages ./I-.H/J also see ;nderner # et al, Eigarette smoking and sleep disturbance <article in Drench=, ?e! #al ?espir. 'une /00F, Golume /H<H (uppl=, *ages F(FA-F(AA. HH/ (wanson '&, et al, The impact o ca eine use on tobacco cessation and withdrawal, &ddicti!e -eha!ior, 'anDeb 3BBA, Golume //<3=, *ages II-F1.
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-ut i not, or i a hea!y user, consider a reduction o up to one-hal o your normal ca eine intake to a!oid o!er-stimulation. ?elaxation through mind clearing and slow deliberate breathing can help induce sleep. #ental relaxation can be as simple as slowly clearing our mind o all other thoughts by ocusing exclusi!ely on a single object or color. 5 sleep continues to be ragmented or is a ecting your health, sa ety or per ormance, turn to your physician or pharmacist or assistance. There are many sleeping aids a!ailable. Don"t allow sleep disruption to become another lame excuse to sabotage reco!ery and destroy your reedom. Che$t /ightne$$ &lthough rarely mentioned in symptom studies, it isn"t unusual to hear chest tightness complaints during early reco!ery. 7hether arising rom tension, stress, depression or somehow related to coughing, lung healing, or lung disease, be care ul as chest tightness can also be a sign o more serious health problems, including serious heart conditions. 5 at all concerned, pick up the phone and contact your doctor. 5 related to anxiety or tension, it may bene it rom relaxation exercises, a warm shower, slow deliberate breathing or moderate exercise. ;lightly ;ore Mouth or /hro t (tudy results are mixed on whether reco!ery actually causes sore throats. 4ears o tobacco use clearly damaged and irritated tissues. *ower ul toxins numbed them to tobacco"s daily assaults. &s tissues re-sensiti)e and heal they may eel temporarily irritated. 5 so, ice or cool liquids may pro!ide soothing and cough drops may generate moisture and temporary relie rom minor discom ort. -ut as a site o other more serious diseases, i mouth or throat pain or discom ort persists, the smart mo!e is to get seen and ha!e it medically e!aluated. Coughing, Mucu$ or . $ l #rip &ccording to the 7ard study, roughly F0C in reco!ery reported coughing on day two, .1C by day se!en, HHC by day ourteen, and 3IC by day twenty-eight.HHH Eonsider
HHH 7ard, ## et al, (el -reported abstinence e ects in the irst month a ter smoking cessation, &ddicti!e
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making an appointment to ha!e a thorough check-up i still coughing a ter ha!ing stopped smoking or one month. & chronic cough can be a warning sign o disease, including lung cancer. & thorough examination that includes a simple chest x-ray can bring piece o mind. Met seen immediately should a cough e!er produce blood in sputum. Eilia are microscopic hair-like projections that line nasal passages, our windpipe <trachea= and bronchial tubes. Eilia inside lung bronchial tubes linking air sacs <al!eoli= to our windpipe oscillate in unison at a rate between I to 33 cycles per second. HH. They act as a wa!e-like broom or slow mo!ing carpet that sweeps secreted mucus, containing trapped contaminants, up and out o our lungs.HHI Tobacco toxins in lict extreme damage on, and near total destruction o , a smoker"s cilia. 5t results in roughly I0C de!eloping a chronic cough <chronic bronchitis=, as in lamed bronchial tubes and lungs ight to expel trapped mucus containing pathogens, toxins and particulate. The good news is that within three days o commencing reco!ery our cilia begin regenerating and within six months they"!e ully reco!ered.HHF They will soon be engaged in cleaning and clearing gunk rom the lungs. 4ears o tar build-up are loosening. (ome will be spit out in phlegm or mucus but most will be swallowed. #ucus and coughing are common, yet according to the 7ard study many experience neither. Elearly our lungs will bene it rom luids to aid with cleansing and healing. &lthough the $1 x 1$ water drinking rule is under attack or not ha!ing any studies to back it <drinking 1 ounces o water 1 times daily=,HHA as o ten said, $absence o e!idence is not e!idence o absence.$ 5ce can sooth and moisten healing tissues. Eough syrups or decongestants may also bring temporary relie rom coughing or irritation. -ut, again, do not hesitate to get seen should your cough persist.
-eha!iors, #ay-'une /003, Golume /F<H=, *ages H33-H/A. HH. (elwyn D&, et al, & per usion system or in !itro measurement o human cilia beat requency, -ritish 'ournal o &naesthesia, 'anuary 3BBF, Golume AF<3=, *ages 333-33I O..F cycles per secondPJ also see, Elary-#eines) E, et al, Eiliary beat requency in human bronchi and bronchioles, Ehest, #arch 3BBA, Golume 333<H=, *ages FB/FBA O33 cycles per secondP. HHI (tannard 7, Eiliary unction and the role o cilia in clearance, 'ournal o &erosol #edicine, (pring /00F, Golume 3B<3=, *ages 330-33II. HHF (pit)er, ', (moking"s 5mpact on the %ungs, /003, 7hyLuit.com, 'oel"s %ibrary. HHA Galtin ,, $Drink at least eight glasses o water a day.$ ?eally8 5s there scienti ic e!idence or $1 x 1$8 &merican 'ournal o ?egulatory, 5ntegrati!e and Eomparati!e *hysiology, :o!ember /00/ :o!, Golume /1H<I=, *ages ?BBH-300..
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&lthough destroyed lung air sacs can ne!er be replaced, those not yet destroyed clean up nicely. 5t isn"t uncommon to see a signi icant increase in lung unction within six months.HH1 5 couldn"t run /00 eet while still smoking and thought 5"d ne!er do so again. 7ith early emphysema, it isn"t like 5"m some big runner now. -ut 5 do run-walk a ew hundred eet at a time at least weekly and 5"m not nearly as winded when the running stops and the walking phase starts. 5 thought 5"d destroyed these lungs beyond repair. wrong. A d Are th nd . $ty / $te$ 4our healed sense o smell and taste may ind the horrible odors and tastes rising-up rom healing lungs or oo)ing rom tobacco marinated gums and mouth tissues disgusting. Muess what8 This is what it was like inside your mouth e!ery day while still using. 5t was just that our senses were so dulled by tobacco toxins that we couldn"t notice. *icture layer a ter layer o cells slowing dying and being replaced. Depending upon how long, requently and intensely we used tobacco, it could take signi icant time or these tastes and odors to ully dissipate. Time, oxygen rich blood, and luids will keep mouth, nasal, throat and respiratory tissues on the road to maximum reco!ery. -rushing a bit more requently and mouthwash should help control odors released rom slowly healing tissues. Aleeding Eum$ Mum bleeding is not unusual during reco!ery. &side rom the impact o brisk brushing that attempts to whiten tar stained teeth, our gums are eeling the impact o tobacco and nicotineree li!ing. (urprisingly, like ne!er-users, the ex-user"s gums are more prone to bleeding, not less. :icotine is a !asoconstrictor that actually constricts and diminishes blood low. 5t"s thought that this may account or smokers ha!ing thicker gum tissues.HHB &ccording to a /00. study, the gingi!al <gum= blood low rate is $signi icantly higher at H days$ into reco!ery. 7ithin I days the liquid sticky plasma proteins normally released by
HH1 -uist &(, The e ect o smoking cessation and modi ication on lung unction, The &merican ?e!iew o ?espiratory Disease, 'uly 3BAF, Golume 33.<3=, *ages 33I-3//. HHB Gillar EE et al, (moking in luences on the thickness o marginal gingi!al epithelium, *esqui Kdontol -ras. 'an-#arch /00H, Golume 3A<3=, *ages .3-.I.
(ometimes it"s wonder ul being
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healthy gums ha!e signi icantly increased and within / weeks are comparable to those o non-smokers.H.0 -ut i it takes a bit o bleeding to begin gradually re!ersing the risk o experiencing /.0C greater tooth loss than a non-smoker,H.3 so be it. Eall your dentist i at all concerned about gum bleeding. 7e d che$ :o study has yet identi ied headaches as a signi icant reco!ery concern. 7hile the 7ard study notes a slight day-three increase, it also pro!ides e!idence that reco!ery may actually reduce headaches. 5t ound that HHC o smokers reported ha!ing headaches immediately be ore commencing reco!ery. 5nterestingly, those reporting headaches peaked on day three <A/ hours= at ..C, dropped to 3AC on day se!en, and declined to a low o just 33C by day ourteen.H./ 7ard"s inding o greater incidence o headaches in acti!e smokers is supported by other studies, which suggest nicotine, a known !asoconstrictor, as a primary culprit. H.H Gasoconstriction is the narrowing o blood !essels with restriction or slowing o blood low, caused by contraction o the !essel"s muscular wall.H.. Knce nicotine"s arri!al ends, brain blood-oxygen and carbon monoxide le!els are restored to normal within twel!e hours. (hould a day three headache occur, keep in mind that according to the ;.(. :ational 5nstitutes o ,ealth, $the most common type o headache is a tension headache. Tension headaches may be due to tight muscles in our shoulders, neck, scalp and jaw. They are o ten related to stress, depression or anxiety.$H.I ?elaxation and slow deep breathing, rest, mind clearing with thought ocusing exercises, a warm bath or shower, or physical exercise may help relie!e tensions and bring relie . &spirin and a host o other o!er-the-counter headache medications are a!ailable.
H.0 #oro)umi T et al, (moking cessation increases gingi!al blood low and gingi!al cre!icular luid, 'ournal o
Elinical *eriodontology, &pril /00., Golume H3<.=, *ages /FA-/A/. H.3 >rall 6&, (moking, smoking cessation, and tooth loss, 'ournal o Dental ?esearch, Kctober 3BBA, Golume AF<30=, *ages 3FIH-3FIB. H./ 7ard, ## et al, (el -reported abstinence e ects in the irst month a ter smoking cessation, &ddicti!e -eha!iors, #ay-'une /003, Golume /F<H=, *ages H33-H/A. H.H *ayne T', The impact o cigarette smoking on headache acti!ity in headache patients, ,eadache, #ay 3BB3, Golume H3<I=, *ages H/B-HH/. H.. :ational 5nstitutes o ,ealth and ;.(. :ational %ibrary o #edicine, Gasoconstriction, #edline *lus, #edical 6ncyclopedia, web page updated 'anuary //, /00A, http9//nlm.nih.go!/#6D%5:6*%;(/ency/article/00/HH1.htm H.I :ational 5nstitutes o ,ealth and ;.(. :ational %ibrary o #edicine, ,eadache, #edline *lus, #edical 6ncyclopedia, web page updated 'uly 31, /001, http9//www.nlm.nih.go!/medlineplus/headache.html
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. u$e :ausea is $an uneasy or unsettled eeling in the stomach together with an urge to !omit. ;sually it isn"t serious and bene its by a!oiding solid oods or at least six hours.$H.F The 7ard study ound that 3FC reported nausea on day one, as compared to /C at precessation baseline. The rate dropped to 33C on day three, 3FC on day se!en, BC at two weeks, and .C on day twenty-eight. -ut take heart, HAC o Ehantix and Ehampix users report nausea, and in some cases its se!ere.H.A Con$tip tion & /00H study ound that one in six new ex-smokers de!eloped constipation and that in one in ele!en the problem became se!ere <$!ery or extremely constipated$=. 5t ound that constipation le!els peaked at about two weeks.H.1 &ccording to a /00F study, nicotine interacts with digesti!e tract smooth muscle contractions <peristalsis=. The digesti!e system needs time to adjust to unctioning naturally without it. -ut constipation is correctable and we need not su er. The article indicates that $magnesium salts are the irst-line treatment or this problem. 5 they ail, neostigmine, an anticholinesterase with parasympathomimetic acti!ity, appears remarkably e ecti!e in correcting this disorder.$H.B &side rom adjusting to nicotine"s absence, what other actors contribute to constipation8 &ccording to the ;.(. :ational 5nstitutes o ,ealth <:5,= $the most common causes o constipation are poor diet and lack o exercise.$ ?egarding diet, it"s caused by $a diet low in iber or a diet high in ats, such as cheese, eggs, and meats.$HI0 &side rom more iber, less ats and increased acti!ity, the :5, recommends plenty o
H.F :ational 5nstitutes o ,ealth and ;.(. :ational %ibrary o #edicine, :ausea and Gomiting, #edline *lus,
#edical 6ncyclopedia, web page updated 'uly /1, /001, http9//www.nlm.nih.go!/medlineplus/nauseaand!omiting.html H.A &ubin ,', et al, Garenicline !ersus transdermal nicotine patch or smoking cessation9 results rom a randomised open-label trial, Thorax, &ugust /001, Golume FH<1=, *ages A3A-A/.. H.1 ,ajek *, et al, (topping smoking can cause constipation, &ddiction, :o!ember /00H, Golume B1<33=, *ages 3IFH-3IFA. H.B %agrue M, et al, (topping smoking and constipation, O&rticle in DrenchP, *resse #edicale, Debruary /00F, Golume HI</ *t 3=, *ages /.F-/.1. HI0 :ational 5nstitutes o ,ealth, Eonstipation, :5DD>, :5, *ublication :o. 0A-/AI., 'uly /00A, http9//digesti!e.niddk.nih.go!/ddiseases/pubs/constipation/
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water, juice or other liquids ree o alcohol and ca eine, which may worsen constipation. $%iquids add luid to the colon and bulk to stools, making bowel mo!ements so ter and easier to pass.$ $&s ood mo!es through the colon, the colon absorbs water rom the ood while it orms waste products, or stool,$ explains :5,. $#uscle contractions in the colon then push the stool toward the rectum. -y the time stool reaches the rectum it is solid, because most o the water has been absorbed.$ $Eonstipation occurs when the colon absorbs too much water or i the colon"s muscle contractions are slow or sluggish, causing the stool to mo!e through the colon too slowly. &s a result, stools can become hard and dry,$ writes :5,. 7hy extra iber8 $Diber is the part o ruits, !egetables, and grains that the body cannot digest,$ says :5,. $(oluble iber dissol!es easily in water and takes on a so t, gel-like texture in the intestines. 5nsoluble iber passes through the intestines almost unchanged. The bulk and so t texture o iber help pre!ent hard, dry stools that are di icult to pass.$ :5, de ines $constipation$ as $ha!ing a bowel mo!ement ewer than three times per week.$ &ccording to :5,, $some people think they are constipated i they do not ha!e a bowel mo!ement e!ery day. ,owe!er, normal stool elimination may be three times a day or three times a week, depending on the person.$ Eonsult your physician or pharmacist and obtain relie should constipation concerns arise. Phy$ic l : tigue .ot ;ymptom The majority o studies conclude that physical atigue is not a normal withdrawal symptom.HI3 5n act, exercise induced atigue has been ound to be a symptom o smoking.HI/ The body is shedding the e ects o years o dependence upon a stimulant. 5 anything, the body is working less not more. 7e experience a metabolism reduction. Kur heart beats slower, our breathing becomes shallower and our body is no longer eeling the e ects o , and working to expel, an endless stream o arri!ing toxins. 7hile early reco!ery may lea!e us eeling emotionally drained, physically we should soon be eeling much better with more energy than we"!e elt in years.
HI3 ,ughes, '?, 6 ects o abstinence rom tobacco9 Galid symptoms and time course, :icotine + Tobacco
?esearch, #arch /00A, Golume B<H=, *ages H/3I-H/A. HI/ ,ughes '?, et al, *hysical acti!ity, smoking, and exercise-induced atigue, 'ournal o -eha!ioral #edicine, 'une 3B1., Golume A</=, *ages /3A-/H0.
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5t is not normal to eel physically tired or atigued. 5 it occurs, get seen and ind out why. Po$$i'le Medic tion !dCu$tment$ &s noted, tobacco, both oral and smoked, contains thousands o chemicals, some o which may ha!e interacted with medications we were takings. $K ten when people stop smoking they may ind that medications that were adjusted or them while smoking may be altered in e ecti!eness,$ writes 'oel.HIH $*eople on hypertensi!es, thyroid, depression, blood sugar drugs, and others may need to get re-e!aluated or proper dosages.$ $The irst ew days, it can be di icult telling the di erence between "normal" withdrawal symptoms and medication dosage issues,$ notes 'oel. $-ut once through the irst ew days, i a person who is on medications or medical disorders inds him or hersel ha!ing physical symptoms that just seem out o the ordinary, he or she should speak to the doctor who has him or her on the medications.$ $*oint out to the doctor that you ha!e recently stopped smoking and started to notice the speci ic symptoms just a ter stopping, and that they ha!en"t impro!ed o!er time.$ Don"t think only in terms o new symptoms. Kld symptoms can disappear. During a /001 question and answer session be ore roughly /00 inmates in a woman"s prison that had recently gone tobacco- ree, one woman in the back raised her hand. $4es mam, your question.$ $5 don"t ha!e a question but a comment,$ she replied. $5 knew this policy change was coming so 5 stopped a month ago. &t the time, 5 was on eight di erent medications or my heart, blood pressure, hypertension, cholesterol and breathing. :ow 5"m down to just two.$ & big cheer went up. >ey to quality and e ecti!e medical treatment is e ecti!e communication between patient and physician. -e sure to accurately describe any symptoms, when they were irst elt, how requently they occur, how long they last, what aggra!ates them and the medications you"!e been taking. & complete picture will greatly aid our doctor in determining whether there is a need to increase, decrease, change or discontinue medications. Po$$i'le 4nderlying 7idden Condition$ (tay alert or the possibility o medical conditions were being masked and hidden by your dependency.
HIH (pit)er, ', #edication &djustments, 'uly 3B, /003, http9//www. n.yuku.com/topic//H03A
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The oral tobacco user introduces more than /,II0 chemicals into their body.HI. & burning cigarette gi!es o more than .,000. & mini-pharmacy, these chemicals were capable o hiding a host o medical conditions, including some caused by tobacco use. Kne that could be noticed with the irst A/ hours is di iculty breathing. 24 y am . aving trouble breat ing2" ".t$s li%e . need to %eep breat ing in deep+ breat after breat after breat .2 ?arely a day passes in o!erseeing our 5nternet sites <7hyLuit, 'oel"s %ibrary, Dreedom and our Dacebook group= without someone in!iting us to play 5nternet doctor. &lthough well intended, 5 am a cessation educator who teaches reco!ery, including symptom possibilities. 5 am not a trained and skilled physician, quali ied to e!aluate, diagnose and treat actual conditions. 6!en though the symptom being described may sound like normal reco!ery, how could 5 possibly know the actual cause8 5"d be guessing. Di iculty breathing or shortness o breath is not normal. (till, such concerns are not uncommon. 7hen 5 hear them, my initial thoughts are outrage and sadness. This could be a smoking induced breathing disorder that until now tobacco industry cigarette engineering had kept hidden rom them. -ut again, 5"d just be guessing. 5nstead, 5 tell them it isn"t normal, that they need to get seen by a doctor as soon as possible. ,ow wrong and damaging could guessing be8 (hortness o breath can be caused by $lung disease, asthma, emphysema, coronary artery disease, heart attack <myocardial in arction=, interstitial lung disease, pneumonia, pulmonary hypertension, rapid ascent to high altitudes with less oxygen in the air, airway obstruction, inhalation o a oreign object, dust-laden en!ironments, allergies <such as to mold, dander, or pollen=, congesti!e heart ailure <E,D=, heart arrhythmias, de-conditioning <lack o exercise=, obesity, compression o the chest wall, panic attacks, hiatal hernia, or gastroesophageal re lux disease <M6?D=.HII *ossible hidden conditions aside, what are the odds o someone in the irst ew days o reco!ery de!eloping pneumonia or noticing a hiatal hernia8 -ut ne!er-users de!elop
HI. ;.(. (urgeon Meneral, ?educing the ,ealth Eonsequences o (moking9 /I 4ears o *rogress9 & ?eport o the (urgeon Meneral9 3B1B, *age AB. HII :ational 5nstitutes o ,ealth and ;.(. :ational %ibrary o #edicine, -reathing di iculty, #edline *lus, #edical 6ncyclopedia, web page updated &pril 3/, /00A, http9//nlm.nih.go!/medlineplus/ency/article/00H0AI.htm
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hernias too. They also catch colds, the lu and get sick. ?emain mind ul that a coincidental illness or other condition could occur during reco!ery. Ean cigarette engineering contribute toward hiding symptoms o early asthma or emphysema8 &lthough disputed by the tobacco industry, it"s reported that cocoa may cause cigarette smoke to act as a breathing nebuli)er.HIF & chemical within cocoa, theobromine, is known to relax airway muscles and expand bronchial tubes. 5t"s suggested that this might allow more nicotine-laden smoke to penetrate deeper and aster, resulting in a bigger hit or bolus o nicotine assaulting brain dopamine pathways sooner. 5n theory, this could keep the user loyal to their brand and coming back or more. &ccording to *hilip #orris, maximum concentrations o cocoa can be up to IC. Theobromine within cocoa accounts or /.FC o its weight. 5 a cigarette contains IC cocoa it also contains up to 3 milligram o theobromine.HIA The tobacco industry knows that cigarette smoking constricts lung bronchial tubes,HI1 that theobromine relaxes bronchial muscles, and that in competition against theophylline, a chemical used in breathing nebuli)ers, theobromine compared a!orably in impro!ing breathing in young asthma patients.HIB -ut *hilip #orris argues that it is $unlikely$ theobromine in cocoa added to cigarettes can produce $a clinically e ecti!e dose.$HF0 Knce secret industry documents e!idence ongoing industry monitoring o both cigarette cocoa and licorice extract le!els or at least three decades. %icorice extract contains glycyrrhi)in which some contend is another means by which cigarettes act as bronchodilators. -ut *hilip #orris says its research shows that licorice extract is $pyroly)ed extensi!ely$
HIF &(,, Tobacco &dditi!es, cigarette engineering and nicotine addiction, 'uly 3., 3BBB,
http9//old.ash.org.uk/html/regulation/html/additi!es.htmlJ as brought to my attention by (chwart), %, $ 5"m an &DD5ET@ ,ooray@$ #arch /, /00/, http9//www. n.yuku.com/topic/33I HIA *hilip #orris ;(&, T#& *resentation on Eocoa to the Department o ,ealth, Earmines, Kctober 31, 3BBB, -ates N/I0II/00IA HI1 ,artiala ', et al, Eigarette smoke-induced bronchoconstriction in dogs9 !agal and extra!agal mechanisms, 'ournal o &pplied *hysiology, Kctober 3B1., *ages 3/F3-3/A0. HIB (imons D6, The bronchodilator e ect and pharmacokinetics o theobromine in young patients with asthma, The 'ournal o &llergy and Elinical 5mmunology, :o!ember 3B1I, Golume AF<I=, *ages A0H-0AA. HF0 *hilip #orris ;(&, T#& *resentation on Eocoa to the Department o ,ealth, Earmines, Kctober 31, 3BBB, -ates N/I0II/00IA
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<decomposed due to heat=, by the up to B00-degree temperatures ound in cigarettes. HF3 &lthough additi!es ha!e likely changed signi icantly since 3BAB, a -rown + 7illiamson report then documented that cigarette brands containing more than 0.IC cocoa included9 -elair, -enson + ,edges, Eamel %ights, Doral, >ool (uper %ights, #arlboro %ights, #erit, :ow, (alem %ights, Tareyton %ights, Gantage, Giceroy %ights and 7inston %ights. -rands then containing more than 0.IC licorice included9 -elair, -enson + ,edges, Eamel %ights, #arlboro %ights, #erit, *arliament, *all #all %ights, (alem %ights, Tareyton %ights, Gantage, Giceroy %ights and 7inston %ights.HF/ Kther possible once hidden health conditions include thyroid problems masked by iodine in tobacco, HFH chronic depression masked by nicotine,HF. and ulcerati!e colitis, also somehow suppressed, hidden or controlled by nicotine.HFI ?emember, nicotine is not medicine. 5t is a natural poison. Cele'r ting /wo Wee($ o1 7e ling@ &s seen, nearly all symptoms o physical reco!ery resol!e within two weeks. &s or brain dopamine pathway unction, yes, there"s likely another week or so o ongoing ine tuning o the number o acetylcholine receptors needed to achie!e balance and normalcy. -ut any remaining adjustment is minor in comparison to the healing completed. 7hile the body"s physical readjustment is all but complete, the scars o use remain and deep tissue healing, cleansing and repair will be ongoing or years. Dor example, while our sense o smell and taste ha!e mended, the a ter-e ects o years o marinating tissues in thousands o tobacco chemicals may linger or weeks. The beauty o two weeks is that our physical addiction is no longer doing the talking. K!erall, we"!e progressed ar enough that we begin sampling what it means to be ree. &nd the massi!e dependency lie we each li!ed is now ar easier to see. 7hile thousands o old nicotine replenishment memories continue to declare that use satis ies wanting, by now truth is becoming clearer. -y now, increasing periods without
HF3 Earmines 6%, Toxicologic e!aluation o licorice extract as a cigarette ingredient, Dood and Ehemical
Toxicology, (eptember /00I, Golume .H<B=, *ages 3H0H-3H//. HF/ -rown + 7illiamson Tobacco Eorporation, Eocoa + %icorice Eontents o Eompetiti!e ,i-Di Eigarettes, 'une 3/, 3BAB, -ates NF10//.H3B HFH Gejbjerg *, The impact o smoking on thyroid !olume and unction in relation to a shi t towards iodine su iciency, 6uropean 'ournal o 6pidemiology, /001, Golume /H<F=, *ages ./H-./B. HF. Eo!ey %(, et al, #ajor depression ollowing smoking cessation, &merican 'ournal o *sychiatry, Debruary 3BBA, Golume 3I.</=, *ages /FH-/FI. HFI %akatos *%, et al, (moking in in lammatory bowel diseases9 good, bad or ugly8 7orld 'ournal o Mastroenterology, December 3., /00A, Golume 3H<.F=, *ages F3H.-F3HB.
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wanting begin suggesting that the only path to bringing nicotine use wanting to a permanent and lasting end is the one now tra!eled. 7e"!e gi ted oursel!es a nicotineree body. The body"s readjustment period is nearly complete. -y now, the !ast majority o subconscious use cues ha!e been extinguished, and our emotional readjustment is well under way. &nd, the number o wanting- ree minutes each day continues to grow. Kur body has adjusted to unctioning without nicotine and we"re standing on our own. 7hether measurable or not, whether appreciated or not, with each passing day the challenges continue to grow ewer, generally less intense and shorter in duration <see Ehapter 3H comments o A/ ex-users=. &lthough nicotine assaults ha!e ended and normal unction has been restored, the scars o the paths and tracks taken by nicotine ha!e been permanently burned and etched into our brain. There"s only one way to ensure that those paths and tracks are ne!er tra!eled by nicotine again. There"s only one way to guarantee that our mind"s priorities circuitry is ne!er hijacked, so as to place nicotine on a par with ood again. :o nicotine today@
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%motion l Reco"ery
Deelings re lect awareness o
our emotions stirring within. The structure and unction o these beauti ul minds blend and melt subconscious and conscious awareness to create an emotional richness that ri!als the stars.
4et, i the only emotions remaining were those untouched by our addiction, our mind"s un eeling night sky would be empty and dark. That isn"t to say that as nicotine addicts we didn"t ha!e emotionally rich, ull and meaning ul li!es. 5t"s that, to !arying degrees and requency our addiction in ected e!ery emotion. ?ising and alling blood-serum le!els o the psychoacti!e chemical nicotine impacted not only dopamine but a host o neuro-chemicals a ecting eelings, emotions and mood, including9 serotonin, norepinephrine, acetylcholine, gamma-aminobutyric acid and glutamate.HFF :icotine dependency is associated with anxiety and mood related disorders.HFA ?esearch shows that the user"s mood impro!es a ter their irst nicotine ix each day. The more badly in need o nicotine the greater the impro!ement. #ood scores are lower in users than non-users throughout the day, with delayed and lower peaks, and decreased subjecti!e eelings compared to non-users.HF1 6motion can be broken down into three o!erlapping categories9 <3= primary emotions, </= secondary emotions and <H= background emotions.HFB *rimary human emotions include surprise, ear, anger, joy, sadness and disgust. HA0 The common thread is that each re lects an almost instant reaction as seen in acial expressions, with no processing or routing inside the rontal lobe o the brain <the
HFF Luattrocki 6, et al, -iological aspects o the link between smoking and depression, ,ar!ard ?e!iew o *sychiatry, (eptember /000, Golume 1<H=, *ages BB-330J also see (lotkin T& and (eidler D', :icotine exposure in adolescence alters the response o serotonin systems to nicotine administered subsequently in adulthood, De!elopmental :euroscience, /00B, Golume H3<3-/=, *ages I1-A0. .
HFA Mro!er >7, et al, Does current !ersus ormer smoking play a role in the relationship between anxiety and mood disorders and nicotine dependence, &ddicti!e -eha!iors, #ay /03/, Golume HA<I=, *ages F1/-F1I. HF1 &dan &, et al, 6 ects o nicotine dependence on diurnal !ariations o subjecti!e acti!ation and mood, &ddiction. December /00., Golume BB<3/=, *ages 3IBB-3F0A. HFB #osca, &, & ?e!iew 6ssay on &ntonio Damasio"s The Deeling o 7hat ,appens9 -ody and 6motion in the #aking o Eonsciousness, *syche, Golume, F<30=, Kctober /000. HA0 %ibkuman T#, et al, #ultidimensional normati!e ratings or the 5nternational & ecti!e *icture (ystem, -eha!ior ?esearch #ethods, #ay /00A, Golume HB</=, *ages H/F-HH.J also see (ha!er *, et al, 6motion knowledge9 urther exploration o a prototype approach, 'ournal o *ersonalty and (ocial *sychology, 'une 3B1A, Golume I/<F=, *ages 30F3-301F.
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pre rontal cortex=, the seat o intelligence and thought. (econdary emotions are all other emotions and result primarily rom rontal lobe and intellectual processing and analysis o the in luence o primary emotions. & truly dynamic being, although appearing as just a list o words, !arying emotions are the product o neuron and chemical interactions. &lthough not easy, while re!iewing the ollowing list, re lect on how li e as a nicotine addict may ha!e touched upon each. ,uman secondary emotions can include eeling9 &ccepting, a ectionate, amused, anticipating, appreciated, bitter, bliss ul, bold, bored, bewildered, cautious, caring, cheer ul, compassionate, competent, composed, con used, constrained, contempt, contented, cowardly, cruel, curious, courageous, dejected, delighted, depressed, detached, disrespect ul, distant, dread ul, disappointed, dismayed, displeased, eager, elated, embarrassed, enjoying, enthusiastic, en!ious, euphoric, exhausted, exhilarated, expecting, amiliar, ond, ree, gaiety, generous, grie!ing, guilty, hate ul, homesick, hope ul, hopeless, humiliated, impatient, incomplete, independent, indi erent, in atuated, innocent, insecure, insulted, interested, irritated, isolated, jealous, jolly, jubilated, loathing, interested, longing, lonely, lost, lo!ing, lust ul, malicious, melancholy, modest, obligated, optimistic, o!erwhelmed, pain ul, mysterious, panicky, passionate, pleasured, piti ul, prohibited, proud, regret ul, rejected, relaxed, relie!ed, reluctant, resent ul, resistant, re!ulsion, satis ied, scorn ul, sentimental, shame ul, sluggish, smug, spite ul, secure, stressed, sympathetic, tender, tense, timid, troubled, uncom ortable, uneasy, weary, woe ul and )ealous. ?elaxed8 ,ow could we expect to e!er in our li etime know total calm or experience ull relaxation with nicotine making our heart pound 3A.I beats per minute aster8 (tressed8 Try to imagine what stress alone would eel like, i not or stress generated acids throwing you into early withdrawal by ioni)ing reser!es o the alkaloid nicotine. ;ncom ortable or uneasy8 5magine entire days, weeks, months or e!entually e!en years <like millions o us, including me= where you are not once punished with wanting, an urge or cra!e to use nicotine. 7hat would it eel like to untangle and ree your emotions rom your dependency8 The inal category o emotion is background. -ackground emotions re lect eelings present when at rest or homeostasis. Kur background emotions were ridden hard by an endless roller-coaster ride o neurochemical lows and highs transporting us rom badly needing a nicotine ix to the $aaah$ wanting relie sensation upon getting one.
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6motional reco!ery isn"t only about na!igating the eelings and emotions brought on by reco!ery. 5t"s about reeing them rom our addiction, about brightening each star that ills li e"s sky. -e ore you is an opportunity to heal pride and sel esteem. 5magine the sea o emotions when you irst reali)e that you really lo!e being ree, that you ne!er, e!er want to go back. 7hen they occur, e!ery physical symptom re!iewed in the last chapter <Ehapter B= will be wrapped in emotions. %ikewise, the subconscious mind"s healing <Ehapter 33= cannot be di!orced rom the eelings we make it sense. &nd how dark would our thinking and conscious reco!ery be <Ehapter 3/= i not painted with emotion8 &lthough 5"!e separated reco!ery"s layers or purposes o re!iew, in reality they"re so intertwined that the best we can hope or is to grasp the ob!ious. (uch complexity re lects the beauty o who we are, and why it"s so sad to continue paying the nicotine addiction industry to pull our emotional strings, as i its puppets. -ut why has it taken so long or us to awaken to the act that our emotions ha!e become as hostage to our dependency as e!ery other part o our being8 &nd what emotions are normal and should we expected during reco!ery8 The human mind is designed to adapt, protect and insulate itsel rom circumstances which seem beyond its control. 5t does so by employing de ense mechanisms that work by distorting or blocking reality and natural instincts. The brain"s well-stocked arsenal o de ense mechanisms includes denial, displacement, intellectuali)ation, projection, rationali)ation, reaction ormation, regression, repression, sublimation, suppression, compensation, dissociation, antasy, identi ication, undoing, and withdrawal.HA3 Dependency reco!ery understanding and insights can help uel and inspire our own personal dreams o reedom, including causing our mind"s dependency de enses to crumble be ore our eyes. 5 they were to crumble, what might emotional reco!ery be like8 %et"s re!iew the natural grie cycle in hopes that understanding it helps accelerate your healing. Lu'ler&Ro$$ grie1 cycle The >ubler-?oss model identi ies i!e discrete stages in the grie cycle when coming to
HA3 De ense mechanism, :ew 7orld 6ncylopedia, &pril H, /001,
http9//newworldencyclopedia.org/entry/De enseXmechanism
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terms with any signi icant emotional loss.HA/ &lbeit chemical, dependency upon nicotine may ha!e been the most intense and dependable relationship in our entire li e. &s a smoker, unless wet and it wouldn"t light, ne!er once did pu ing on a cigarette let me down. 6!en i a brand we hated, nicotine"s $aaah$ wanting relie sensation was always a ew seconds away. 5 we smoked nicotine ten times per day and a!eraged 1 pu s per cigarette, that"s 10 times a day that we puckered our lips up to some nasty smelling butt spewing orth more than our thousand chemicals that included hundreds o toxins, 13 o which are known to cause cancer. 7hat human on earth did we kiss 10 times each day8 7ho did we depend upon 10 times a day8 ,ow many days during our li e did we think or say our name more than 10 times8 &ny8 5magine being closer to our addiction than our own name. 5n 3B1/, 'oel (pit)er applied the >ubler-?oss grie cycle model to the emotional journey na!igated during reco!ery.HAH The i!e stages o emotional healing include9 <3= </= <H= <.= <I= Denial9 $5"m not really going to quit. 5"ll just pretend and see how ar 5 get.$ &nger9 $,a!e 5 really had my last nicotine ix8 $This just isn"t air@$ -argaining9 $#aybe 5 can do it just once more. Two days without, 5"!e earned it@$ Depression9 $This is ne!er going to end.$ 7hat"s the use8$ $7hy bother8$ &cceptance9 $,ey, 5"m eeling pretty good@$ $5 can do this@$ $This is great@$
5t"s important in na!igating emotional reco!ery to not get stuck in a stage be ore reaching acceptance. ;nderstanding the roots o each will hope ully help empower a smoother and quicker transition. &s we re!iew each stage, keep in mind that the >ubler-?oss"s grie cycle o emotional loss is not etched in stone, nor need it occur in the order presented. Kne or more phases may be absent, while another is re!isited. Kb!iously, it"s hoped that by spending time now re lecting on denial, anger, bargaining and depression that each can be minimi)ed i not a!oided altogether.
HA/ >ubler-?oss, 6li)abeth, $Kn Death and Dying,$ 3BFB, ?outledge, 5(-: 0.3I0.03IB. HAH (pit)er, ', 'oel"s %ibrary, ;nderstanding the 6motional %oss 6xperienced 7hen Luitting (moking, 3B1/,
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5n the per ect world, knowledge and understanding would allow us to skip the irst our phases entirely and jump right to acceptance. &nd it happens ar more o ten than you might think. -ut i it doesn"t, don"t ret. 4ou"ll na!igate each just ine.
#eni l
Denial is a state o disbelie . The denial phase o emotional reco!ery is associated with coming to terms with the act that a long and intense chemical relationship has ended. 5t"s almost the opposite o acti!e dependency denial which used distortion and blocking techniques to pro!ide co!er and insulation, so as to enable continued use. Denial is the unconscious de ense mechanism - just below the sur ace - that allowed us to resol!e the emotional con lict and anxiety that would normally be elt by a person li!ing in a permanent state o sel -destructi!e chemical bondage.HA. #ost nicotine addicts we"ll see today are hea!ily insulated by a thick protecti!e blanket o unconscious denial rationali)ations, minimi)ations, ault projections, escapes, intellectuali)ations and delusions. Kur denial helped insulate us rom the pain and reality o capti!ity. 5t also helped us pretend that the problem was somehow being sol!ed. -ut here, during reco!ery, those same anxiety coping de enses begin to distort reality about what"s really happening. &s mentioned, 5 start seminars by asking or an honest show o hands to the ollowing question, $,ow many o you eel that you will ne!er, e!er smoke again8$ ?arely will a hand go up. 6!en though all wanted to stop, then and there all were in denial, as none belie!ed they would. &lthough we want to stop, on a host o le!els the mind isn"t yet con!inced. 5 con!inced, why do so many o us treat reco!ery as though some secret8 &nd why lea!e an escape path such as that one hidden cigarette, or a means to quickly obtain more8 Denial is normal. -ut i allowed, it can trans orm disbelie into action. $5 don"t want to stop just yet,$ decides ?yan. $5 am per ectly healthy using, so why stop now,$ asks 6mily8 $5"m di erent, 5 can control use and keep it to just one or two a day,$ asserts &shley. ?egrettably, relapse is at hand or ?yan, 6mily and &shley. 7hile insulation in allowing
HA.
Denial. <n.d.=. The &merican ,eritage Dictionary o the 6nglish %anguage, Dourth 6dition. ?etrie!ed 'uly /3, /001, rom Dictionary.com
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us to begin this journey -- including allowing you the courage to reach or this book cessation disbelie can easily become a path o betrayal. The denial phase protects us against the immediate emotional shock o lea!ing the most intense relationship we"!e likely e!er known, e!en while embarking upon a journey rom which there should be no return. 5t"s a shock bu er that allows us time to come to terms with where we now ind oursel!es. 5t operates unconsciously to diminish anxiety by re using to percei!e that reco!ery will really happen. & number o times 5 went three days and then $rewarded$ mysel with that one pu that always spelled de eat. Elearly, 5 hadn"t made it beyond denial. -ut i 5 had, the next phase encountered may ha!e been anger.
!nger
&nger is a normal and expected emotional reco!ery phase. 5t"s also a way to experience the low o missing adrenaline that was once part o our nicotine high. &nxieties lowing rom anger can also be used to intentionally uel rage. 5 take no pride in recalling that 5 could became so nasty and create so much turmoil among those 5 lo!ed, that 5 could con!ince them that 5 needed my cigarettes back.. -ut there are important distinctions between anger elt during the emotional reco!ery stage and using it as an adrenaline crutch or a sick relapse ploy. The anger phase o reco!ery is a period o healing where we begin to awaken to the reali)ation that it may actually be within our ability to pull this o and succeed. 5t"s awareness that, just maybe, our last pu , dip, chew or !ape e!er is already behind us. Durable nicotine use memories lowing rom capti!e dopamine pathways ele!ated that next ix to one o li e"s top priorities. -ut emotional reco!ery has now transported us rom ear o stopping to ear o success. 5s it any wonder that anger would be the mind"s reaction8 5t"s now sinking in. (uccess is occurring in spite o denial. & once high priority relationship is ending. This reali)ation can eel o!erwhelming. :ow, all the new ex-user needs is some excuse, any excuse, to let it all out, to !ent, to turn an ant hill into a mountain. Eon licting moti!ations, reedom or eed-em, risk o succeeding, ear o the unknownJ just one spark, any spark, and the uneducated ex-user stands primed to lash out.
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7hile this high-energy phase o the emotional stage o goodbye is a normal step in reco!ery, the educated ex-user both recogni)es its arri!al and understands anger"s roots. ?ecognition is critical as it pro!ides a protecti!e seed o reason inside a mind looking or a spark, a ear dri!en mind poised to abandon rational thought. 5 allowed, that spark may acti!ate the body"s ight or light response, releasing a cascade o more than one hundred chemicals and hormones. The prospect o success is not a logical reason to get mad, enraged or ight. The educated mind knows that emotion can be contrary to our well being and best interests. &nger ignores all positi!es while pretending a sense o loss, a loss based largely on alse use rationali)ations. (o how does a mind trained in recogni)ing and understanding reco!ery anger pre!ent it rom harming us and the world around us8 Ehapter 33 on subconscious reco!ery pro!ides a number o techniques or na!igating a cra!e episode which may not peak or three minutes. 5n that anxiety underlies both cra!e episodes and anger episodes, they should ser!e you well. %et me lea!e you with one exercise which may generate the patience needed to mo!e beyond anger. &nother day o reedom causes a sense o loss to collide with the likelihood o success. & spark is generated. 5t"s time or patience, just one micro-second at a time. ?ecogni)e the anger building within. ;nderstand what"s happening and why. ?eali)e that unless being physically assaulted, that only bad can come rom unleashing your body"s ighting chemicals. &nger is almost ne!er a solution. 5t re lects primiti!e impulsi!e instincts out o control. 5t brings strong potential to harm both us and innocent !ictims, lea!ing emotional wounds that may ne!er heal. 5 possible, sit down. (lowly close your eyes while taking a slow deep breath into the bottom o both lungs. Docus all concentration on your a!orite color or object, or upon the sensations associated with inhaling and exhaling your next breath. Deel the cool air entering, and its warmth while slowly exhaling. -aby steps, just one second at a time. Take another slow deep breath while maintaining total inner ocus. Deel the sense o calm and inner peace as it begins to wash o!er you. &s calmness arri!es slowly open your eyes. :ow, i you wish, respond to the situation with logic, reason and calm.HAI
HAI 7hile debate abounds about meditation"s ability to heal the body, and study quality to date has been horrible,
there is limited e!idence o some orms o meditation diminishing blood pressure, see ;.(. &gency or ,ealthcare
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,ow long will the anger phase last8 &s long as you allow. Elearly, knowledge can pro!ide the insights needed to recogni)e transitions and hope ully react in healthy, non-destructi!e ways. 5t"s what anger management is all about. ,ope ully, understanding and acceptance will help accelerate emotional reco!ery. -ut i not, don"t be disturbed as each step re lects normal emotional healing. Dears, cycling emotions, an addict"s relapse ploys, or eeling a sense o loss, reco!ery presents plenty o opportunities to encounter anger. 7e also need to remain mind ul that normal e!eryday li e produces anger too, e!en in ne!er-users. &t times, anger"s causes may o!erlap and get tangled. -ut e!en then, we ha!e it within us to ully control anger impulses, without harm to anyone. (uccess at hand, where does the mind turn next8 7hat is anger"s ultimate solution8 & debate is about to begin. ,ow do we keep our cake while eating it too8 -ut this isn"t about cake. 5t"s about a highly addicti!e chemical with tremendous impact upon our physical, subconscious, conscious and emotional well-being.
A rg ining
"0aybe .$m t e exception
to t e 5aw of Addiction! 0aybe . can use ,ust once-" Ehapter . re!iewed use rationali)ations employed by the still eeding addict in an attempt to justi y that next ix. ;sing many o the same rationali)ations, here bargaining"s primary hope is more about continuing this journey home while also !isiting with nicotine now and then. 5nstead o grie simply accepting an end to nicotine use, dependency ignorance toys with breaking ree while remaining great riends. -argaining can be with our particular nicotine deli!ery de!ice, another orm o deli!ery, oursel!es, lo!ed ones or e!en our higher power. 5ts aim is the impossible eat o letting go, without letting go. 5 allowed, the emotional con lict o wanting to say $hello$ while saying $goodbye$ can easily culminate in relapse.
?esearch and Luality, 6!idence ?eport/Technology &ssessment :umber 3II, #editation *ractices or ,ealth9 (tate o the ?esearch, &,?L *ublication :o. 0A-6030, 'une /00A.
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$'ust one,$ $just once$ can e!ol!e into $this is just too hard,$ $too long,$ $things are getting worse not better,$ $this just isn"t the right time to stop@$ &lthough a signi icant portion o this book is about bargaining, i allowed, this book itsel can and will pro!ide an abundance o uel or the bargaining mind. Dor example, e!ery user and e!ery reco!ery are di erent. (haring $a!erages$ and $norms$ with primary ocus upon the most common orm o deli!ery will naturally generate tons o ammunition or those whose dependency or reco!ery traits are beyond $a!erage$ or don"t in!ol!e smoke. >ey to na!igating con licted eelings is to demand honesty, while keeping our primary reco!ery moti!ations !ibrant, strong and on our mind"s center-stage. The wind beneath our wings, allowing reedom"s desire to die in!ites destructi!e and intellectually dishonest deals to be made. 5nstead o buying into relapse, remember, so long as 300C o the planet"s nicotine remains on the outside it"s impossible to ail. -ut what happens inside the grie!ing and bargaining mind once it reali)es that brain dopamine pathway design makes it impossible to arrest our dependency while letting it run ree8
#epre$$ion W!R.<.E - 3 e following depression discussion s ould not be construed as medical

advice! .t is a discussion for t ose going cold tur%ey+ not for t ose using cessation medications or products! Regardless of cessation met od+ if you+ your family or caregiver notice agitation+ depressed mood+ or c anges in be avior t at become disturbing or alarming+ or if you experience suicidal t oug ts or actions+ see% emergency medical assistance! The abo!e warning was necessary because depression is not some ixed and interchangeable emotion, as though some license plate that its e!ery car. %ike the word $wind$ it can range rom a so t gentle bree)e to a ull-blown hurricane. The word depression can range rom a short period o normal and expected sadness to ull-blown clinical long-term <chronic= depression with suicidal thoughts, planning or attempts. (o what"s the di erence between a period o normal sadness and ull-blown major clinical depression8 %et"s look at the symptoms o major depression. -ut be ore doing so, do not use the ollowing list to attempt to sel diagnose yoursel as
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the D(#-5G standards ha!e other depression de initions too, which include many quali iers. 5t"s why we ha!e and need mind health pro essionals such as psychiatrists. Menerally, under D(#-5G standards, a person must exhibit at least I o the ollowing B symptoms or at least two weeks in order to be diagnosed as ha!ing $major depressi!e disorder$ or #DD9 <3= eeling sad, blue, tear ulJ </= losing interest or pleasure in things we pre!iously enjoyedJ <H= appetite much less or greater than usual, accompanied by weight loss or gainJ <.= a lot o trouble sleeping or sleeping too muchJ <I= becoming so agitated, restless or slowed down that others begin noticingJ <F= being tired without energyJ <A= eeling worthless or excessi!e guilt about things we did or didn"t doJ <1= trouble concentrating, thinking clearly or making decisionsJ <B= eeling we"d be better o dead or ha!ing thoughts about killing oursel!es. 6!en i a person exhibits I o the abo!e B symptoms, the symptoms cannot indicate a mixed episode, must cause great distress or di iculty in unctioning at home, work, or other important areas and may not be caused by substance use <e.g., alcohol, drugs, medication=. -ut in regard to cold turkey nicotine cessation there could be an o!erriding consideration, what"s know as the $berea!ement exclusion.$ &s re!iewed in the prior chapter under $(ymptoms,$ it is the expert opinion o the editor o the D(#-5G standards that depression that is a normal and expected reaction to a signi icant emotional loss is exempt under the D(#-5G $berea!ement exclusion$ rom being classi ied as depression, so long as the symptoms are relati!ely mild and it doesn"t last longer than two months.HAF 7hat 5"d like to ocus upon here is $why$ is sadness or depression a normal step in the emotional grie!ing process8 7hat"s the purpose o depression8 7hile the anger phase o emotional reco!ery is ueled by anxiety, depression is emotional surrender. 5t re lects a wide spectrum o !arying degrees o hopelessness where anxieties o ten subside. *sychiatrist *aul >eedwell suggests that depression is part o what it means to be human, that it"s a de ense rather than de ect. Dr. >eedwell contends that depression orces us to pause and e!aluate loss, to change or alter damaging situations or beha!ior, and that upon re lection and reco!ery we o ten experience greater sensiti!ity, increased producti!ity and richer li!es.HAA
HAF :ational *ublic ?adio, &ll Things Eonsidered, The Elinical De inition o Depression #ay Ehange, &pril H,
/00A www.npr.orgJ also see 7ake ield 'E, et al, 6xtending the berea!ement exclusion or major depression to other losses9 e!idence rom the :ational Eomorbidity (ur!ey, &rchi!es o Meneral *sychiatry, &pril /00A, Golume F.<.=, *ages .HH-..0. HAA >eedwell, *aul, ,ow (adness (ur!i!ed, the e!olutionary basis o depression, /001, ?adcli e *ublishing, 5(-:-30 3 1.F3B 03H .
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7hile success ul nicotine dependency reco!ery demands a degree o re lection, ob!iously not all depression alls within the $berea!ement exclusion,$ is $relati!ely minor$ in nature, nor impro!es within F0 days. ?egardless o de initions or exclusions, i at all concerned about continuing or worsening depression, don"t wait. Eet $een nd e" lu ted@ 5 already taking medication or depression, keep in mind that your prescription may need adjustment. 5 nicotine was masking organic depression, relie could be just a doctor"s !isit away. Kne thing"s or certain, the highly addicti!e super toxin nicotine is not an answer or solution.
!ccept nce
The !ictory phase o the >ubler-?oss grie reco!ery cycle is acceptance. 5t"s the $this is do-able$ moment o an emotional journey that can mark the transition rom a $user trying to stop$ to $ex-user.$ 5t may or may not ha!e been pretty getting here. :ow and then, you may still encounter in requent or seasonal unextinguished subconscious eeding cues. &nd it"s likely that your pile o old replenishment memories will, or now, continue their gradually waning tease. 5t"s also likely that the pile"s lure will continue to be ueled by a lingering romantic ixation or two, that might bene it rom ocused honesty. -ut you did it@ 5n regard to your emotional reco!ery, i you"!e been able to let go and ully accept letting go then your emotional journey is complete. Eongratulations@ (till only one rule ... none today@
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Ch pter 11
;u'con$ciou$ Reco"ery
/he 4ncon$ciou$ Mind
6ndlessly hammered by
la!or, aroma, pleasure, riendship, ad!enture, rebellion and a ordability marketing, our subconscious mind was the nicotine addiction industry"s subliminal target. 5 it didn"t work they wouldn"t annually spend billions doing it. The subconscious is listening. Twice the tra!eling hypnotist sold me a couple o days o unbelie!able hypnotic bliss, be ore 5 tested it and relapsed.HA1 -ut looking upon our subconscious mind only in terms o being the playground o others cheapens and makes it look dumb, while ignoring our conscious ability to do the same in retraining it. 5 so dumb, why can our subconscious see subliminal messages in!isible to the conscious mind, or eel the in luence o tobacco marketing that our consciousness thinks has been ignored8 7hy can it react to triggering cues written upon it by hypnotic suggestion or sel conditioning, cues meaningless to conscious awareness8 Dumb8 7hen typing on a keyboard, what part o the mind and le!el o awareness is locating and striking the correct key8 7hile operating a !ehicle, who is really controlling which oot needs to push on which pedal and how hard, or doing the dri!ing as we read billboards, talk on the phone or daydream8 Kur conscious mind has unknowingly aided in helping teach our subconscious skills and how to per orm acti!ities, including using nicotine.HAB :ow it"s time to knowingly teach it how to unction without it. 7hether re erred to as our subconscious, unconscious or preconscious, science is still in the early stages o disco!ery in understanding the scope o its in!ol!ement in dayHA1 &bbot :E, et al, ,ypnotherapy or smoking cessation, Eochrane Database o (ystematic ?e!iews, /000J
</=9ED003001, which examines B hypnotherapy studies and concludes9 $7e ha!e not shown that hypnotherapy has a greater e ect on six month quit rates than other inter!entions or no treatment.$ HAB -argh '&, et al, The ;nconscious #ind, *erspecti!es on *sychological (cience, 'anuary /001, Golume H<3=, *ages AH-AB.
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to-day li e. 5t"s e!ery bit as real as the ne!er seen portion o an iceberg, think o Disney 7orld and awareness o the magic abo!e ground, while a massi!e unseen city beneath brings the magic to li e. 5t"s normal or us to deeply belie!e that our consciousness is the one doing things, that it causes our actions a ter care ul deliberation, that our beha!ior was our idea. 7hile this is our sel -perception, a growing body o e!idence suggests that like Disney"s puppets, the conscious mind is not the primary source moti!ating beha!ior, that in many cases our subconscious has already made up our mind or us.H10 5t"s suggested that the subconscious mind has e!ol!ed as a highly adapti!e $beha!ioral guidance system$ which acts on impulse. 5t"s becoming more widely accepted that the impulse or beha!ior lows rom our subconscious, that our consciousness then sei)es upon the idea as its own. 5t"s suggested that the real role o our consciousness is as impulse gatekeeper, and trying to make sense a ter the act o beha!ior that the gatekeeper allowed to occur. H13 (ources o subconscious impulses can include e!olutionary moti!ations, past personal pre erences, cultural norms, amily !alues, past experiences in similar situations, how others in the same situation are currently beha!ing, or be the product o conditioning, both rein orcement <operant= and association <classical=. #ultiple sources o subconscious beha!ioral impulses make con licts ine!itable. Drug addiction re lects a con licts war )one. Kur subconscious has its own beha!ioral goals, goals hidden rom awareness. H1/ ?eading these words is clear e!idence that $you$ want to break ree. 5t"s likely your subconscious does too. -ut a ter being conditioned by years o nicotine dependency wanting, use and relie , and by alse gatekeeper explanations as to why use was again necessary, without honesty and teamwork subconscious reco!ery can be messy and longer than necessary.
H10 Maldi (, et al, &utomatic mental associations predict uture choices o undecided decision-makers, (cience,
&ugust //, /001, Golume H/3<I1B/=, *ages 3300-330/. H13 7egner D#, *recis o the illusion o conscious will, -eha!ioral -rain (cience, Kctober /00., Golume /A<I=, *ages F.B-FIBJ as re!iewed in -argh '&, et al, The ;nconscious #ind, *erspecti!es on *sychological (cience, 'anuary /001, Golume H<3=, *ages AH-AB. H1/ -argh '&, et al, The automated will9 ;nconscious acti!ation and pursuit o beha!ioral goals, 'ournal o *ersonality and (ocial *sychology, December /003. Golume 13, *ages 300.-30/A.
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>per nt conditioning Kperant conditioning is a process that operates to modi y beha!ior, in our case nicotine use. 5t does so through positi!e or negati!e rein orcement <dopamine $aaah$ wanting relie or the anxieties o early withdrawal=, so that we come to associate the relie or displeasure produced by the rein orcement with the beha!ior.H1H Drug use beha!ior conditioning re lects unintended expectations training o the subconscious mind. ,undreds or thousands o annual nicotine use repetitions created strong subconscious associations between using nicotine and the adrenaline charged $aaah$ wanting relie sensation which ollowed.H1. Kperant conditioning associated with experiencing $aaah$ wanting relie was only one side o operant control. 7e were also controlled by displeasure and ear conditioning associated with the consequences o ignoring nicotine"s twohour hal -li e. Knce hooked, we quickly disco!ered that delaying replenishment or too long made us anxious, irritable and depressed our mood, while replenishment brought temporary relie . %ike being beat with a whip or recei!ing an electrical shock, the anxiety consequences o ha!ing waited too long between eedings operated to condition us to a!oid anxieties by engaging in replenishment early and o ten. Trapped in a perpetual cycle between wanting and relie , is it any wonder that both our subconscious and conscious grew to deeply belie!e that nicotine use de ined who we were, that replenishment was as important as eating, and that li e without it would be empty, meaningless or nearly impossible8 The good news is that within A/ hours o ending use the subconscious has no choice but to begin noticing that peak withdrawal has been achie!ed and is now gradually beginning to subside, yet li e goes on.
H1H operant conditioning. <n.d.=. The &merican ,eritage (tedman"s #edical Dictionary. ?etrie!ed &ugust H3,
/001, rom Dictionary.com website. H1. ?ose '6, et al, 5nter-relationships between conditioned and primary rein orcement in the maintenance o cigarette smoking, -ritish 'ournal o &ddiction, #ay 3BB3, Golume 1F<I=, *ages F0I-F0B.
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7hile likely still anxious and alert, the most intense period o reco!ery is o!er. (o long as all nicotine remains on the outside, ears and anxieties associated with the onset o withdrawal need ne!er again be encountered. 7hile negati!e rein orcement operant conditioning is quickly extinguished by diminishing punishment or not using, positi!e rein orcement operant conditioning associated with the tease o thousands o old $aaah$ replenishment memories will take additional time to o!ercome. 7hile we cannot erase thousands o old $aaah$ wanting relie memories, conscious honesty and dependency understanding enable us to see them or what they truly re lect, an accurate record o the times when an acti!ely eeding drug addict"s replenishment brie ly satis ied drug wanting. ?ecasting them in truth ul light can diminish or e!en end their remaining tease and in luence upon us. -ut let"s not ool oursel!es. 6ach memory remains tied to the same dopamine pathway that created it. 6!en i we go years without nicotine, the e ects o just one power ul pu , dip, chew or !ape somehow breathes new li e into old $aaah$ memories, and at least one aspect o positi!e operant conditioning. 7hether wanted or not, use would soon ha!e our brain demanding more and us obeying. The good news is that simply becoming mind ul o how subconscious positi!e and negati!e operant conditioning played a part in controlling us can aid in helping extinguish it and take back control.H1I &lthough not always easy, the solution always remains simple ... no nicotine today@ Cl $$ic l conditioning &s it relates to nicotine, classical or *a!lo!ian conditioning is conditioning in which, through repetition, a person, place, thing, acti!ity, time or emotion <a conditioned stimulus or use cue= becomes so paired with using nicotine that encountering the use cue alone becomes su icient to trigger wanting, an urge or cra!e. H1F (ubconsciously triggered anxieties are the mind"s means o commanding that we again bring nicotine into the body.
H1I -rewer '&, et al, Era!ing to Luit9 *sychological #odels and :eurobiological #echanisms o #ind ulness Training as Treatment or &ddictions, *sychology o &ddicti!e -eha!iors, #ay /1, /03/. H1F classical conditioning. <n.d.=. #erriam-7ebster"s #edical Dictionary. ?etrie!ed &ugust H3, /001, rom Dictionary.com website.
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%ike *a!lo!"s dogs, which he conditioned to expect ood and begin sali!ating upon the ringing o a bell, we each conditioned our subconscious to expect arri!al o a new supply o nicotine in speci ic situations. Dor example, your mind can be trained to want nicotine upon simply seeing a picture o a green triangle. & recent classical conditioning study did just that. 5t conditioned smokers to associate smoking with an object that had pre!iously been entirely neutral.H1A The conditioning was accomplished by 10 times pairing an imagine o a green triangle with a smoking related image <people holding or smoking cigarettes=. 6ach pairing was shown to smokers or less than hal a second <.00 milliseconds=. &lthough less than a second, the subconscious mind was watching and learning. :ot only did smokers report increased cra!ings upon being shown the green triangle alone without the smoking related image, brain responses recorded by 66M <electroencephalograph= supported their claims. ?esearchers ha!e success ully used sight, smell and hearing to establish new conditioned use cues in smokers.H11 6ncountering the new cue triggers use expectations and an urge to smoke, with an increase in pulse rate. ?esearchers ind it easier to establish new cues among light smokers, who ob!iously ha!e ewer existing cues than hea!y smokers. 5 cra!e episodes eel real and physical in nature there"s good reason. &lthough nicotine- eeding cues are psychological in origin, they trigger physiological responses within the body. :ot only do the stimulant e ects o using nicotine increase pupil si)e, researchers ound that encountering a !isual
H1A %ittel # and Dranken 5,, 6lectrophysiological correlates o associati!e learning in smokers9 a higher-order conditioning experiment, -#E :euroscience, 'anuary 33, /03/, 3H91. H11 %a)e! &-, et al, Elassical conditions o en!ironmental cues to cigarette smoking, 6xperimental and Elinical *sychopharmacology, Debruary 3BBB, Golume A<3=, *ages IF-FH.
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nicotine use cue will increase pupil si)e, an autonomic response.H1B ;sing brain scans, researchers disco!ered increased blood low during cue-induced cra!ings in the brain"s !entral striatum, amygdala, orbito rontal cortex, hippocampus, medial thalamus, and le t insula,HB0 regions associated with $aaah$ wanting relie and anxiety. They also ound that the amount o brain blood low <per usion= positi!ely correlated with the intensity o the cue induced cigarette cra!ings in both the pre rontal cortex and the posterior cingulate, regions known to control attention, moti!ation and expectancy.HB3 4ears o subconscious conditioning had us reaching or a nicotine ix and conducting replenishment without our conscious mind recogni)ing that we had encountered a use <conditioned stimulus=, and o ten without noticing that replenishment was underway. (tudy the next smoker you see. &s i on autopilot, it is !ery likely that the drags you"ll watch being inhaled will be taken while their unconscious mind is in ull control. 5 can"t begin to count the number o times 5 looked down and was surprised to see the ashtray ull and the pack empty. :icotine"s hal -li e combined with our dependency"s le!el o tolerance to determine how many times daily we"d need to replenish. *ossibly unaware we were doing so, we each established daily replenishment patterns that taught and conditioned our subconscious when to expect more. 5t was watching and remembering as use cues arri!ing !ia sight, smell, sound, taste, touch and emotions were quickly ollowed by arri!al o more nicotine. Cr "e epi$ode inten$ity - &s we na!igated our day our subconscious recogni)ed use cues and issued gentle commands letting us know it was again time or replenishment. (ometimes the urges were noticeable and sometimes not. They could arri!e as ull-blown cra!e episodes i replenishment was o!erdue. ?ecent indings suggest that the insula, in the brain"s limbic region, may act as a control center able to alter the intensity o anxiety commands in response to encountering a time, place, location or emotion during which we had conditioned our subconscious to expect nicotine.HB/
H1B Ehae 4, et al, (ubjecti!e and autonomic responses to smoking-related !isual cues, The 'ournal o
*hysiological (ciences, &pril /001, Golume I1</=, *ages 3HB-3.I. HB0 Dranklin T?, %imbic acti!ation to cigarette smoking cues independent o nicotine withdrawal9 a per usion #?5 study, :europsychopharmacology, :o!ember /00A, Golume H/<33=, *ages /H03-/H0B. HB3 (mall D#, et al, The posterior cingulate and medial pre rontal cortex mediate the anticipatory allocation o spatial attention, :euro5mage, #arch /00H, Golume 31<H=, *ages FHH-F.3. HB/ :aq!i, :,, et al, Damage to 5nsula Disrupts &ddiction to Eigarette (moking, (cience, 'anuary /00A, Gol. H3I <I133=, *ages IH3-IH.
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The intensity o a particular cra!e episode appears to be in luenced by a number o actors. & /00A study ound that the two most signi icant were how recently we had used and our le!el o impulsi!eness.HBH Kb!iously, the longer without nicotine, the longer anxieties ha!e to build. 4ou"d think that during reco!ery a magic moment would occur when the body becomes 300 percent nicotineree, and our subconscious notices that we"re still ali!e, well and unctioning. 7hile it may aid in diminishing underlying anxieties, conditioning is a creature o habit. (till, once beyond peak withdrawal, all le!els o awareness are con ronted with escalating awareness that we"!e been li!ing a lie, that once all nicotine is out o our system, things slowly start getting better not worse. 5t"s here that ears o ailure butt heads with ears o success. &s or impulsi!eness, it"s the trait that played a key role in many o us experimenting with using nicotine in the irst place. :ow that same trait sees relapse as a quick- ix solution. *atience in standing up to impulsi!ity can itsel oster con rontation anxieties. Kur hopes and dreams o a lasting dependency solution are pitted against thousands o old $aaah$ memories promising instant yet temporary relie rom wanting. Truth is, only one choice pro!ides a way out. Truth is, the only path home is to choose the bigger, better yet delayed reward. Truth is, e!ery acti!ity done while under nicotine"s in luence can be done as well as or better without it. &sk yoursel , what is the only permanent solution to replenishment urges and cra!es8 *ut impulsi!eness to work on the right team. 5n!ite your impulsi!eness to act as guardian o!er the next ew moments in remaining 300 percent nicotineree. %et it ser!e as a !igilant ally in protecting reedom, pride and your growing sel esteem. 5magine the creation o healthy, positi!e impulses that instantly respond to protect us rom challenge. 5magine all le!els o awareness orming a skilled ire ighting team that remains on scene and ready to extinguish any bla)e. &lthough one study noted that the le!el o depression among women, but not men, was capable o impacting cra!e episode intensity,HB. study a ter study inds little or no
HBH Silberman #%, et al, The impact o gender, depression, and personality on cra!ing, The 'ournal o &ddicti!e
Diseases, /00A, Golume /F<3=, *ages AB-1.. HB. Silberman #%, et al, The impact o gender, depression, and personality on cra!ing, The 'ournal o &ddicti!e
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di erence between male and emale success rates.HBI &lthough the thought o a depressed woman ha!ing to endure a slightly more intense cra!e episode is disheartening, keep in mind that all episodes are extremely short li!ed, and i she stays clean she"ll soon ne!er need ace them again. -ut as re!iewed in Ehapter 30, whether male or emale, do not ignore or make light o ongoing depression. 7hile the irst ew days can be emotional, especially i ear dri!en, within H weeks brain sensiti!ities should be restored to normal. 5 there"s no joy in your day get seen and e!aluated by a physician skilled in treating depression. 7hy allow treatable depression to bring you to the brink o relapse8 7hy allow it to ser!e as an excuse or continued use when chronic nicotine use likely contributed to causing it8HBF 5nstead, put a physician on the team@ & ood cra!ing study ound that !i!idness o imagery associated with ood in luenced ood cra!ing intensity.HBA Mo ahead. Mi!e it a try. *icture your a!orite ood. :ow make the mental image as !i!id and detailed as possible. Deel the urge8 :ow picture your particular brand o nicotine deli!ery de!ice. 7hat color is it8 ,old it in your hand. (mell it. Deel the urge8 7hy not use reco!ery imagery as a subconscious re-training tool8 7hy not lash our own subliminal messages8 *icture yoursel engaging in e!ery acti!ity during which you used nicotine but now com ortably doing so without it. :otice how each acti!ity is done as well as or better than be ore. Taste the natural la!or o a mouth reclaimed. *icture the pureness and arri!al o that irst ull day where the thought o $wanting$ ne!er once crosses your mind. (ee such days soon becoming more and more common, until becoming your new sense o normal. %isten as the noise o addiction"s daily chatter at last comes to an end. Deel the beauty and emotion o a brain responding to li e instead o nicotine. Controlling eBpect tion$ - & /003 conditioning study taught smokers to expect to be able to smoke during speci ic situations. 5t encouraged hal o the study"s participants to try to identi y when the use cue had occurred.HB1
Diseases, /00A, Golume /F<3=, *ages AB-1.. HBI 6tter 'D, et al, Mender di erences in the psychological determinants o cigarette smoking, &ddiction, 'une /00/, Golume BA<F=, *ages AHH-A.HJ HBF (obrian (>, et al, *renatal cocaine and/or nicotine exposure produces depression and anxiety in aging rats, *rogress in :europsychopharmacology + -iological *sychiatry, #ay /00H, Golume /A<H=, *ages I03-I31. HBA Tiggemann #, et al, The phenomenology o ood cra!ings9 the role o mental imagery, &ppetite, December /00I, Golume .I<H=, *ages H0I-H3H. HB1 Dield #, et al, (moking expectancy mediates the conditioned responses to arbitrary smoking cues,
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&s with the green triangle study, researchers disco!ered that encountering and noticing the use cue would generate cra!ings, with increased sali!ation and skin conduction. The study"s indings teach us that the more aware we become o our use cues, the more pro ound use expectations become. #ore importantly, it teaches that once study participants were told that they would no longer be able to smoke once the pre!iously identi ied use cue appeared, that cra!ings were therea ter absent and extinguished. Ean conscious expectations control both subconscious expectations and the presence or absence o cra!ing8 &bsolutely@ 5t means that what we think and belie!e is critical, that we can be what we expect.HBB Think about the tra!eling smoking cessation hypnotist using their conscious mind to relax our conscious mind, so as to allow them to rewrite subconscious expectations. The problem with single-session cessation hypnosis isn"t that it does not or cannot work, at least brie ly. 5t"s that it only addresses a single layer o reco!ery, the subconscious, while ignoring the ongoing negati!e in luence o conscious stimulation and use related thoughts. Think about the repeated subconscious impact o the title o &llen Earr"s book $The 6asy 7ay to (top (moking.$ 6ach time the book is opened the subconscious is hit with the message that stopping is easy. 5nside, &llen does the same thing that 'oel (pit)er does in the irst two chapters o his ree ebook $:e!er Take &nother *u .$ 5t"s the same thing 5 do in Ehapters H <$Luitting 4ou$=, . <?ationali)ations= and 3/ <Eonscious ?eco!ery= o this book. 7e in!ite the ensla!ed mind, both conscious and subconscious, to see through the use lies our addiction compelled us to in!ent. 5 willing to engage in open and truth ul analysis, once done you may eel little or no sense o loss. 5 nothing to lose, there"s nothing to ear. 5 no ear, there should be little or no anxiety. Eould letting go entirely generate an easy or e!en cakewalk reco!ery8 &bsolutely@ -ut e!en i challenged, like 5 was, reco!ery is do-able. 7e don"t need to be trained hypnotists to use our conscious mind to calm, reassure,
-eha!ioural *harmacology, 'une /003, Golume 3/<H=, *ages 31H-3B.. HBB Dols #, et al, (mokers can learn to in luence their urge to smoke, &ddicti!e -eha!ior, 'an-Deb /000, Golume /I<3=, *ages 30H-301.
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sooth or create subconscious expectations. Draw near and use truth to reassure your subconscious. 5t"s listening. Try engaging in slow deep breathing while progressi!ely relaxing your body. Luiet all chatter inside your mind by ocusing, to the exclusion o all other thoughts, upon an image o your a!orite place..00 Knce totally relaxed, share your dreams and rewrite expectations. ?eassure your subconscious. %et it know there is absolutely nothing to ear in coming home to entire days where we ne!er once want or nicotine. Teach it that contrary to the lies, you won"t lose a single riend or acti!ity, that li e will be better not worse. 6ncourage your subconscious to join orces in embracing reco!ery, that challenge is good not bad as it leads to cue extinguishment and reedom. 4our mind and body will likely ne!er know a more intense period o healing than this reco!ery. 5n!ite your subconscious to de end and bask in reedom"s glory. 5n!ite it to eel the delight o ongoing !ictory and your growing sense o pride. Deep relaxation may be challenging during the irst A/ hours. 5 so, think about how relaxed the conscious mind and body become immediately be ore slumbering o into sleep. (ei)e upon and use these precious seconds be ore sleep, when our conscious and subconscious draw near. Ealm subconscious ears as you slumber into sleep. Throw out the lies. Eelebrate today"s !ictory and picture tomorrow being your most ruit ul day o reco!ery yet. (lide o into sleep eeling ree and proud.
Common 4$e Cue$

7hen during each day did your subconscious expect nicotine8 7as its cue the smell o morning co ee, starting the car, placing a dinner plate into the sink, the sound o a bottle or can opening, or ice cubes illing a glass8 7hile ew o us appreciated the precise cue recogni)ed by our subconscious, we each ha!e a pretty good eel or most situations during which we trained our mind to expect replenishment. 7hat ollows is a brie re!iew o possible use cue situations. Don"t be intimidated. ;se this re!iew to think about your own use patterns. &nd then imagine extinguishing e!ery one o your use cues, and totally reclaiming your li e. Don"t ear it, welcome it.
.00 &nbar ?D, (ubconscious guided therapy with hypnosis, &merican 'ournal o Elinical ,ypnosis, &pril /00F,
Golume I0<.=, *ages H/H-HH..
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!cti"itie$ - Kur morning acti!ity trigger may ha!e been climbing out o bed, making the bed, getting dressed, caring or a pet, associated with break ast, reading the paper, drinking co ee, stepping outside, brushing our teeth, watering plants, or e!en using the bathroom. #andatory daily acti!ities such as eating and sleeping compel us to quickly meet, greet and extinguish any and all associated cues. 5magine so tying nicotine use to using the bathroom that once use ends we are brie ly le t wondering whether we"ll e!er be able to ha!e a bowel mo!ement again. 5 parents, cues may be associated with waking your children, eeding them, making lunch and getting them o to school. Knce home there"s homework, a ter school or weekend acti!ities, summer planning and acti!ities, tending to their needs, ixing dinner, baths, getting their clothes ready and bedtime. &nd then there"s housework, daily planning, talking on the phone, laundry, taking a break, paying the bills, tele!ision, using the computer, walking outside, and gardening or yard work. &nd then there"s the workplace. There, you may ha!e come to see nicotine replenishment as a reward <a $smoke break$= or ha!ing accomplished some task. Tra!eling to work, arri!ing, either nicotine-use breaks or using while working, deadlines, lunch, stress, the end o the workday, hea!y catch-up replenishment while tra!eling home, some o us so tied nicotine use to work that we can"t imagine e!er being able to be producti!e workers again. Delay in con ronting and extinguishing work associated conditioning can be costly. 7ork a!oidance can add mountains o needless pressure and anxiety to reco!ery. 7hy ear destroying all work related use cues and being rewarded with a use- ree workplace8 -e bra!e. Take that irst step. 'ust a tiny one, and the step that ollows will become easier. Then there are possible cues associated with arri!ing home, reading mail and email, preparing dinner, the e!ening news, hobbies or leisurely acti!ities, social time, caring or pets, preparing or bed or romance. The only use cues we suggest delay in encountering are associated with using alcohol or other inhibition diminishing chemicals. &s we"ll discuss more in a moment, unless we ha!e co-dependency concerns <see
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Ehapter F=, these are non-mandatory acti!ities that can be delayed a ew days, at least until through the most challenging portion o reco!ery. ,ere, it needs noting that there can be multiple cues related to alcohol use, including the location, people present, the presence o cigarettes or other users, peer pressures, music, singing, relaxation, dancing, celebration or intoxication. 0oc tion$ - Think about the locations you requented that may ha!e become conditioned use cues9 entering the house, bathroom, a work area, your smoking room, garage, backyard, the garden, outdoors, a !ehicle, bus stop, walkway, workplace, bar, pub or restaurant, or entering or lea!ing a store. 7e used nicotine in some locations more than others. ,ow o ten did we use in association with a place o worship, a doctor"s o ice, a hospital, mo!ie theater or concert8 5 we established use cues, when might they next be encountered8 People - 7e may ha!e established cues associated with speci ic riends, acquaintances or co-workers. 5 so, when will you next see them8 Then there are those people whose personalities somehow increased our anxieties. 'ust seeing them could trigger a cra!ing. &nd don"t orget those who didn"t use nicotine and tended to !isit and stay longer than our un ed addiction could tolerate. 7hat will happen the next time they !isit and then lea!e8 /ime$ - Eonditioning could be associated with waking, mealtime or break-time. Eues could be related to the hours or minutes appearing on a clock or watch. They may be associated with the time that our workday ends, a tele!ision program or the hour when preparing or bed. Times o the year may ser!e as conditioning9 a !acation, spring and blooming lowers, arri!al o summer heat, all"s cool temperatures, alling lea!es, that irst rost, winter or snow all. -ut don"t be surprised i by then your cra!e generator seems to ha!e lost its punch. 5nstead o ull-blow cra!ings, remote, in requent or seasonal cues may by then eel more like a ew seconds o sti bree)e. 6!entually, the time and distance between remote un-extinguished use cues will become so great that any bree)e is barely noticeable or e!en laughable. They"ll become a long o!erdue reminder o the ama)ing journey you once made. %"ent$ & There were some e!ents that ser!ed as cues or most o us. ?esearch has
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ound that seeing and smelling a burning cigarette will cause a cue induced cra!ing during early reco!ery..03 7ould watching another oral tobacco user put tobacco into their mouth trigger a cra!ing in most oral users8 5 wouldn"t be surprised. 7eddings, unerals, the birth o a baby and o er o a cigar, holidays, birthdays, :ew 4ear"s, reco!ery is about taking back li e, just one piece at a time. The smell o morning co ee, seeing a smoking riend, hearing laughter, tasting your a!orite drink, touching your nicotine deli!ery de!ice, wouldn"t it be ascinating to ha!e ull and accurate awareness o all nicotine use conditioning while na!igating reco!ery8 &lthough con!entional wisdom suggests that we attempt to disco!er our cues be orehand, rankly, e!en when we think we"!e identi ied the exact cue adopted by our subconscious we"ll o ten miss the mark. 5nstead o rustrations associated with being unable to accurately predict subconscious cues, it"s probably best to remain calm yet ully prepared to react on a moment"s notice. %motion$ & &s re!iewed in Ehapter 30, the range o human emotion pro!ides our subconscious with a wide spectrum to pick rom. %aughter, sorrow, a sense o accomplishment or de eat, worry or calmness, each has potential to generate a cra!ing i the mind made a use association. 6xtended emotions such as those associated with inancial strain, serious illness, injury, or the death o a lo!ed one, were ripe or cue establishment. Withdr w l cue$ - K!erlaying operant conditioning expectations atop cra!es associated with classical conditioning, atop physical withdrawal and emotional reco!ery, brings potential to oster a somewhat intense initial A/ hours. The good news is that we mo!e beyond peak withdrawal within three days, that reco!ery"s greatest $potential$ period o challenge, including extinguishment o our most basic daily use cues <waking, walking, talking, eating and sleeping=, is behind us within hours. 5t"s why watching pharmaceutical companies sell expensi!e products which drag withdrawal out or weeks or months is so disturbing. &nd how does popping a piece o nicotine gum or a nicotine lo)enge into our mouth when a use cue is encountered extinguish conditioning8
.03 :iaura ?, et al, 5ndi!idual di erences in cue reacti!ity among smokers trying to quit9 e ects o gender and
cue type, &ddicti!e -eha!ior. &ddicti!e -eha!iors, #arch-&pril 3BB1, Golume /H</=, *ages /0B-//..
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&dd in products like Ehantix/Ehampix, which has been linked to suicide and it makes you wonder whose interests are being protected. 7hen it comes to the number and types o use cues our subconscious established we"re each unique. &lthough natural to want to run and hide rom conditioning, cra!e episodes are good not bad, as extinguishing each use cue is our stepping-stones to a nicotineree li e.
!re cr "e epi$ode$ re lly le$$ th n 3 minute$?

4es, generally. &lthough we don"t yet know why, within three minutes it is normal or cra!e episode anxieties, anxiousness and/or panic to peak and begin easing o . &lthough ama)ingly little research in this area, it"s a basic reco!ery lesson widely shared across the 5nternet. 7hile possible that more than one un-extinguished subconscious cue may be may encountered within minutes o each other, years o online cessation group discussions suggest that it isn"t as common as we might think. 7hat is o ten seen are periods o conscious thought ixation being con used with a subconsciously triggered cra!e episode. Think about your a!orite ood. ,ow long can you continue to stay ocused and ixated upon it8 Ean you do so or 30, /0 or e!en H0 minutes8 The only limit upon the duration o ixation is our ability to maintain conscious concentration and ocus. The primary distinction between a subconscious cra!e episode and conscious ixation is control. 7hile we ha!e substantial direct control o!er the duration o ixation, and signi icant control o!er how the conscious mind reacts when a subconscious cue is encountered, our subconscious controls the timing and duration o cue-triggered episodes. The importance o the distinction is the reco!ery con idence pro!ided in knowing that subconscious challenge will pass within H minutes. -ut i cue triggered cra!e episodes peak and begin to subside in less than three minutes, why do the minutes sometimes eel like hours8 /ime di$tortion & /00H study ound that distortion o time perception is one o the most common nicotine dependency reco!ery symptoms..0/
.0/ >lein %E, (moking &bstinence 5mpairs Time 6stimation &ccuracy in Eigarette (mokers,
*sychopharmacology -ulletin, #ay /00H, Golume HA<3=, *ages B0-BI.
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(mokers were asked to estimate the passing o .I seconds both while still smoking nicotine and during a second session a ter which they had not smoked any nicotine or /. hours. Their time estimates were also compared to a control group o non-smokers. 7hile at a loss to explain why, researchers ound that time estimation accuracy was signi icantly impaired <H00C= in smokers who had not smoked nicotine or /. hours, as compared to estimates made while smoking. The ability o smokers who had not smoked or /. hours to estimate the passing o .I seconds was also impaired when compared to estimates made by non-smokers. -ut timing estimates were ound to be similar between non-smokers and smokers while smokers were allowed to continue smoking. Leep w tch or cloc( h ndy - 7hat the study didn"t assess was the estimation o time during occurrence o a cra!e episode. 7hether cessation time distortion is ultimately ound to be physiological, psychological or some combination, knowing that it exists suggests the need to look at a clock or watch during an episode, in order to bring honest perspecti!e to time. 7hen a cra!e arri!es, immediately look at your watch or a clock and note the time. The anxiety rush, dread and/or deep seeded belie that the only way to make the cra!e end is to bring more nicotine into your body will soon peak and then pass. :ot only will your reco!ery remain ali!e and well, at the end o the episode you"ll likely recei!e a reward, the return o yet another aspect o nicotineree li e. 5t"s important to note that or the 3.AC o adults diagnosed with panic disorder under diagnostic standards such as the &merican *sychiatric &ssociation"s D(#-5G manual, that D(#-5G criteria indicates that panic attacks may not peak or up to 30 minutes. .0H Docus your panic attack coping skills training on handling nicotine cessation panic attacks. &lready highly skilled, hope ully you"ll ind this aspect o nicotine dependency reco!ery the least challenging o all. 7e"re each ully capable o handling a ew brie moments o anxiety. &ll o us. &ccurately measuring the episode"s duration will pre!ent time distortion rom making it appear H00 percent longer than reality. Don"t let time distortion depri!e you o your dream o again com ortably engaging li e as $you.$
.0H &merican *sychiatric &ssociation, *anic Disorder, Diagnostic and statistical manual o mental disorders, ourth edition, 3BB.
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7ow o1ten do cr "e epi$ode$ occur? The best we can do in answering this question is to share study a!erages. The ob!ious problem with a!erages is that we may not be a!erage. & 3BB1 real-time cra!e coping study closely ollowed smokers or two weeks and collected some ascinating data..0.
5t ound that the day on which the most cra!e episodes were encountered was the third day o reco!ery, with an a!erage o F.3 cra!es. Day our"s a!erage dropped to H.I with day i!e generating just H cra!es per day. -y day ten the a!erage ell to just 3.. episodes per day. 5 each cra!e episode is less than H minutes, and the a!erage on the most challenging day is F.3, that"s a total o 31.H minutes o cra!e anxiety on your most challenging day o reco!ery. Ean you handle 31.H minutes o serious challenge in order to reclaim your mind and li e8 &bsolutely@ 7e all can. -ut what i you"re not a!erage8 7hat i you ha!e conditioned your subconscious to ha!e twice as many cues as the a!erage user8 That would mean that you could experience a maximum o HA minutes o total cra!e
.0. K"Eonnell >&, et al, Eoping in real time9 using 6cological #omentary &ssessment techniques to assess
coping with the urge to smoke, ?esearch in :ursing and ,ealth, December 3BB1, Golume /3<F=, *ages .1A-.BA.
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episode anxiety on your most challenging day. 5s there any doubt whatsoe!er that you handle HA minutes o challenge in order to permanently reclaim the dri!er"s seat o your mind8 &nd you won"t be asked to do it all at once. 'ust up to three minutes at a time and then take a break. 7e should also prepare you or the possibility o a small spike on day se!en. 7hile the a!erage study participant was down to just o!er / episodes per day by day six, day se!en brought an a!erage o . cra!ings, be ore returning to / on day eight. 7e can only guess as to why. &nd there are lots o theories. Kne is that li e is measured in weeks and a ull week o reedom pro!ided the irst signi icant reason or celebration. Did your subconscious associate use with celebration8 5 so, what about the celebration that turns sour, like when e!eryone but mom orgets our birthday8 Eould that generate a second episode8 &gain, we can only guess. 7hat we do know is that 3/ minutes o additional challenge on day se!en, ollowed by F minutes on day eight, is entirely doable. %ooking at the study"s chart, notice how both physical withdrawal and the a!erage number o subconsciously triggered cra!e episodes peak on day three8 Eoincidence8 :ot necessarily. 7hile we ha!e little control o!er nicotine"s hal -li e, the reco!ery day on which we decide to ully engage li e and con ront the bulk o our normal daily subconscious cues is !ery much within our control. 'oel always started his clinics on a Tuesday night. ,istorically, many programs encouraged users to start on the weekend, thinking that it will help a!oid work pressures. 5 so, #onday brings day three, work, and the irst ull engagement o li e.
Cue %Btingui$hment
?eal-world e!idence <empirical= suggests that most subconscious use cues are extinguished a ter a single encounter, during which the conscious mind tells the subconscious mind $no.$ This does not mean that encountering the same nicotine use reminders day a ter day won"t cause the conscious mind to ocus or ixate upon $thoughts$ o wanting. 5t means that the irst encounter, where the subconscious learns that our consciousness will no longer respond to the cue is normally su icient to break the use association and end the mini-panic-attack type cra!e episodes which ollowed.
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?eco!ery is about re-learning to engage in e!ery acti!ity we did as users, but without nicotine. &s 'oel notes, ending all nicotine use almost immediately compels us to con ront and extinguish all nicotine-use conditioning related to sur!i!al acti!ities such as breathing, eating, sleeping and using the bathroom..0I 7hile essential to eed the children and get them o to school, early ears o encountering another cra!e trigger can moti!ate postponement o non-essential acti!ities such as housework or proper personal hygiene, at least brie ly. (ome try to hide rom li e. -ut, not without a price. & dirty house or tall grass may breed their own escalating internal anxieties or cause needless amily rictions. 'oel cautions that aside rom threatening our li!elihood and making us look like a slob, i we attempt to hide and a!oid con ronting use cues associated with non-sur!i!al acti!ities or too long, we may begin to eel intimidated that we will ne!er be able to engage in one or more o these acti!ities e!er again. Then there are non-mandatory acti!ities such as partying, dating, nurturing relationships, tele!ision, the 5nternet, sports, hobbies and games. The only way to extinguish use cues associated with an acti!ity is to engage in the acti!ity, con ront the cue and reclaim that aspect o li e. &gain, holding o too long can intimidate us into eeling that we can ne!er do it again. ?eco!ery anxieties generated by delay in reclaiming any aspect o li e are totally within our ability to eliminate. &t worst, the acti!ity is just three minutes o challenge away rom again being yours. Then again, there may not e!en be a challenge. %ast night 5 walked into a con!enience store to pay or gas while wearing my $,ug me 5 stopped smoking$ tee shirt. The clerk behind the counter asked i it were true. 7hile literally surrounded by cigarette packs, cartons, oral tobacco products and cigars he asked, $Did you really quit8$ $4es,$ 5 said. $& ter thirty years and being up to three packs-a-day@$ $5 ha!en"t had a cigarette or a week,$ he said. 4ou could eel his pride. 7hile heading out the door 5 heard the lady who had been behind me say, $Two packs o #arlboro %ights, please.$ Think about his irst day on the job a ter his last nicotine ix. 5magine your li!elihood requiring you to repeatedly reach or and handle cigarettes, a conditioned use cue or nearly all o us.
.0I (pit)er, '., &lcohol and Luitting, 'une B, /003, http9//www. n.yuku.com/topic/33AAF
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4es, his irst time may ha!e triggered a cue induced mini anxiety attack. 5 so, what are the chances he was so busy that it peaked and passed be ore he had an opportunity to take a break and quiet it by relapse8 7hile subsequent sales may ha!e caused urges associated with conscious thoughts o wanting, the di erence was the absence o an uncontrollable anxiety episode. This time, the intensity and duration o the experience was almost totally within his ability to control. -ut be care ul here. (ome conditioned use cues are so similar to others that we ail to grasp their distinction. Dor example, the #onday through (aturday newspaper may ha!e only been associated with smoking nicotine once, while (unday"s paper is much thicker and may ha!e required replenishment two or more times to read. Cue eBpo$ure ther py - Eue exposure therapy or E6T is intentional exposure to drugrelated use cues in order to more quickly extinguish learned associations..0F & tool o modern drug treatment programs, it can be our tool too. 7e can either wait or time and li e to bring nicotine use cues to us, or seek out and extinguish them as quickly as we desire. Dor example, it"s likely that nicotine use cues are associated with our daily work schedule or chores. 7e can ear and delay encountering these work related use cues or intentionally target them or extinction. Kur problem in using E6T is the same problem con ronting researchers and drug treatment programs. 7e can"t possibly know all the use cues adopted by the subconscious mind. 6!en i we did, some situations, such as changing seasons or holidays, would be beyond our ability to reproduce. E6T is, at best, only a partial tool. &lthough we ha!e the ability to boldly and quickly reclaim most aspects o li e, we need to accept that some cues will sur!i!e and arri!e when presented by time or circumstances. (till, intentionally con ronting as many as possible will oster con idence and help prepare us to e!entually extinguish all o them.
.0F %ee ', :icotine cra!ing and cue exposure therapy by using !irtual en!ironments, Eyberpsychology +
-eha!ior, December /00., Golume A<F=, *ages A0I-3H.
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&lso, when encountering what appears to be a use cue, how do we distinguish between true subconscious classical conditioning <an uncontrollable response= and conscious thought ixation <a controllable situation=8 5t isn"t always easy. 6!en a ter nearly all o our subconscious use cues ha!e been extinguished, it"s normal and natural or our senses to notice old use situations. The di erence is that now we"re in ull control o our mind"s response. Try to imagine and picture a high quality photograph o your a!orite ood. *icture the best photo o it that you"!e e!er seen. 5t oo)es and drips with la!or. Ean you smell it8 5magine that irst bite. (a!or the la!or and sense the $aaah$ wanting relie sensation that ollows. 7hile 5 controlled the imagery cues, you controlled the intensity and duration o any desire or urge elt. 4ou were totally ree to stop at any time. ?esearchers ha!e disco!ered that young smokers respond to E6T better than long-term smokers..0A 4ounger users o ten ha!e established ewer nicotine use associations and their memories house signi icantly less dependency baggage. E6T and intentionally trying to meet, greet and extinguish use conditioning is contrary to historic cessation lessons, the remnants o which can still be ound at some 5nternet sites. Dor example, the ;.(. go!ernment"s leading cessation booklet is HA pages and called $Elearing the &ir.$ *age B tells readers to stay away rom places smoking is allowed, and stay away rom people who smoke. The title o page /. reads, $(tay away rom what tempts you.$ ?eaders are then told to $(tay away rom things that you connect with smoking,$ like not sitting in their a!orite chair or watching their a!orite TG show. They"re told to dri!e a di erent route to work or not dri!e at all and take the train or bus or a while. .01 ,ow can we reclaim dri!ing or our a!orite TG program i taught to ear and a!oid it8 ;n ortunately, my go!ernment"s primary cessation booklet is loaded with serious con licts. The title o page B reads, $#eet those triggers head on.$ (ounds great, right@ -ut then the irst two sentences on page B state, $>nowing your triggers is !ery important. 5t can help you stay away rom things that tempt you to smoke.$ 7ell, which is it, $meet those triggers head on$ or $stay away$ rom them8 Elearly, it"s wise to stay away rom nonsense booklets such as $Elearing the &ir$ as they will only
.0A Traylor &E, et al, &ssessing cra!ing in young adult smokers using !irtual reality, The &merican 'ournal on
&ddictions, (ep-Kct /001, Golume 3A<I=, *ages .HF-..0. .01 :ational 5nstitutes o ,ealth, Elearing the &ir, &pril /00H, :5, *ublication :o. 0H-3F.A.
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cloud it urther. %et me share one more glaring $Elearing the &ir$ con lict. *age 3A is entitled, $#edicines that help with withdrawal.$ The page tells readers, $4ou may eel dull, tense, and not yoursel . These are signs that your body is getting used to li e without nicotine. 5t usually only lasts a ew weeks.$ There are medicines that can help with eelings o withdrawal9 ... $nicotine gum, nicotine inhaler, nicotine lo)enge, nicotine nasal spray, nicotine patch.$ The ob!ious question becomes, how does the body get $used to li e without nicotine$ by eeding it $nicotine8$ Kb!iously, it can"t. -ack to cue extinguishment. 7hat i we could extinguish some o our conditioned cues without experiencing any cra!ings8 ?esearch suggests that through conscious thought and its subconscious in luence that we ha!e the ability to create new expectations conditioning that o!erpowers old use conditioning, thus allowing a possible a!enue by which we can a!oid a particular cra!e episode altogether..0B &gain, think about how the single-session tra!eling hypnotist is able to brie ly interrupt use urges and cra!es. 5t isn"t magic. They relax our consciousness and then create new expectations. &lso, re lect again on the subconscious impact o the title to &llen Earr"s book $The 6asy 7ay to (top (moking.$ Don"t underestimate the ability o your conscious thinking mind to in luence your subconscious. (o long as we"re being honest, we are what we think. #y most dreaded use cue was walking into the pub a ter work and ha!ing a couple o beers with the guys, as we debated and sol!ed the world"s problems. 5"d lost my longest attempt e!er by combining alcohol with a alse belie that 5 could handle $just one.$ This time, online peer support taught me about use cues triggering cra!es and 5 expected a massi!e one. 5 eared it so much that 5 delayed the a ter-work gang or three weeks. 5 kept thinking how 5 missed my riends, our discussions, a cold beer, and 5 wanted it all back.
.0B Dols #, et al, (mokers can learn to in luence their urge to smoke, &ddicti!e -eha!ior, 'an-Deb /000, Golume
/I<3=, *ages 30H-301.
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Dinally, heading into my ourth week, 5 mustered the courage. ;pon opening the door, my healed sense o smell was immediately struck by an o!erpowering stink. ,ad it always been this bad8 5ndirect sunlight highlighted a thin indoor cloud that swirled as the door closed behind me. There they were, thirty or so a ter-work buddies tackling the day"s e!ents. (canning the room 5 was shocked to disco!er that all o them, without exception, were either smoking a cigarette or had a pack and ashtray within reach. 7hy hadn"t 5 noticed this be ore8 &lthough less than one-quarter o &mericans smoked, 5 was now disco!ering that nearly all o my riends were nicotine addicts. ,ow could this be8 7as it coincidence8 5 was prepared to turn and run i needed but it didn"t happen. & cra!e didn"t come. & ter a couple o minutes 5 grew bra!e and ordered a beer. 5t still didn"t happen. 7hat was going on8 This was my most eared situation o all and yet no cra!es, )ero, none. ,ow could 5 be standing here, beside smokers pu ing away and yet no urge8 5"m sure 5 could ha!e stayed and drank another but 5"d been in there or nearly a hal hour. 5 ound mysel thinking about my still healing lungs e!ery time sunlight pierced the smoke illed room. 5ncreasingly, 5 elt a slight burning sensation. #y lungs didn"t deser!e this. 5t was time to lea!e. %ooking back, it"s likely that 5"d gi!en so much thought to my biggest ear, while harboring dreams o reclaiming that aspect o li e, that desire somehow se!ered nicotine use associations. 5 went back again, a month or so later, with the same result. -ut 5"d punished these lungs long enough and it just didn"t seem right. Kur conditioning patterns mirrored how we li!ed li e. 7e cannot reclaim li e by a!oiding it. & /00/ study ound that BAC o inmates orced to stop smoking while in prison had relapsed within F months o release..30 7hen arrested, each was still an acti!ely eeding nicotine addicts. Knce released,
.30 Tuthill ?7 et al, $Does in!oluntary cigarette smoking abstinence among inmates during correctional
incarceration result in continued abstinence post release8$ <poster=. /Fth :ational Eon erence on Eorrectional ,ealth Eare, :ash!ille, Tennessee, Kctober /3, /00/.
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imagine their irst time dri!ing a car, walking into a bar or running into an old smoking buddy. They were hit head-on by conditioned nicotine use cues associated with a host o situations that their arrest and imprisonment had pre!ented rom being extinguished. &s the correct portion o $Elearing the &ir$ states, $meet those triggers head on.$ They mark the path home. 4es, you may ind that there are some aspects o li e that you no longer desire but that will be your choice. Con1ronting lcohol rel ted cr "e trigger$ - &s discussed in the Ehapter F topic $6arly &lcohol ;se ?isky,$ alcohol use is associated with roughly hal o all relapses. 5t"s the exception to the rule that we should try to quickly extinguish all learned nicotine use associations. ?egarding alcohol, it"s prudent to allow oursel!es a ew days to get our reco!ery legs under us and mo!e beyond peak withdrawal be ore attempting use. 6!en then, due to diminished inhibitions, the smart mo!e is to consider breaking drinking down into more manageable challenges that present ewer cra!e triggering cues. ;se associations between alcohol and nicotine can in!ol!e multiple cues. 7e may ha!e use cues associated with entering a drinking location, engaging in a drinking related acti!ity, sitting down, seeing alcohol containers, hearing ice cubes hit a glass or the sound o a bottle or can opening, picking up a drink, tasting that irst swallow, or beginning to sense the onset o alcohol"s inhibition diminishing e ects. 7e may ha!e de!eloped nicotine-alcohol use associations where the use cue is encountering a drinking acquaintance, riend or another nicotine user, being around lots o other users, seeing ashtrays, cigarette packs and lighters within easy reach, seeing a cigarette machine or !isible packs or cartons or sale behind the bar, or e!en sight o a jug illed with ree matches. ;se cues could be associated with engaging in con!ersation while drinking or ha!ing con!ersation shi t gears into debate or argument as alcohol"s inhibition diminishing e ects begin to be elt. 5mpaired judgment and diminished inhibitions may ha!e established nicotine use cues associated with hearing music, eeling the beat, singing karaoke, dancing, playing games, lirting, ear, rejection, acceptance, partying, joy, sadness or beginning to eel drunk and turning to nicotine to stimulate the body"s ner!ous system.
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(o how do we tackle alcohol-nicotine use associations8 Eonsider the bene it o learning to use alcohol and extinguish your primary alcohol-nicotine use associations in the sa est en!ironment a!ailable <usually our home=, away rom other potential use associations. Ean you handle nicotineree alcohol consumption when unaccompanied by other possible nicotine-alcohol use cues8 5 not, you may be acing alcohol abuse or dependency concerns as well. 5 so, the situation isn"t hopeless. &lthough entirely possible to arrest either dependency alone, research suggests substantial bene its in arresting alcohol and/or other drug addictions at the same time <see Ehapter F - $6arly &lcohol ;se ?isky$=. Knce able to drink alcohol without using nicotine it"s time to extinguish other nicotinealcohol use associations. Eonsider not using any alcohol during your irst encounter with other potential alcoholnicotine use situations, or limiting alcohol use so as to allow yoursel greater conscious and rational control. Eonsider drinking a bit slower than normal, spacing drinks urther apart or drinking water or juice between alcoholic drinks. Eombine your intelligence with baby steps. ,a!e an escape plan and a backup plan and be prepared to deploy both. (ince hal o all atal !ehicle collisions in!ol!e alcohol use, i you do drink, make sure that dri!ing a !ehicle is not part o the plan.
/he Aigger the Aetter

&lthough the cra!e episode chart re lects a!erages o data rom a speci ic study o a unique population, it shows two actors common to e!ery reco!ery. 5t e!idences that the number o daily cra!e episodes quickly peaks. 5t also shows that the number o episodes then begins to gradually decline. %et"s ocus upon what happens once the number o daily cra!e episodes experienced, i any, begins to decline. 5 say $i any$ because knowledge and understanding ha!e potential to make reco!ery a cakewalk. ;nless hiding in a closet in order to a!oid temptation, locked up in prison or laid up in the hospital, we ha!e no choice but to meet, greet and extinguish the bulk o our subconscious eeding cues within the irst week. The number and requency o early challenges helps keep us alert, prepared and ready to deploy our cra!e coping de enses on a moment"s notice.
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&s shown by the cra!e episode chart, by day 30 the a!erage study participant was experiencing just 3.. cra!e episodes per day. That translates to less than i!e minutes o signi icant challenge. -ut what about the days that ollow8 7hat would be the natural and expected consequences o beginning to go entire days without once encountering a still acti!e cra!e trigger8 7hat will happen to anticipation, your preparedness, your de enses and battle plans once you experience a day or two without challenge8 Dor purposes o discussion only, let"s pretend that during reco!ery days 3., 3I and 3F, although you remained occupied in dealing with conscious thinking about wanting to use, that you did not encounter any un-extinguished eeding cues or experience any ull-blown cra!e episodes. &lthough unlikely you would ha!e noticed, wouldn"t it be normal to begin to relax a bit and slowly lower your de enses and guard8 &nd then it happens. Kn day 3A you encounter an un-extinguished use cue. (urprised, it catches you totally o -guard and unprepared. 4ou scramble to muster your de enses but it"s as i you can"t ind them. 5t"s as i they too are being swallowed by a ast mo!ing tsunami o rising anxieties. 4ou eel as i you"!e been sucker-punched hard by the most intense cra!e e!er. 5t eels endless. 4our conscious thinking mind begins suggesting that things are getting worse, not better. The thought o throwing in the towel and gi!ing-up suddenly begins sloshing about inside a horri ied mind. 5t"s then, when things seem worst, that we need to brie ly pause and re lect upon what we"re really seeing. Things are not getting worse, but better. Think about how long it"s been since your last signi icant challenge and how relaxed you allowed yoursel to become. 5t"s likely that this episode is no more intense than prior ones. 5t"s just that you"d taken o your li e jacket and you couldn"t quickly locate and put it on. 4ou panicked. 5 such an e!ent should happen to you, 5 encourage you to stop, re lect and then celebrate@ 4ou"!e reclaimed so many once conditioned aspects o a nicotine dependent li e that
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serious challenges are beginning to grow rare. Kh, you may still encounter remote or e!en seasonal triggers. -ut with the passing o time they"ll grow urther apart, shorter in duration and generally less intense. ?emember to keep a clock handy so as to de end against time distortion. :one o us will e!er be stronger than nicotine but then we don"t need to be as it"s simply a chemical with an 5L o )ero. Trust your dreams to your !astly superior intelligence, your greatest weapon o all. :o matter how ar we tra!el or how com ortable we become, there"s still just one guiding principle allowing us to remain here on the ree side o the bars, while keeping our dependency under arrest on the other ... no nicotine today.
Rew rd
Eonsider re!ersing your mind-set. ?eco!ery isn"t about punishment but rewards. Kur chemically ensla!ed sur!i!al instincts teacher was ooled. 5ts job was to make dopamine pathway acti!ating e!ents nearly impossible in the short term to orget or ignore. 6xcept or responding to the wrong input, it unctioned as designed. 5t did its job and did it well. -ut now it"s time or a mind schooled in nicotine dependency and reco!ery to sa!e the day. 6xtinguishing each conditioned use cue rewards us with the return o another aspect o a nicotineree li e. 7hy ear being able to inish work, a meal, exit a store or dri!e without experiencing an urge or cra!e commanding replenishment8 7hen a cra!e arri!es, think about the pri)e at the end. ?e lect on wanting or more nicotine being permanently e!icted rom the yard, bathroom, porch, car, work and play, and no longer associated with our relationships, acti!ities or emotions. Era!e episodes re lect e!idence o where we"!e many times been, and what we were orced to do once there. -ut not anymore@ The moments can again be ours. #oments o subconscious healing are good not bad. (oon, you will ha!e reclaimed so many aspects o li e that, like putting together a pu))le, it will re lect a li e reclaimed.
Cr "e Coping /echniIue$

,ow do we success ully na!igate a less than three minute cra!e episode8 7e"!e already re!iewed a ew ways, including reaching or your list o reasons or commencing reco!ery.
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%et"s take a look at additional coping techniques. %m'r cing cr "e epi$ode$ - ;pon sensing danger, our sur!i!al instincts tell us to either prepare to stand and ight or get ready to run. 7hat approach will you use8 ;pon encountering a cra!e episode will you duck and run or turn and ight8 7hile the objecti!e is clear - to not use nicotine - our natural instincts on how best to achie!e that objecti!e may not be the easiest path to tra!el. Ean we hide rom cra!ings or will they ind us8 Ean we runaway or will they catch us8 5t"s the same with going toe to toe in battle, isn"t it8 Ean we beat-up cra!es and make them surrender or cry uncle8 Ean we scare them away8 6ncountering and extinguishing use cues is how we mend, heal, repair and reclaim a nicotine dependent subconscious mind. 5t"s how we destroy use expectations and take back li e. 7hile nicotine is a natural poison, what about cra!es8 Ean a cra!e that lasts a couple o minutes destroy tissues, clog arteries and cause a heart attack or stroke, promote cancer, or contribute to early dementia8 7ill a cra!e cut us, make us bleed or send us to the emergency room8 Ean it physically harm us8 5 not, then why ear it, why run, why hide8 ,ow much o the anxiety associated with reco!ery is sel -induced8 :early all. (o, why agoni)e o!er the anticipated arri!al o that next cra!e8 Knce it does arri!e, why immediately begin eeding our mind additional anxieties that only uel the ire8 %et"s not kid oursel!es. The anxiety associated with a cra!ing or nicotine is as real as the eyes reading these words. &nd ear o anxiety hides solutions. 7hile ully capable o mentally embracing and wrapping our arms around anxiety"s energy, ew ha!e e!er done so. 5nstead, what we eel is a tremendously in lated experience ueled by anticipation, dri!en by ear, and possibly tense due to a history o prior relapse. Try this, just once. 5nstead o in!iting your body"s ight or light response to in lame the situation, when the next cra!e arri!es, stop, be bra!e, drop your guard, take slow deep deliberate breaths and in your mind imagine reaching out and wrapping your arms around the cra!e"s anxiety energy.
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5t won"t harm or hurt you. 5t"s normal to be a raid but be bra!e or just one moment. 5magine wrapping yoursel around the episode and ully embracing it. Eontinue taking slow deep breaths as you clear your mind o all chatter, worries, ears and thoughts so that you can sense and appreciate the episode"s le!el o raw anxiety. Touch it, sense it, hug it hard. Doing so will not make it any more intense than it otherwise would ha!e been. 4ou"re witnessing a moment o the most pro ound healing your mind may e!er know. 4es, there is anxiety. -ut possibly or the irst time e!er, it"s not being ed and ueled by you. :ow eel as the cra!e episode"s energy peaks and then begins to gradually subside. 4ou"!e won@ 4ou"!e reclaimed another aspect o li e. &nd you did so by way o courage not dread, by a hug, not hiding. 4ou"!e seen that the greatest challenge presented by natural reco!ery cannot hurt you. Knly we can do that. 6mbrace reco!ery don"t ear it. There"s a special person waiting down the road. 4our birthright, it"s a long lost riend you"ll come to know, sa!or, enjoy and lo!e. #i$tr ction coping - Dar less courageous, distraction is any mental exercise or physical acti!ity that occupies the conscious mind long enough to allow challenge to pass. &lphabet or counting association schemes demand some degree o ocus and concentration. They pro!ide an instant means o occupying the mind. &n alphabet association scheme can be as simple as going through the alphabet while trying to associate each letter with a person, place, animal or ood. Take ood or example. The letter $&$ is or grandma"s hot apple pie. $-$ is or a nice crispy piece o bacon. $E$ is or a rich and moist chocolate cake. 5 challenge you to try and get to the challenging letter $L$ be ore three minutes pass and challenge subsides. *hysical distraction possibilities include turning to your a!orite non-nicotine acti!ity, a brie period o physical exercise or something as simple as brushing your teeth. &cti!ities such as screaming into a pillow, squee)ing a tree or biting your lip are a!ailable should you e!er eel a need to !ent. The pillow won"t scream back, 5 doubt you"ll hurt the tree and your lip will heal.
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Rel B tion coping - 6mbracing cra!e episodes is one means o increasing relaxation by pre!enting the addition o sel -induced anxieties. #editation is another tool or na!igating a cue induced cra!e episode. #ost orms o meditation use breathing and ocus as a means to oster inner peace and tranquility. ?esearch con irms their ability to calm anxieties..33 Try this. Eom ortably sit in a chair or on the loor. (traighten yet relax your spine. :ear the le!el o your na!al, lay one hand in the palm o the other with thumbs slightly touching. Mently close your eyes. :ow allow your breathing to slow and deepen. Ealm and settle your mind by ocusing exclusi!ely upon the eelings and sensations o breathing. Docus entirely upon that next breath. Deel the cool air entering your nostrils and its warmth as you slowly exhale. 7hen a thought arises don"t chase it but instead breathe it away. Eontinue ocusing upon each breath. &s challenge subsides, allow yoursel to become increasingly aware o your surroundings as you slowly open your eyes. 5nstead o ocusing upon breathing, other orms o meditation, such as panic attack coping or mind ulness based stress reduction, encourage exclusi!e ocus upon your a!orite color, person or that $special place.$ 7e also should mention laughter. ?esearch shows that laughter acti!ates !arious muscle groups or a ew seconds each, which immediately a ter the laugh leads to general muscle relaxation, which can last up to .I minutes..3/ %aughter also induces sporadic deep breathing..3H There"s also e!idence suggesting that among those with a sense o humor, that laughter and smiling may result in diminished anxiety and stress..3. ?emember, this is conditioning that you created. 5t"s now commanding relapse, the introduction o nicotine back into your body. 7hy not gi!e laughter"s calming e ects
.33 &gency or ,ealthcare ?esearch and Luality, #editation *ractices or ,ealth9 (tate o the ?esearch,
6!idence ?eport/Technology &ssessment :umber 3II, &,?L *ublication :o. 0A-6030, 'une /00A .3/ *askind ', 6 ects o laughter on muscle tone, &rchi!es o :eurology + *sychiatry, 3BH/, Golume /1, *ages F/H-F/1J as cited in -ennett #*, et al, ,umor and %aughter #ay 5n luence ,ealth9 555. %aughter and ,ealth Kutcomes, 6!idence--ased Eomplementary and &lternati!e #edicine, #arch /001, Golume I<3=, *ages HA-.0. .3H Dry 7, The respiratory components o mirth ul laughter, 'ournal o -iological *sychology, 3BAA, Golume 3B, *ages HB-I0J as cited in -ennett #*, et al, ,umor and %aughter #ay 5n luence ,ealth9 555. %aughter and ,ealth Kutcomes, 6!idence--ased Eomplementary and &lternati!e #edicine, #arch /001, Golume I<3=, *ages HA-.0. .3. 4o!etich :&, et al, -ene its o humor in reduction o threat-induced anxiety, *sychological ?eports, Debruary 3BB0, Golume FF<3=, *ages I3-I1.
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a try. 7hat"s there to lose8 !n lytic l coping - ,ere, moments o challenge are spent ocusing upon and analy)ing the situation. 6mbracing a cra!e episode its nicely here too. (o does pulling out and re!iewing your list o reasons or commencing reco!ery. &lso consider re!iewing them when not challenged, so as to help keep your moti!ational batteries ully charged. 7hat cue triggered the episode8 7hile we can"t know or certain, what"s your best guess8 7hat acti!ity, emotion, person, place or time might the nicotineree you be awarded once this cra!ing passes8 %ook at a clock and time the episode. ,ow long did it take be ore its anxieties peaked8 5s that shorter or longer than your last challenge8 ,ow long had it been since your last signi icant challenge8 Eonsider keeping a cra!e episode log. They make interesting reading. %ike medical records, they allow us to quickly look back and see how ar we"!e come. & log can pro!e !aluable while waiting or the inal reco!ery layer to pass, conscious reco!ery. 5t"s here that the pace o noticeable change will naturally begin to slow. >r l coping - Kral coping is a orm o crutch substitution. 5t is capable o ostering use conditioning which causes continuing use o the crutch long a ter challenge has ended. ;sing ood as an oral crutch can ob!iously add extra pounds. &ll oral coping strategies should be a!oided, especially any that imitates use or the handling o any object that imitates your nicotine deli!ery de!ice. 5mitating any addiction related beha!ior helps maintain that beha!ior, delays suppression o old use memories, in!ites use ixation, prolongs reco!ery and thus ele!ates risk o relapse. 5 you ind yoursel reaching or something more substantial than a toothpick or toothbrush, make sure it isn"t attening and something you"d eel com ortable doing anywhere or years to come. 5 you"re ha!ing di iculty a!oiding reaching or extra ood, consider eating healthy. Ean you eat an entire apple in H minutes8 5 so, according to the DD&, that"s 10 calories and . grams o iber. Di!e asparagus spears are /0 calories, one medium si)ed stalk o broccoli is I0, a se!en inch carrot is .0 calories, one-sixth o a medium head o cauli lower or two medium stalks o celery total /I calories, a medium cucumber is .I calories, a medium orange 10, one medium peach is .0 calories, se!en radishes total /0, eight medium
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strawberries are A0, and one medium tomato is HI calories.
;e $on l, 7olid y nd <n1reIuent Cue$

6xpect to arri!e home with a ew seasonal, holiday and in requent cues not yet encountered and extinguished. -ut take heart, an occasional reminder o the ama)ing journey you made can help end o complacency. 5n requent cues can be associated with a !acation, a wedding, death, uneral, meeting an old riend or e!en illness. Dor example, there"s a good chance that catching that irst cold or experiencing that irst bout o lue a ter commencing reco!ery will be your irst illness as an ex-user. 7hen a cold or lu struck while still using it likely diminished use, thus possibly adding early withdrawal to the illness. 7hen your cold or lu symptoms started to impro!e you likely quickly increased nicotine use in an e ort to end withdrawal. &s when an illness is ending, the subconscious may also ha!e been trained to expect a sudden increase in use ollowing a death or uneral. The good news is that any remaining subconscious use associations a ter arri!ing on 6asy (treet are likely weak, as death and illness ha!e hope ully been rare. &lso, the mind"s cra!e anxiety generator depends hea!ily upon !ibrant and rein orced new use memories or its punch. :o new use memories are ser!ing as memory bank in usion reminders or thousands o old use memories. The good news is that each day o not using helps ensure that remaining challenges are shorter in duration and generally less intense. During your second nicotineree lap around the sun, with ama)ingly ew exceptions, nearly all nicotine use cues will ha!e been extinguished. Kh, you"ll still ha!e a conscious use thought now and then <Ehapter 3/=. -ut with time they grow urther apart too. 5 allowed, they"ll become laughable yet welcome reminders o your journey home. :ow that you know more about subconscious reco!ery than most physicians <as ew medical schools de!ote any class time to studying cessation=, what i it were possible to minimi)e or eliminate cra!e episodes altogether8 7hat i use cue extinction could occur without crisis8
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The next chapter, Ehapter 3/, re!iews the primary source o cra!e episode anxieties, our thousands o old nicotine replenishment memories documenting use ha!ing satis ied wanting, and the scores o explanations we in!ented to explain why we would soon use again. There"s still just one rule. 5t"s that one equals all, that lapse equals relapse, that just one pu and nicotine will acti!ate the same brain dopamine circuitry that makes going without eating seem nearly impossible. 7hy pretend or expect a di erent result8 'ust one rule ... none today@
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Ch pter 12
Con$ciou$ Reco"ery & Journey /hin(ing
Think o
it as journey thinking. The inal yet longest layer o reco!ery is rooted in the time needed to mo!e beyond use related memories, belie s and thoughts. This chapter"s objecti!e is to accelerate conscious reco!ery. Dirst, we"ll ocus on the truth about that pile o old wanting satis action memories, the anxiety in!iting bars that helped orm our prison cell. (imply put, why in!ite torment by the lie each memory deli!ers, that use is the solution to wanting8 &lso, why be teased by a biological need to eed which no longer exists within /-H weeks o ending use8 :ext, we"ll examine a ew additional alse use belie s that our lack o dependency understanding may ha!e orced us to in!ent. (imply put, why allow use lies in!ented by a mind that knew almost nothing about chemical dependency to combine with thousands o old wanting satis action memories and uel irrational ears, anxiety or e!en panic8 5magine what would happen i willing to totally let go o all use justi ications. 7hy not gi!e truth a chance8 7hile reedom begins the moment we say $no$ to more, truth o ers potential to accelerate trans orming $no$ into calm.
/he :in l /ruth

&lthough 5 ha!e no idea where you are in reco!ery, or i you"!e e!en started yet, let"s assume or a moment that you"re almost home. 4ou adopted a protecti!e $one day at a time$ reco!ery outlook that has kept you rooted and grounded in here and now. 4ou learned to remain patient during a less than H minutes cra!e episode clamoring or compliance. 4ou stuck with it or the ull A/ hours needed to empty your body o nicotine. &t last you were clean@ 4our healing and glory continued or the two to three weeks needed to re-sensiti)e and down-regulate receptor counts, allowing your brain to ully adjust to unctioning without nicotine. 4ou con ronted and extinguished all but remote, in requent or seasonal subconscious use cues, and are now less than two weeks away rom that irst ull day o total and complete
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mental quiet and calm, where you ne!er once think about wanting to use. (till, now, you ind moments each day where your mind continues to be occupied with thoughts o using. The waning tease o years old $aaah$ wanting satis action memories continue to call, each proclaiming that the way to end wanting is to use. 5t normally happens something like this. 4our eyes, nose or hearing sense some aspect o use, or a leeting thought turns your attention to the subject o using. -e ore you know it, old use memories begin suggesting that use can end wanting. &n internal debate commences, as an old use justi ication enters your mind and bumps heads with the reality that you"!e already stopped. -e ore considering the use rationali)ation that sur aced, let"s re lect on a ew truths about the pile o old use memories that awakened it. 7hy8 -ecause while we cannot erase them, honest light can diminish or e!en eliminate their pester and tease. ?ecall the 3BB0 -randon study re!iewed in Ehapter /. 5t ollowed and examined lapse and relapse in smokers who"d success ully completed a two-week cessation program. .3I 5t also documented the primary emotion elt immediately a ter relapse <initially termed lapse=. &ssume that many o them were close to where 5"!e asked you to pretend you are now, a couple o weeks away rom that irst ull day without wanting. 4ou"!e already succeeded in ully na!igating physical withdrawal. There is no chemical missing and no chemical in need o replenishment. 4our brain has ully re-sensiti)ed and down-regulated. The biological need or nicotine in order to maintain the addict"s sense o $nicotine normal$ no longer exists. 4our brain"s sense o normal <homeostasis= has been restored. -ackground dopamine le!els <tonic le!els= are ele!ated, and their decline no longer induces wanting or nicotine. (o, with nothing missing, what would be the primary emotion you"d expect to experience i you lapsed and used nicotine8 &ccording to the -randon study, the !ast majority had a negati!e reaction. &mong them, 3HC elt depressed and hopeless, HHC experienced anxiety and tension, 3FC were angry and irritated, and 3/C elt boredom or atigue. Knly H.FC reported what most o us would ha!e expected ollowing normal replenishment, which was
.3I -randon, T, et al, *ostcessation cigarette use9 the process o relapse, &ddicti!e -eha!iors, 3BB0J 3I</=, pages 30I-33..
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$ eeling relaxed.$ There"s no denying that sagging blood nicotine le!els reduced background or tonic dopamine, which generated wanting. 6ach nicotine ix stimulated the release o a burst o dopamine <a phasic release= which ele!ated tonic le!els and satis ied wanting. 6ach use also created a new high de inition dopamine pathway memory o how wanting was satis ied. Eollecti!ely, thousands o old such use memories daily pounded home the message that use satis ies wanting. Together, they helped orm our prison cell, a thick wall pre!enting us rom seeing truth. #ore easily seen during this inal layer o reco!ery, their collecti!e in luence in!ites and osters use anxieties. 7hile still using, those anxieties moti!ated us to in!ent use compliance rationali)ations. :ow during reco!ery, i allowed, debating and struggling with our use rationali)ations can oster anxiety. 4es, each ix brought the addict a true sense o relie . &nd yes, old wanting satis action memories were !alid when made. ,owe!er, one critical actor has changed. The brain has now ully adjusted to unctioning without nicotine. There is nothing missing. 5 we !isit online reco!ery orums and dig back through messages describing relapses that occurred beyond week /-H weeks, those describing the sensations they experienced ha!e a common ring. They read like this, $5 had a mouth ull o smoke, 5 was di))y and 5 coughed, but 5 didn"t get the sense o satis action 5 expected. 5t just didn"t come@$ %i))y, a member o 7hyLuit"s Dreedom support site wrote9 $The irst cigarette a ter our years tasted like %uther"s -oot. 5t was horrible. 5 smoked the whole thing wondering why 5 was smoking it <answer9 tequila and complacency=. 5 woke up the next morning eeling worse than any hango!er could possibly eel, because 5 wasn"t hungo!er.$ $5"d inhaled poison the night be ore. #y head was killing me, 5 elt nauseous and my lung elt as though 5"d sucked up broken glass. There was no "aaah" eeling. 5t was more like "aauugghh@@@" 7hat had 5 done to mysel 8$.3F
.3F %i))y-, The Dinal Truth, ?esponse N33, Dreedom rom :icotine, 'une /F, /00F.
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Thousands o enticing old use memories stored in the pre- rontal cortex tell the relapsing person to expect a sense o relie and satis action, that use will satis y wanting. -ut in that their brain had already ully adjusted to unctioning without nicotine, their wanting itsel was memory based and the expected $aaah$ wasn"t there. ;nlike when those old $aaah$ sensations were recorded, there was nothing missing and nothing in need o replenishment. #emories suggested a physical need that no longer existed. The absence o nicotine was blamed or each memory"s tease, thus trans orming a culprit into a cure. (o, with great expectations they took that irst hit o nicotine and it ailed to measure up. 7hat happens next8 (adly, the uneducated user is likely clueless as to why lapse didn"t match expectations. They"ll ind the absence o an $aaah$ wanting relie sensation hard to belie!e. They know that the satis action message being shouted by thousands o old replenishment memories was true when made. &lthough relapse has already occurred and ull blown wanting and begging will soon return, they"ll likely keep digging inside the pack, pouch, tin, packet, tube or box, trying to get use to match expectations. 6!entually they"ll succeed. &cti!e dependency is soon restored, o ten with an increase in le!el o use <a tolerance increase possibly due to nicotine binge gorging ollowing relapse=. :ow, they can look in the mirror and say to themsel!es, $(ee, 5 was right.$ $(moking did bring me a relaxed $aaah$ eeling and sense o relie @$ (till, the basic wanting satis action message suggested by each old use memory was a lie e!en when made. ;se cannot and does not end wanting. To the contrary, it"s the only way to ensure its sur!i!al. The only way to end wanting is to na!igate this temporary period o readjustment called reco!ery. ?eali)e that all memories o that $per ect$ ix were created inside the mind o an acti!ely
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eeding drug addict riding an endless cycle o nicotine/dopamine highs and lows. 7hile thousands o old replenishment memories document use gi!ing us a brie pause in wanting, they belong to who we once were. &nd who we once were demanded explanation. Kur dignity needed to sur!i!e.
#ignity=$ #eni l
&s teenagers, what most o us thought would be a brie rebellious experiment was quickly trans ormed into a power ul permanent chemical addiction, as occasional nicotine use became regular, and optional use mandatory. (tudies con irm that or some o us it only took coughing and hacking our way through a couple o cigarettes be ore sla!ery"s shackles began to tighten..3A Di!e, ten, i teen nicotine ixes a day - when would enough be enough8 $Tomorrow, tomorrow$ became the li etime cry o millions. 7elcome to the realities o chemical ser!itude, a world built upon lies. (cience calls our lies denial. Denial is an unconscious de ense mechanism, just below the sur ace, or resol!ing the emotional con lict and anxieties that naturally arise rom li!ing in a permanent state o sel -destructi!e bondage. The three primary areas o denial relied upon by nicotine addicts are dependency denial, cost denial and reco!ery denial. 5n each, truth is sacri iced or piece o mind or to justi y relapse. :early e!ery nicotine addict we"ll see today is insulated rom the pain o capti!ity by a thick blanket o denial rationali)ations, minimi)ations, ault projections, escapes, intellectuali)ations and delusions. Together, they create the illusion that a problem either doesn"t exist or is somehow being sol!ed. The a!erage addict musters the con idence to challenge their addiction once e!ery two to three years. :ot knowing the %aw o &ddiction and ighting in total darkness, only about 3 in /0 succeed in breaking ree or an entire year. 7ith respect to smoking, by ar the most destructi!e and deadliest orm o nicotine deli!ery, these horrible reco!ery statistics e!entually result in hal o us dying by our own hand. There are more than i!e million senseless sel -destructions annually. They stand as
.3A DiDran)a '?, ,ooked rom the irst cigarette, (cienti ic &merican, #ay /001, Golume /B1<I=, *ages 1/-1A.
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irre utable e!idence o denial"s depth in insulating us rom the extreme price paid with each pu , a bit more o li e itsel . Knce we"!e accepted that the basic message deli!ered by thousands o old replenishment memories is alse, this inal layer o reco!ery o ers opportunity to laugh at use explanations once deeply belie!ed. Dirst, let"s be clear. Kne need not do anything to succeed except to end use. 5t"s how the !ast majority o $real-world$ ex-users did it. They simply waited and allowed su icient time to pass until both the tease o their pile o old wanting satis action memories and their use justi ications aded into calm. Ean we accelerate the process by seeing the truth about both8 &bsolutely@ 5magine ha!ing a brain wanting disorder, a mental illness as real and permanent as alcoholism and not knowing it. 5magine residing inside a chemically dependent mind yet not reali)ing that it had desensiti)ed itsel by growing millions o extra nicotinic-type acetylcholine receptors in multiple brain regions. 5magine no awareness that nicotine controls the low o more than 300 chemicals inside our body. -ut we didn"t need such details to know we were hooked. 7e"d already experienced increased anxieties a ter ha!ing waited too long between eedings. Deep down, we knew we"d lost the autonomy to simply turn and walk away. &nd e!en though we"d tried to tune it out, we also couldn"t help but hear the dull roar o the endless stream o new medical studies. They reminded us how each and e!ery pu destroys more o our body"s ability to recei!e and transport li e-gi!ing oxygen. They warned o the deadly consequences o continuing to inhale the 13 cancer causing chemicals so ar identi ied in cigarette smoke, or the /1 ound in smokeless tobacco juices. 7e knew we were slowly building cancer time-bombs throughout our body. 7hat we didn"t know was how to stop building and start di using. (o how did our conscious mind cope with the sobering reality that our brain was sla!e to its own sel -destruction8 ,ow did we look in the mirror each morning and maintain any sense o dignity, sel -
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worth or sel -respect while constantly being reminded that we were prisoners to dependency, decay, disease and death8 &s smokers, how did we cope with each day bringing oursel!es a bit closer to completing the act o committing chemical suicide8 5t was easy. 7e learned to lie. 7e called upon our intelligence and conscious mind to help build a thick protecti!e wall o denial that would insulate us rom our dependency"s hard, cold realities. Kur basic wall building tools were conscious rationali)ations, minimi)ations and blame trans erence. 7e could then hide when those on the outside elt the need to remind us o who we really were, and what we were doing. 5t was also a place to hide when cra!es and urges reminded us that nicotine use was no longer optional, a home to explanations or our in!oluntary obedience to them. &lthough nicotine"s two-hour hal -li e was the basic clock go!erning mandatory eeding times, we became creati!e in in!enting alternati!e justi ications and explanations. 7hile most o us admitted to being hooked, we minimi)ed the situation by pretending that all we really had was some $nasty little habit.$ 5n our pre-dependency days <i there were any, as some o us were born hooked=, there was no dopamine pathway wanting moti!ating use. -ut once eedings became mandatory, it didn"t matter how we elt about them. Ehoice was no longer an issue. 6!en i we didn"t ully appreciate our new state o permanent chemical capti!ity, we rationali)ed the situation based upon what we ound oursel!es doing.
/e ring #own the W ll

5n Ehapter . we re!iewed common rationali)ations9 dignity"s wall o illusion, :icodemon"s lies. 7e learned that :icodemon does not exist. :or are there any other internal monsters. ?epeated use athered dopamine pathway dependency. Dependency combined use patterns, conditioning, sensations and rationali)ations to ather a ull-blown addiction. :icotine is not a riend and using isn"t about lo!e, la!or, pleasure, boredom, concentration, making co ee taste better or stress reduction.
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(uch rationali)ations insulated us rom a harsh world that was o ten in our ace and just wouldn"t let up. They were bricks in a wall made thicker by each empty pack, tin, pouch, tube, box or cartridge. Kur only wall building limitation in adding new bricks was our imagination. ,a!e you e!er noticed just how challenging it is to coax a smoker or oral user out rom behind their wall8 Mi!e it a try. 5t"s one o li e"s greatest challenges. & ter years and hundreds o additions, like a turtle drawing into its shell, it"s a solid and secure place to hide rom those seeking to impose their will upon us. Dependency"s protectors, during reco!ery the wall"s bricks, the lies we in!ented, become the enemy. ;nchallenged, they pro!ide super uel or relapse. 6specially here, during reco!ery"s inal phase, once no longer clouded or obscured by physical, emotional or subconscious challenge. ,ere, a simple sight, sound or smell can awaken our use memory bank"s collecti!e in luence. 5ts tease in!ites remaining use rationali)ations to sur ace. Eombining old use memories with a use justi ication can lea!e the new ex-user eeling o!erwhelmed and debating whether it"s all worth it. ?est assured, take heart, the peace and tranquility once addiction"s chatter ends is worth thousands o times more than the price o getting here. &gain, it"s not necessary that any o us set out to intentionally dismantle our wall o denial. Time will e!entually wear it down so long as, just one hour, challenge and day at a time, we keep our dependency under arrest. -ut in that our wall simply re lects rationali)ations that we oursel!es created, we ha!e it within us to rethink each, thus diminishing or e!en destroying their in luence upon us. (till, that"s easier said than done. 7hy8 -ecause each use justi ications is rooted in truth a!oidance, the exact opposite o what"s needed to let go o it. $Ju$t thin( 'out $omething el$e$ - Kur natural instinct is to try to ignore or suppress $junkie thinking$ when it attempts to take root and play inside our mind. $'ust try to think about something else.$ ?esearch shows that attempts at thought suppression may actually ha!e the re!erse e ect o causing the thought to-be-suppressed to intrude with greater requency into our consciousness..31
.31 ?assin 6, et al, *aradoxical and less paradoxical e ects o thought suppression9 a critical re!iew, Elinical
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Trying to think about something else o ten back ires making things worse. &s 'oel notes, the core o most internal debates likely in!ol!es ixation on the thought o ha!ing $just one,$ $one pu ,$ $one cigarette$ or $one ix.$ $5t"s hard to think about something else because one pu seems like such a wonder ul concept. They are o ten reminiscing about one o the best cigarettes, or more accurately, about the sensation around one o the best ixes they e!er had. 5t may be one they smoked /0 years earlier but that is the one they are ocused on,$ notes 'oel. $(o what about thinking about something else8 7ell, it"s hard to think o something else that can deli!er such pleasure as this magic memory,$ suggests 'oel. $6!en i they success ully think o something else and o!ercome that urge, they walk away rom the moment with a sense o longing or sadness with what they ha!e just been depri!ed o again.$ >eep in mind that their $pleasure$ and $magic memory$ is likely associated with ending one o the most intense moments o wanting their addiction e!er mustered. (o, what works instead8 $Ehange the tactic,$ ad!ises 'oel. $5nstead o trying <o ten unsuccess ully= to think o something else, acknowledge the desire. Don"t tell yoursel you don"t want one, you do and you know it.Z Y-ut remember there is a catch. To take the one you ha!e to ha!e all the others with it. &nd with the others, you ha!e to take all the problems that go with "them." The smell, the expense, the embarrassment, social ostraci)ation, the total loss o control, and the health implications.$ 'oel encourages us to see $just one$ or the alsehood it re lects. -y thinking about the entire spectrum o dependency that comes with $just one$ we can walk away rom the encounter eeling good about breaking ree. 7e won"t eel depri!ed but grate ul. The more !i!idly and accurately we are able to recall ull-blown dependency, the less we"ll think about it. $5n a sense orcing yoursel to remember will help you orget,$ 'oel notes. $:ot orget using, but the antasy, the appeal o a nicotine ix.$.3B &s with $just one,$ $just once,$ instead o trying to run or hide rom use rationali)ations that enter your mind, grab each by the horns. &nd don"t let go until you"!e turned it inside out. Think about the ensla!ed mind that created it. ,ow much did any o us then know about nicotine dependency8
*sychology ?e!iew, :o!. /000, Golume /0<1=, *ages BAH-BBI. .3B (pit)er, ', $'ust think about smoking else,$ &ugust H3, /00/, http9//www. n.yuku.com/topic/3/I13
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6xamine each use rationali)ation in honest light. Do you recall where it came rom8 5s that how you elt the !ery irst time you used nicotine8 Does tobacco industry store marketing play to it8 7ould relapse somehow make the rationali)ation permanently go away, or instead guarantee its sur!i!al8 Ean you say with certainty that it"s true and honest, or was it in!ented by a mind that needed justi ication or answering nicotine"s next dinner bell8 7hether we choose to attempt to destroy rationali)ations or wait or new non-use memories to suppress them, the day is approaching when you"ll awaken to an expectation o going your entire day without once wanting to use. Kh, you"ll still ha!e thoughts now and then, but with decreasing requency, shorter duration and declining intensity. They"ll become the exception, not the rule. They say that $truth shall set us ree$ but there"s an e!en better guarantee. 5t"s impossible to lose our reedom so long as we re use to allow nicotine back into our body. The next ew minutes are all that matter and each is entirely do-able. Thoughts or no thoughts, there was always only one rule ... no nicotine today, :K:6 <.> .icotine %!er=@
More 0ie$
5n Ehapter . we examined the primary and most common use rationali)ations. %et"s look at a ew more. -ut why8 -ecause use justi ications in!aded nearly e!ery aspect o our thinking. ;nless willing to let go, we not only risk becoming a reluctant ex-user, down the road they become complacency"s seeds or relapse. -ut letting go requires awareness that something is being retained. 7e each in!ented our own unique list o use excuses. (ome can be easily o!erlooked. ,ope ully the ollowing additional examples will brush against and pro!oke awareness o additional areas o use thinking in need o honest re lection. &s mentioned earlier, conscious rationali)ations usually all into one o three categories9 dependency, cost or reco!ery. #ependency R tion li5 tion$ Dependency rationali)ations seek to deny or minimi)e being hooked, or suggest reasons
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or continuing use. %et"s look at a ew examples. 2< don=t e"en (now i1 <=m hoo(ed. <="e ne"er tried $topping2 & (ome ha!e ne!er made a serious reco!ery attempt. -ut why8 7hat better way o ne!er ha!ing to admit chemical dependency or experience de eat than by a!oiding e!idence that a problem exists8 2< only u$e once d ily@2 (ome rationali)e that their use le!el is too little to be addicted, lie about how much they use, or i addicted that they are somehow better than other users because they used less requently. The need or such minimi)ations is e!idence itsel o dependency denial. -eing a little bit addicted is like being a little bit dead. 2< don=t u$e@2 - 6!en worse are the closet smokers like my grandma *olito who constantly tried to con!ince us that the thick cloud o smoke rolling out o the bathroom behind her simply wasn"t there. ,ow much more !isible could denial be8 2< only $mo(e 'ec u$e it gi"e$ me $omething to do with my h nd$2 - 7hittling wood, knitting and juggling are also things to do with our hands and they don"t come with a I0 percent chance o li e ending 3H to 3. years early. (uch weak dependency denial rationali)ations ignore that doodling with a pen, playing with coins, squee)ing a ball or using strength grippers may be habit orming but are non-addicti!e. 7hile we might get ink on oursel!es, become rich or de!elop massi!e orearms, our chance o serious injury, disease or death is near )ero. 2<t=$ my right to 'low $mo(e@2 & Truth is, we were chemically obligated to blow smoke. &nd as ar as smoking rights, they continue to e!aporate. (ocial controls to protect the rights o non-smokers continue sweeping the globe. 5 smoking nicotine truly is as addicti!e as heroin, should we be surprised as society continues its march toward banning smoking within !iew o children8 5t"s already happening in parks, on beaches, on hospital grounds, and on entire college campuses. 5t"s increasingly an issue in determining child custody and !isitation obligations in di!orce actions. &nd where permitted by law, employers are beginning to re use to hire those testing positi!e or nicotine or cotinine.
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2/he$e new 1l "or$ re 1 nt $tic@2 & *ina colada, pumpkin pie, watermelon, pralines n" cream, marshmallow, raspberry cheesecake, peach schnapps, maple, sugar cookie, key lime, chocolate mint, bubble gum, pineapple, electronic cigarette e-liquid nicotine is today a!ailable in e!ery la!or imaginable. The nicotine addiction industry is pro!iding those hooked on replacement nicotine or e-cigarettes plenty o reasons to explain continued use. -ut how many chew expensi!e cinnamon or ruit la!ored nicotine gum I, 30 or 3I times daily because o great tasting ruit, mint or cinnamon8 ,ow many suck or !ape cappuccino la!ored nicotine because o a deep lo!e or the taste o co ee8 &nd where does the e-cigarette user turn when their last atomi)er breaks8 & straw maybe8 (low deep breaths8 5 don"t think so. 2<=ll cut down or $mo(e Cu$t one now nd then2 & (uch rationali)ations pretend that chemical dependency is some nasty little habit capable o manipulation, modi ication and control. 7e are drug addicts. &lthough accompanied by alertness, our addiction is as real and permanent as alcoholism. ;sing less than our le!el o tolerance demands will likely lea!e us in a perpetual state o withdrawal. 7hile we may use less o ten, we can compensate by smoking, chewing or sucking harder, or i a smoker by sucking deeper and holding it longer. Co$t R tion li5 tion$ Eost rationali)ations either deny or minimi)e use harms or costs. ,ere"s a ew o the more common ones. 2< u$e $mo(ele$$ to' cco nd it=$ 1 r $ 1er2 & 7hile true, we ha!e little current appreciation or what $sa er$ really means. K!erdue research into health risks associated with long-term oral tobacco use is inally recei!ing attention. 5t"s being moti!ated by an increasing percentage o users trans erring their dependency to oral tobacco, replacement nicotine or electronic cigarettes. -ut results will arri!e slowly. 5t may be decades be ore we"ll ha!e accurate risk pro iles or each orm o deli!ery. Dor example, one /001 study ound that the odds o a smokeless tobacco user experiencing a atal ischemic stroke were A/C greater than or non-users. ./0
./0 ,ergens #*, et al, (mokeless tobacco and the risk o stroke, 6pidemiology, :o!ember /001, Golume 3B<F=, *ages AB.-ABB.
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-ut the e-cigarette is new. ,ow many more years will it be be ore e-cig users know their stroke risks8 & glaring de ect in most current harm reduction risk analysis is that risk calculations are being created by studying oral tobacco or snus users, most o whom had little or no prior smoking history. Does it make sense to suggest to a smoker with /0 pack-years o damage to their body, that i they trans er their dependency to smokeless tobacco that they"ll suddenly ha!e the same risks as the smokeless user who has ne!er smoked8 2< $mo(e light$ nd they=re not $ ' d2 & %ights and ultra-lights are ully capable o deli!ering the same amount o tar and nicotine as most regular brands, depending on how they"re smoked. They do not reduce most health risks including risk o heart disease or cancer. 5n act, those who smoke them o ten compensate by co!ering the holes with their lips or by taking longer or deeper drags, thus introducing more tar not less. 2<=m only hurting me@2 1 ?e lect upon the emotional pain and inancial loss your needless dying and death would in lict upon lo!ed ones. ,ow should they explain your death8 7as it an accident8 7ere you murdered8 7as it stupidity8 7as it suicide8 Did you intentionally kill yoursel 8 2Ce$$ tion c u$e$ weight g in nd th t=$ Cu$t $ d ngerou$2 & This intellectual denial pre-assumes a large weight gain and then makes an erroneous judgment regarding relati!e risks. ?eco!ery does not increase body weight, eating does. #etabolic changes primarily associated with the heart not ha!ing to pound as ast may account or a pound or two. -ut you"d ha!e to gain an additional AI pounds in order to equal the health risks associated with smoking one pack-a-day <7helan, & (moking Mun, 3B1.=. 2<t=$ too p in1ul to $top@2 & Eompared to what8 5magine a diagnosis o lung cancer and ha!ing your le t lung ripped out, ollowed by chemotherapy. 5magine years spent trying to reco!er rom a serious stroke or massi!e heart attack, or ighting or e!ery breath through emphysema-riddled lungs as the twel!e steps to the bathroom totally exhaust you, as you drag your oxygen along too. 2/here=$ $till plenty o1 time le1t to $top2 & >eep in mind that one-quarter o all adult smokers are being claimed in middle-age, each an a!erage o //.I years early. &lso keep in mind that such igures are just a!erages, that many die sooner.
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7e"!e been sharing stories o young !ictims at 7hyLuit since 3BBB. The common thread among most claimed in their H0s or .0s is that they started using while still children or in their early teens. 2! cure 1or c ncer i$ coming $oon2 & -etween 6urope and :orth &merica, tobacco will claim more than one million !ictims this year. ,ow many o them thought that a cure was on the way8 (adly, it was alse hope. 7hich type o lung cancer are you hoping they"ll cure9 squamous cell, oat cell, adenocarcinoma, or one o the less common orms8 6!en i the right cure arri!es, what will be le t o your lungs by the time it gets here8 5 gambling on $how$ tobacco will kill you, don"t orget to consider heart attack, stroke and emphysema. 20ot$ o1 $mo(er$ li"e until ripe old ge2 & %ook around. Kld !ibrant smokers are rare. 5 you do ind old smokers almost all are in poor health or in ad!anced stages o smoking related diseases, with many on oxygen. (mokers tend to think only in terms o dying rom lung cancer when tobacco kills in many ways. Dor example, circulatory disease caused by smoking kills more smokers each year than lung cancer. (ome point to actor Meorge -urns who smoked cigars and li!ed to age 300. -ut how long would Meorge ha!e li!ed and how healthy would he ha!e been i he hadn"t smoked cigars8 7hat"s wrong with li!ing a long and healthy li e8 2<t=$ too l te now to he l the$e lung$2 & :onsense@ Tissues not damaged beyond repair will heal and may pro!ide a substantial increase in o!erall lung unction. ./3 6!en with emphysema, although destroyed air sacs will ne!er again unction, reco!ery will halt the needless destruction o additional tissues. 2We h "e to die o1 $omething2 & This rationali)ation all but admits our own intentional slow-suicide. -ut 5 challenge you to locate e!en one terminal lung cancer patient who wasn"t horri ied upon learning that they"d actually succeeded. (ome apply the cup hal - ull rationali)ation to smoking"s I0C adult kill rate, .// suggesting that what it really means is that there"s a I0C chance that $smoking won"t kill me.$ Try to name any other acti!ity in which we"d willingly participate i there were a I0C chance o getting killed.
./3 -uist &(, The e ect o smoking cessation and modi ication on lung unction, The &merican ?e!iew o ?espiratory Disease, 'uly 3BAF, Golume 33.<3=, *ages 33I-3//. .// 7ald :' and ,ackshaw &>, Eigarette smoking9 an epidemiological o!er!iew, -ritish #edical -ulletin, 'anuary 3BBF, Golume I/<3=, *ages H-33.
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Reco"ery R tion li5 tion$ ,ere"s a ew reco!ery rationali)ations, each designed to postpone or delay cessation. 2<=ll $top 1ter the neBt p c(, neBt c rton, neBt month, my neBt 'irthd y or .ew 3e r$= d y2 & 5 hate to think about how many times 5 lied to mysel with such nonsense. &nd which pack, carton, month or birthday presents the best chance or success8 7hy did 5 limit mysel to always purchasing only a one-day"s supply8 -ecause tomorrow was always the day 5"d stop and 5 couldn"t see throwing extra packs away. 2<=ll $top neBt wee(2 & Dor some o us it was always next week, next month or next year. Kthers go so ar as to actually set a date. Doing so always made today"s use more tolerable, as we pretended that our problem would soon be sol!ed. 2<=m w iting on p inle$$ cure2 & Don"t hold your breath. The day science can make our painless -- so as to a!oid any emotional loss -- is the day it will be capable o erasing the emotional loss associated with ending the most dependable chemical relationship we"!e likely e!er known. 2/he 3rd gener tion " ccine i$ coming@2 & :?T, Syban, Ehantix or Ehampix, and ailure o two generations o !accines, nicotine addicts ha!e been teased or decades with promises that new magic cures were on the way. #ost recently, the promise was that our to i!e !accine shots o!er six months would cause the body"s immune system to create large antibodies, that would quickly bond with nicotine molecules, making them too large to cross through the blood-brain protecti!e iltering barrier and stimulate dopamine pathways. 5t was wish ul thinking. 5t didn"t work. Gaccine users ound ways to relapse e!en with all those expensi!e injections and antibodies e!erywhere../H 7all (treet 'ournal headlines declared in 'une /03/ that $Gaccine (hows *romise or :icotine &ddiction.$./. 5nstead o injecting antibodies, the new !accine tricks the li!er into constantly producing them, at least in mice. &nd as the 7(' article notes, therein lies the problem, $making the leap rom OmiceP to people will be a challenge. Kther recent attempts ailed to pro!e e ecti!e in people a ter initially encouraging animal studies.$
./H Eornu) ', et al, & !accine against nicotine or smoking cessation9 a randomi)ed controlled trial, *los Kne. /001 'un /IJH<F=9e/I.A. ./. 7inslow, ?on, Gaccine (hows *romise or :icotine &ddiction, 7all (treet 'ournal, 'une /A, /03/
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2My 1 mily c n=t h ndle reco"ery2 & -lame trans erence seeks to place the cause or de eat upon others. 5t"s easy to intentionally exaggerate withdrawal !ia anger or other antics to the point o making li e a li!ing hell or riends, lo!ed ones or co-workers. Trans erence can blame relapse on a lack o support, a relationship, stress ul times, inancial hardship, other smokers, alcohol or e!en our job. 2< won=t 'e 'le to $top unle$$ $omeone $top$ with me2 & #any pretend that they cannot succeed because their husband, wi e or riend won"t stop too. This procrastination brick allows use to continue until someone else takes action. 7hat i they ne!er stop8 (adly, millions ride this waiting rationali)ation all the way to an early gra!e. 5t"s nice when riends or lo!ed ones make this journey with us. -ut i not happening, someone needs to be bra!e and go irst. Then, it"s simply a matter o being patient and teaching by example, allowing them to obser!e reedom"s ull glory. 2Mom Cu$t died. .ow Cu$t i$n=t the time2 & (moking won"t bring back mom or dad, nor cure any other ill in li e. &s 'oel teaches, success during a period o high stress insures that uture high stress situations won"t ser!e as justi ication or relapse. 2<=d $top 'ut withdr w l ne"er end$@2 & ,ogwash@ 7hy not dispro!e this one by li!ing the truth8 Mi!e it a go@ 2<1 < $top, <=ll Cu$t $t rt ' c( g in. < lw y$ do2 & Truth is, we do not ha!e to relapse. ?elapse occurs because we ail to respect the %aw o &ddiction. 7e !iolate the %aw because we allow oursel!es to orget why we stopped or in!ent some lame excuse such as those abo!e. 5n act, this reco!ery is absolutely guaranteed to be our last e!er, so long as nicotine ne!er again inds its way into our bloodstream, so long as we continue to li!e on the right side o the $%aw.$
Con$ciou$ :iB tion

&s mentioned, we do our thinking inside our pre- rontal cortex. 5t"s the large lobe just abo!e our eyes. Eonscious ixation is the ability o the rational thinking mind to become completely engrossed, absorbed and preoccupied with a single subject, issue or train o thought. &s you"ll recall, while subconscious conditioning somehow limits the duration o a cue triggered cra!e episode to three-minuted or less, conscious ixation can last as long as our
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ability to concentrate, remain ocused and stay absorbed. ,ow will you react when thoughts o $wanting$ to use begin bantering about inside your mind8 7ill you ixate upon them or instead sei)e the moment as an opportunity or conscious healing8 7anting"s arri!al presents a chance to re lect upon both wanting"s source or oundation, and the thinking or debate that ollows. Don"t worry, neither ixation nor analy)ing it can harm us. 5n act, as 'oel o ten reminds us, it"s impossible to relapse by thinking. Knly action can destroy our healing and glory. Elearly, we cannot erase thousands o old wanting satis action memories, or the use justi ications we in!ented to explain creating another. 7hat we can do is use honesty and insights to destroy their in luence upon us. 5nstead o an addict"s use memories becoming uel or ixation and relapse, truth and understanding can trans orm them into laughable reminders o the prison we once called home. 7hile still using, how many times did we reach or and rely upon each o our use excuses8 During reco!ery, how many times will each use excuse pop into our mind8 The arri!al o each is a golden opportunity or a mind no longer under nicotine"s in luence to analy)e a drug addict"s use justi ications in honest light. 5t"s a chance to use insight and understanding to recast hundreds or e!en thousands o similar dependency memories all at once. (uch repainting or recasting o use thinking can accelerate reco!ery. (till, there may be one or more elements o junkie thinking that seem di icult to let go. 5n your mind, there may be one or more attractions to nicotine use that truth and insight ail to impact. 5 so, accept them, or now, and mo!e on. -ut in doing so, try to it any such remaining attractions into the bigger dependency picture. 5 willing to be brutally honest about the prison cell we once called home, little will remain to embrace. %ike eyes on a potato, any lingering romantic use rationali)ations will be surrounded by tasty and edible truths. The concern is that once home and residing here on 6asy (treet that, like ertili)er, complacency can cause those remaining eyes to begin to sprout, grow and e!entually destroy the tastiness surrounding them.
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(taying ocused on dependency"s bigger picture -- that one equals all -- can help keep their in luence in perspecti!e. 7e sometimes encounter long-term ex-users whose remaining use rationali)ations are beginning to combine with complacency and ele!ate their risk o relapse. (ome will disclose that they still think about using and ha!e recently ound themsel!es doing so more requently. & ew questions may aid in helping them regain perspecti!e.

7hen was the last time you experienced an urge to use8 7hat thoughts went through your mind8 ,ow long did it last8 ,ow intense was it8 ,ow long be ore that urge did you experience the pre!ious urge8 5 you don"t mind sharing, what did you like most about using8 7hat did you dislike most8 Do you understand that or ex-users that there"s no such thing as just one8
Those in the irst ew days o reco!ery would laugh at what the long-term ex-user considered an $urge.$ :ormally it"s a brie passing thought that lasts seconds and is quickly abandoned. Digging deeper may allow identi ication o the particular rationali)ation that was likely ne!er directly con ronted during reco!ery. ;nchallenged, like a cancer, it"s signi icance now grows. (o called $experts$ claim that nicotine dependency is a chronic relapsing condition. -ut it doesn"t ha!e to be. (till, you"ll sometimes meet current smokers who"ll tell you that they once stopped or I, 30 or e!en /0 years and then smoked one, and soon ound themsel!es smoking more than e!er. #any can recall the use rationali)ation they ixated upon in the seconds be ore relapse. &ma)ingly, some still belie!e in it e!en though it cost them their reedom. 5magine or a moment that once here on 6asy (treet that you"!e brought one or two remaining romantic use notions with you. 5 so, consider wrapping them in this o ten quoted reco!ery mantra9 "I'd rather be an e61user (ho sometimes thin:s about usin) than a user al(ays thin:in) about sto@@in)."
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2Ju$t once, Cu$t once@2

The most atal conscious ixation o all is the raud o $'ust one.$ $'ust one little pu $, $one dip,$ $one chew.$ $'ust once@$ & primary maxim o drug addiction is that $Kne is always too many and a thousand ne!er enough.$ 5nstead o picturing just one or just once, try to picture all o them, the return o our entire dependency and the endless chain o eedings that would ollow. 7hy pretend that we are stronger than the design o brain circuitry built to guarantee results8 7hy ignore the act that just one hit o nicotine will acti!ate hal o that circuitry8 7hy not instead accept that just one hit and our brain will demand more, that we are true drug addicts, that we can"t ha!e just one, or use just once. 5 close with the ollowing article 5 wrote in (eptember /000, 3A months into my reco!ery. 5t re lects my own conscious journey and how my use perceptions changed o!er time.
/he Joy o1 ;mo(ing?

Kut on the town, you watch as your good riend -ill lights-up and sucks down a deliciously deep pu , and then lays the pack on the table between you. Eindy, your talkati!e co-worker, blows smoke your way while gloriously wa!ing her cigarette like a conductor"s baton. &rthur and Denise, two smoking strangers, gra!itate toward one another and engage in light-hearted con!ersation while guarding a store"s entrance. 7hile stopped at a light, 6llen inhales a deep and relaxing pu in the car beside you. $Kh but to again share in the joys o smoking,$ you think to yoursel , $to pu , to taste, to blow, then relax.$ The joys o smoking8 'oy8 4esterday, -ill stepped in a pile o dog dung but ailed to notice until he turned and was pu))led by the strange brown tracks across his sky blue carpet that lead to his right shoe. -ill"s sni er has been almost useless or more than /0 years. & pack and a hal a day smoker, he"s experienced two cases o pneumonia o!er the past H winters, with the last one putting him in bed or F days. (truggling or each breath, -ill
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still managed to smoke a couple each day. ,is doctor has pleaded with him or years to stop. -ut, ha!ing already tired and ailed using e!ery new product his doctor recommended, he eels like a total and complete ailure. Eindy"s two teenage sons harass her almost daily about her smoking. They can"t walk anywhere as a amily without her cigarette smoke inding the boys. 7hen it does, they make her want to crawl into a hole as they both start coughing and gagging as i dying. 7hen smoking, they ne!er walk together, it"s either ahead or behind or mom. :on-smokers, she dreads the se!en hour dri!e to her parent"s house next week but can no longer make excuses or !isiting only once in H years. Eindy knows that they"ll pass three rest areas along the interstate but it will be di icult to ib about ha!ing to go to the bathroom at all three. Two will ha!e to do. The date or the trip arri!es. (he skips making break ast to ensure that the boys will demand that they stop to eat along the way. Eindy shakes her head a ter coming back in rom loading up the car. :ot only does she ha!e a cigarette in her hand, the ashtray on the table is smoking one too. -e ore lea!ing town, she stops to ill up with gas. (he eels ar more secure a ter stu ing two new packs into her purse, while sneaking two quick pu s on the way back to the car. &rthur, a I.-year-old two pack-a-day smoker, has small cell lung cancer in the right lobe. ,is ast growing tumor is now almost three months old and a little bigger than an orange. &s he sits rolling coins to purchase the .0 milligrams o mandatory daily nicotine needed to stay within his com ort )one, he does not yet know he has cancer. &lthough he has twice coughed up a small bit o bloody mucus, he quickly dismissed it both times. Drankly, he just doesn"t want to know. There is a bit o chest pain but that"s nothing new, as chest tightness has occurred on and o or the past couple o years. &dditional thick bloody mucus will soon scare &rthur into a doctor !isit and a chest xray. The delay will cost him a lung. During the . months that ollow, he"ll battle hard to sa!e his li e. 5n the end &rthur will lose. ,is ate is the same as B/C diagnosed with stage 555 small cell lung cancer, death within i!e years.
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& workaholic, 6llen has done !ery well inancially. ,er li e seems to ha!e e!erything except companionship. & three pack-a-day smoker, she constantly smells like a walking tobacco actory and o ten turns heads and noses when entering a room. & serious chain-smoker, she tells those around her that she enjoys her cigarettes. Deep down, she knows that she is a drug addict and belie!es that she just can"t quit. ,er car windows, house blinds and orehead continually share a common guest - a thin oily ilm o tobacco tar. 6llen has a date next Driday, a two pack-a-day smoker named 6d. They"ll ind com ort in sharing their addictions. Denise started smoking at age 3H while her lungs were still de!eloping. Eonstantly clearing her throat, month by month her breathing capacity continues to slowly deteriorate. (moking lines and wrinkles abo!e and below her lips ha!e aged a once attracti!e ace ar quicker than its H/ years. Eonsidered $cool$ when she became hooked, the go!ernment recently banned smoking in all public buildings. The headline in the local paper she"s holding is about the city proposing a ban on smoking in the park across the street. &bout to lose her smoking park bench and eeling like a hopelessly addicted social outcast, a single tear works its way down her cheek. 7hy8 -ecause 3I pounds o!erweight to begin with, a year ago Denise success ully broke ree or almost / months by exchanging cigarettes or a new crutch called ood. (he threw in the towel a ter outgrowing her entire wardrobe. Three months ollowing relapse and still depressed o!er her de eat, all the new weight remains with her. &lready on high-blood pressure medication, Denise is about to become a regular user o anti-depressants too. The joy o smoking8 'oy8 Dortunately or Denise, a caring riend will tell her about a ree online orum called 7hyLuit.com. There, she will disco!er the core principles underlying her almost two decades o chemical dependency upon nicotine.
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(he"ll de!elop the patience, outlook and understanding needed to na!igate the temporary period o re-adjustment called reco!ery. (he"ll also de!elop the mental skills and healthy body needed to success ully tackle her unwanted pounds. ,ow8 'ust one ounce at a time. &ll that matters are the next ew minutes and each is entirely do-able. There will always be only one rule that comes with a 300C guarantee o success or all who ollow it ... no nicotine today@
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Ch pter 13
7omecoming
,ow do we know when we"re home8
5 you"!e e!er mo!ed, you know there"s a big di erence between mo!ing into a house and ha!ing it eel like home. The correct answer is, you are home when you eel it@ (ome eel at home in a couple o weeks while others need months.
! ;ilent Cele'r tion

&ma)ingly, within / to . months the adjustment process transports most in reco!ery to a point where they experience that !ery irst day where they ne!er once $think$ to themsel!es, $gee, 5"d sure like a smoke,$ $dip,$ $chew,$ $lo)enge,$ $!ape$ or $piece o nicotine gum.$ & ter the irst such day they become more and more common. (oon, they become our new norm in li e, with the distance between the occasional $thought$ growing urther and urther apart. 5 it happens sooner or takes longer, don"t ret@ 5 sooner, enjoy it, 5 longer, patience, it"s coming@
0ong&/erm Quiet nd C lm
5magine entire days, weeks, months, or e!entually e!en years without your mind e!er once eeling an urge to use nicotine. 5magine li!ing in a constant state o total com ort without any nicotine use related anxieties whatsoe!er - none, )ero, nil, complete and total tranquility. 5t"s where hundreds o millions o com ortable ex-users reside today. 7ere any o them truly stronger than nicotine8 7ere any o them stronger than us8 Kr, is that just another lame use excuse8 & ter arresting my thirty-year dependency, my reco!ery e!ol!ed to the point o substantial com ort by about eight weeks, a ew weeks earlier than most but later than some. 5t was then that 5 experienced my last major subconscious cra!e episode. &nd about then when 5 started to notice that the once steady stream o thoughts o wanting were e!er so slowly becoming ewer, shorter and generally less intense. During the irst ew weeks 5 worked hard to maintain a strong positi!e attitude while
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re using to allow negati!e thoughts to in ect my thinking and dreams. 7hile eeding mysel large doses o positi!e thought, 5 also con ronted and analy)ed those remaining thoughts that kept in!iting relapse. (oon, it was no longer a matter o trying to belie!e what 5 was telling mysel . 5 did belie!e in the new nicotineree me@ &lthough at times intense, 5 did my best to remain ocused on the long o!erdue healing occurring within. 5 saw each day and e!ery day as a ull and complete !ictory in and o itsel . Today 5 was ree. Today was about healing@ &nd there were lots o little gi ts along the way. The new smells, tastes, energy, extra pocket change, the whiteness emerging in my smile, pride, empty pockets, a bit bigger step, odorless ingers, hope, endurance, an ash-less world, new ound time, long o!erdue sel -respect, gradually lengthening periods o com ort, reedom and e!en a ew extra pounds, it was simply me coming home to meet me. 6!entually the minor urges and periods o thought ixation became urther and urther apart. & ter two years o reedom 5 ound mysel going months without an urge. The last time 5 experienced anything that can be airly called an $urge$ was in December /003, two years and se!en months a ter starting my journey. &m 5 a!erage or normal8 5n rankness, probably not. 5 worked with ar too many !ictims to ha!e retained e!en one use justi ication.
Er du lly #imini$hing /hought$ nd 4rge$

#ost ex-users report that reco!ery was less challenging than expected. #any report cakewalks. -ut it wasn"t or me. There were a couple o moments where 5 elt totally o!erwhelmed. Thank goodness such moments were ew and brie . The beauty o reco!ery is that with each passing day the requency, duration and intensity o challenge is $generally$ on the decline. -ut like trying to watch a rose bud open, seeing the decline while li!ing it can at times seem nearly impossible. -e ore we know it, the storms turn to bree)es, with a possible gust now and then. 5t"s entirely normal during the irst couple o years to experience occasional thoughts o wanting, or e!en encounter a remote, seasonal or in requent nicotine eeding cue. 5t may be associated with uncommon e!ents such as a relationship ending, crossing paths with an old riend, the birth o a baby, a wedding receptions or e!en death. 5t"s also possible to retain a romantic attachment to using, a link capable o ostering desire until ready to let go.
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Kne o the most popular discussions at 7hyLuit"s peer support group Dreedom is entitled, $Tell a newbie how many seconds a day you still want a cigarette.$ -elow are messages posted to the discussion. 6ach opens by indicating how long the person had been nicotineree. They then tell us how long each day they still want a cigarette. >eep in mind as you read them that, or the most part, these are educated ex-users. 5t"s likely that part o their reason or posting to this particular discussion was excitement o!er how much easier an educated reco!ery can be.
. days9 $#y experience so ar has been tough but tolerable. 5"m HI and ha!e been smoking a pack/day since 3A. ;p until . days ago, 5 elt completely powerless in the ace o nicotine, like 5 was especially weak to it"s powers - but reading has helped me to reali)e that nicotine has done the same exact thing to all o us.$ Mus I days9 $5 think there are probably 3I0 seconds in my current days that 5 want a cigarette, and 5 ha!e to remind mysel , 5 am a non-smoker and the reasons why and that smoking a cigarette is stupid and will do nothing but harm me. #y dad died in December o lung cancer.$ Darla F days9 $5 probably only get one real cra!e a day now. The irst two days 5 had really bad cra!ings at all the usual times that 5 would light up. Third and ourth days seemed like 5 only had /-. bad cra!es. Day I through now it seems like its just one. &nd e!en that one cra!e isn"t that big o a deal. ,owe!er, 5 do get those "pangs.":ot pangs o $need$ though. 5t"s more like 5"m just missing something and a second o sadness comes o!er me...then 5 just reali)e that "Kh yeah, 5 would ha!e been smoking a cigarette now@"$ Easey A days9 $5 think about smoking maybe once or twice a day or 3 or / minutes. 5"m so turned o by smoking that some days 5 don"t think about smoking at all and 5 am only one week in.$ Mina 1 days9 $$6!en though it"s been just o!er a week 5 can honestly say 5 don"t really E?&G6 a cigarette anymore. 5"m not saying 5 don"t think about them, 5"!e been an addict or /. years. -ut 5 don"t cra!e them, 5 don"t want them. Time spent remembering them, probably a couple o minutes a day, but when you consider that 5 use to spend o!er H hours a day abusing mysel with them and much o the rest o the time wishing 5 wasn"t abusing mysel , that"s small potatoes@ &s one o my a!orite quotes says9 "5"d rather be an ex-smoker who occasionally thinks about a cigarette than a smoker who is obsessed by them@"$ *heonix 30 days9 $Ten days now and 5 still think about it a ew times an hour or a ew seconds. -ut 5"m mostly thinking about how 5 don"t smoke anymore@ Gery simple@ #aybe once a day, 5 get blind-sided with a !ery strong and power ul thought o $5 ha!e to ha!e a cigarette, :K7@$ #y responding thought is $-ut, 5 don"t smoke anymore$ and it"s MK:6@ ,&,&,&@ The $gotta smoke$ thoughts are getting rather wimpy. There seems to be absolutely :KT,5:M behind them@ 5t"s a beauti ul thing 9-=$ Mlynda 3H days9 $(till ha!en"t wanted one and it is day 3H, yes on a Driday, lol, 5 ha!e
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thoughts like "gee 5 would ha!e just lit up," "again," "another instance." 7hat is more ama)ing is the thoughts that come "5 ,&G6:$T T,K;M,T KD & E5M&?6TT6@" :ot cra!es, thoughts.$ Tagsgirl 3H days9 $Dor the past two days 5 ha!e actually gone hours without thinking about a smoke....,ours@ That has not happened in a long time. 5 look orward to the time when 5 can go or days without hardly a thought o those nasty little things.$ Tubes 3. days9 $5 think about cigarettes about H times a day, they last about H minutes each, which is the actual time it took to smoke one cigarette. 5 don"t want one, it is just a thought that does not last long, and it goes away. 5 eel awesome and now ha!e a much better li e with my children and husband.$ -arbara. 3I days9 $$5"!e been nico- ree or / weeks, 3 day and now only ha!e . or I urges each day. This is a de inite impro!ement o!er the constant cra!es o the irst H days@ 5 know 5 ha!e to be patient ... and also try to enjoy each !ictory o!er e!ery urge that 5 de eat@$ 'udy 3F days9 $(urprisingly, only a couple o times a day..... or not more than H0 seconds each time. &!eraging about a minute-and-a-hal on the usual day. &lso, these are just habit-dri!en thoughtsJ thinking about smoking on the way to the car, but 5"m per ectly ine once 5 get there, or thinking about ha!ing a cigarette be ore bed, but knowing that 5 sleep so much better without it. These are just thoughtsJ by acing them, they ha!e no power o!er me@$ #ichelle:E 3A days9 $5 think about a cigarette se!eral times a day, but only one or two o those is an actual $want$ and not just a thought. That"s a change rom actually crying or want o a cigarette on day two, to shrugging o a couple o little wants in the course o a day in just o!er two weeks" time ...awesome.$ (te 31 days9 $5 dont think about smoking !ery much.. maybe 30-/0 seconds a day. -ut 5 do think about not smoking a lot @@@@@@$ ?ob 31 days9 $*robably about . minutes thinking about it, maybe H0 seconds with a bit o an empty eeling, cra!ing something that might be nicotine.$ #aisie 3B days9 $5 smoked or .0 years, at least a pack a day. &m 5 ha!ing cra!es8 4es. &re they easier or harder than 5 thought they would be8 6asier. Do they become less and less in duration as time goes by8 4es they do@ 5 ha!e cra!es about . to I times a day lasting seconds.$ 'ill /3 days9 $5 cra!e a cigarette maybe once a day. 5t lasts about .I seconds. 5 eel sooooo much better since 5 quit@@@ The cra!es 5 can handle...$ &h0H0. // days9 $5 ne!er want one. Kh, 5 may occasionally think 5 should be ha!ing one. -ut 5 can"t say 5 want it. 6!en those thoughts ha!e become rarer and rarer. 5 ha!e been totally ama)ed at how quickly 5 went rom needing one e!ery couple o hours <i 5 was doing good= and ha!ing no desire or one. 5 am thrilled to be smoke ree.$ %eigh /H days9 $(ome days 5 don"t cra!e at all, and the most is just once and it last or a ew seconds.$ (ue) /. days9 $5 am into my /.th day and honestly 5 don"t e!en think about cigarettes unless 5 see someone smoking or smell it and then 5 think how nasty and disgusting it is@ & ter smoking or HA years that is pretty ama)ing ... o course there is an occasional trigger but not on a daily basis@$ -e! /I days9 $& ter just three weeks 5 am down to once or twice a day. 5 ha!e e!en
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gone entire days without thinking about it@ & ter 3B years o smoking up to two packs a day, that"s pretty ama)ing to me.$ 'oe /F days9 $5 do think about smoking e!ery now and then, but 5 de initely don"t think as much about smoking as 5 did when 5 still smoked H0 cigarettes a day.$ >linka /F days9 $5 would say 5 probably think about a cigarette H to I times a day <which is down rom like a million@@ haha= and 5 actually "want" a cigarette 3 time a day. This is antastic to me@ 5 was so scared that 5 would ight or the rest o my li e like 5 was in the irst week, but ha!e come to reali)e this simply is not true.$ &myAB /B days9 $This has gone textbook as described on this site. Today 5 ha!e one cra!e a day but e!eryday it gets a little more !ague.$ *hillip H0 days9 $& ter one month 5 still think o cigarettes. The thoughts are in / orms. The irst is not a cra!e but just thinking about a situation or acti!ity that relates to smoking. 5t doesn"t bother me at all. This happens about H to . times a day. The second is the cra!e. 5t only lasts about 30 to /0 seconds. The cra!es are not as bad as they were a ew weeks ago.$ 'ohn H3 days9 $5t"s still early in the reco!ery process so 5"m not going to say 5 don"t think about them...because 5 do, but in all honesty it"s not really that much. The thoughts come quickly rom time to time, but they lea!e just as quickly.$ &bu Daud3 H/ days9 $5 don"t ha!e cra!ings. 6!er. 5 sort o eel like ha!ing a cigarette maybe /H times a day or a total o about F0-B0 seconds <at most=. That"s about 3 3// minutes a day.$ #att H/ days9 $5 work with smokers and dippers all day. 6!ery time 5 saw someone smoking 5 would think ,mmm ... time or a smoke and actually go or my pocket to get one out and then remember- 5 can"t@ This went on or the irst two weeks and 5 was wondering i this was how it was going to be or me ore!er. 5 had smoked a pack plus a day or H0 years it was so much a part o my li e that 5 igured 5 would always eel the urge to smoke when 5 saw someone else smoke. & ter the /nd week 5 was eeling much more con ident and determined and when 5 thought about smoking it was that 5 was sooo ... glad that 5 didn"t anymore. :ow a ter our weeks plus 5 think about smoking maybe /0 seconds a day and it"s ne!er an urge to smoke, its a sense o something missing but not missed. The law o addiction is the irst thing 5 think o when 5 think about smoking and 5 know that as long as 5 remember that 5 will :e!er Take &nother *u .$ Min) H. days9 3-H minutes per day on a!erage 5 still want a cigarette. 5t"s not a cra!ing that happens during the irst H days, not an itch that goes or 3-H weeks a ter you quit. 5t"s just a small thought.$ %e!aser HA days9 $The thought o smoking is not e!en a daily occurence anymore. 7hen 5 do think o it it is not an urge but just a thought. 5t does get better. &t one time 5 didn"t think it would but it did.$ (aree H1 days9 $5 can honestly say that 5 ne!er want a cigarette. (ometimes 5 will get a random thought about ha!ing one, but it is quickly gone once 5 remind mysel that 5 don"t smoke any more.$ 'ason .I days9 $5t has been at least two weeks since 5 actually 7&:T6D a cigarette. 7hat 5 ha!e now are !agrant thoughts about smoking that pass in a matter o a ew
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seconds--and 5 ha!e actually had one day where 5 reali)ed the next morning that 5 hadn"t thought about smoking at all. That"s a ter .IU years as a smoker o at least / packs a day.$ Eli .F days9 $5 am a newbie at just 3 month, / weeks, / days. 5 still think about smoking quite o ten. 5 would say at least a hal an hour a day. 5 was worried about this but now that 5 ha!e written it down 5 reali)e that it really isn"t to bad, considering 5 used to think about smoking about e!ery hal hour or so. -ut 5 do reali)e that 5 think much more about not smoking than 5 do about smoking.$ (te!e .A days9 $5 maybe spend / minutes out o an entire day thinking about cigarettes. 5 no longer obsess about them, and 5 ind the act o smoking, well, ilthy. 5 ha!en"t yet had those wondrous days where there are no thoughts at all, but 5"!e come pretty close.$ Diana I3 days9 $,ow o ten a day do 5 think about cigarettes8 :ot !ery o ten. 5 5 do think about cigarettes it is only or a ew seconds a day but today 5 spent )ero seconds thinking about cigarettes.$ ,erman I1 days9 $5 think about smoking most days but spend :K time wanting to smoke now. There is nothing 5 want back about nicotine and cigarettes.$ Doc F0 days9 $...thought a ew times o ha!ing a smoke but it"s a passing thought now, it has little strength.$ Da!e T FA days9 $Thoughts ha!e completely dropped o to random, leeting, a spit second i 5 choose to notice them. Kccasionally, there is a new trigger but relati!ely easy to deal with now that 5"m no longer struggling.$ 5lona FB days9 $Kn a usual day, 5 don"t want a cigarette at all. (ometimes 5 ha!e a cra!ing or two, and they last or about H seconds each. Then they"re gone. 5t"s brilliant@$ ?ed(unDlower A3 days9 $5"m I1, smoked since 3F, a pack a day, ha!e been nicotine ree or A3 glorious days and 5 don"t want them, don"t need them, don"t miss them and rarely think o them. 5 don"t e!en remember smoking.$ (arah A/ days9 $5 only think about cigarettes on the weekend at a nightclub when a smoker stands next to me and 5 ha!e to mo!e because it smells so bad.$ ?ochelle A. days9 $#aybe H-I seconds e!ery couple o days. (eriously, it does get so much easier.$ -eth AA days9 $5 am ama)ed at how quickly 5 went rom needing a cigarette e!ery hour or less to going days without wanting one at all. 5 was a !ery hea!y smoker <H to . packs a day= and 5 expected years o wanting to smoke. 5 had my irst day without any urges a least / weeks ago. 5 can"t remember the last time 5 wanted a cigarette. &t least a ew days ago. Dor the last H or . weeks the rare urges ha!e been so easy to deal with that 5 think they pass without me remembering 5 had one. 5 know 5 can get through H minutes without nicotine, so why dwell on it8$ 'im , 1F days9 $Knce e!ery two weeks or about H-I minutes.$ Diane 30I days9 $Three and a hal months in 5 want a smoke 0 seconds. There are still occasional triggers 5 run across, but 5 would say that is about once a week and 30 days now, and getting longer in between. 5 ha!e achie!ed com ort. *.(9 #y wi e still smokes, so it is possible to be around it and not want it.$ ?oy 301 days9 $?arely, !ery rarely, do 5 e!en think about smoking. 5 am not quite our months quit and 5 had smoked or .0 years. To me that is absolutely incredible@
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Luitting is so much easier, and so much more rewarding, than 5 e!er dreamed it could be. &nd 5 know 5"ll ne!er go back to a li e o eeding the addiction.$ (tella . months9 $...maybe six or se!en seconds o $thoughts$ a week. 5"m one !ery happy camper.$ *at I months9 $5 sometimes get hooked into a romantic thought about smoking, a memory, but it is merely a thought and not a desire or a need or a want.$ #oira I months9 $5 smoked or H1 years, in the end at H 3// packs a day. (topped cold turkey on 'an. 33, /03/, my irst attempt. 5 now ha!e smoking thoughts just a ew times per week, and they"re not "dwelling" thoughts - they just last 3 or / seconds or less. 5"m !ery proud o my progress.$ Golt#an F months9 $5"m thinking that 5"d like a cigarette or F seconds a week. 7hen 5 smoked, there were probably at least / occasions each day when 5 wanted to smoke but couldn"t, because 5 was in a no-smoking o ice or a restaurant or on a train. 6ach o those occasions lasted say H0 minutes a!erage. That amounts to /I,/00 seconds a week when 5 was su ering signi icant anxiety and withdrawal symptoms, ar worse in intensity than any discom ort 5 ha!e su ered rom not smoking since 5 stopped.$ #arty A months9 $:e!er a want, need or cra!e ... *assing thought8 #aybe a couple times a week.$ ?'7 1 months9 $Thinking about a cigarette is no longer a daily acti!ity. 5 5 ha!e a thought it is weeks apart and lasts or only I seconds or less. 5 treat the thought like a pesky, dirty ly and swat it rom my mind@ Dreedom is sweet@@@$ 'rock.3H B months9 $Sero. 5 do still think about them once in awhile, but ne!er want one. #y hard won reedom is too precious at this point to throw away o!er a lousy pu .$ ?oy 30 months9 $5 ha!e not wanted a cigarette e!en once or many months now. 6!en a couple o unexpected triggers did not result in my wanting a cigarette, just the reali)ation that a brie cra!ing is a minor annoyance :KT a desire to smoke@$ 'e ery?7 30 months9 $5 ha!e not wanted to ha!e a cigarette is many months now. 5 ha!e no cra!es at all and there is only an occasion <e!ery H-. weeks= that 5 will think or a second, "7ait, something is missing," only to smile as 5 reali)e 5 would be ha!ing a cigarette i 5 was still li!ing in my addiction. -ut 5 do :KT want to smoke. 5t is only a reminder o how chained 5 was. 5 was a hea!y smoker or so long, 5 thought 5 couldn"t stop@ 4es, com ort does come. #uch aster than 5 thought possible. The rewards are so plenti ul, 5 am ull o gratitude.$ 6ndura 30 months9 $7hen 5 think about cigarettes <which is hardly e!er=, 5 am grate ul that 5 don"t ha!e to buy them, roll them, smoke them, cough a ter them, wake up in the morning eeling tight in the chest a ter smoking too many o them, smell my clothes, hair, skin a ter smoking them, worry about my health a ter smoking them, eel shame and guilt a ter smoking them ... you get the point. Dreedom is ,;M6@ -est thing 5"!e e!er done.$ %ara 33 months9 $5 might ha!e had a thought about ha!ing a cigarette a ew days ago but 5"m not sure. 5t could be my old age kicking in. They pop into my head and out again so rarely and so quickly they don"t e!en register anymore.$ *at
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3 year9 $Today is exactly 3/ months since 5 had my last pu . This is the greatest gi t 5 ha!e e!er gi!en mysel , and let me assure you, 5 :6G6? think o ha!ing a smoke, but think o ten o how ree 5 am. 5 you think 5"m just a strong person, let me tell you how weak 5 am. 5 am an alcoholic and a compulsi!e gambler. 5 am as weak as can be to my addictions. -ut today 5 choose not to pu .$ (te!e 3 year9 $$5t"s been a long, long time since 5 last wanted one - months, 5 suppose. The cigarettes, urges and cra!es ha!e simply !anished out o my li e. 5 stay prepared, and with the knowledge gained here 5"ll always be ready or an urge, but the truth is, 5 think it"s o!er now. 5 don"t want cigarettes any more, that"s all there is to it.$ (usanne 3 year, / months9 $5 ha!en"t wanted a cigarette or a !ery long time, 5 do howe!er think about smoking airly o ten but only because it is a reminder o how wonder ul it is to be ree@@$ %ucie 3 year, H months9 $)ip, )ero, nada@$ #elrose 3 year, . months9 $5 think about ha!ing one on what probably amounts to about F seconds a week@$ &nnies3 / years9 $5 am !ery happy to report that 5 don"t e!er ha!e urges anymore. 5 5 think about nicotine at all, it"s about how proud 5 am$ to be ree. 7helen / years9 $5 ne!er thought 5 could stop smoking or that 5 would completely stop thinking about cigarettes - but 5 ha!e and its wonder ul@$ (ally / years9 $5 ne!er think o smoking really. 5 think 5 had a leeting thought one spring day when 5 was ha!ing a glass o wine and standing on the deck.$ 'e / years9 $S6?K@$ #elrose / years9 $5 can truth ully say that 5 just do not think o smoking. 5 ne!er thought 5 would be able to say that, but it"s true@@$ Gicki H years9 $:ull, nix, none, nothing, )ip, )ero ... honestly, my nicotine-related thoughts are annoyance at the smell o cigarettes i 5 can"t a!oid it.$ #eg H years9 $& ew times in the past year the thought o smoking crossed my mind.$ 'oseph . years9 $,ow many seconds a year8 :one@@@$ %aura . years9 $5 ne!er think about smoking, except the occasional wish or a riend or acquaintance to know the peace that comes with ne!er taking another pu .$ >e!in I years9 $5 came to this website o!er I years ago struggling with addiction like e!eryone else. ,ad tried stopping many times in li e, but cigarettes always came back to me until 5 educated mysel . :ow 5 can happily say 5 am still ree rom my addiction, and 5 ne!er want a cigarette.$ 'a))%ady A years9 $#y amily smokes. 5 ne!er desire it e!en i they"re around me smoking.$ &nne 30 years9 $6!ery so o ten -- maybe once e!ery H or . months -- 5"ll pass by someone who"s reshly lit up, and there will be a leeting nostalgia. :e!er lasts or more than a ew seconds, and 5"d de initely ne!er describe it as wanting a cigarette. #aybe a bit like a poison dart rog... curious to look at, but 5 don"t ha!e any desire to lick its skin.$ K-ob
5t"s been more than a decade since 5"!e experienced anything that could be considered a cra!e. During that time there ha!e been a couple o darting thoughts, none o which
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lasted long enough to grab. #aybe someday an urge or cra!e will again occur. #aybe tomorrow. -ut i so 5"m certain that 5"ll wear a smile during the entire brie encounter, as it will be a long o!erdue reminder o the ama)ing journey 5 once made. 7elcome home@ &s you know by now, we get to stay so long as we remain committed to a single principle ... no nicotine today@
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Compl cency 9 Rel p$e

C ring 1or >ur Reco"ery
Dirst, the good news. The risk o
relapse declines with the passage o time@ 7hile roughly BIC o uneducated smokers who attempt to stop smoking relapse within a year, the relapse rate declines to just / to .C per year rom years / to 30, and then alls to less than 3C a ter 30 years../I >eep in mind that those rates were generated by ex-users who generally had little understanding o nicotine dependency and no ormal respect or the %aw o &ddiction. 5 obedient to %aw our risk o ailure remains )ero. -ut just one power ul hit o nicotine and the addict is back. 7hile ignorance o the %aw is no excuse, the !ast, !ast most ex-users do not remain exusers because o understanding or respect or the %aw, or because o $one pu $ relapse rates seen in studies. They do so because once home they disco!er that li e without using is !astly better than using. 7hile the relapse rate or years / though 30 may seem small, when added together the risk becomes signi icant. Kne recent study suggests that as many as 3AC who succeed or 3 year may e!entually relapse../F These ex-users don"t relapse because they dislike being home. They do so because they lose sight o how they got there, who they are, and the capti!ity they escaped. &mong educated ex-users there appear to be three primary actors associated with relapse9 <3= a natural suppression o memories o reco!ery"s early challenges, </= they rewrite, amend or decide to test the %aw and <H= they pretend that they ha!e a legitimate excuse to break or ignore it. (hould these actors combine with an o er o a ree cigar, alcohol use around those still using./A or occur in an impulsi!e-type person,./1 the risk o relapse gets magni ied.
./I >rall 6&, et al, (moking relapse a ter / years o abstinence9 indings rom the G& :ormati!e &ging (tudy, :icotine and Tobacco ?esearch, Debruary /00/, Golume .<3=, *ages BI-300. ./F ,ughes '?, et al, ?elapse to smoking a ter 3 year o abstinence9 a meta-analysis, &ddicti!e -eha!iors, December /001, Golume HH<3/=, *ages 3I3F-3I/0. ./A >rall 6&, et al, (moking relapse a ter / years o abstinence9 indings rom the G& :ormati!e &ging (tudy, :icotine and Tobacco ?esearch, Debruary /00/, Golume .<3=, *ages BI-300. ./1 Doran :, 5mpulsi!ity and smoking relapse, :icotine and Tobacco ?esearch, &ugust /00., Golume F<.=, *ages F.3-F.A.
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Reco"ery Memory ;uppre$$ion 5t"s normal to slowly grow complacent during the months and years a ter ending nicotine use. Eomplacency is ueled by ailing memories o daily capti!ity and the actors that compelled us to seek reedom. 5t"s also ueled by an inability to recall the intensity o early withdrawal anxieties, the power o cue triggered cra!e episodes or the duration o conscious ixation. #ost o us ailed to keep a detailed record o why we commenced reco!ery or what those irst two weeks were like. 7ithout a record to remind us, we"re orced to rely upon our memory to accurately and !i!idly preser!e the truth, the whole truth and nothing but the truth. -ut now, the memory in which we placed our trust has ailed us. 5t isn"t that our memory is bad, aulty or doing anything wrong. 5n act, it"s working as designed to preser!e in as much detail as possible li e"s joy ul e!ents, while suppressing and helping us orget li e"s stress ul e!ents, anxieties, trauma and pain. To do otherwise would make li e inside these minds unbearable. 5n act, post-traumatic stress disorder <*T(D= is belie!ed to re lect a breakdown in the mind"s ability to orget. ./B 5 women were orced to remember the agony and pain o childbirth, most would likely ha!e only one child. 7e are each blessed with the ability to orget. (o how does the reco!ered nicotine addict who ailed to record their journey home re!i!e their passion or reedom and recall liberty"s price8 5 we orget the past are we destined to repeat it8 :ot necessarily. -ut just as any lo!ing relationship needs nourishment to lourish, we should not take our reco!ery or granted or the lame could e!entually die, and the ire go out. 5t"s my goal to protect my reedom until 5 draw my last breath. 5 you eel the same, then we need to nourish our desires. 5 we do, we win. 5 not, we risk complacency allowing nicotine back into our bloodstream. 7e risk dying as sla!es. 7hether daily, monthly or just once a year, our reco!ery bene its rom care. -ut where do we turn i our reco!ery memories ha!e been suppressed and we"!e kept no record8
./B Meraerts 6, #c:ally ?', Dorgetting unwanted memories9 directed orgetting and thought suppression methods, &cta *sychologica <&mst=, #arch /001, Golume 3/A<H=, *ages F3.-F//J also see, %e!y -', &nderson #E, 5ndi!idual di erences in the suppression o unwanted memories9 the executi!e de icit hypothesis, &cta *sychologica <&mst=, #arch /001, Golume 3/A<H=, *ages F/H-FHI.
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Kur best resource is probably our brothers and sisters still in bondage. 7hy not enlist their help in re!itali)ing our own memories o acti!e dependency8 Talk to them. %et them know what you seek. 6ncourage them to be as candid and truth ul as possible. &lthough it may look like they"re enjoying their addiction, their primary objecti!e is to stay one step ahead o insula dri!en urges and cra!es. Tell them the truth about where you now ind yoursel . &lthough not always the case, with most you"ll ind their responses inspiring. -e kind and sincere. 5t wasn"t long ago that those were our shoes. Try hard to recall those irst two weeks without nicotine. Think about earlier uneducated attempts. 7hat were they like8 Ean you recall your mind begging to be ed8 Deel the anxieties. 7ere you able to concentrate8 ,ow was your sleep8 Did you eel depressed, angry, irritable, rustrated, restless or anxious8 7ere there rapidly cycling emotions, irrational thinking or emotional outbursts8 Do you remember these things8 Do you remember the price you paid8 Do you recall the reasons you willingly paid it8 5 you ha!e access to a computer, go online and !isit any o the scores o smoking cessation support groups. There we"ll ind thousands o battles being ought, hear a multitude o cries and watch hundreds struggling or sur!i!al as they dream o the calmness and quiet you now call home. The newbies you"ll see cannot begin to imagine tra!eling so ar that remembering the turmoil they now eel will someday soon become their greatest challenge o all. 5 permitted, send a message to those in need. The most important thing you can tell them is the truth about why you came. 5 still in the irst ew days they may be acing signi icant anxieties. Their mind may ha!e them con!inced that their emotional storm will ne!er end. Don"t pretend that you can eel their anxiety. 5nstead gi!e them what they need, the truth. %et them know that you"!e tra!eled so ar that it"s now di icult to relate. Tell them how com ortable and complacent you"!e grown. Describe last week and how many seconds, i any, that you de!oted to thinking about using. Dear o the unknown is rightening. Teach them what li e on 6asy (treet is like. -y aiding them we aid oursel!es.
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5t may be that complacency has you at a point where thoughts o wanting are again taking root. -ut think back. ,ow long had you gone without wanting8 5 it is happening, rekindling pride in the ama)ing journey you once made may silence such chatter. 5 occurring, 5"d encourage you to re-read Ehapters . and 3/, as 5 suspect that you"!e either de!eloped a romantic ixation with using, or ailed to let go o one during reco!ery. !mending the 0 w o1 !ddiction The second complacency actor working against us is a strong, natural desire to want to belie!e that we"!e been ully cured, that we can now handle $just one,$ $just once.$ -ut just one pu , dip, chew or !ape and $do not pass go, do not collect T/00.$ Mo directly to the addict"s prison and surrender your reedom. 5t isn"t that we don"t belie!e the %aw. 5t"s probably more a matter o growing to belie!e that we"re the exception to it. 7e con!ince oursel!es that we"re stronger, smarter or wiser than all addicts who came be ore us. 7e amend the law. 7e put oursel!es abo!e it. $'ust once, it"ll be ok, 5 can handle it.$ $5"m stronger than them.$ $& little reward, it"s been a while, 5"!e earned it.$ (uch thoughts in ect the mind and eed on themsel!es. ;nless interrupted by reason and truth, our period o healing and reedom may be nearing an end. 5 allowed to ester, all our dreams and hard work risk being lushed like a toilet. 5nstead o pretending we can handle$ just one,$ such encounters demand truth. -e ore reaching the point o throwing it all away we need to be honest about what"s about to happen. 5 this moment should e!er arri!e, try telling yoursel this be ore bringing nicotine back into your body9
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$#y reedom will now end@$ $5"m going back.$ $5 can handle all o them, gi!e them all back to me, my entire addiction, all the trips to the store, the buys, the money, and the empties.$ $5 want it all back.$ $Mo ahead, slowly harden my arteries and eat my brain.$ 5 a smoker, $ ill my world with ash, co!er me in that old amiliar stench, and let morning again be or coughing.$ 5 an oral user, $take my hair, destroy my teeth, and put sores back into my mouth.$.H0 $*ut me back behind bars, make me an outcast, throw away the key and let me die with my master still circulating in my !eins.$ $5 accept my ate$ $5"m ready to surrender@$ 5t"s ar easier or the junkie mind to create a one pu , one dip or one chew exception to the $law$ than to admit the truth. 5nstead o picturing just one or once, picture all o them, at least a ull year"s supply. *icture trying to it them into your mouth all at once because day a ter day, month a ter month, year a ter year a ter year that"s exactly where they"ll be going. $To thine own sel be true.$ 4ou deser!e it - you paid the price - you earned it@ 5 you ind yoursel attempting to rewrite the %aw, stop, think, remember, re lect, read, re!isit, re!i!e and gi!e to others, but most important, be honest with you@ /he Per1ect %Bcu$e The inal ingredient is an excuse. Dor many, any excuse will do, e!en joy@ 5t could be a reunion with an old buddy who uses, one too many drinks with riends, a wedding, a graduation, or e!en a baby"s birth and someone handing you a cigar. 5magine being curious about the new electronic or e-cigarette with its atomi)ation chamber, smart chip, lithium battery, and cartridge illed with apple, cherry, strawberry, chocolate, !anilla, co ee, mint or tobacco la!ored nicotine. 5magine watching an e-cigarette instantly !apori)e nicotine when sucked and seeing a little light at the end imitate a real cigarette"s heat. 7hat about a chance encounter with a sel ser!ice display o ering two pieces o :icorette"s new Einnamon (urge,$ $Druit Ehill$ or $Eappuccino$ la!ors o nicotine gum or one penny@
.H0 *olito '?, %ong-term :icorette gum users losing hair and teeth, 7hyLuit.com, December 3, /001.
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7hat about being tempted to try one o the other new nicotine deli!ery de!ices now hitting the streets8 5t"s exactly what those selling them are hoping will happen. 5magine being o ered the new ully dissol!able tobacco/nicotine toothpicks, sticks, ilm or candy la!ored orbs. -ut joy ul or e!en stupid nicotine relapse is harder to explain to oursel!es and to those we lo!e. The smart addict waits or the great excuse, the one that will be easy to sell to both themsel!es and others. &s sick as it may sound, the easiest to sell is probably the death o a lo!ed one. &lthough e!eryone we lo!e is destined to die and it will happen sooner or later, or the re ormed addict it"s the per ect excuse or relapse. 5 mean, who can blame us or ingesting highly addicti!e drugs upon the death o our mother. &nyone who does would ha!e to be extremely insensiti!e or totally heartless@ ?ight8 7rong@ There is no legitimate excuse or relapse. %osing a job, the end o a relationship, a serious illness, disease, a terrorist attack, inancial problems, a lood, earthquake, hurricane, an auto accident, are all great excuses too - it"s drug time again@ The addict is back@ ;tterly terrible e!ents will happen in each o our li!es. (uch is li e. &dding ull-blown nicotine relapse to any situation won"t ix, correct or undo our underlying concern. Take a moment now and picture yoursel ully na!igating the worst nightmare your mind can imagine. (ooner or later it will happen. 7hen it does, staying clean and ree may be the most positi!e actor during this period o darkness. ?emember, we"!e only traded places with our chemical dependency and the key to the cell is that one hit o nicotine that will orce your brain"s sur!i!al instincts teacher to teach a alse lesson, and make that lesson nearly impossible in the short term to orget. &s long as we stay on reedom"s side o the bars, we are the jailers and our dependency the prisoner. There are only two choices. 7e can complete this temporary period o adjustment and enjoy com ortable probation or li e, or introduce nicotine back into our bloodstream, relapse, and intentionally in lict cruel and unusual punishment upon these innocent bodies or the remainder o their time on earth.
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5 the irst choice sounds better - li etime probation - then we each need only ollow one simple rule ... no nicotine today@
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/he le$$on le rned - Kne o two things happens ollowing relapse. 6ither the user will think they ha!e gotten away with using and, as a result, with the passage o time a $ alse sense o con idence$ will ha!e them using again, or they"ll quickly ind themsel!es back using nicotine at their old le!el o daily intake, or higher. &lthough it sounds strange, as 'oel notes, the lucky ones are those who quickly ind themsel!es once again ully hooked..H3 7hy8 -ecause this group stands a ar better chance o associating that irst pu , dip or chew o nicotine with ull and complete relapse. 5nstead o learning the %aw o &ddiction rom some book such as this, they stand a chance o sel -disco!ering the law through experience and the school o hard-knocks. 5t"s a lesson that"s become increasingly di icult to sel -disco!er since 3B1., when the DD& appro!ed the irst o a now !ast array o nicotine replacement products <:?T=, the nicotine gum. Today, the lesson that just one hit o nicotine spells relapse gets muddied and buried by promotion and marketing associated with ine ecti!e nicotine weaning schemes. Those standing to pro it rom the sale o :?T ha!e re-labeled a natural poison medicine. They teach that instead o ending nicotine"s use that you need to replace it, and describe doing so as $therapy.$ 5t"s why teaching and sharing the $%aw o &ddiction$ with those still in bondage is the most important gi t we can gi!e. *re-:?T generations enjoyed clean mental chalkboards upon which to record prior relapse experiences. Today the chalkboards o millions are so illed with con licting messages that identi ying truth has become nearly impossible. This generation needs us. They need our insights. /here i$ no legitim te rel p$e Cu$ti1ic tion - K!er the years we"!e heard nearly e!ery relapse justi ication imaginable. (ome relate extremely horri ic and brutal li e situations and then put their back against the wall as i daring you to tell them that their nicotine use and relapse wasn"t justi ied.
.H3 (pit)er, ', The %ucky Knes Met ,ooked, 7hyLuit.com, 'oel"s %ibrary 3B1..
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Muess what8 &gain, there"s absolutely no legitimate justi ication or relapse. :one, )ilch@ &s 'oel puts it, we understand why the person ailed. They $!iolated the %aw o &ddiction, used nicotine and are paying the mandatory penalty \ relapse. 7e also know that any excuse that the person is attempting to gi!e or ha!ing re-awakened an acti!e chemical dependency is total nonsense. There is no justi ication or relapse.$ .H/ Don"t expect any serious support group or competent nicotine dependency reco!ery counselor to allow relapse excuses to stand unchallenged. They can"t, as silence is a teacher too. ,ere, a deadly one. 5t"s $like someone standing on a ledge o a building,$ writes 'oel. $Do you want the people standing on the ground gi!ing the person on the ledge reasons not to jump, or a ter listening to all the woes in the indi!idual"s li e saying, "Mosh, 5 understand what you are saying." "5 eel that way too." "5 guess i 5 were in your shoes 5 would jump too." "Don"t eel guilty, though, we understand."$ $5 don"t want this statement to be read like a mockery o those attempting to o er help,$ says 'oel. $5 am trying to illustrate an important point. Kb!iously, i the person on the ledge jumps he or she will die. -ut understand, that i a person relapses and doesn"t quit, he or she is likely to ace the same ate, just time delayed.$ $4es, i you saw a person on a ledge you would try to use empathy to coax him or her back. -ut, empathy would be in the orm o explaining that you understand his or her plight but totally disappro!e o his or her current tactic or dealing with it. There are better ways to resol!e these problems than committing suicide.$ $4ou may understand the eelings the person had. 4ou may ha!e e!en elt them at some point yoursel . -ut you don"t gi!e into the eeling,$ writes 'oel. 7e are nicotine addicts9 real, li!e honest to goodness drug addicts. 5 we were all heroin addicts sticking needles into our arms, when one o us relapsed and started again injecting heroin into their !eins, would the rest o us pat them on the back and tell them that $it"s ok$8 7ould we tell them $don"t worry about it,$ $it"s just a little slip, nothing big$ $you just keep slipping and we"ll just keep hugging you each time you come back.$ $,ey, we all slip e!ery once in a while, it"s just part o li e,$ that $it"s no big deal$8 :o big deal8 (urrendering control o li e to an external chemical is a big, big deal. The smoker waiting or the sky to all while committing slow motion suicide is massi!e.
.H/ (pit)er, ', 7e ;nderstand 7hy 4ou ?elapsed, 7hyLuit.com, 'oel"s %ibrary, /00/.
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Continuing 4$e R tion li5 tion$ 7hile the relapsed addict may eel that their reason or relapse was su icient, it will not be su icient to explain the act that they ind themsel!es still using. They now need a new rationali)ation to explain why their relapse justi ication has passed, yet they ha!en"t stopped using. 2<=m Cu$t too we ( to $top.2.HH This excuse dismisses or ignores ha!ing been success ul up to the point o relapse. Kb!iously, they were not too weak then. This user would bene it by ocusing upon and breathing renewed li e into reedom"s neglected dreams and desires. During their next reco!ery they need to master putting and keeping those dreams in the dri!er"s seat o their mind, especially during challenge. They"d be wise to re!iew the cra!e coping techniques shared in Ehapter 33 and prepare or battle by arming themsel!es with additional coping skills. They need to appreciate that the growing pride they elt be ore they relapsed can take root anew in just a ew hours, as they na!igate withdrawal again, just one challenge at a time. 2Well, t le $t < tried.2.H. &s 'oel notes, chalking the attempt up to $experience$ will mean absolutely nothing unless the user $objecti!ely e!aluates what caused his relapses.$ $5nstead o recogni)ing his past attempts as ailures, he rationali)es a positi!e eeling o accomplishment about them. This type o rationali)ation all but assures ailures in all uture attempts.$ ,e needs to understand that claimed use justi ications ne!er cause relapse. &dministering another dose o nicotine is what causes relapse, not the circumstances surrounding it. 2< (now < will $top g in.2.HI This addict justi ies continued use today by promising to na!igate withdrawal in the
.HH (pit)er, ', $5"m just too weak to quit smoking@$ 7hyLuit.com, 'oel"s %ibrary, 3B1.. .H. (pit)er, ', $7ell, at least 5 attempted to quit. That is better than not trying at all,$ 7hyLuit.com, 'oel"s
%ibrary, 3B1F. :ote9 re erences to the word quit ha!e been replaced with the word stop or stopped. .HI (pit)er, ', $5 know 5 will quit again,$ Debruary //, /003, http9//www. n.yuku.com/topic///BA1
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uture. -ut what i their now shattered dreams and desires ne!er again become su icient to moti!ate them to stop8 7hat i there just isn"t time8 7hat i continuing use causes the ats and plaque building and gathering within an artery deli!ering oxygen to their brain to become ully blocked be ore arri!al o the courage to again say $no.$ Knce su iciently re-moti!ated, why should they expect a di erent result i they still ha!e little or no understanding as to why the last relapse occurred8 5 their moti!ations are su icient now and they understand why they relapsed, what are they waiting or8 They are likely waiting because they"!e in!ented some new silly drug use rationali)ation as to why now just isn"t the right time. 2<="e tried e"erything to $top nd nothing wor($.2 'oel tells the story o one clinic participants, a woman named -arbara. (he $told me that she had once attended another clinic and liked it more than ours. 5 asked her how long she had stopped a ter that program and she said, "Kh, 5 didn"t stop at all."$ $5 then asked her how many o the other people succeeded. (he replied, "5 don"t know i anybody stopped." 5 then asked, i nobody stopped then why did she like the program more8 (he answered, "7hen 5 completed the program, 5 didn"t eel bad about smoking@"$.HF 5 o ten hear, $5"!e already tried cold turkey plenty o times@$ 7hat this person doesn"t yet appreciate is that education is a reco!ery method. 5n contrast to uneducated abrupt nicotine cessation it"s like turning on the lights. *roducts and procedures clearly can ail to produce as ad!ertised. -ut it"s a little hard to blame knowledge and understanding when our actions are contrary to them. %ike any tool, knowledge cannot take credit or being used, nor blame or being ignored. ;nlike products, this book can ne!er claim credit or ha!ing endured a single challenge or any reader. Eredit or their ongoing !ictory will always be 300 percent theirs. %ikewise, responsibility or allowing nicotine back into their bloodstream and brain is totally theirs too.
.HF (pit)er, ', $5"!e tried e!erything to quit and nothing works,$ Debruary 3F, /00/,
http9//www. n.yuku.com/topic/3/3/3
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2M y'e <=m di11erent.2.HA 2M y'e < c n=t Iuit.2.H1 5t isn"t that this person is di erent. 5n act, they"re the same as us. ?elapse a ter relapse, with at least a do)en serious ailed attempts o my own, 5 e!entually came to belie!e that it was impossible or me to stop. & ter one last ailed attempt in early 3BBB, 5 surrendered to the act that 5 was a drug addict, hopeless and would die an addict"s death. 7hat 5 didn"t then reali)e was that each o those battles were ought in ignorance and darkness. 5 was swinging blindly at an unseen opponent. 7hat 5 didn"t reali)e was that 5"d ne!er once brought my greatest weapon to the battle ield, my intelligence. 5"d made reco!ery !astly more challenging than need be. 5 skipped meals, added hunger anxieties, mind og, experienced ca eine doubling associated with at least a pot o co ee daily, and leaned hea!ily upon others or support. 5nsanely, more than once 5 celebrated and rewarded mysel with just one cigarette a ter three days, once the early anxieties began easing o a bit. 5 knew nothing o the body"s ability to rid itsel o nicotine within A/ hours. &nd ha!ing inter-spaced cold turkey with at least our :?T attempts, 5 was totally lost. 7as nicotine medicine or was it what was keeping me hooked8 ,ow could 5 possibly sel disco!er the %aw o &ddiction !ia one pu and relapse when now being taught that nicotine was medicine8 7as 5 weaker than the hundreds o millions who had success ully stopped8 7as 5 di erent8 Eertainly not with respect to what happens once nicotine enters the brain. &s 'oel notes, it is impossible to locate any person who relapsed who didn"t introduce nicotine back into their bloodstream. More %Bcu$e$ Coming &s ar as relapse excuses are concerned, li e will pro!ide an abundant supply or anyone looking or them. 7e will ha!e riends or lo!ed ones who will get sick, diseased and die. Dying is a normal part o li e. 5 the death o someone close to us is an acceptable reason or relapse then the reedom and healing o nearly a billion now com ortable ex-users is
.HA (pit)er, ', $#aybe 5"m Di erent$ 7hyLuit.com, 'oel"s %ibrary, 3B1I. .H1 (pit)er, ', 5 Ean"t Luit or 5 7on"t Luit, 7hyLuit.com, 'oel"s %ibrary, 3B1F.
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at risk. 6xpect imper ect humans to do the unthinkable. 7e change, disagree, sometimes break promises, argue, and start and end relationships. 6xpect inancial distress as ood, medicine, uel and li!ing costs continue to rise. The loss o a job or inability to work may be an injury, disease or pink slip away. Dloods, droughts, ires, tornadoes, earthquakes and hurricanes will happen. *eople die, !ehicles collide, sports teams lose, terrorists attack and wars will be waged, won and lost. %i e promises loads o excuses to relapse. -ut reedom"s promise is absolute. 5t is impossible to relapse so long as all nicotine remains on the outside. 7e each ha!e a 300 percent guarantee o staying ree today so long as no nicotine gets inside.
7 rm Reduction
7hat i we do relapse8 7hat then8 ,ope ully, relapse will instill a deep and pro ound respect or the power o one hit o nicotine to again take the mind"s priorities teacher hostage. ,ope ully, belie in the %aw o &ddiction will therea ter ore!er remain beyond question. ,ope ully, we"ll immediately work toward re!i!ing and strengthening our dreams and soon start home again. -ut i not, what then8 &nd what i our relapse was to the dirtiest, most destructi!e and deadliest orm o nicotine deli!ery e!er de!ised, the cigarette8 7e"re told it accounts or /0C o all deaths in de!eloped nations..HB &ccording to the 7orld ,ealth Krgani)ation, smoking is expected to claim more than one billion nicotine addicts by the end o the /3st century. ?espected nicotine toxicologist ,ein) Min)el, #D writes, $burning tobacco ... generates more than 3I0 billion tar particles per cubic inch, constituting the !isible portion o cigarette smoke. -ut this !isible portion amounts to little more than I to 1 percent o what a lit cigarette discharges and what you inhale during pu ing. The remaining B0C o the total output rom a burning cigarette is in gaseous orm and cannot be seen.$..0 #any health o icials wish they could immediately trans er all smokers to less destructi!e orms o nicotine deli!ery. &nd some are now strongly ad!ocating it.
.HB 7ald :' and ,ackshaw &>, Eigarette smoking9 an epidemiological o!er!iew, -ritish #edical -ulletin, 'anuary 3BBF, Golume I/<3=, *ages H-33. ..0 Min)el, >,, 7hy Do 4ou (moke8 7hyLuit.com, Debruary F, /00A
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$5 :?T were e!er able to replace smoking, which is highly unlikely,$ writes Dr. Min)el, $morbidity and mortality caused by nicotine itsel would mani est o!er time and replace that o cigarette smoking. 5t would probably be lower or the adult, but nicotine exposure during etal de!elopment and in ancy could ha!e alarming consequences or a ected populations.$ ,ow many ewer deaths would occur8 7e don"t really know. &lthough most harm reduction ad!ocates are extremely optimistic and expect massi!e reductions, their suppositions ignore the act that most smokers ha!e already logged years o tobacco toxin and carcinogen exposure. ,ow does their continuing use o the super-toxin nicotine actor into the damage already done8 7hat are the long-term risks associated oral tobacco, electronic cigarettes, and replacement nicotine in long-term ex-smokers8 5t may take decades be ore science can untangle relati!e risks and draw reasonably reliable conclusions. &s or any traditional combustion-type cigarette claiming to be less harm ul than other burning cigarette, don"t buy it. 5nhaling gases and particles rom a burning mini toxic waste dump is inherently dangerous and extremely destructi!e. & recent study examined the e ects o smoke rom three brands claiming harm reduction upon normal embryonic stem cell de!elopment. 5t ound that smoke rom these so-called harm-reduction cigarettes inhibited normal cell de!elopment as much $or more$ than traditional brands...3 (ome public health ad!ocates are alarmed that harm reduction campaigns may actually back ire, keeping millions who would ha!e success ully arrested their chemical dependency hooked and cycling back and orth between cigarettes and other orms o nicotine deli!ery. They are also concerned that harm reduction campaigns tossing about terms such as $sa e,$ $sa er,$ or $sa ety$ may actually entice ex-smokers to relapse. 5 hold in my hand sample packets containing two /mg pieces o $Dresh Druit$ and $5ce #int$ :icorette gum with tooth whiteners. 5 was told that these sample packs were being sold at sel -ser!ice checkout counter displays in Eanadian beer stores or one penny. ,ow many ex-smokers will be tempted to gi!e it a try while drinking alcohol8 ,ow
..3 %in (, et al, Eomparison o toxicity o smoke rom traditional and harm-reduction cigarettes using mouse embryonic stem cells as a no!el model or preimplantation de!elopment, ,uman ?eproduction, :o!ember /B, /001 O6pub ahead o printP.
29-
many will relapse8 ,ow much o this sample gum will end up in the hands o youth8 The second sentence on the back o each Eanadian sample pack tells smokers that :icorette gum isn"t just or stopping smoking. $:icorette gum can also be used in cases in which you temporarily re rain rom smoking, or example in smoke- ree areas or in other situations which you wish to a!oid smoking.$ 5magine pharmaceutical companies do!e-tailing their marketing with that o tobacco companies in order to make continued smoking easier or more con!enient. ,a!e you e!er wondered why you ha!e ne!er once heard any pharmaceutical industry stop smoking product commercial suggest that, $(moking causes lung cancer, emphysema and circulatory disease, that you need to buy and use our product because smoking can kill you$8 4ou ha!en"t and likely ne!er will. -ut why8 &s hard as this may be to belie!e, the pharmaceutical and tobacco industries ha!e operated under a nicotine marketing partnership agreement since about 3B1.. The once secret documents e!idencing the agreement are many, and suggest that neither side may directly attack the other side"s products.../ The primary purpose o their partnership is to ensure the purchase and use o each side"s dopamine pathway stimulation products. They want you to pay them to satis y your dependency"s wanting. This book"s purpose is to aid you in arresting it. -ack to harm reduction where both sides in the debate appear to be o!erstating their case. (ome opposed to harm reduction ha!e argued that the risks associated with a smoker trans erring to oral tobacco is like getting hit by a small car instead o a large truck, like shooting yoursel in the oot instead o the head, or like jumping rom a three-story building rather than one ten stories tall. %acking accurate relati!e risk data themsel!es, the harm reductionist counters by
../ (hamasunder -, -ero %., Dinancial ties and con licts o interest between pharmaceutical and tobacco companies, 'ournal o the &merican #edical &ssociation, &ugust 3., /00/, Golume /11<F=, *ages AH1-A..J also see the ollowing once secret tobacco industry documents a!ailable at TobaccoDocuments.org9 *# ;(& internal memo dated A//3/1/, -ates N/0/HABBAB1J *# ;(& internal memo dated I/A/1., -ates N/0/HABBABBJ *# ;(& internal memo dated 30//I/1., -ates N/0/HABB103J *# ;(& letter dated 3//3A/1., -ates N/0/HABB10.J *# ;(& internal memo dated 3////1I, -ates N/0/HABB10HJ *# ;(& internal memo dated B/F/1I, -ates N/0/HABBABFJ /nd *# ;(& internal memo dated B/F/1I, -ates N/0/HABBABIJ *# ;(& internal memo dated 3//3F/1I, -ates N/0/HABBA1BJ *# ;(& internal memo dated 3/1/11, -ates N/I0003FAFIJ *# ;(& letter dated I/1/B3, -ates N/01HA1IFA/J -ritish &merican Tobacco collection letter dated 1/3/B3, -ates NI001A/FA1J *# 5nternational letter dated .//H/B1, -ates N/0F.BI/H0A.
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asserting that, $-ased on the a!ailable literature on mortality rom alls, we estimate that smoking presents a mortality risk similar to a all o about . stories, while mortality risk rom smokeless tobacco is no worse than that rom an almost certainly non- atal all rom less than / stories.$..H $7e estimate$8 5t"s disturbing to see us stoop to educated-guessing when it comes to li e or death. 5t is also disturbing that no serious harm reduction ad!ocate has yet been willing to pro!ide an accurate accounting o known and suspected harms associated with chronic nicotine use. They know that the amount o nicotine needed to kill a human is 3FF times smaller than the amount o ca eine needed to do so <.0-F0 milligrams !ersus 30 grams=.... 4et, in order to sell smokers on $sa er$ deli!ery many ha!e resorted to alsely portraying nicotine as being as harmless as ca eine. ,arm reduction ad!ocates ha!e also done little to quiet concerns about the impact o marketing upon youth, messages already bombarding them with a wide array o tempting la!ors being portrayed as !astly sa er than smoking. They seem unconcerned by an increasing number o adolescent nicotine harm studies showing nicotine"s horri ic toll on the de!eloping adolescent brain...I %et me gi!e just one example among many. 6!er wonder why those who started using nicotine as children or early teens tend to ha!e greater di iculty learning through listening8 ?esearch shows that adolescent nicotine disrupts normal de!elopment o auditory brain ibers. This damage
..H *hillips EG, et al, Deconstructing anti-harm-reduction metaphorsJ mortality risk rom alls and other traumatic injuries compared to smokeless tobacco use, ,arm ?eduction 'ournal, &pril 31, /00F, Golume H, *ages 3-I. ... *olito, '?, :icotine 3FF Times #ore Deadly than Ea eine8 7hyLuit.com, Debruary 3F, /00F. ..I (lotkin T&, et al, &dolescent nicotine treatment changes the response o acetylcholine systems to subsequent nicotine administration in adulthood, -rain ?esearch -ulletin, #ay 3I, /001, Golume AF <3-/=, *ages 3I/-3FIJ also see, (lotkin T&, 5 nicotine is a de!elopmental neurotoxicant in animal studies, dare we recommend nicotine
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may inter ere with the ability o these ibers to pass sound, resulting in greater noise and diminished sound processing e iciency...F ,arm reduction ad!ocates not only ignore the harms in licted by nicotine, they ignore nicotine"s greatest cost o all, li!ing e!ery hour o your li e as an acti!ely eeding drug addict. They must, otherwise they couldn"t sell it. They ocus on dying not li!ing. (ome ha!e resorted to accusing cessation educators and counselors unwilling to incorporate harm reduction lessons into their reco!ery programs as ha!ing a $stop or die$ mentality. 5t is as i they ha!e no appreciation or the act that bargaining is a normal phase o reco!ery, and there may be no more in!iting bargain or a drug addict than one which in!ites them to keep their drug. 5t"s why it pains me to include this harm reduction section here at the tail end o this book. 5 worry that some new struggling ex-user reading this book, who would ha!e succeeded i this section had not been included, will instead sei)e upon the words that ollow as license to relapse. -ut the alternati!e, the potential or relapse and then smoking yoursel to death because relati!e risk had ne!er been discussed or explained, is totally unacceptable. (till, as Dr. Min)el notes, it would be nice i we knew the actual relati!e risks in contrasting oral tobacco to :?T but we don"t. 7hat is the relati!e risk when comparing cigarettes to oral tobacco or to electronic cigarettes or replacement nicotine8 7e know that cigarettes currently contribute to nearly i!e million deaths this year, and that cigarettes release more than .,000 chemicals while oral tobacco releases /,II0 chemicals. 7e also know that 13 potential cancer-causing chemicals ha!e been identi ied in cigarette smoke..A !ersus /1 in oral tobacco...1
replacement therapy in pregnant women and adolescents8 :eurotoxicology and Teratology, 'anuary /001, Golume H0, 5ssue 3, *ages 3-3B. ..F 'acobsen, %>, et al, *renatal and &dolescent 6xposure to Tobacco (moke #odulates the De!elopment o 7hite #atter #icrostructure, The 'ournal o :euroscience, December I, /00A, Golume /A<.B=, *ages 3H.B33H.B1. ..A (mith E' et al, 5&?E carcinogens reported in cigarette mainstream smoke and their calculated log * !alues, Dood and Ehemical Toxicology, 'une /00H, Golume .3<F=, *ages 10A-13A. ..1 5&?E #onographs on the 6!aluation o Earcinogenic ?isks to ,umans, (mokeless Tobacco and (ome Tobacco-speci ic :-:itrosamines, /00A, Golume 1B.
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The only as yet known harm ul agent in both the new electronic or e-cigarettes <which uses an atomi)er to create a nicotine mist=..B and replacement nicotine <:?T= is nicotine, and trace amounts o tobacco-speci ic nitrosamines <T(:&"s=, which should be correctable !ia quality control. (till, additional research is needed as we ha!e little long-term data or pure nicotine, as nearly e!ery user has years o cigarette or oral tobacco exposure, which makes it nearly impossible to determine direct and proximate cause. Elearly, smokers ace serious risk o many di erent types o cancers, a host o breathing disorders including emphysema, and serious circulatory disease as carbon monoxide combines with nicotine to destroy !essel walls and acilitate plaque buildup. (moking"s risks and roughly I0C adult kill rate are well known. 7hat wasn"t being studied until recently were the health concerns being expressed by long-term :?T users. &lthough we still don"t know whether or not :?T user health concerns are in act directly related to chronic nicotine use, online complaints among those who ha!e used nicotine gum or one year or longer include9 &ddiction with intense gum cra!ings, anxiety, irritability, di))iness, headaches, ner!ousness, hiccups, ringing in the ears, chronic depression, headaches, heart burn, ele!ated blood pressure, a rapid or irregular heart beat, sleep disruption, tiredness, a lack o moti!ation, a hea!y eeling, recessed, bleeding and diseased gums, diminished sense o taste, tooth enamel damage, tooth loss, jaw-joint pain and damage <T#'=, canker sores with white patches on the tongue or mouth, bad breath, dry mouth, sore or irritated throat, di iculty swallowing, swollen glands, bronchitis, stomach problems and pain, gastritis, se!ere bloating, belching, achy muscles and joints, pins and needles in arms and hands, uncontrollable oul smelling gas that lingers, a lack o energy, loss o sex dri!e, acid re lux, stomach ulcers, ecal impaction rom dehydration, scalp tingling, hair loss, acne, acial reddening, chronic skin rashes and concerns about immune system suppression. .I0 7hile smoking"s harms are clearly !astly greater and ar more li e threatening than nicotine"s, how do we weigh and balance pure nicotine"s ongoing use harms against smoking"s8 ,ow many millions o additional air sacs would these lungs ha!e today i 5"d permanently trans erred my dependency to nicotine gum the irst time 5 used it in 3B1I or 1F8 5 my goal had been long-term gum use instead o 1 to 3/ weeks during cessation, would 5 ha!e been more willing to accept gum"s slower, less precise and less controllable deli!ery8
..B *olito '?, Do >ennedy and 7axman know about electronic or e-cigarettes8 7hyLuit.com, #arch /B, /001. .I0 *olito '?, %ong-term :icorette gum users losing hair and teeth, 7hyLuit.com, December 3, /001.
29+
5 5"d permanently trans erred my dependency to cleaner deli!ery in 3B1F, would 5 be able to run or more than a ew hundred eet today8 7ould 5 ha!e more teeth8 5 5 had allowed mysel to become hooked on the cure, as an estimated HAC o ;.(. nicotine gum users were as o /00H,.I3 would 5 ha!e had the moti!ation to e!entually break ree rom all nicotine, as 5 did on #ay 3I, 3BBB when 5 stopped smoking8 7ould 5 ha!e created 7hyLuit two months later in 'uly8 7ould 5 ha!e met 'oel in 'anuary /0008 7ould this book ha!e been written8 5 don"t know. #aybe, maybe not. ,ope ully you understand a bit better my reluctance to suggest that i you relapse to smoking nicotine, that i a non-pregnant adult, that you consider attempting to adapt to a cleaner orm o deli!ery. There, 5"!e done it. -ut my dream isn"t about seeing you de!elop the patience to allow yoursel time to adapt to and remain sla!e to a cleaner and less destructi!e orm o deli!ery. 5t"s that you de!elop the $one day at a time$ patience needed to go the distance and allow yoursel to sample and taste the reedom and healing beyond. Knce ree, 5 pray you ne!er orget the most important lesson o all. &s 'oel says, the true measure o nicotine"s power isn"t in how hard it is to stop, but in how easy it is to relapse. Thousands o words but still just one guiding principle determining the outcome or all ... no nicotine today@ 4es we can@ -reathe deep, hug hard, li!e long,
.I3 -artosiewic), *, & Luitter"s Dilemma9 ,ooked on the Eure, :ew 4ork Times, *ublished9 #ay /, /00.J quoting, (hi man (, ,ughes '?, et al, *ersistent use o nicotine replacement therapy9 an analysis o actual purchase patterns in a population based sample, Tobacco Eontrol /00H :o!emberJ 3/9 H30-H3F.
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!ppendiB !) Reco"ery Journ l*#i ry

3. #y nicotine use history9
/. #y core moti!ations or wanting to end nicotine use9
H. #y reco!ery attempt history and the real reason each attempt ailed9
.. & brie summary o what the irst week o this reco!ery was like9
I. The total minutes daily 5 spent thinking about wanting to use nicotine at9 H0 hours A/ hours9 3 7eek9 / 7eeks9 . 7eeks9 F weeks9 / months9 H months9 F months9 3 year9
F. Things 5 want to remind mysel o on my one year anni!ersary9
A. The names o two other acti!e users whom 5"!e taught the %aw o &ddiction9
1. The names o two children or teens whom 5"!e taught the true power o nicotine9
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www.WhyQuit.

Freedom from Nicotine The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

www.WhyQuit.com :reedom 1rom .icotine & /he Journey 7ome

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

'ohn ?. *olito :icotine Eessation 6ducator

Copyright John R. Polito 2009, 2012

.icotine !ddiction 101

?emember how your body reacted to that

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

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Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

Freedom from Nicotine - The Journey Home

:reedom ;t rt$ with !dmitting !ddiction

Copyright John R. Polito 2009, 2012

:reedom 1rom .icotine & /he Journey 7ome

:reedom 1rom .icotine & /he Journey 7ome

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:reedom 1rom .icotine & /he Journey 7ome

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