Wellness Wednesday – Strategize to kick the habit

Shonia Struck, an employee with UNMC Physicians, hasn’t smoked since March 22 of this year.

Before that, she had smoked more than a pack a day for about 14 years.

Tips from Dr. Klingemann Here are some tips from Dr. Klingemann to help get through nicotine cravings: Cravings generally last from three to five minutes — so try to focus on something else for a few minutes and the worst part of the craving should be gone. Wear a rubberband on your wrist and snap it a couple of times when a craving starts — this refocuses your thought. Focus on the negative outcomes that are awaiting you if you continue the addiction. Think about how your health-related illnesses will impact your family. Chew a piece of sugarless gum or candy. Stick a toothpick, drinking straw or pencil in your mouth for a couple of minutes. Call a friend or counselor for immediate help. Go for a walk. Go in an empty room and scream for a couple of seconds. And, most importantly, think about why the craving is affecting you so strongly at that stitch-in-time. What triggered it? How can you solve that particular problem? Can you reduce the frequency or intensity of that “trigger”? Apply what you have learned to the rest of your quit attempt. Don’t give up. Look at these cravings as learning experiences. People who succeed at quitting solve their problems as they go along.

She used Chantix — which helped her deal with the physical withdrawal from nicotine. And as for triggers, those habitual behaviors that spark the urge to use tobacco, well, here’s what she had to say about that.

“I needed to make a very conscious effort to change the things that are normal, everyday life,” Struck said. “In the morning, when I got up, normally I went straight outside for a smoke. So instead I decided to go straight to the shower, then I didn’t have time to smoke.”

And after dinner, instead of lighting up, she decided to take out the trash or lay out the next night’s dinner.

“I never craved them after the first week really,” she said. “Small changes made a huge difference.”

Amen to that, said Tom Klingemann, Pharm.D., an adjunct professor in the College of Pharmacy who also is an expert on tobacco cessation.

Small, strategic moves go a long way toward success in kicking the habit, Dr. Klingemann said.

Most tobacco cessation programs deal with two factors — the physical addiction to nicotine and the psychological addiction to the habit.

Chantix and other drugs help with the physical aspect, but the psychological and habitual aspects are the real tricksters when it comes time to quit, Dr. Klingemann said.

Other stories Below is a schedule of stories in this series on tobacco cessation. Week 1 — Going tobacco free Week 2 — Quitting strategies Week 3 — Cravings and triggers Week 4 — Support systems and medicine Week 5 — Relapse Week 6 –Weight gain and the oral fixation Week 7 — Benefits of non-smoking

Triggers and habitual behaviors are powerful traps that lead many people back to tobacco use and not accounting for them in a plan to kick the habit can be disasterous, he said.

“It’s the old adage, failing to plan means planning to fail,” Dr. Klingemann said.

When he helps patients set up cessation plans, Dr. Klingemann has them write diaries of their tobacco use in which patients chronicle how often they engage in their habit, when they do it and why they do it.

This allows the user to see the patterns of their tobacco use, which then allows them to form a plan on how to avoid situations that trigger the desire to use tobacco.

Using Struck’s examples above, if waking up in the morning is a trigger to smoke, make a plan to do something right way — such as take a shower or make lunch.

“If you plan and account for these triggers, quitting can be fairly simple,” said Dr. Klingemann, who smoked for 10 years before quitting in 1990. “But if you don’t plan, you’re liable to get smothered by the strong urges that come when you encounter triggers.”

In his work with patients, Dr. Klingemann has seen people get rid of furniture that they regularly smoked in and change their route on their drive home from work because using tobacco was part of these routines.

“To many people, this may sound ridiculous, but these seemingly minor changes make a huge difference and can help people head off cravings,” he said. “And in the end, these simple actions actually save lives.”