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Smoking and Tobacco

Quitting for Good

01/07/2011

Question:

I quit smoking successfully 3 months ago but now I am back to smoking as much as ever. Every time I have quit I’ve told myself, “This is so hard, I never want to put myself through this again.” But every time something in my life happens that is stressful, I go running back to my cigarettes. What can I do? I am so frustrated!!

Answer:

First, recognize that you are not alone. Nicotine is one of the most addictive substances known to man, and relapse - returning to your addiction - is an expected part of healing from this addiction. The trick is, not to think of these previous episodes as failures, but as practice for the next effort that will ultimately be successful. If these efforts are to be thought of as practice, then you have to learn from them, and it appears you have.

It seems your primary reason for relapse is stress, which again puts you in crowded company. Stress is the most common reason given for returning to smoking. In fact, the best predictor of success or failure in cessation is the extent to which the smoker learns to use their cigarettes to regulate their mood. In order to know whether this is you, think about what we refer to as your “always smoke feelings.” Every smoker has feelings that tend to trigger the urge to smoke such as frustration, anger, sadness, anxiety, overwhelmed, upset, disappointed, loneliness, or insecurity. The more always smoke feelings you have, the more likely it is that stress will cause relapse, since smoking has become a primary coping mechanism for these feelings.

In avoiding relapse the next time around, start with this insight, and then build in an alternative response - a plan for what you will do when you have these feelings rather than smoking. Check out the OFF (Officially Free From) Nicotine Smoking Cessation Particpation Guide to find out more about breathing techniques, self massage approaches, and the “smoker’s switch” that work as effective alternative responses for many smoker who have become Officially Free From Nicotine.

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Response by:

Scott H Frank, MD, MS Scott H Frank, MD, MS
Associate Professor of Epidemiology and Biostatistics
School of Medicine
Case Western Reserve University