Smoking cessation programs

Knowledge is power

Change takes courage

Stress levels may be highest during the first two weeks after quitting.

During the first few weeks of quitting, even a small stressor can lead to the urge to smoke.

Smoking cessation classes provide techniques, tools, and resources for support that can:• Make cravings more

manageable• Support the transition to a

new identity as a non-smoker

Nicotine Is Special

• Nicotine is the all-time addictive drug of choice because so many people use it in so many different ways: to wake up, to get to sleep, to de-stress, to get energy, to relax.

• There are eight patented ways to increase nicotine content by adding it to the tobacco after it's harvested.

• Five of them work to add nicotine to filters and wrappers. • Another 12 are used to develop advanced technology to manipulate

nicotine levels and develop new chemical variants.

Smoking is one of the few drugs that is easily woven into daily routines.

Why smoking behavior is hard to change: its all in our head

Newly-abstinent smokers were shown visual cues associated with smoking while their brain activity was studied using neuro-imaging;

The visual cues activated the area of the brain responsible for automatic responses- learning habits or things we do by rote, like riding a bike or brushing our teeth.

Duke University Medical Center (2009, January 7). Why Smokers Struggle To Quit: New Findings. ScienceDaily. Retrieved February 28, 2011, from http://www.sciencedaily.com /releases/2009/01/090105175324.htm

Brains gone wild

• Suppose you always have a cigarette with coffee or tea – or always smoke when talking on the telephone, or while driving.

• The repeated pattern of behavior trains your brain to link these two activities.

• Over time, it becomes very hard to do one without the other.

Stress drives cravings. Smoking perpetuates stress.

Long-term gain:Success at quitting smoking eases depressive symptoms

Recent studies show that breaking the cycle of tobacco use to medicate negative feelings and depression has benefits to mental as well as physical health.

C. W. Kahler, N. S. Spillane, A. M. Busch, A. M. Leventhal. Time-Varying Smoking Abstinence Predicts Lower Depressive Symptoms Following Smoking Cessation Treatment. Nicotine & Tobacco Research, 2010; DOI:

10.1093/ntr/ntq213

Short-term pain:Getting through cravings is a challenge

Using any substance repeatedly – especially to

manage emotional or psychological stress - produces neural pathways that have a life of

their own.

Nicotine is a very a short-acting drug so it has to be used repeatedly.

The Neuroscience of Bonding

When smoking is bonded to other behavior that behavior triggers cravings

3 Brain Regions involved with nicotine dependence and cravings

• BLUE: the thalamus, the brain region critical to one's ability to calm down when stressed.

• RED: the striatum, a region implicated in the pleasure system of the brain.

• GREEN: the anterior cingulate cortex, a region vital to self-control and concentration.

Credit: Image courtesy of Duke University Medical Center

Help for the craving brain

The thalamus - critical to one's ability to calm down when stressed responds to:• Hypnotherapy• Mindfulness Techniques, e.g. yoga, meditation• Anti-depressant medications • Herbal combinations• Acupuncture• Exercise

The striatum deals with systems of the brain associated with pleasure/rewards

• Creative experiences – music, comedy, art, writing,

• Fun!!!• Exercise• Massage• Positive social interactions• Food•

The anterior cingulate cortex: self-control and concentration

• Activities that occupy the hands, e.g. knitting, crafts, playing a musical instrument

• Cognitive shifts: locating one’s identity as a non-smoker and the relationships that support it

• Recognizing triggers and organizing ways to avoid them

• Cognitive planning – consciously replacing a smoking-related behavior with a different behavior

How to break a “smoking bond” before you quit: an example from NY Quits

• Instead of having a cigarette with your coffee or tea, have it before or after,

• Slowly add a couple of minutes between them over the next several days.

• Set a goal to wait 15 minutes between your cigarette and your drink.

• Drink your coffee or tea in a place where you don’t usually smoke, or vice-versa.

• If you drink coffee or tea with caffeine, you may want to gradually reduce the amount of caffeine you consume by switching to decaf. Feeling “jittery” is a common side effect of quitting smoking. If you add caffeine the side effect may be a bit worse.

The anterior cingulate cortex, a region vital to self-control and concentration

Cognitive shifts – locating a “non-smoker” identity and relationships that support itSocial support, e.g. Nicotine Anonymous Knitting, crafts, playing an instrument

Breaking the “smoking bond” after you quit: an example From NY Quits

• Hold your cup in the hand where you used to hold a cigarette• Keep your hands busy with a doodle pad, crossword puzzle,

newspaper, to-do list or dunk low-fat cookies into your tea or coffee.

• Between sips, take deep breaths and savor the aroma of the coffee or tea.

• Don’t sit in the same seat or the same room where you used to sit when you were smoking.

• Stand up and drink your tea or coffee quickly and then go for a walk.

• Call a relative or friend or the NYS Smokers’ Quitline for encouragement.

What happens when we quit

Within 20 minutes• Blood Pressure returns

to normal.• Heartbeat stabilizes. Within 8 hours• Oxygen level in your

blood increases.• Mucus begins to clear

out of your lungs making breathing easier.

Within 48 hours• Sense of smell and taste

improve.• Chances of heart attack

decrease. Within 3 months• Circulation improves.• Immune system improves.• Possible savings of over

*$400.

What happens when we quit

Within 9 months• Sinus congestion,

wheezing, shortness of breath and phlegm production decreases.

• Lung Function improves.

1 year• Risk of dying from a heart attack

is cut in half.• Possible savings of over $1,600

(for a pack-a-day smoker at $4.50 per pack)

5 years• Stroke risk is reduced to the

same level as a non-smoker.

• 10 years• The chances of getting lung

cancer are cut in half

Successful wellness programs respond to people where they are

Change can make a person feel like a fish out of water. Lifestage designs wellness programs that match participants’ expressed degree of readiness to change.

496 Smithtown Bypass Suite 202Smithtown NY 11787 631-366-4265

lifestage_2000@yahoo.com

Contact us for a free consultation

631-366-4265 www.lifestage.org

Jude Treder-Wolff, LCSW, RMT, CGP & Nicholas Wolff, LCSW, BCD, TEP