If I Wanted to Quit Smoking

Things I did the day I quit alcohol that I would never, ever do again: keep it secret, not tell my doctor, not tell my friends, just decide one day to quit, and do it on my own.

I’ve been without alcohol for almost two years.* If I were also addicted to the nicotine in cigarettes, I think I’d be ready to try to become abstinent from smoking. Given my terribly difficult experience with abstinence from alcohol during these past 23 months, and given my research and experience with treating addiction, I would start my quit date completely differently.

I would:

1. Make a plan.
2. Create a team.

More specifically, I would:

Study the latest research on smoking cessation. A compilation for us is here and Wikipedia has a nice entry on smoking cessation.

Study the symptoms of nicotine withdrawal and determine which I think would be most problematic for me.

Make an appointment with my primary care physician. I would tell her I wanted to stop, run my research and anticipation of challenges by her, and ask her if I had her support. (She’s seen thousands of people quit or try to quit. I’ve seen one person quit – my mother.)

If my doctor said yes, I’d listen to her suggestions based on her expertise and experience. Given I have an ingestion addiction – mine is to alcohol – and I ingest a prescribed benzo each night for another condition, I doubt she would suggest medication-assisted cessation. I would be hesitant to ingest another strong substance given I seem to have a Princess and the Pea inner chemistry.

If I didn’t have those conditions, I’d take the meds. Abstaining from alcohol will cause withdrawal. Detox from nicotine is like detox from alcohol and other drugs. I think the statement “What doesn’t kill you makes you stronger” is cruel and shaming. What’s hard enough to kill you damages you, often beyond repair. I didn’t know meds were available for me when I was quitting alcohol. I would have taken the meds.

Ask my doctor to take my calls for 6 weeks from my quit date. I’ll promise to only call her in emergencies. And it’s only for a short time. By 6 weeks, my nicotinic receptors should be beginning to return to normal. But anxiety for me can manifest as thoughts that something is wrong physically. What it feels like is that my emotional brain takes over and I am unable to access my rational brain. If I could call her and say, “My hands are shaking. I Googled and I think I have Parkinson’s,” she could say, “Hand tremors are normal during nicotine withdrawal.” Her voice of authority and reason would calm and reassure my emotional brain so it would be less overwhelming to my rational brain. That would be a 60-second phone call that would probably keep me from picking up a cigarette.

Ask my friends for help. When I look at the list of nicotine withdrawal symptoms, the two I think would challenge me most would be anxiety, irritability, and physical pain from headaches. Anxiety threatens my relationship with myself, irritability threatens my relationship with others, and physical pain alarms, then demoralizes me. I would ask a friend to serve as my “anxiety coach” and another friend to serve as my “irritability coach.” I would ask my doc what I can do, and take, to ease headaches. I would check in with them once per day and call additionally as needed.

Tell my partner, friends, family members, boss and co-workers. While I am going through withdrawal and when I am with others, I anticipate that I will be too absent or too present, either preoccupied with my inner state or taking my inner state out on others. I’m not going to be that great to be with. But there’s absolutely no one who wants me to keep smoking. If I let them know beforehand that I’m going to feel tragically hurt and sob uncontrollably and, in the next moment, feel unjustly treated and shout uncontrollably – and think I’m absolutely right to do so – they’re less likely to take my words personally and will probably voluntarily help me manage my strong emotions.

Ask someone to quit with me. I tried to quit drinking by myself. Only in the company of others was I able to quit and stay quit. I assume the same would be true of smoking.

If I were going to go “cold turkey” and quit out right, I would write an hour-by-hour schedule for myself for an entire week. I’d share it with my team – doctor, friends, etc. I probably would set up a Doodle and ask them to call me hour-by-hour. It’s the all-day, every-day nature of addiction that does us in. I would do everything I could to protect myself from getting worn down and weak from wrestling with my addiction on my own.

If I were going to taper, I would follow this brilliant strategy of a friend who quit successfully: count how many cigarettes I smoke in a day. Let’s say that’s 30. Tomorrow, I smoke 29. The next day, I smoke 28. I cut a cigarette a day. That eases the withdrawal symptoms and eases me into what to do during the day instead of smoke. She didn’t smoke the 1 cigarette on the last day but kept it as psychological protection to have in case she “needed” it. My mother did a similar tapering process, didn’t smoke again, but kept that last cigarette for years.

Know that I’ll experience abstinence from nicotine as pain.   I thought I would feel better once I quit alcohol. Ha.

Knowing better now, I’d plan for pain – emotional and physical. If I were having dental surgery, before the surgery I’d help myself out. I’d empty and refill my ice trays and stock up on Jello, pudding, and chicken broth. Maybe some ice cream. Why in the world wouldn’t I plan in the same way to ease and comfort myself through quitting smoking?

What helps give me immediate relief from emotional pain is calling someone, plugging myself into an audiobook, and coloring. So I would put the names of people on my refrigerator (knowing that under the duress of withdrawal my mind won’t be able to remember that I have their names and numbers in my phone), download audiobooks onto the iPod, and put coloring books and crayons front and center on the dining room table. I don’t care if it looks messy. I’m quitting smoking here.

And I’d know I’d need to take care of myself for awhile. Anhedonia, the inability to feel pleasure, is associated with alcohol and drug withdrawal, including nicotine withdrawal. Knowing going in that I’ll try to feel better, and not be able to, will help me hang in there long enough for the anhedonia effect to pass.

Know that what smoking stopped for me will be started again. If I started smoking to feel like I fit in, when I stop, I’ll feel like I don’t fit in anymore. If I started smoking to ease anxiety or anger, the anxiety or anger will be back. Before I got addicted to alcohol, I had reasons why I drank those first glasses of wine. The same would be true for those first cigarettes. The reasons will be back.

Begin counseling before I quit. I would run my quitting plan by a counseling professional and ask for suggestions. I would make follow-up appointments now to get weekly or twice weekly counseling during the first six weeks, and continue until I felt really sound.

According to The Fix’s list of The 10 Hardest Drugs to Kick, I’ve been abstinent from alcohol, a measly #6 in the queue. Nicotine is #3, just below heroin and crack. I might or might not be able to kick smoking. But having learned bittersweet lessons from becoming abstinent from alcohol – it’s a hell that can be managed and having supportive people in one’s life is lovely – with a plan and a team, I think I could give myself a good chance at it.

*I originally wrote this post in 2014. As of this update – June 22, 2018 – I have been abstinent from alcohol since December 28, 2012.

The views expressed are mine alone and do not necessarily reflect the positions of my employers, co-workers, clients, family members or friends. This content is for informational purposes only and is not a substitute for medical or professional advice. Consult a qualified health care professional for personalized medical and professional advice.