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Stopping Smoking On Your Own: Tips and Tricks

Posted on 14 January 2008 by JamesHamilton

Smoking was the twentieth century’s badge of adulthood. At one point, three quarters of the population of the United Kingdom were smokers. Now it’s down to a quarter. Cigarettes are going the way of bowler hats and leaded petrol.

It’s happening because people are stopping smoking in droves. Most of them are doing it without any assistance: NHS clinics, hypnotherapists, Allen Carr and co. account for only a small proportion of the ongoing smoking cull.

So the chances are that anyone reading this who is considering moving on from this iconic habit has it in mind to go it alone. Perhaps some of what happens will make life easier – or at least clearer.

If you haven’t done so already, you might want to read my earlier articles on the subject here and here.

Belief and Stopping Smoking
Stopping smokers are liable to experience something akin to a reversal of the placebo effect. Most smokers believe that stopping will be hard to do. That, on its own, clear of any other factors, will make stopping more difficult than it need be.

It’s not a daft thing to believe. If you’ve already had a series of “failed” attempts to stop smoking, or if you’ve watched friends and colleagues climbing walls in the first days after stopping, or if you’ve watched the UK government’s spectacularly unhelpful “don’t give up on giving up” advertising campaign, then “hard” might seem like a fair summary of the situation.

But believing that stopping is hard brings its own baggage.

I can tell you now that stopping smoking does not change the world you live in very much. It’s the same stressful, neurotic, randomly dangerous place, and non-smokers are equally acquainted with grief. Stopping smoking doesn’t lead you to sunlit uplands.

When you stop smoking, you are just going to have to deal with life in a different way. You’re still going to have to deal with it. And in those first few days, life is going to come at you from all directions. What is going on will have nothing to do with whether you’re smoking or not, but the chances are that because you believe stopping smoking is difficult, you are going to attribute every last irritation and loss of temper and low feeling and hunger pang and so forth to the absence of cigarettes in your life. You’ll be looking out for these feelings too. It’s like one of those cognitive exercises: look around the room for something coloured red, only this time, you’re scanning the environment for the things that get your goat.

If you expect to feel bad, and are going to attribute that feeling bad to cigarettes, you’re going to have a worse time than you really need to.

So what I suggest is that you make a deal with yourself before stopping. Take it on board that the lack of cigarettes does not account for all of your mood (let’s agree that it’s partly responsible, just out of respect for common sense). Assume that part of what you’re experiencing is just life. The rest – that part you are attributing to cigarettes – is that grand dark night of the soul that men and women who have never smoked will never get to experience, outstare and outlast, that time under mental and emotional fire that stopping smokers discover that they can endure and never after forget that they can endure.

But is there something you can do to weaken that belief before you start?

You have a lot of people in your life who once smoked and are now non-smokers. I might have met some of them: before I went into practice, I interviewed close on a thousand. When I set out, I had no idea how I myself was ever going to manage to stop smoking, and I was deeply afraid that I would become one of those smokers who’d leave it too late, and suffer both illness, pain and the darker pain of regret and self-recrimination, who’d put that load of grief and anguish on my family and friends.

But the more people I spoke to who’d managed this strange, impossible thing, the more everyday it began to seem, the more it was brought down to size. I discovered that not every smoker goes through agonies – that the experience is heavily dependent upon our essential personalities. If, like me, you are prone to blowing things out of all proportion, it can be useful to gather these role models around yourself. Simply, if they can do it, so can you. And if it took them several attempts (it took me north of thirty) then you have permission not to succeed first time. If you fail this time, you don’t have to be hard on yourself: get up and go again.

So, talk to the non-smokers you know. They’ll have a range of experiences to impart, and perhaps some additional advice or tips that have escaped great minds like mine. And it’ll weaken your belief that it’s hard. And that’ll help.

Get Straight About Your Reasons

By and large, the reasons smokers give for wanting to stop fall into the same few categories. Health, don’t-want-to-be-a-slave, smell/dirt, money, “other people”, smoking’s growing pariah status. The trouble with these reasons is that they are poor sources of motivation. Most of them are too easy to get around – smoking outside turns out to be preferable in the short term (and it’s always the short term where smoking is concerned), breath freshener works, being a slave isn’t that bad really, and smoking still isn’t all that expensive compared to the price of a round of drinks.

Look on these classic smoker’s reasons not as reasons to stop, but as a list of smoking’s little inconveniences. Reasons to fear continuing to smoke. None of them, not even health in the majority of cases, mean that you have something real to show for stopping smoking. I repeat: don’t expect stopping smoking to transform your life. On its own, what stopping smoking does for you is remove a convenient source of stress relief, quick concentration, social connection and style. On its own, stopping smoking is a net loss.

That’s not to say that you won’t succeed in stopping smoking when you’re doing it just for smoking’s sake. I know plenty of people who’ve done just that, and so do you. But this is about making the whole thing more straightforward.

It’s better to have, or to create, something in your life that means a great deal for you that stopping smoking can be just one part of. That’s why pregnant women often find stopping smoking easy (not all – genetic disposition/personality works here too, as my own mother will tell you).

What that might be is absolutely individual. I stopped smoking in order that I could jam the fact of my success up the nose of a close but irritating friend again and again over many years. That’s not a worthy goal, and it makes me look like the way it makes me look. You might prefer the man about to adopt with his wife, who wants to keep up with his new son until the son is at least 14. Or the saxophonist who knows she has the potential to go pro – once her lungs have recovered their capacity after stopping smoking. Or the runner, dreaming of a race along the Andes to raise money for a cause dear to their heart.

If at all possible, don’t stop smoking just for stopping smoking’s sake. Have a greater cause. It’ll make stopping more straightforward, and it’ll keep you interested in stopping if you do that human thing and have a setback.

Consider Deliberately Failing To Stop Smoking

A study – which is now so deeply buried in the BMJ’s archive that I can no longer find it – established some years ago that people who repeatedly fail in successive attempts to stop smoking nevertheless gradually improve their chances of success next time.

The study shouldn’t have been necessary. Of course repeated attempts get you closer to eventual success.

For one thing, you get used to the idea of trying to stop. The next attempt is not such a big deal as the first. The pressure upon you lessens with each attempt, and, perhaps counterintuitively, perhaps not, that increases your chances of success. If you can fail and not start hitting yourself with blame and recrimination, then the stakes for your next attempt are lower, and the whole experience will be better.

For another, you get to know what to expect. You grow to know and recognize your own reactions to the stopping smoking situation, and begin to learn your own workarounds.

You get used to the idea of going days without smoking simply because you’ve done it. And although it might not have “caught” with you first time, the prospect is less frightening.

I’ve met many people who decided to “give up” for a fixed period, but who then simply failed to begin again. After a while, you forget those experiences of psychological advantage from smoking. That’s the point when you walk past the tobacco counter in the supermarket and the display – once so colourful, now, in the UK, a sea of white warning and panic – and find that it means nothing to you. It inspires all the appetite and pangs of the catfood aisle.

If your first attempt at stopping smoking was traumatic, you can learn through other attempts that it need not always be so.

Choosing and Making Your Time To Stop

With many habits, such as excessive drinking, or Class A drugs, choosing a special moment at which to quit them is largely futile, if you are working alone. Not so with smoking.

That’s one reason why that although many New Year Resolution stopping smokers fail, a fair few make it through the net and out to the other side. January 1 is a date like few others, and it’s a strong peg to hang something like stopping smoking on.

I’d recommend augmenting the peg, however. As per becoming clear about your reasons, it can be good to roll stopping smoking in with a raft of other minor changes. Stop smoking at the same time as starting the novel, or setting up a GTD sytem, or losing a pound or two.

And, in private, mark the occasion. I say in private because I’m sceptical that having a load of people aware that you’re stopping smoking is a great idea. I’ve never found that terribly motivational – if I’ve been in that situation, more often than not I’ve merely “gone underground” with whatever it was I was allegedly stopping doing.

Smoking was this great twentieth century thing, something you have in common with writers, film stars, leaders and politicians, soldiers in the trenches and heroic doctors on insane shifts, miners and airmen. What an army of pathetic addicts that had so many in its ranks of brilliance, courage, humour and self-sacrifice.

Go and find a high view, smoke your last cigarette there, and enjoy it. Then, quietly, put it out, and walk away into the rest of your life. Buy a special pack if you like – my grandfather smoked Camels, my stepfather B&H Gold – why not a pack from your past? Or pay a visit to Davidoff in London and go for something unusual. Smoke your last and then begin the rest of your life with a meal at a new restaurant, or with a run in the dawn sunlight.

What Not To Try

“Cutting Down.” Really not worth the bother. There really isn’t any proper evidence that you can wean yourself off nicotine slowly, let alone any evidence that doing so produces a more tolerable experience than going cold turkey. In the years immediately after the Second World War, rationing and low incomes made it worthwhile for many British smokers to attempt to play out their limited cigarette supply over a longer period than they would otherwise have done. Almost invariably, cigarettes earmarked for tomorrow or the day after tomorrow were smoked “today”. Anyway, you deserve to treat yourself with more respect than this.

Stopping Smoking On Holiday. It spoils your holiday, and then the real world comes rushing in all at once and overwhelms you. Do it whilst you’re at work. Mark stopping with a special occasion, sure, but not a two-week type of one.

Putting the money you save into a special jar. Non-smokers don’t do this. All it will serve to do is remind you of smoking. And, do you plan to give yourself change out of a note? Or put money in the jar using your switch card? Remember that you’ll still be making all the other real-world transactions which once would have included cigarettes anyway. Again, either be smoking or not smoking: there is nothing between the two save dangerous no-man’s land.

Asking other people to step in if they see you smoking. Your friends and relatives don’t deserve that kind of burden, and you don’t deserve the damage this can do to your relationships. Either fully own your smoking or become a non-smoker. If you need to consider doing this, you need to do some further thinking about stopping before you embark on it. Reread my articles, or for a different opinion on all of this, try this series by Gillian Riley.

Avoiding situations where you expect to smoke. I stopped drinking, but I didn’t avoid my friends or the pub. If you try to avoid places of temptation, you will find there are so many of them that your life is mangled and you will, quite rightly, resent what has brought that about. My advice is, go out, enjoy yourself, see people, do things, have your life. The rewards of stopping smoking are too slight to be worth changing your life upside down for – that’s not rhetorical, just the plain fact of the matter. Stopping smoking does not lead to nirvana: it leaves you in the same neurotic world you were in before.

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Stopping Smoking – A Review of Methods

Posted on 03 January 2008 by JamesHamilton

As a preliminary follow-up to my previous article, I thought it would be useful to review some of the existing smoking cessation approaches from the point of view of someone who has worked extensively with smokers. I’m going to touch upon NRT (nicotine replacement therapy), group counselling, hypnotherapy, and acupuncture. There are others out there, of course.

NRT – Nicotine Replacement Therapy

When I was still myself a smoker, NRT was just emerging and beginning to obtain the acceptance it has now. The idea behind it is a simple one: people get addicted to nicotine rather than to smoking, so let’s give them an alternative source of the nicotine and wean them off it. It’s assumed that gradually reducing nicotine intake will be accompanied by a lessening dependence upon it, which assumes in turn that a dependence upon nicotine was present in the first place. When NRT first came onto the scene, the second of these assumptions had some decent evidence behind it – it was established that nicotine was psychoactive, although only since the advent of superior brain scanners of different kinds have we understood some aspects of how nicotine acts in the brain and body. The first assumption remains just that, an assumption, a hope to cling to.

In the United Kingdom, advertising for NRT claims, correctly, that it more than doubles your success at quitting. I’m afraid that doesn’t say very much. The most favourable peer-reviewed NRT research I’ve been able to find is this from the British Medical Journal – the researchers chose a laudably long reference period, giving follow-up results after six years. The study was concerned with comparing success rates between a group of smokers using nicotine patches only and a group using both patches and nicotine inhalators:

After 6 years, 1 out of 6 participants was still abstinent in the treatment group compared with 1 out of 12 in the patch only group.

I’m assuming that people looking to stop smoking are interested in stopping for more than six years. In these circumstances, the figures are deeply depressing. More depressing still is that the figures obtained by this study are actually higher than those obtained by practically every other (and there are hundreds of properly run studies of this kind going on all the time – try Cochrane Tobacco Addiction Group Specialized Register and the databases MEDLINE, EMBASE, AMED, SCI, SSCI and CISCOM for starters).

And more depressing still is that no one seems to notice how terrible these figures actually are. Given that nicotine is a dangerous substance in its own right, over and above any tendency to create dependence, given NRT’s proneness to side-effects, and given the sheer demand from smokers for effective cessation methods, I would have hoped to come across at least one researcher’s comment expressing regret at the enormous failure rates experienced by NRT patients.

My hunch is that NRT is driven largely by people who have themselves never smoked and who are therefore looking from the outside in. There’s long been a desperate desire for “drugs to fight drug addiction”, especially given that psychotherapy has, by and large, failed to provide any breakthroughs.

I reflect on one thing. I must have spoken to thousands of people who have succeeded in stopping smoking, the majority of them with no assistance whatsoever from an outside source. In every case, I was the first person with a serious professional interest in their success to have asked. I’d like to see a series of studies that interview, in-depth, 10,000+ successfully stopped smokers to see if the same patterns emerge as emerged for me when I undertook my own, more limited and subjective, interview research.

Group Counselling

NHS Smoking Cessation services keep reasonably good statistics, albeit in the short term. Here is a summary of the state of play as of mid-2001. 48% of participants were still abstinent after four weeks. The same document assumes that only 60-65% of that 48% will relapse by the end of the year, without giving any grounds for that assumption. If that were true, NHS clinics would be managing a success rate of one-third, which would be headline news if true – that’s the sort of figure we can start to get to work with, after all. But the true story is almost certainly sadder and darker.

Eugene Mill’s BMJ paper looked at Tyne and Wear. He says:

In 2003-4, 20 103 people in the region used smoking cessation services, of whom 9910 had still quit after four weeks (49.3%). Of these, I estimated 35-40% would still have quit after a year,2 a long term figure of 3500-4000.

Again, there are no reasons given for that estimate, and I think it’s too high. One reason is the sheer scale of drop-out from these services, as seen in the Scottish experience.

Of the 46,466 quit attempts made between 1st January and 31
st December 2006, there were 45,641 for which one month follow-up
data was available. Of these, 15,471 were recorded as successful
quits. This figure is based on client self-reported ‘not smoked, even a
puff, in the last two weeks’. Follow-up may have been undertaken ‘face to
face’, by telephone or by letter/written questionnaire. Of the remaining
30,170 cases, 15,384 had smoked in the last two weeks and
14,786 were ‘lost to follow-up’/unknown.

Information on exactly what kind of support is given in NHS clinics is relatively hard to come by, not for any sinister reason but because practice varies from place to place, there are pilot schemes to take account of and so forth.

Nevertheless, these are still depressing figures.

Whenever NHS attempts to improve matters in these areas are concerned, funding is always an issue – one quarter of the British population smoke, of whom a substantial number not only want to stop but actively try. There are not enough NHS clinics around to dent the numbers, and if I find the figures depressing, I hope that’s not taken as criticism of the people working in that system and doing their best to achieve the impossible with the minimum.

Hypnotherapy

As a qualified hypnotherapist, let me give a word of warning. Two, in fact. If you are thinking about “trying” hypnotherapy, here is what to avoid.

Avoid any therapist who cites, without source, studies “indicating” that their “new methods” are achieving a 95% success rate. Where they exist, and quite often they don’t, these “studies” are not what I mean by study i.e. properly conducted, peer-reviewed research. One hypnotherapist I know contacts 100 or so of his smoking clients after a year and takes his success rate from that – which strikes me as a reasonable approach in the circumstances. Most won’t.

Avoid anyone claiming that a “new combination of NLP and hypnosis/hypnotherapy” is bringing home the goods. NLP is a marrying of some ideas from CBT and hypnosis, so the statement is tautologous and merely displays that the advertiser is ignorant of their own field.

There is an almost complete lack of smoking cessation studies in relation to hypnosis. In fact, there is an almost complete lack of any studies whatsoever outside of NRT and behavioural therapy (whether individually or in groups). This is a consequence of the lack of a standard hypnotherapy procedure for smoking cessation, the lack of a single governing body for the field, and the sheer difficulty of excluding certain variables from study. It’s also the result of contemporary hypnotherapy’s deliberate positioning of itself outside the medical mainstream, for all that the BMA has accepted it as a valid approach since the 1950s and the existence of the British Society of Clinical and Academic Hypnosis.

At root, hypnotherapy’s approach to smoking cessation is entirely psychological, and there are two principal approaches. On the one hand, some practitioners will attempt to take and magnify your anti-smoking feelings and magnify them to the point where the iidea of smoking is too disgusting to contemplate. On the other, some practitioners will attempt to replace your smoking habits and the benefits you gain from smoking with more helpful habits and feelings – to replace the psychological experience of smoking with a superior experience or set of experiences.

Few studies, and not a lot worth reading. There’s this, from the New Scientist in 1992, which cites a metaanalysis undertaken on behalf of ASH (which I can’t find a confirmatory source for – I’d like to know how they overcame the heterogeneity of existing studies that other attempted analyses complain about) and also this more general article from Scientific American, but it’s not much to lean on.

My gut feeling from my own practice is that I achieved between 40% and 60% success rates over 12 months. I receive the occasional email from people years on who are still smoke-free. But I suspect that a significant number of my former clients who did go back to smoking simply didn’t blame me or the therapy for it.

You’ll excuse me if I leave the placebo effect out of it for now. We are going to know what that is, in measurable terms, in the not too distant future, and I’ll discuss it then. It’s no more than a phrase describing something we don’t understand for now.

Acupuncture

Again, practices vary: the word of mouth accounts I’ve had are black and white, either instantly and effortlessly successful or not at all.

The impression I gain is that it works better for the type As amongst us.

I suspect that the Cochrane Review Summary here – which complains about the paucity of studies – has it about right.

Allen Carr’s Easyway

I’d say worth a try, because the Allen Carr Clinic approach is both an actual process you can go through, but it respects your intellgence and invites your dissent and argument. That makes it highly unusual in the therapy field to put it mildly.

No other approach has created quite the wave of enthusiasm, yet there are no proper studies to add to it. That’s a shame; I’d be fascinated to see them.

The core idea, for what it’s worth, is that nicotine sets up a chain reaction – the relief afforded you by a cigarette is not genuine relief but merely temporary respite from the symptoms of nicotine withdrawal. A host of psychological consequences follow. Frankly, the outcome thus far of research in brain scanners bears Allen Carr out more than it bears out the wean-them-off ideas of the NRT adherents, but there are problems involving the relationship between the interval between cigarettes and the active life of nicotine in the brain. Nevertheless, it’s an idea worth pursuing further than it has been.

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Stopping Smoking – A Sport Psychology View

Posted on 31 December 2007 by JamesHamilton

The truth is – many top sportsmen do smoke. They always have done. And not the nearly men, either. Zinedine Zidane, Johann Cruyff, Diego Maradona, Shane Warne, the Charlton Brothers and Dino Zoff are all inarguable top achievers and all inarguable smokers. There’s a pretty talented British Division to add to the list: Paul Gascoigne, Freddie Flintoff, Jimmy Greaves.

Tiger Woods smokes.

So did I, and lists like these made me seethe with rage at having to stop. Why should I, when… but I knew why. Dark thoughts at the back of the mind: I didn’t want to shorten my precious life unavoidably. But still, to be leaving this kind of company! It’s something to have in common with men who I then saw as heroes, something to chalk up when other things like skill, tenacity and courage were lacking.

I had a bad time stopping. I didn’t really want to, for one thing. At that time, I owned a bound volume of back numbers from a 1930s 35mm photography magazine. It was clear from the ads in that that my grandparents didn’t have to worry about smoking. Everyone did it, and no one knew it was harmful. (I’ve learned since from talking to people who were alive and smoking at that time that they did suspect it was bad for them, but that they didn’t think they’d live long enough for it to make any real difference. If they’d known they were going to live so long, they’d have taken better care of themselves, etc..) Ready for your trip, 1930s man? Got your cigarettes, your lighter, your 35mm camera, your car keys, your hip flask? In that order? How I envied the dead their peace of mind, if not their World Wars. If Kingsley Amis’s letters are anything to go by, getting good tobacco in 39-45 was an absolute pain. To say nothing of beer.

I suppose fortunately, smoking was the third thing in the whole of my life about which I managed to be stubborn. (The first was first love and the second Oxford University). It took me 30+ attempts to stop, and led to a change in career. Smoking got me into psychology, professionally, in the same way as financial idiocy got me out of it again this year. I’ve already told the story of how an afternoon’s smoking whilst poring over Allen Carr’s Easyway To Stop Smoking Permanently put the idea of a business into my head, and how I then spent many months reading my way through the scientific literature and interviewing everyone who’d talk on the subject. This eventually led to my success in stopping, and in helping other people in time to stop too.

From a sport psychology point of view, stopping smoking is a good example of something really ruddy awkward. At this time of year, when people are writing New Year’s Resolutions, it points up the main differences between resolutions – which largely fail and make their owner feel bad – and goals, which have some chance of making it through.

“Resolutions” tend to be negative (stop smoking, lose weight), punitive (stop being so lazy/negative/nagging/depressed), not personally meaningful (they’ll be things, like stopping smoking, that we don’t want to do but which sound in principle like what a “proper person” would do or want), hard to envisage (smoking looks like.. that, but what does “not smoking” look like, or not eating, or not drinking, other than a great white nothing?) and above all, we generally won’t have a clear idea of how we mean to bring them about or how we intend them to fit into our lives as a whole, our social milieu.

Done properly, goals are quite different, and I’m going to be talking about them a great deal here over the next few weeks. They are different, at least in the way I do them, not only in that they are positive, meaningful and visible to you, not only in that there is at least some measure of planning involved to bring them down to specific actions you can take, but in that they obey certain rules. Here are the rules:

  • You must screw up, get things wrong, fail from time to time, to stay within the rules. This is human behaviour, and non-human behaviour just isn’t cricket where this is concerned.
  • You must forget to pursue your goals, you must drop them accidentally from time to time and find them again months or years later. Again, this is human behaviour, and non-human behaviour isn’t cricket.
  • Your goals are subsidiary to your life. This is a fact – life being what happens while you have other plans. But it’s an attitude, too – your goals must serve you, and the process of going after them must make your experience of life more rewarding in some way or it’s probably not worth it. Effort and suffering can be rewarding and meaningful, but be ready to court martial your goals if they start to work against you. This is about life becoming better, not about punishing you because you’re bad.

There are others, but all in good time.

Sports psychology splits goals into three main types, and knowing what these are helps a great deal in stopping smoking.

  1. Outcome Goals. If you are an athlete, this means winning – winning a signficant competition. Stopping smoking could be an outcome goal, but at this point take my word for it that it’s better off as one of the other two kinds.
  2. Performance Goals. If you are an athlete, a performance goal might be to achieve a certain time, or a certain distance, or a certain weight lifted. A performance goal is something your opponent can’t influence. You are in control. Performance goals overlap to some extent with the third type:
  3. Process Goals. Process goals are about technique. For a swimmer, the outcome goal might be an Olympic medal, the performance goal a certain time achieved, and a process goal perfecting a certain type of kick in the turn. I would put footballer’s Opta stats under process goals – so many passes completed, so many shots on target as a percentage.
  4. The problem with doing the obvious thing, and taking “stopping smoking” as an outcome goal, is that stopping smoking in of itself is rarely meaningful enough on its own to work well. You’ll have to lean on my experience in working with smokers in this – we spend (spent, now that I’m off piste for the time being) more time searching for what would make it meaningful, and making that real, than anything else.

    Why isn’t it meaningful? Why can’t it be a nice, simple outcome goal?

    Look at the reasons smokers give for wanting to stop. Health – I don’t want to get ill. Money – it’s expensive. Social – it’s a dirty habit, and fewer people do it; I feel like a pariah. The smell, the mess. Not wanting to be a slave to it anymore. Not wanting to feel stupid. And so forth.

    If your reasons for stopping have not been enough to actually stop you in the past, they are not going to do it now. They are not going to acquire superstrength overnight and begin to work where once they failed. All of these reasons are very good – but they just aren’t strong enough. Aside from health: if your doctor has told you that you are going to die in a few months’ time from smoking unless you stop (and there are few circumstances in which that might happen; smoking diseases, once underway, are very bad news and once the death sentence is passed, that’s generally it) and you believe him, that is sometimes strong enough. Pregnancy is very often strong enough.

    They aren’t meaningful because there is very little in it for you. If you stop smoking “cold turkey” on New Years’ Day, you will wait twenty years to find out whether or not you have saved your health. In the meantime, the improvement in your general health will be imperfect and glacially slow. What have you got to show for stopping smoking? A long wait – in my experience. The money you save will just vanish in some other way, most likely. What seems like a lot totted up over a year is actually just the equivalent of a round of drinks, or a joint of meat, or less than a cinema ticket or paperback book. And if you put the money into a tin on the mantlepiece.. you are doing better than most. I’d forget to do it after a few days. As for the smell, a promise: after you’ve stopped smoking, the smell of tobacco smoke will become far more disgusting to you and more headache-provoking than it ever was before you started. You will be worse off in that respect. (There are some people who find themselves eagerly sniffing the air for the smell – which goes to show that rules aren’t absolute. These people are going to have a job staying “stopped” – not because they’re weak or stupid, but because that difficulty goes with that experience).

    In short, the classic reasons for stopping smoking do not leave you better off in a way you can enjoy now. Not in a significant way. Outcome goals do leave you better off, so long as they are properly formed. Outcome goals have to make you, personally, feel better. We can’t always predict what will make us feel better, and indeed we are famously bad at such predictions. Stopping smoking does not transform the rest of life.

    But it can become part of something that does transform the rest of life. For me, stopping smoking became part of the wider goal of building my business and having the experiences that went with that. Helping others; ending up in unexpected places; meeting extraordinary people; finding that I was capable of more than I’d thought.

    For me, stopping smoking was a process goal. Or, rather, it was a series of process goals. Let me explain what I mean.

    As I’ve said, “stopping smoking” is a negative. You can see yourself washing up; you can see yourself not washing up (think of a sink full of pans and dishes). But thinking of an empty hand is unspecific. Your hands are empty much of the time. An empty hand doesn’t directly refer to “not smoking”.

    Fortunately, smoking is not a futile thing to do, and we can break it down into what it is actually doing for us – and then find a means of fulfilling those needs in better ways. Often, there’s a “universal” way of fulfilling those needs – by fulfilling greater needs that have a prevailing imperative over the ones smoking fulfils.

    Smoking does different things for different people living in their respective contexts and milieus. But these are what appear to be the most general benefits people gain from smoking:

  • Smoking helps you to relax.
  • Smoking helps you to concentrate
  • Smoking gives you something to do when bored
  • Smoking can keep you company when you’re lonely
  • Smoking gives you something to do with your hands
  • Smoking gives you social confidence, perhaps an air of “street”
  • Smoking looks elegant, even sexy
  • Smoking can mark special moments – after dinner, after sex
  • Smoking makes drinking better, and goes well with tea/coffee
  • Smoking is a powerful de-stresser
  • Smokers are the sociable ones
  • Smoking gives you a way to break the ice (“cigarette?” – proffers packet)
  • Smoking “scratches the big itch of life” (ht: Rob Kelly)
    1. Not all of those will be true for everyone, and some of them will be controversial to people with other ideas about the nature of smoking. The steady social dismissal of smoking makes many people reluctant to admit that there is anything at all to gain from smoking.

      But I’d argue that there are good reasons to break smoking down this way. For one thing, it explains smoking. Cigarettes went around the world at lightning speed – in sixty years changing from bizarre Ottoman Turk practice to that thing two thirds of the population did without thinking. Cigarettes did more for people, more easily, than any product ever known before or since. The Ipod isn’t the perfect product (and just you wait for the deafness epidemic..); a pack of Woodbines is. Smoking doesn’t stop you driving, flying, working machinery, making love, watching TV, shopping, eating; you can buy cigarettes anywhere 24/7 (only of petrol and junk food can the same be said) and they are, in the QVC phrase, so easy to use.

      For another, it restores the smoker’s sense of control. This is important. I found my own smoking infuriating, inexplicable. I could give up rowing, or concert-going. But not this. Why not? Because although the individual benefits I was getting from smoking were relatively small, they were cumulative (20 a day) and universal, amounting to a very large overall psychological benefit. What that means is that it’s an enormous tragedy that smoking should be so bad for health. It’s so good in so many other ways.

      For another, it should be apparent that these benefits can be obtained in other ways, from other things.

      Some people do go down the road of taking each benefit, each need, in turn and seeing how they can supply themselves with it in alternative ways from smoking. Others – and I count myself here – find more universal ways of doing it.

      Here’s where outcome goals do come in. If your outcome goal is deeply meaningful to you, and smoking is in the way of its achievement, then stopping smoking automatically becomes a process goal. What’s more, the psychological benefits of smoking recede. Because of your outcome goal, the benefits are now having to compensate you for not achieving this huge meaningful thing. And they, like the classic “reasons to stop smoking” are ultimately limited in their strength. They are not strong enough to compensate for disabling your outcome goal.

      For instance? I have had clients who were runners, and wanted to reach the next level. One I remember in particular, who had a race in mind, along the top of the Andes. We worked together to make it possible for them to see and feel that outcome – the spectacular scenery, the air in the lungs, the legs in that mode where it feels as though they can run forever.. we made every part of that outcome real. The feeling of being there, of actually having made it, the pride and satisfaction. And the steps to get there, the plan, the what-do-I-do-absolutely-next. At a certain point, the whole thing becomes clear; the person begins to trust themselves that they will take those specific steps, and thus they begin to believe, absolutely, that they will be there in the Andes. At that point, the achievement of making it there begins to work for them, in advance. They begin to enjoy the psychological benefits of the achievement, because of that element of self-trust. And the benefits of something that meaningful outweigh entirely what lies in the way – smoking. And when that happens, the habit just becomes an irrelevance, a left-over, and it crumples.

      Another example. A talented musician, whose dream was to become a professional, playing on stage. Hers was a wind instrument, and her tutor was aware of the depth of her ability. But because she smoked, her breathing was impaired, and her lung capacity reduced. Her tutor told her that she could make it – if only she stopped smoking! We worked together to make that prospect feel real and doable for her – every aspect of what it would really be like (including the mundane and the downsides, as unrealistic visions have no real power in them). She realised that smoking was in fact all that stood between her and her dream – and, once again, the benefits of the dream being realised more than compensated for the loss of the benefits of smoking. Smoking became an irrelevance, an outdated thing, and she stopped, effortlessly. She’s in Paris now, playing live with famous names.

      And then… there’s my story. Ahem. Not so glamorous or glorious, but the same principles apply. I began planning my business in the mid-90s, and one day I was having a drink with this bloke. We’re old friends, and as is sometimes the way with old friends, most of our conversations sound like all-out arguments. I’d been “sharing my plans” with him – the new techniques I’d pioneer, the consultancy I’d build, and would have built had I not been such a fool with money. He kind of listened, and then said something I’ll never forget:

      You’ll never stop smoking, James. You have an addictive personality.

      I thought, “I’ll show you, you *****”. That cigarette was my last. The prospect of an exciting new life (and it turned out to be that, for quite a lot of the time, at least at first) and of shoving his words back up his nose in perpetuity (and I do, unlovely as it is) outweighed the benefits of smoking and made them irrelevant to me. I haven’t smoked since.

      A word about “addiction”. There is no doubt at all that cigarettes, largely through the medium of nicotine, is highly psychoactive. It makes you feel different. Of course it is – otherwise, no benefits. Some people are in greater need of those benefits than others – especially sufferers from the various anxiety disorders and depressive conditions. It is clear to me that the task of stopping smoking is genuinely a great deal harder for such people, many of whom are undiagnosed or who, for the perfectly good reasons of protecting their own dignity and sense of self, would find diagnosis distasteful. It’s harder, and it’s not their fault it’s harder – no one brings such conditions upon themselves as these things are subject to fate and luck.

      Our understanding of the action of nicotine in the brain is far greater now than it was five years ago, and the growth of that understanding is accelerating. In my opinion, one result has been to utterly undermine the claims of most existing smoking cessation programmes but especially nicotine replacement therapy or NRT. Television adverts are accurate when they claim that NRT more than doubles your chances of success. It does, from about 2-4% to as high as between 10 and 16 percent. I leave you to decide if that amounts to abuse of statistics.

      In terms of addiction, I do not like most attempts to ram cigarettes, alcohol, heroin, cocaine, skunk, gambling, sex-lines and the rest in together under that heading – I don’t see how it helps our understanding or our attempts to provide effective treatments. Lance Dodes’ theory that “addiction” is a subset of more generally obsessive behaviour looks more promising than a thousand articles whittering on about dopamine. Luckily, what I think, or what anyone else thinks, isn’t crucial. Neuroscientific research has a habit of rendering old jargon, old concepts and old thinking irrelevant in spite of the personal biases of those involved.

      But if you accept that nicotine is essential – and I do – it’s worth considering that it’s essential, not in of itself, but what its effects mean to you personally, and where that meaning stacks up in your overall scheme of things. If your outcome goal is good enough, stopping smoking won’t be the most challenging process goal you’ll ever face.

      Of course, the Zinedanes and Cruyffs pose a problem. If fags don’t stop you making the World Cup Final… shhh…

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