By Suzanne Harris, RN
When we are about to make a major lifestyle change like becoming tobacco-free, the way we envision our goal can determine how successful we are in achieving it. One patient who came to our clinic at UCSF for smoking cessation counseling had smoked for 40 years and never tried to quit before. He told me:
“I can’t imagine never smoking again. I just don’t have any experience not smoking every day and the thought of quitting for good terrifies me.”
That patient had just received a serious cancer diagnosis and his physicians had told him he would have to stop smoking before undergoing surgery the following week. It was clear from our discussions that he had far more anxiety over quitting smoking than he did about the surgery or even his cancer diagnosis. Here he was facing one of the most stressful situations of his life and being told to give up the one behavior he’d relied on his whole life to manage stress.
I suggested we take that particular goal off the table and that he stop stressing himself with thoughts of never being able to smoke again. “Really”? he said. “But my doctor says I have to quit before he will do the surgery!” I asked him if he could imagine stopping just for the surgery and not putting pressure on himself to quit for good. He replied, “Well, yes, I can imagine doing THAT.”
We proceeded to put a plan in place based on stopping for the surgery and arranged for him to use nicotine patches, lozenges and a Nicotrol inhaler to ease the withdrawal from cigarettes. He actually found it rather easy to stop with multiple nicotine replacement products and counselling. By the time of his surgery, he had stopped smoking and decided to stay off cigarettes to improve his chances of recovery. Seven years later, he was still tobacco-free.
Maybe you can identify with this patient’s initial feelings. You might have gotten through some really tough situations in your life – but just the thought of quitting smoking fills you with anxiety or mild panic. That feeling might make you make you feel like smoking even more or want to put off quitting for now. But notice that it’s the “thought of quitting for good” or “never smoking again” that prompts the feeling of anxiety. We’ve recorded a mental exercise to help you reframe how you think about your goals called “Have to or Want to.”
When we think I have to do something, it can raise feelings of resistance. Many of us don’t want to do what “we have to do.” You can have thoughts of, “Do I have to do it? I don’t want to do that.”
Try saying “I want to.” Let in that sink in to your system.
You are doing something that you want to do. You are in the driver’s seat. You have control.
My name is Suzanne Harris and I am a registered nurse and a certified smoking cessation expert.
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