- Maintain an inventory of tobacco behavior – keep a log of every time he or she uses tobacco – the time of day, the physical surroundings, whether under stress or while relaxing, etc. This answers the questions of “when?” and “where?”
- Recognize cues to use tobacco (Fiore et al., 2000) - Identify events, internal states, or activities that can trigger tobacco use (Examples: negative mood, being around other tobacco users, drinking alcohol or coffee,.) This answers the question of “why?.”
- Develop coping skills (Fiore et al., 2000)
- Anticipate and avoide temptation - clear tobacco and tobacco-related items out of the home, work and play environment;.
- Mentally rehearse not using tobacco in situations where historically the client has used tobacco.
- Reframe: Change the word selection regarding the quit process from one of “difficulty” and “loss” to one of “challenge” and “choice.”
- Implement lifestyle changes to reduce stress and improve quality of life
- Assertiveness training (American Lung Association, 1996): The client learns how to state what he or she need without impinging on the rights of other people in the situation;
- Regular exercise can boost quit rates (Fiore et al., 2000) and improve mood;
- Post-cessation weight gain can occur but does not occur in all instances and, in any event, can usually be managed (Fiore et al., 2000); it must be stressed to the client that quitting tobacco provides great health benefits that far outweigh any health risks incurred by a slight weight gain
- Nutrition: Withdrawal Diet Plans (Waltz, 1996):
- High-fiber, low-fat diet encouraged to limit weight gain during cessation. Alkaline diet (a diet high in raw fruits and vegetables) can slow nicotine metabolism and ease withdrawal:
(Kawachi, et al., 1995)
- Learning strategies to cope with urges and cravings: We know that cravings generally last about 30-90 seconds and that they can be effectively deflected until they go away. One technique for dealing with these is known as the Four D’s:
- Delay (example: “I am going to wait 15 minutes until my next cigarette” – and then increase this period as the days go by)
- Drink water,
- Deep breathe,
- Distract (find something else to do, something that does not trigger tobacco use, such as taking a walk, changing surroundings, taking a shower)
- Imagery
- Relaxation
- Positive affirmations regarding self-confidence and worth; affirmations that the client CAN quit and DESERVES to quit and be healthy
Additonally, we want to teach the client about Relapse And Relapse Prevention Skills, which incorporate many of these behavior modification techniques and emphasize the value of Social Support Systems in successfully quitting and staying quit. Aversion Therapy approaches,including rapid smoking to the point of nausea or self-administered mild electric shock while smoking, may be effective, but research has not consistently confirmed the benefit of this approach (Fiore et al., 2000; Hajek P & Stead LF, 2006)
More helpful links:
About tobacco cessation and weight control:
About Behavior Modification in general:
About Self-Mangement of Cravings:
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