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With Mayo Clinic behavioral counselor Jennifer A. Kern, M.S., C.T.T.S.
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July 3, 2008
To prevent a relapse, remember the 4 D's
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By Jennifer A. Kern, M.S., C.T.T.S.

When quitting tobacco use, cravings are just part of the game. Most people experience them in some form or another with varying frequency and intensity.

When going through the quit process watch out for these four main triggers to relapse: Hunger, Anger, Loneliness, Tiredness. So, when cravings pop up, remember to H.A.L.T. Stop for a moment and check in on how you're feeling. Pay attention to what you need.

It is important to have some strategies to deal with cravings when they strike. One must have a "fire plan," a way to escape urges without falling back into the flames of tobacco use. A few easy tricks to remember are the 4 D's:

  • Delay — do not respond to your cravings, but wait for them to pass.
  • Distract — in order to help cravings pass more quickly, get your mind engaged in something else.
  • Drink water — drinking water can help by giving you something to hold in your hands and put in your mouth.
  • Deep breathe — taking slow, deep breaths not only helps calm you, it also mimics the motion your body goes through when you smoke. This can help you to feel more comfortable when combating urges by minimizing "missing" the cigarette.

On holiday weekends and other special occasions when you might be in high-risk situations, think of specific ways in which you can maintain your independence from tobacco. Plan ahead. Have substitutes handy. Limit alcohol use or avoid it all together. If you are attending events where other smokers are present, try to stick with the non-smokers. Find ways to remove yourself from tempting situations and be in touch with a support person when needed.

24 comments posted
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October 26, 2008 12:34 p.m.
wellits been almost 4months now of no smoking. and i am so friggin proud. i am amazed at how much better i feel. I love what you said Anne...very inspirational. Thank you.
- kerry
October 13, 2008 9:03 p.m.
I quit in 1983 after 16 years of smoking. The worst time was in the 11th through 12th week. My house was the cleanest it had been. When someone said,"Sit", I said, "No, I'll want a cigarette". If I craved a cigarette I would say out loud, "If I smoked right now I'd have a cigarette!" You can do it! One of my peeves was that cigarettes had control over me and I didn't like anything having control over me. So I tool control over it. I have been smoke free for 25 years and I wouldn't want it any other way. Today I sit here unable to breath very well. My lungs capacity to hold air is deminished. It is not life threating but I have been on this couch for a week, a beautiful Maine fall week. If I continued to smoke who knows if I would have seen this fall at all. Please, for you, for when death looks you in the eye you'll wonder why you didn't take control. Life offers few real choices, this one is real, this one is life. Just Do It.....
- Anne
October 8, 2008 9:42 p.m.
I am 37 and have been smoking for 20 plus years - minimum of a pack a day. I stopped 3 days ago cold turkey and so far, so good. Some cravings have been pretty intense but seem to pass rather quickly. My biggest issue is associating all of the fun times in my life with cigarettes and knowing the cigs will no longer be there when these activities are encountered again. In other words, smokes have always been there and it seems strange that they will not be present - actually somnewhat depressing. Too bad!!!! I am trying to persevere and get through this week and go from there!! Wooooo hooooo to a helathier lifestyle!
- Jim
August 20, 2008 9:50 p.m.
I forgot to say...I was a closet smoker so I never smoked at work or around friends and family...I used to waste lots of time with brushing teeth, washing hands, spraying scent, changing clothes, covering hair...just to hide the habit. I likely have a couple hours extra each day since I don't have to go through all the above activities...oh, and did I say chew gum and suck mints to hide the breath? Plus, I am saving the $$ each month I spent on cigs, which is close to $100, for something special.
- Lynn
August 20, 2008 9:43 p.m.
My IQ date is June 8, 2008. I find it helpful to visit sites such as this and read others' comments about their struggles and the "what works for me" hints. I like the comment that smoking one will lead to smoking another...just like Lays Potato Chips...Sometimes I see smokers and think, "Lucky." But actually I am the lucky one...I can breathe easier, fill my lungs full and hold it, and my cough is gone... Continued best wishes to all us quitters! Being a quitter is a very good thing.
- Lynn
August 15, 2008 6:54 p.m.
I smoked for 20 years. I have quit for 6 weeks. I miss it like a loved one. I have had to re-learn how to cope with feelings, especially anger. I used the patch, lots of suckers and when i crave real bad...i think of how i have suffered from withdrawl for this long..so why ruin it by smoking again. And by this time, the fact that I am a "non-smoker" is a bigger high than any nicotine buzz. It all comes down to this..what do you TRULY want?
- kerry
August 8, 2008 7:36 a.m.
I quit for 20 years, cold turkey, but then went through a really stressful time and started smoking again.... I've smoked for 4 years now. I work in a County building and the County has enacted a new rule (8/1) that says there is no smoking anywhere on Country property. That means no more walking outside to smoke. I had wanted to quit, but I wanted it to be my decision, so I quit on 7/31. What I'm using is the Nicotrol Inhaler. It includes a 'cigarette holder' so you are mimicing the same actions as smoking. Another trick I use when feeling a craving is to say to myself "I Choose Not To Smoke." That reinforces the fact that this is my choice!
- Sheryl
August 6, 2008 11:29 p.m.
I am still a smoker and would like so much to quit .I beleive lazar treatment was the only thing that helped me stop for a few days but I'm not sure if that is available in our town now . I had one free session I could have went to but didn't go. I would like to quit for my daughter and my grand children . there's so much negetive talk about smokers --It's imbarrassing . They make you feel and treat you like a 3rd class person . I wish the goverment would put all smokers on a deserted Island for afew months and treat you with spas ,back rubs ,healthy food ,exercise room ,swimming pools and have a person to help you get through the whole thing .It's only the rich that could have such a paradise . I beleive if the goverment wants people to quit ==they should send us loosers to a place like this .
- nancy
July 30, 2008 6:25 a.m.
I am desperate for advice. I have breast cancer, emphesema,and a huge chance of getting lung cancer. I'm so addicted. It's suicide but i want to live yet i can't seem to stop. I've used all the replacements for nicotine, hypnosis, you name it.My doctor says i will have heart failure, i just underwent surgery for a bypass in my right leg due to smoking mostly. It builds plaque and i couldn't walk without pain. All of this and i still buy those damned cigarettes. Please, help me. I have to stop but really enjoy them.Please answer me.
- Barbra
July 26, 2008 4:34 p.m.
To Dan...It's normal to have a cough for a few weeks, especially if you were a heavy smoker. Your lungs are trying to rid themselves of the layer of mucous they no longer need. If it lasts more than a month I would consult your physician. Same for the weakness depending how drastic it was, remember nicotine is a stimulant.
- Nurse Mandy
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Nov 22, 2008