How to beat the triggers that make you crave a cigarette
When Rafe Poirrier smoked cigarettes, he smoked as soon as he woke, after eating, while driving, and whenever he took a break at work.
"I think my favorite (part) was socializing - hanging out with smokers outside an office building, at a bar or in a park," said Poirrier, 51, of Houston.
Physical cravings combined with environmental, behavioral and personal triggers like those Poirrier experienced, can make quitting very difficult. In fact, a 2009 study showed that simply viewing an image of a person smoking can trigger someone who has recently quit to abandon their newfound resolve.
The classic example of how a trigger works is from Psychology 101: Pavlov's dogs salivated every time they heard Ivan Pavlov ring a bell because the researcher always rang a bell before feeding them.
"We too have these conditioned responses," said clinical psychologist Barry J. Jacobs, a Pennsylvania-based clinical psychologist and health care consultant. "Certain stimuli wind up giving us a certain response."
Jacobs, who specializes in helping people form good health habits, adds that when a person smokes while drinking coffee, for example, cigarettes and coffee eventually become associated so that when the person drinks coffee they automatically want a cigarette.
"Coffee becomes a trigger," he said.
Triggers come in a few categories. Etta Short, director of clinical development and support at Optum, a corporate tobacco cessation program, said dependence on the nicotine in tobacco causes physical cravings that become paired with actions and emotions throughout the day.
Triggers associated with behaviors include driving, finishing a meal or talking on the phone. Environmental triggers include spending time with smoking friends or being at a bar or music concert. And emotional triggers can include stress, boredom, anger or even pleasurable feelings.
For Poirrier, who started smoking at age 20 while on a college exchange program in France, it was a business trip. Although he had quit smoking two years earlier, returning to Paris caused a personal trigger so strong and so unexpected that he relapsed.
"I think the need to smoke was fueled by nostalgia," said Poirrier, who smoked for more than two decades.
His relapse was short-lived. He walked throughout the city smoking the cigarettes in that single pack for hours, then took the metro back to his hotel, smoked one last cigarette outside and tossed the remainder.
That was in 2014. "I haven't smoked since," he said.
Poirrier initially quit when his workplace became smoke-free, which caused him to cut back from his three-pack-a-day habit to one pack a day. But he also had a constant cough, struggled to catch his breath when walking up stairs and was concerned about the effects of secondhand smoke on his kids.
He said staying focused on the benefits of not smoking helps him to avoid triggers now.
Tying the motivation to quit to those types of core values can really help, Short said.
"Living up to core values is a strong intrinsic reinforcement that helps the person stick to the plan and not let triggers get in the way of the resolve."
Short said the way to turn your back on triggers is to anticipate them and make a plan with coping strategies, such as substitutes for smoking, distractions, relaxation techniques and motivating statements.
She also recommends nicotine replacement therapy to manage physical cravings so that the person can stay focused.
"The first two to four weeks are the toughest," she said. "But for many people, it takes much longer for all triggers to fade."
The benefits of quitting smoking now
According to the American Heart Association and the U.S. Surgeon General, this is how your body starts to recover when you quit smoking:
In the first 20 minutes: Your blood pressure and heart rate recover from the nicotine-induced spikes.
After 12 hours: The carbon monoxide levels in your blood return to normal.
After two weeks: Your circulation and lung function begin to improve.
After one to nine months: Clear and deeper breathing gradually returns; you have less coughing and shortness of breath; you regain the ability to cough productively instead of hacking, which cleans your lungs and reduces your risk of infection.
After one year: Your risk of coronary heart disease is reduced by 50 percent.
After 5 years: Your risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Your risk of cervical cancer and stroke return to normal.
After 10 years: You are half as likely to die from lung cancer. Your risk of larynx or pancreatic cancer decreases.
After 15 years: Your risk of coronary heart disease is the same as a nonsmoker's.
Other general benefits of quitting:• You'll be able to exercise or be physically active with less shortness of breath.• Your clothes, hair, body, car and home will smell better.• Your sense of taste and smell will return to normal.• The stains on your teeth and fingernails will start to fade.• You'll save hundreds or thousands of dollars a year.