149
"Relaxation" smokers need to find some other relaxing activity, like 
reading, knitting, walking, etc. Smoking for concentration under stress 
could be replaced by tapping your fingers, chewing gum, stroking a 
smooth stone. For "boredom" smoking, you could substitute a fun 
mental or physical activity. For "emotional-stress" smoking, substitute 
relaxation (Methods #1, #2, & #5 in chapter 12). Any new activity 
that also improves your general health or is just plain fun, e.g. 
reading, napping, joking, playing with the kids, cuddling, can be 
substituted for a smoke. All these things make stopping the bad habit 
easier.  
As described in the classical conditioning section early in the 
chapter, cigarettes are paired so often with reducing high anxiety that 
the smoking process becomes a temporary tranquilizer. Thus, if we 
become anxious, angry, or depressed, smoking (or the smoking 
"break") becomes a brief self-medication for these unpleasant 
emotions. If cigarettes have soothed our stress or hidden our 
depression many thousands of times, it may become harder to quit 
smoking because we are both withdrawing from an addictive drug, 
nicotine, and re-experiencing (or getting no relief from) our dreaded 
old emotions. Indeed, some depressed smokers do experience 
especially strong urges to smoke after quitting (researchers report this 
reaction is related to your genes). And, a variety of increased 
psychological distress may occur when the self-medication is stopped. 
For instance, people who have a history of recurrent major depression 
become depressed again 30% of the time after stopping smoking 
(Covey, Glassman & Stetner, 1997). I suspect this increasing 
(uncovering) of psychological stress is fairly rare in persons who have 
no psychiatric history of depression because, as mentioned, on 
average the anxiety level tends to go down (not immediately but 
gradually) after quitting smoking. In any case, one needs to be alert to 
the possibility of depression and find or develop ways, including 
medications for a while, of handling any increasing emotions (chapters 
5, 6 & 7). Don't delay getting help if needed... and try to avoid falling 
back on your old self-medication--smoking.  
For ex-smokers, even those without a history of depression, feeling 
down is the most common cause of a relapse. Be especially cautious 
during "down" times. It takes several weeks for the urges to smoke to 
fade away. So, in any case, expect to suffer for a while, the first week 
may be nicotine withdrawal but after that the urges are probably 
psychological or habits. Researchers report that most people 
experience the strongest urges just prior to quitting and that the "urge 
for a cigarette" gradually declines after the moment you quit. You will 
usually find that the urges to smoke are not continuous, they come 
only episodically--just like in the past you only needed a cigarette 
episodically. The trick is to distract your attention from the brief high 
urge phase--or to tough it out, saying "I can handle this." The urge will 
soon fade away, so Nicotine Anonymous says "take it one urge at a 
time."