Smokers tend to think of quitting as a huge, insurmountable obstacle. It's more realistic—and more useful—to think of it as a gradual, step-by-step process. Here's how to plan your course and what to expect along the way, along with some suggested activities to help you cope.

1. Think about cutting down/quitting

Talk to others about smoking. Observe how nonsmokers react to smokers. Observe negative aspects of smoking. Smoke in front of a mirror to see exactly what goes on when you smoke.

2. Seek more information about quitting.

Ask ex-smokers how they did it. Tell a friend you're exploring healthier alternatives to smoking. When you feel an urge to smoke, wait a minute before lighting up; experience the urge fully and think of other ways to respond to it. Reward yourself for becoming more aware of your smoking patterns.

3. Modify your smoking risk (switch brands, cut down, etc.).

Start a smoking journal and record when you smoke more or less than usual. Try stress-reduction techniques. Adopt a healthful new activity that's incompatible with smoking (swimming, dancing, etc.). Switch to a lower tar brand. Reward yourself for each risk modification.

4. Decide to quit (no date set).

Keep track of the number of cigarettes you smoke each day. Stop buying cartons; buy only one pack at a time. Identify your top cigarette triggers. Brush your teeth several times a day. List the reasons you want to quit. Switch brands every week, each brand being lower in tar than the last. Postpone every third cigarette. Ask family and friends for ways they can help you quit.

5. Set a quitting date.

Sign a stop-smoking contract. Sit in the nonsmoking sections of restaurants and airplanes. Prepare at least three responses to your top 10 cigarette triggers. Switch brands after every pack. Postpone every other cigarette. Cut back on alcoholic beverages. Set up a health bank. (Deposit a certain amount of money each week that you'll get back after you stay smokeless for a specified period of time. Or quit with a group; whoever remains smokeless after a specified period divides the kitty.)

6. Refrain from smoking for 24 hours.

Schedule healthful activities (walks, bike rides, fishing, etc.). Have your teeth cleaned. Send your favorite clothes to the cleaners. Discard all your ashtrays. Pamper yourself as much as possible.

7. Complete your first week as a nonsmoker.

Treat yourself to daily rewards (massages, hot baths, etc.). Avoid smoking and drinking areas. Notice how much better your food tastes. Continue to work on your cigarette triggers.

8. Complete your first month.

Begin a regular exercise program. Add one new stress-reduction technique to your activities each week.

9. Complete your first trimester.

Gently increase your exercise level. Treat yourself to a weekend getaway. Volunteer to help a smoker quit. If you've been using a nicotine replacement, begin to cut back.

10. Complete your first year.

Throw a party to celebrate!

During stages 1 through 5, you may find yourself in a state of profound and confusing ambivalence. Studies show that during this period a smoker's positive feelings about smoking do not disappear, although the negative feelings increase considerably. It is only after you actually quit that this conflict begins to ease.

One smoking researcher suggests you make a list of pros and cons of smoking. Chances are they will be fairly evenly balanced in stages 1 through 5. But after you have actually quit, the list of cons will get longer while the list of pros will get shorter and shorter—and gradually disappear altogether.

By Tom Ferguson, M.D.

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