Monday, July 27, 2015

Tobacco Cessation - Staying on Track

Dr. Robert Hanks, director of counseling and testing services at USA
On Aug. 1, 2015, the University of South Alabama and USA Health System will become tobacco-free campuses. As part of this transition, the university will offer assistance to employees and students who wish to stop using tobacco products, including smokeless and e-cigarettes, through several tobacco cessation programs. This article is the third of a four-part series about tobacco cessation. Part 1 can be found here and Part 2 can be found here.

Once you quit smoking or stop using tobacco products, the next step in the process is staying on track. 

Dr. Robert Hanks, director of counseling and testing services at USA, said the main component for quitting smoking and staying tobacco free is identifying your personal barriers and ways to avoid or cope with those barriers. 

“Being confident in one’s ability to quit is important and key to successful cessation efforts,” Dr. Hanks said. “Even if you slip, it is best to be able to put that in perspective and not allow that to result in you giving up. Slips are a natural part of quitting. It is best to view it not as a failure, but as an opportunity to learn.”

Another way to avoid slipping back into tobacco use is by avoiding triggers, or behaviors that become linked to smoking.

“People who are quitting will need to evaluate their mood and environmental conditions that might lead to an urge to smoke,” Dr. Hanks said. “They will often have to change their regular routine. For example, they will need to substitute smoking after eating a meal with another activity to fill the void. This could be a wide range of things such as relaxation strategies, calling a friend, pleasant diversions or exercise.”

For those who are breaking the smoking habit, one way to avoid triggers is to stay away from smoking areas and get soft materials like rugs and upholstered furniture deep cleaned to remove the smell of cigarettes.

Dr. Hanks encourages those who are contemplating quitting to reflect on their prior quitting efforts and think about some of the things that were helpful in quitting, as well as the things that weren’t helpful. This will help you evaluate what works best for your next attempt.

Counseling is another successful method for staying on track. Counseling provides a supportive face-to-face discussion. Esther Rogers, employee assistance program counselor at USA, said the first thing she does with a person who is trying to quit tobacco is assess their situation. “I will start by asking them if they have family support,” Rogers said. “Are they planning on seeing a doctor? Have they tried to quit before, and if so what worked then?”

From there, Rogers said she and the person will make a plan about what to do when they face a trigger and when they have a craving. The final part of the assessment is getting the person to set a goal for when they want to quit.

The main aspect of quitting is to discuss the realistic things that are going to happen. People who are trying to quit tobacco are going to go through withdrawal symptoms and will possibly relapse before they quit for good. Rogers explains that it is a process – keep the positives in mind, and remember your motivation for quitting.

Withdrawal symptoms can include jitteriness, irritability, headache, insomnia, anxiety, increased appetite, weight gain, depressed mood, restlessness and anhedonia – no longer taking interest or pleasure in things in which you previously derived interest or pleasure.

“These symptoms usually peak at three to five days, resolve around two weeks and diminish overtime,” said Dr. Alana Schilthuis, assistant professor of internal medicine at the USA College of Medicine and an internist with USA Physicians Group. 

There are several ways to combat these withdrawal symptoms. Dr. Ehab Molokhia, associate professor of family medicine at the USA College of Medicine, recommends asking your primary care physician about medications approved for smoking and tobacco cessation.

Medications are designed to help reduce withdrawal symptoms. The combination of different methods such as counseling and medication is more effective than either alone.

Other ways to manage withdrawal symptoms are visiting a counselor to help you through the quitting process; staying active and exercising to relieve tension; using relaxation exercises; making plans beforehand on how to deal with stressful situations; making friends with ex-smokers and non-smokers to provide support and keep you on track; and keeping in mind that quitting smoking is a process.

For more information on quitting, visit For help locating a primary care physician with USA Physician Group call (251) 434-3711.

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