Chapter 10

Changing Thoughts and Actions

IN THIS CHAPTER

Finding new ways of thinking

Developing new action plans to combat cravings

Relating to feelings in new ways

Many people think of addictions as purely a physical phenomenon. And it’s true that addiction to nicotine is partially caused by a biological process in the brain. But if that were the whole story, the 70 percent of smokers who say they want to quit would stop by the drugstore, buy some nicotine replacements, and quit. End of story.

It’s quite true that nicotine replacement therapy (NRT) helps people quit. But NRT does not suffice for most smokers. There must also be a change in the way smokers think, act, and feel for most quit attempts to succeed.

In this chapter, we explain the relationship between triggers, thoughts, feelings, and actions. Then we give you the tools you need to challenge and change the way you think and feel about quitting. Next, we look at smoking triggers and ways to handle those with avoidance when you can and actions when you can’t. Finally, we show you new ways to relate to your feelings, so they don’t continue to sabotage your efforts to quit smoking, smokeless tobacco, or vaping.

Throughout this chapter, we usually refer to smokers and smoking. That’s for convenience. Most people addicted to nicotine smoke cigarettes. However, many are addicted to other forms of tobacco, such as chew or snuff, and some are struggling with a nicotine vaping habit. We want you to know that the same techniques we offer to smokers apply equally to people with other habits they want to break.

Exploring the Relationship between Triggers, Thoughts, Actions, and Feelings

Most smokers are aware of triggers that lead them to reaching for a smoke. For example, during the first cup of coffee in the morning, following an argument at work, while watching an exciting sports event—these could all serve as triggers for a smoker (see Chapter 2 for more examples of smoking triggers).

It’s easy to think that triggers cause you to smoke. But there’s far more involved. Triggers set off a cascade of thoughts, feelings, and actions. Let’s take a deeper dive into the relationship between triggers and what follows them.

You may not realize that there are thoughts and feelings prior to your action of smoking. That’s because these thoughts and feelings have become so automatic that you’re probably not consciously aware of them. For example, if your smoking trigger is the first cup of coffee in the morning, you may reflexively reach for a cigarette without thinking and light up. You may have been aware of a small urge or feeling that you wanted that smoke. But because you had no intention of not lighting up, the awareness of the urge was weak.

Imagine what happens when you frustrate that trigger. That’s when the thoughts and feelings tumble into your consciousness. “What, I can’t have a cigarette? I must have a cigarette. I’ll feel horrible without my first cigarette in the morning. I can’t even enjoy a cup of coffee. Life is horrible. I’m deprived. I can’t stand it!”

Sound familiar? And following these thoughts, you probably do feel even more intense urges and cravings and sadness and basically horrible. It’s helpful to understand how this relationship plays out in addiction. But first, here’s a quick review of terms:

• Triggers: Situations, events, or occurrences that are connected with the action of smoking. Triggers are the result of associated experiences over time, such as smoking in the car, smoking after sex, or lighting up following a meal. Triggers can also be a particularly emotional event such as a stressful day at work or an argument.
• Thoughts: The interpretations or perceptions that you have about the trigger. Examples include: “I have to have a smoke in this situation,” “I can’t enjoy a meal without the anticipation of smoking,” and “I’m stressed out, so I have to smoke.”
• Feelings: The most common feelings associated with smoking are cravings and urges. But frustration, irritation, anxiety, sadness, aches, yearnings, and feelings of emptiness are also prevalent. In addition, positive feelings also occur around smoking. For example, smokers often report contentment, relaxation, relief, and pleasure during or after smoking. Naturally, most smokers say they’re reluctant to give these positive feelings up. Who can blame them?
• Behaviors: Obviously, a cigarette is the first option most addicted smokers turn to. Quitters come up with different solutions such as chewing gum, spending time in the hot tub, going for a walk, or taking deep breaths.

USING COGNITIVE BEHAVIORAL THERAPY

Much of the material contained in this chapter comes from the principles found in cognitive behavior therapy (CBT). CBT is a type of psychotherapy that has been found to help with a wide variety of problems. A small sampling of these problems includes

• Addictions (including smoking)
• Anger
• Anxiety
• Chronic pain
• Depression
• Panic disorder
• Phobias
• Post-traumatic stress disorder (PTSD)

Numerous randomized, controlled research studies have supported the value of CBT for helping people deal with these problems. Core principles include the idea that the way people think about events greatly impacts how they feel about them. CBT also places importance on changing behaviors, which can also impact feelings and thoughts. CBT is optimistic in that it’s assumed that people can learn new patterns of thinking and behaving in more satisfactory ways.

One reason we find CBT appealing is that it helps people learn to be their own therapist. CBT teaches people new ways of coping and behaving, more effective problem solving, and how to change their thinking in more adaptive ways. The influence of the past is acknowledged as important, but more emphasis is generally placed on recent events and the present.

You can probably list off major triggers you have for smoking. And behaviors are apparent as well — you light up or do something else. But many people confuse thoughts and feelings. For example, you may say to yourself, “I feel like I can’t stand to not have a cigarette on my break at work.”

That statement is not a feeling, it’s a thought. A feeling is what occurs after you say, “I feel like I can’t stand to not have a cigarette on my break at work,” to yourself. After having that thought, you then feel strong cravings for a cigarette on your work break. The cravings are the feeling.

Another example is when you say to yourself, “I feel horrible when I don’t smoke.”

Again, that is a prediction, a thought about what will happen when you don’t smoke. The feeling of “horrible” has not yet happened. But guess what, it probably will because you predicted it.

Thinking Differently about Triggers

People tend to believe that feelings occur as a direct result of situations or events that happen to them. In other words, events, occurrences, and triggers are responsible for how they feel. In terms of smoking, triggers are a type of smoking-related event, occurrence, or situation. How many times have you heard someone say the following?

• My computer crashed, and I feel horrible.
• I ran out of cigarettes, and feel desperate.
• I broke my fingernail, and I’m totally stressed.

It’s easy to say that the preceding events caused the feelings. But let’s take another run at the same events and add the underlying thoughts. It’s those thoughts about what happened that directly lead to your feelings. See Table 10-1 to further understand the relationship between events, thoughts, and feelings.

Maybe you think those feelings are inescapable. In other words, you think that your thoughts are a direct result of the event that occurred, and feelings follow naturally. Put that thought on hold for a moment.

Instead, consider how you would likely feel if you had different thoughts about what happened. The same event but viewed with a different thought or interpretation leads to strikingly different feelings. Table 10-2 shows how different thoughts lead to different feelings.

TABLE 10-1 Connecting Events, Thoughts, and Feelings

Events or Triggers	Thoughts	Feelings
My computer crashed.	It’s going to cost me a fortune and I don’t have time for this!	I feel horrible and angry.
I ran out of cigarettes.	I can’t stand going another two hours before I can buy more.	Desperate cravings.
I broke my fingernail.	Everyone will notice; it looks terrible.	Totally stressed and irritated.

TABLE 10-2 Connecting Events, New Thoughts, and New Feelings

Events	Thoughts	Feelings
My computer crashed.	I’ve had computers crash before. It’s a hassle, but not exactly the end of the world.	Mildly irritated.
I ran out of cigarettes.	This happens to me all the time. I’ll be okay for a while.	Blasé.
I broke my fingernail.	Like, no one will care or notice.	Close to neutral.

You can see how different ways of looking at an event or trigger lead to altered, less upsetting feelings, including reduced cravings to smoke. You may be thinking, right now, “What does this have to do with me? I just want to quit smoking. I’m not really concerned about all these thoughts, feelings, and triggers. I want to cut to the chase, get rid of the awful cravings, and stop smoking!”

We hear you. But changing the way you think can help you get there. And we wish, like you, that it was easy to do.

What makes it hard, is the fact that most people don’t really think about what they think. They don’t examine their thoughts. Instead, they interpret or perceive things automatically without a lot of attention to the process. Most folks simply assume that their thoughts are accurate.

Just because you have a thought doesn’t make it true. Thoughts are merely thoughts, not facts. Consider putting a sign on your bulletin board or at least your mind, “Just because I think something doesn’t make it true!”

In the following sections, we give you the tools for uncovering distortions in your thinking (we all have them), re-examining your thinking, and designing new, more adaptive thinking that can help you get to the finish line of quitting smoking, using smokeless products, or vaping.

Finding distortions in your thinking

The human brain is a thinking machine. Streaming thoughts churn constantly in response to daily life events. Some thoughts are accurate. But the brain likes to take shortcuts. And inaccurate thoughts are often simpler and come from past experiences that may no longer be relevant in your world today.

Inaccurate thoughts become habitual over time. For example, people with chronic pessimism tend to look at everything as having a negative outcome. They repeat pessimistic thoughts so often that they no longer notice a sunny day or a glass half-full. And they don’t question their bleak predictions and perceptions.

The following sections describe the common ways thoughts can be distorted as related to urges, cravings, aches, and yearnings to smoke. Look for yourself in these thought distortions. Don’t worry; we’ll help you figure out how to challenge and replace them with more useful thinking.

Catastrophizing

One of the most common thought distortions is what’s known as catastrophizing. This distortion habitually makes “much ado about nothing,” as Shakespeare wrote. Others call it making mountains out of molehills. You may be resisting this interpretation. Quitting smoking is a big deal — it is a mountain!

You’re right; quitting is a big deal. And no easy task. But it’s not undoable. It’s not impossible. If your thoughts are distorted by catastrophizing, you’ll struggle all the more. The story of Isaiah (see the nearby sidebar) illustrates what catastrophizing can do to your quitting efforts.

If you hear these words or phrases rattling around in your head, it’s a good indication that you’re something of a catastrophizer:

• Awful
• Can’t stand it
• Dreadful
• Hopeless
• Horrible
• Terrible
• Worst thing in the world

Don’t despair. If you’re a catastrophizer, it’s hardly the worst thing in the world. You can overcome this thinking. We show you how in this chapter. Recognition is the first step.

WHAT CATASTROPHIZING LOOKS LIKE

Isaiah goes to the dentist for a routine exam and cleaning. While there, his dentist tells him that he has some oral lesions in the lining of his mouth. He tells Isaiah that those lesions may be at risk for turning into cancer and that his tobacco chewing has likely caused them. At this point, Isaiah’s dentist recommends a referral to a specialist to be on the safe side and states, “In most cases like yours, quitting tobacco chewing will probably keep the lesions from turning cancerous. It’s good we caught this really early. But you do need to stop your tobacco consumption.”

Isaiah leaves the dental office in a daze. He texts his girlfriend to call him immediately and tells her, “The dentist said I’ll die of oral cancer if I don’t stop chewing tobacco immediately. I can’t do that! I’m so upset about the cancer; I’ll never be able to deal with withdrawal symptoms. I can’t believe I’m going to die before I’m 45. Life isn’t fair.”

You can imagine that Isaiah is not in good shape to handle depriving himself of tobacco. He’s also in no shape to logically manage his current health issues. He is inadvertently making things much worse by wallowing in his catastrophic thinking style.

Fortune telling

People who engage in fortune telling predict the future. And guess what? As far as we know, no one can really do that with much accuracy. Some predictions are more likely true than others. For example, if all you eat every day is cake and ice cream, we can predict that you’ll suffer from malnutrition and probably gain some weight. Or if you hop on a train traveling to Toronto, you’re most likely to end up in Toronto.

However, when it comes to quitting smoking, fortune-telling predictions are usually negative and foretell bad outcomes. They don’t do much to make quitting easier. Instead, by jacking up your emotions, fortune telling usually makes progress harder.

Common examples of fortune-telling phrases include

• Without tobacco, I’ll never be happy.
• I’ll never enjoy coffee again if I quit.
• My cravings will never go away.
• I couldn’t ever enjoy time with my friends without vaping.
• I’m too weak; I could never quit.
• I could never find non-vaping friends to spend time with.
• I’m so addicted; I’ll always have to smoke to survive.
• If I quit vaping nicotine, I’m certain to gain 30 pounds.
• If I quit, everyone will hate me because I’ll turn into a total crab.
• My husband will leave me if I quit smoking — he’ll never quit and he couldn’t live with a nonsmoker.

Notice how the phrases include absolutist words such as always, never, everyone, total, and couldn’t, without exceptions considered. That’s always a clue that pernicious fortune telling is in play. Interestingly, after decades of work with clients trying to change troubling emotions and problematic behaviors, we’ve found that well over 95 percent of fortune-telling predictions end up not panning out. And the few times that they did, rarely did the predictions cause the expected degree of misery and distress.

THE FORTUNE TELLER

Mia is a graduate student in environmental engineering. She’s a secret vaper, never vaping around her peers. Nonetheless, she has become quite addicted to nicotine. She vapes almost constantly when she’s studying at home, believing that vaping improves her focus and concentration.

Mia is surviving on student loans, so the costs of her vape juice and vaping paraphernalia are of some concern to her even though they’re cheaper than cigarettes. Mia is also a bit concerned about her addiction to nicotine and the risks of unknown chemicals in her e-liquid. Mia starts thinking about quitting and indulges in fortune telling, distorted thinking such as the following:

• I’ll never be able to study without a nicotine hit.
• No doubt I’ll gain tons of weight if I quit.
• I can’t face life without vaping.
• I’m too addicted physically to handle quitting.

With fortune telling pervading her mind, Mia doesn’t have the confidence to quit vaping. She also believes that her good grades are the result of studying under the influence of nicotine. She believes that without nicotine, she’d surely fail and face dismissal from graduate school. Predicting bad fortune ahead stops Mia from even trying to quit.

Predictions are powerful. They influence people’s decisions about lots of things, including whether to quit smoking. Mia’s story (in the nearby sidebar) shows how dire fortune telling leads to her giving up on quitting vaping.

Mental filtering

Mental filtering is another type of cognitive distortion. This distortion discounts and discards any data that does not fit with a preconceived notion. For example, if someone is quitting smoking, and fears that pleasure will plummet, the mind can make the data conform to that prediction with mental filtering. In other words, enjoyable times will be quickly forgotten, and unpleasant events well remembered.

FILTER ME THIS

Joshua quit smoking just ten days ago. He had planned his quit day and received lots of support from his family and friends for almost a week. Then things get a little tougher. Joshua’s cravings are strong, and he begins to believe that he’ll never be happy again. He tells his girlfriend that he doesn’t think it’s worth being so unhappy because of quitting. She asks why. Joshua says, “Since I quit smoking, I haven’t laughed once, and I’ve been in constant misery. Nothing’s fun anymore.”

Joshua’s girlfriend grins and says, “So, don’t you think last night was a little fun? You sure seemed to enjoy it!”

Joshua allows himself a small smile and nods. He says, “Well, yeah, that was pretty nice. But we can’t be doing that all day.”

His girlfriend replies, “Yeah, but let’s go over some of the good stuff that happened today alone. First, you told me this morning that you felt really good. Then you got that text from someone who wanted to interview you for that job you applied for. And you really seemed to enjoy that comedy show we watched together. Is it possible you’re not letting yourself focus on the positive things that are going on in your life? I’ve heard that nicotine addiction can do that. It should get better, though. And meanwhile, how about we repeat last night’s activity?”

Joshua feels a bit chagrined and puts his arm around his girlfriend. He realizes he has been zeroing in on negative events to the exclusion of some very nice positives. He knows he’s lucky to have his girlfriend’s support.

Nicotine activates the dopamine pathways in the brain, thus enhancing the experience of pleasure. Withdrawal involves a temporary depletion of available dopamine It’s no wonder that many quitters addicted to nicotine can’t see the possibility of a pleasurable life without it. However, given enough time, quitters usually re-establish a balanced life with both pleasure and pain.

Mental filtering caused Joshua (see the nearby sidebar) to ignore the pleasurable events in his current life and focus on his unpleasant cravings. His girlfriend helped him step back and look at events more objectively. It’s easy to fall into the habit of mental filtering.

Addiction’s aches and yearnings push you to filter out positives and dwell on negatives. Why? In order to suck you back into smoking. If things are as bad as mental filtering would have you believe, of course you’ll want to smoke!

The “Reevaluating your thoughts” section, later in this chapter, shows you how to overcome the mental filtering problem, as well as other types of thought distortions.

Black-and-white thinking

Black-and-white thinking is a surefire way to trip up your quit-smoking program. This distortion views the world and events as all or nothing, good or bad, wonderful or horrible, with little in between. It’s an extreme way of thinking and extremes generate lots of emotion.

So, extreme thinking can cause cravings to become intolerable instead of uncomfortable. A single puff on a cigarette becomes a reason for a total relapse (see Chapter 19). The following list exemplifies black-and-white thinking.

• I have no self-control at all.
• I must be perfect.
• There’s a right way and a wrong way to do things with nothing in between.
• I absolutely can’t stop smoking even for a single day.
• My partner won’t give me any support at all.
• I never succeed at difficult tasks.
• I am completely addicted to smoking; it’s hopeless.

You can see where black-and-white thinking goes. You don’t have much hope for success if you engage in this type of thought distortion. But there is hope! You can change your thinking style.

Personalizing

Another popular thought distortion is known as personalizing. This distortion leads you to interpret everything that happens as related to you — whether it really is or not. For example, if a driver in the next lane cuts you off, personalizing will lead you to believe that the other driver did it intentionally to mess with you. This belief leads you to anger. However, it could be that the driver was on her way to the hospital to give birth to quintuplets! Or maybe the driver was inattentive and didn’t even see you — not a good thing, but not about you personally.

So, what does personalizing have to do with quitting smoking? Personalizing leads to difficult emotions like anger, rage, or shame, which can be dealt with by what? Smoking, of course! Sarah’s story (see the nearby sidebar) shows how personalizing makes her battle to quit smoking more difficult.

TAKING EVERYTHING PERSONALLY

Sarah is in her fourth week of abstinence from smoking. She’s feeling pretty good about her progress. Downright confident, in fact. Sarah is the lead of her eight-person sales team. Her boss calls a meeting of the team. He provides statistics indicating that their last quarter wasn’t as good as the previous two quarters. He asks for feedback and ideas about what happened.

Sarah feels awash with shame. She sees the boss looking straight at her when he’s talking. She believes that her boss, obviously displeased with her performance, is likely to fire her. Her first instinct is to go outside for a smoke break. She desperately wants that smoke. But, instead, she pops in a nicotine lozenge and decides to stick it out.

Her colleague, Fred, interjects, “You know, I think all this seeming drop in sales is probably due to the fact that I was out for six weeks on family leave when I broke my leg. And Lucy is still out on maternity leave. If you calculate what both of us would have normally brought in, we’re probably a bit ahead of expectations.”

Her boss replies, “Yeah, I knew this team had been doing a fabulous job. And I particularly want to give a shout-out to Sarah for her amazing leadership and innovative ideas.”

Sarah’s habit of personalizing almost got the upper hand and caused her cravings to surge. She managed to resist the impulse and, luckily, her colleague stepped in to give a rational explanation. However, Sarah will remain at some risk if she doesn’t get a grip on her tendency to personalize.

Unyielding obligations

This thought distortion causes you to think you should be doing something different from what you’re doing currently. “I should,” “I must,” and “I have to” are prime examples of this thought distortion. The human mind likes to appraise, evaluate, and judge everything. This tendency adds additional, unnecessary pressure to any undertaking, including smoking or vaping cessation efforts. Review the following list to get a flavor of the pernicious effects of such thinking:

• I must not get crabby.
• I shouldn’t have to suffer withdrawal symptoms.
• I must quit smoking now.
• I have to stay upbeat.
• I should work at this harder.

You may be thinking all these statements are true. Why worry about them? Well, let’s try a quick rewording of the statements and see if they feel a bit different and less harsh:

• I’d like to work on being less crabby.
• I’d prefer not to suffer withdrawal symptoms.
• I’d like to quit smoking now.
• I’d like to stay more upbeat.
• It would be great if I could work a bit harder on this.

When your thinking includes distortions such as should, must, or have to, you’re likely to believe you’re coming up short. Most obligatory evaluations of yourself can be softened. The reason to do that is that the more you believe in should, must, and have to, the harder things get. Concepts like it would be better, I’d like to, and I’d prefer do the job with less emotional turmoil.

Reevaluating your thoughts

Having distortions in your thinking causes you to have more intense emotions, which are generally negative. In turn, when you already have cravings, those distortions can become more extreme. A vicious cycle ensues.

WHAT HAPPENS WHEN YOUR THOUGHTS ARE DISTORTED

Before quitting, Noah finds himself worrying about whether he can stand the withdrawal symptoms and feelings. He sees himself as weak and predicts that he won’t be able to be successful. He thinks to himself, “Nicotine gets me through the day. I don’t think I can stand quitting. But I absolutely must try.”

And sure enough, the second day with cravings going up, he says, “I can’t stand it. I knew I would fail. I’ve never been very good at sticking with anything hard. Maybe I’ll try quitting again in a year or so. I just don’t have the willpower now.”

So, Noah gives up. But what if he challenges his thinking? Could there be a different outcome? The next sections will help Noah and you reevaluate your thoughts.

For example, someone who tends to catastrophize, filter out positive information, apply unyielding obligations to himself, and fortune tell, may begin the quitting process with considerable apprehension. That person would also lack the self-confidence necessary to take on quitting. Changing thinking will help build up that confidence. Noah decides to give up smoking. See what happens to his ready-to-fire thought distortions when the cravings strike (see the nearby sidebar).

We categorize thought distortions as catastrophizing, fortune telling, mental filtering, black-and-white thinking, personalizing, and unyielding obligations. Perhaps you noticed that the various types of thought distortions overlap. For example, the thought of “I won’t be able to stand it” is a clear example of catastrophizing. However, it’s also an example of fortune telling. In fact, most distorted thoughts contain two or more distortions simultaneously. Does this matter? Not really. The techniques for challenging thought distortions work pretty well for all types of distortions.

Examining the evidence

Not all of your thoughts are wrong, distorted, or erroneous. For example, if you have the thought “I’d really like to have a cigarette now,” you’re probably completely correct and honest. There’s no distortion. Yes, you wish you could have a cigarette.

It’s only when you add obvious distortions, such as “I absolutely must have a cigarette right this minute,” that your thinking starts to look warped. And hopefully you can see, the later thought will evoke much greater emotionally driven urges and cravings.

Here are some evidence-gathering questions you can ask yourself about your smoking- and vaping-related thoughts in order to challenge them and come up with something more realistic.

• Are my thoughts absolutely, 100 percent true all the time?
• Is it possible that I’m exaggerating?
• Have I ever handled anything challenging in the past and gotten through it?
• Am I filtering out any important information?
• Do I have experiences that would contradict this thought?
• Have my dire predictions always come true?

In an earlier sidebar, “What happens when your thoughts are distorted,” we present the story of Noah, a young man with multiple distorted thoughts. He believes that he must quit, predicts that he won’t be able to stand the withdrawal, that he doesn’t have willpower, and is too weak to face challenges. Not surprisingly, Noah’s quit attempt fails after a couple of days. However, when he challenges his distorted thinking, he may be able to try again much sooner than he thought.

Take a look at Noah’s answers to the evidence-gathering questions:

• Are my thoughts absolutely, 100 percent true all the time? Well, I quit for a few weeks last year and it was starting to get a little easier. I was able to stand the withdrawal symptoms. I started smoking again at a party. That was stupid.
• Is it possible that I’m exaggerating? Okay, I said I can’t stand the withdrawal symptoms. It’s not like I’m in horrible pain. They’re sure uncomfortable — but I can manage if I don’t talk myself out of it.
• Have I ever handled anything challenging in the past and gotten through it? I’ve done some hard stuff in the past — like the time I flunked organic chemistry. I was devastated, but I took it a second time, studied like crazy, and passed. That was so hard, but I did it.
• Am I filtering out any important information? I’m ignoring the facts that I could really use the extra money that not buying cigarettes would give me and that I would be quite a bit healthier without smoking.
• Do I have experiences that would contradict these thoughts? I’m not actually weak. I’m very strong when it comes to being responsible in all other areas in my life. Smoking is hard to give up, but I can do it if I try.
• Have my dire predictions always come true? I guess I predicted that I wouldn’t be able to quit smoking. That does not have to be true. When I failed chemistry, I thought I’d never be able to pass. I proved myself wrong. I can do the same with smoking.

What do you think of Noah’s chances of being successful will be after challenging his thinking? Have they improved? We think so (and our thoughts are certainly not distorted!).

Moderating extremist words

Thought distortions greatly aggravate negative emotions. Thus, they make you feel much worse than you would have without distortions. Thought distortions often involve extreme words such as the following:

• Always
• Awful
• Devastating
• Horrible
• Impossible
• Never
• Unbearable

Imagine trying to quit using tobacco or nicotine and describing the process using extremist words. For example, a vaper might say, “Life without nicotine is unbearable. It’s utterly impossible to get through the day. It would be horrible to quit and never have that nicotine buzz again. I’ll always vape.”

You can soften the impact of extremist words if you modify and replace them with flexible, less absolute words and phrases. Few things are totally impossible. Although some things are devasting, they aren’t frequent and they’re usually temporary. Rarely is life unbearable.

If your life truly feels unbearable, that’s probably a sign of significant emotional problems, such as depression. We strongly urge you to see a mental health professional as soon as possible. If you feel hopeless or like ending your life, another good option is to start by calling the National Suicide Prevention Lifeline available 24 hours a day at 800-273-8255. They also have an online chat available at www.suicidepreventionlifeline.org/chat. To get the text crisis line, text HOME to 741741.

Let’s take each of the extremist words and come up with a more flexible, logical, and supportable word or phrase:

Extremist Words	More Flexible Words
Always	Most of the time
Awful	Distressing
Devastating	Upsetting
Horrible	Unpleasant
Impossible	Very difficult
Never	Not usually
Unbearable	Uncomfortable

It helps to think about your extremist language like saying your car never has any gas at all or it’s always totally, completely full. Only once in a blue moon are those extreme thoughts accurate. The truth is your car could be quite low on gas, or pretty topped off, but most of the time, it’s somewhere in the middle. So, when you’re thinking about your thinking, consider using a moderate, balanced set of words. Such words will evoke less distressing emotions and feel easier to deal with. They’re likely to be more supportable by evidence as well.

Sitting across from a friend

It’s human nature to feel upset or distraught when you’re going through a tough time. And quitting an addiction like smoking is definitely in the tough category. Sometimes it’s particularly tough when urges unexpectedly surge. And when times are tough, it’s often comforting and helpful to spend some time with a friend. But what if your friends are tied up or unavailable? Or perhaps you don’t want to bother them or share your troubles. Or maybe they’re still smokers.

We have a strategy that many people find helpful. It’s called the two-chair technique. With this method, you can access a friend within yourself. Almost all people have a reasonable, logical part of their minds in addition to an emotionally driven side (see Chapter 2). When you quit smoking and urges emerge, the emotional side of your brain tries to take charge. Accessing your friend within yourself helps you fight back with reason, evidence, and logic.

In order to do that, we have an exercise for you to try. Okay, we know it sounds a little weird, but really in our many years of psychology practice (as well as a bunch of research studies), we’ve seen this work for lots of people. So, put your reservations aside for a moment and do the following:

1. Set up two chairs facing each other only a foot or two apart.
2. Label one of the chairs, “My emotional mind.”
3. Label the other chair, “My logical, reasonable mind.”
4. Imagine two of you, one in each chair.
5. Now, the real you needs to sit in the emotional mind chair.

6. Tell the imagined logical, reasonable part of you why quitting smoking (or vaping or chewing) is utterly impossible, horrible, not worth it … you get the idea.

   Conjure up every rationale you’ve ever used to justify continuing to smoke or cave into a craving.

7. When you’re out of emotionally based reasons, switch to the logical, reasonable mind chair and argue back.

   Tell the emotional part of your mind why it’s wrong and foolish to continue thinking like that. Talk about the numerous health concerns you’re addressing by quitting and why it’s all so important to you.

8. When you run out of logical arguments, switch back to the emotionally driven chair.

   Think of more reasons to dispute the logical part of your mind until you run out again.

9. Keep switching chairs until you’ve run out of arguments.
10. Summarize what you’ve learned.
11. Repeat this exercise from time to time whenever you find the emotional side of you starting to take charge.

We’re not suggesting that your emotions are always wrong. There are times your gut tells you something worth listening to. But when it comes to addictions, strong emotions usually lead you astray — they are not your friend.

The nearby sidebar shows how Miguel, a lifelong smoker, uses the two-chair technique to deal with strong urges and cravings.

Understanding how thoughts interfere with your smoking cessation attempts will help you quit. But there’s an important side benefit — when you recognize distortions in your thinking about smoking, you can apply what you’ve learned to other aspects of your life. For example, if you have bouts of anxiety, sadness, or anger, reevaluating your thoughts can help you deal with these issues, too.

TALKING TO YOURSELF

Miguel quit smoking two months ago and has had only two cigarettes since then. Miguel is watching politics on TV and finds himself getting upset and a bit angry. His go-to reaction, of course, has always been to reach for a cigarette at times like this. Predictably, he feels a huge uptick in his cravings. His emotional mind is telling him that he can just have a couple of cigarettes and he’ll feel better. He can then quit again.

Something tells him, however, that his impulse may not be such a good idea. He struggles for another half-hour and feels even stronger urges. Then he remembers the two-chair technique and decides to take a run at it. Here’s what transpires when he sits in each chair.

• Emotional chair: Those stupid politicians make me so mad — I need a cigarette to deal with this! I can smoke a couple and just go right back to quitting. I need it. It will help. Don’t stand in my way. I can’t stand the cravings.
• Reasonable chair: Hold your horses there. Politicians all do that to you; you can’t go running for a few smokes every time you hear one say something outrageous. Smoking even just one or two cigarettes won’t change what politicians say. Remember the last couple of times you had a “cheat” cigarette? It made your cravings intensify. Is that what you want? That’s not sensible.
• Emotional chair: Yeah, well, I really want a damn cigarette! What’s the big deal? I can handle it; I managed before when I cheated.
• Reasonable chair: Maybe you’d call that handling it. You almost went nuts after you cheated. You spent three days with miserable cravings. You know, if you just wait this out, you’ll feel better in just a couple of hours. Isn’t it better to feel you accomplished something rather than cave into what cigarettes want you to do?
• Emotional chair: Okay, already. I’m not happy about it, but I’ll try what you’re saying. Maybe I should go for a walk like my quit plan suggests.
• Reasonable Chair: Good choice. And, I don’t know, but maybe you should watch a bit less politics. You know it’s one of your triggers. There’s some great comedy on cable. Better to laugh than to get ticked off and smoke.

Miguel figured a few things out from this exercise. First, he doesn’t have to cater to his cravings. His addicted mind doesn’t have to stay in charge of him. He sees how the emotional part of his mind wants him to cheat and disregard consequences such as increased cravings and the possibility of a full-blown relapse.

The next time you find yourself captive to the messages coming from the emotional side of your mind, try the two-chair technique.

Relating to your thoughts in a new way

Problematic, distorted thoughts can be challenged through checking the evidence, replacing extreme words with flexible language, and using the two-chair technique (see the previous sections). If you’ve tried these strategies and they do the trick for you, you may not need to read this section. However, you may have made progress in challenging your distorted thoughts but want something more.

When you think about your thinking, it’s so easy to believe that your thoughts are real and have great meaning and importance. And sometimes that’s the case. For example, when you think you need to pay your bills, you probably do! Your thoughts are telling you an accurate, important piece of information.

But when your thoughts tell you “I can’t stand it,” “I must have a cigarette now,” “I’ll be miserable forever,” or “Maybe I’ll just have a couple of smokes,” then they aren’t giving you information with great meaning and importance. And they are not true!

Another way of dealing with problematic thoughts is not to replace them at all but relate to them in a new way. Try realizing that thoughts are just thoughts. You can hear them and refuse to engage with them. You can merely let them go.

We have three quick techniques for letting your thoughts go. They take a little whimsical use of imagination. But suspend your judgment of these until you’ve tried them.

• Leaves: Imagine writing your thoughts on a large leaf. Look at the leaf and read your thought. A gentle wind picks it up and drops it into a stream. The leaf gradually floats downstream.
• Clouds: Imagine you have a magic pen that can write on clouds. Write your problematic thought on one of those clouds. Read it and watch it slowly drift by.
• Train cars: Imagine a very long freight train approaching. It has your thought written on each car as it slowly chugs along down the tracks. Wave goodbye as it passes.

You use these techniques to stop engaging, arguing, or evaluating your thoughts. Earlier techniques show how to rethink thoughts. This approach helps you merely let them go. You’ll never stop having problematic thoughts from time to time, but you can choose to deal with them differently — just another part of life passing by.

As you let go of thoughts, your actions will change. For example, if you think, “I must have a cigarette,” and you let that thought go, you may choose to do something different. In other words, you’ll feel less compulsion to pick up another cigarette.

Listening to Feelings and Urges

Trying to avoid all unpleasant feelings, when you’re battling an addiction, is a certain path to failure. But that’s what many quitters desperately try to do. They turn to substitutes such as NRT or ask for medications to eliminate cravings (see Chapter 9). They go to hypnotherapists, dabble with acupuncture, or take supplements, all in a frantic effort to avoid the cravings that come with quitting.

There’s nothing wrong with trying, and sometimes these endeavors work. In fact, NRT and prescribed medications can temper the bad feelings. However, for most people who are trying to quit, some bad feelings emerge, no matter what. But, the more you absolutely need to completely quash these feelings, the more likely they’ll overwhelm you.

If cravings, urges, yearnings, aches, and feelings of emptiness derail your efforts, we have a different suggestion for your consideration. As counterintuitive as it may seem, open up space for these feelings.

The feelings we’re interested in here include only those that tend to send you on a quest to find and consume tobacco or nicotine. Typical, problematic feelings that trigger lapses include

• Aches
• Anxiety
• Boredom
• Cravings
• Emptiness
• Loneliness
• Stress
• Urges
• Yearnings

Most common feelings or emotional triggers are distressing in nature. However, sometimes people find themselves triggered by positive emotions such as joy and excitement. The negative cravings and urges follow the initial positive feelings.

To handle these feelings in a different way, start by examining them closely. When they occur, jot down where you feel them in your body and how intense they are, and maybe rate them on a 1-to-10 scale of intensity. Time them, too — do they last a few minutes, an hour, or what? Look at them objectively like you have to write a science report on them. Allow them space to exist and realize they don’t have to overwhelm you.

For this approach to feelings, you don’t have to write down where they occurred or what caused them. We only want you to concentrate on feelings from an objective distance. The nearby sidebar offers an example.

OBSERVING YOUR OWN FEELINGS

Ella has tried to quit vaping five or six times to no avail. She has been using NRT but still has powerful urges to vape. Nonetheless, she is determined not to let nicotine control her life any longer. She tracks her feelings related to vaping. She writes:

• I notice I have a strong craving as soon as I get home from work. I feel anxious at a level of 5 or 6. Both of these feelings live in my throat. It feels uncomfortable, like I need more air.
• Okay, I’m going to wait this out. I want to make space for my feelings. I think I’ll walk around as I study these emotions. The moment I decided not to succumb, the feelings jumped. They’re a level of 7 or 8 now. Wow my throat feels tighter and I can even feel it in my chest.
• This may not be working, but I’m going to hang in there. I see I’m tensing my hands, too. My teeth are clenching as well. Kind of like I’d feel if I were giving a presentation at work. But now I’m feeling a slight improvement. It’s almost as if my describing how I feel is helping just a bit. Now, it’s almost ten minutes since I started this. I feel pretty okay. Maybe just a 2 or 3. I think I’ll make it through without vaping.

Ella discovered that she doesn’t need to totally eliminate difficult feelings and that she couldn’t do so even if she tried. By opening up space and studying her feelings, she found a path toward acceptance. Acceptance helped soften the feelings and made them less overwhelming.

Become a scientist interested in the science of feeling and emotion. Study your own feelings in a detached and objective way. As you practice relating to your feelings in this new way, you’ll likely find that you begin feeling differently. Not radically and not all at once. Just a bit less intense and a bit more manageable.

Opening up space and accepting feelings can help you in other aspects of your life as well. If you have anxiety or depression, acceptance of feelings can help. When you try to suppress or deny difficult feelings, that can cause greater emotional distress. That distress can lead to physical complications such as high blood pressure, digestive problems, tense muscles, and greater urges to smoke. Accepting emotions allows you to process them and let them go.

If feelings of depression or anxiety or any other emotions are interfering with your everyday functioning or causing considerable distress, help is available. Consult a mental health professional or your primary care provider.

Taking New Actions

In the earlier sections of this chapter, we discuss how thoughts, feelings, and triggers can lead people to smoke or vape. In this section, we talk about how changing behaviors can help you keep your impulses to indulge at bay. It begins with avoiding triggers and doing something different when you can, making the triggers less potent when possible, and taking specific actions to handle smoking triggers when they can’t be avoided.

Avoiding and minimizing triggers when you can

Realize that you can’t avoid all smoking triggers all the time. But you can reduce the frequency and degree of your interactions with triggers that tempt you to smoke. Some exposure to triggers is necessary to break a habit, but you need to build up strength to be able to face the biggest challenges.

If at all possible, avoid the obvious, most problematic triggers. For example, if you play poker on Friday nights and the gang all smoke, take a breather, so to speak. Your buddies will understand. Don’t think for a second that you’ll be able to deal with such a loaded situation right out of the starting block.

That’s even more true if alcohol is involved because alcohol reduces inhibitions and self-control. For that matter, watch out for that after-work drink or, even worse, drinks (plural). That’s especially true if your drinking is associated with a relaxing cigarette. Alcohol is often a trigger for smoking.

If you can’t easily stay away from alcohol, it could be that you have two addictions in play. Lots of people have difficulty with alcohol and function very well. They don’t appear to be what most folks would consider an alcoholic. But if you drink more days than not and consume more than two drinks per day for men or more than one drink per day for women, you could experience health problems from your drinking eventually. You can check on the extent of your possible problem by going to www.checkupandchoices.com and take their confidential free screener for drinkers. It’s been well researched as valid. If you do have a problem, they’ll let you know about possible next steps.

For those who attempt to quit alcohol and other substances, there appears to be a better chance of sobriety when cigarettes are given up at the same time.

Another situation that you may be able to easily avoid is going outside with the smokers during your breaks at work. Take a walk instead and be sure to go out another door or avoid the smokers as you leave. Consider having a cup of relaxing tea at your desk. Avoid smokers as much as you can, for at least a few months, if possible.

Don’t go into the store where you regularly buy your smokes or vapes. For that matter, don’t go near the store — it’s too tempting to stop and go in. If you can, go to another neighborhood or make a detour. The more triggers that you can flat out avoid, the better, especially in the early going.

On the other hand, some situations are hard to avoid. If you smoked in the car every day while driving to work, you have a challenge. You could possibly take public transportation to work for a while or use a ride share. Or maybe you could carpool.

Barring these possibilities, you may need to come up with a distraction. Possibly you could find an especially engrossing podcast or audiobook.

Quitting smoking is one of the best things you can do for your health. Be smart. Do everything you can do to be successful. Pamper yourself. Avoid temptations when you can and make a plan ahead of time for when you can’t avoid triggers for smoking.

Having an action for every trigger you can’t avoid

Some triggers you can’t avoid. If you smoke after every meal, obviously you can’t stop eating. If you smoke on the couch while you watch TV, we don’t expect you to give up your favorite shows. After all, you’re giving up something else you’re extremely fond of, right?

Instead when you can’t avoid a trigger, change it up. Don’t sit still after a meal. Do something different. Be a hero and clean the kitchen or take a walk. During the first few weeks, moving away from the trigger spot may be the best way to deal with it. As for TV, change chairs or watch in a different room. Have some healthy snacks available that you can chew while you watch.

Some triggers may be difficult to change up. For example, it’s tough to change up talking on the telephone. For cases like that, we encourage a brief burst of exercise. It can be done before or after the call. Obviously, clear this suggestion with your doctor first if you have any health issues. Do just enough exercise to get your heart rate up. A few minutes is usually all you need. By changing your body’s in-the-moment metabolism, you change up the physical experience of urges and cravings.

Here are a few brief exercise bursts for your consideration:

• Jumping jacks
• Squats
• Pushups
• Quick-feet jogging in place

If you have arthritis, an injury, or another physical condition, there are lots of modifications you can find on the Internet. Or consider consulting a physical therapist or personal trainer.

None of these alternative or modified actions will work for everyone. Some people find movement of almost any kind helps. Others like to listen to podcasts or music. Do what works for you. We give you many more options in Part 4.

Confronting triggers head on

Don’t make it your goal to avoid all triggers of urges and cravings. In fact, after you master the first month or so of quitting, we encourage you to consider intentionally exposing yourself to some smoking triggers. That’s in order to build up your endurance and ability to handle inevitable encounters.

If you try this strategy and find it difficult, we encourage you to drop it. Some people find it enhances their quit attempts, but it’s not for everyone. Not to worry — there are plenty more strategies in this and other chapters.

We’re going to pretend that you’re starting a light, free-weight training program. You start off easy — maybe 5 pounds. Then after you master 5 pounds, you advance to 8 pounds, and then on to 12 pounds and beyond (you can change up the weights in your mind to fit your own strength and fitness level).

This weight-training metaphor can help you understand how gradual exposure to tobacco or vaping triggers can build up your strength and resistance. Here’s how to do that in a gradual, controlled way:

1. Make a list of smoking triggers relevant to you.

2. Rate each one for intensity (easy, moderate, difficult).

   Every trigger and rating will be different for every person.

3. Pick one trigger for each category that you can plan to deal with.

4. Spend 5 minutes in the presence of an easy trigger.

   Gradually increase the time to 10 minutes and then 15 minutes. Repeat until cravings decrease in response to that trigger.

5. Do the same with a moderately difficult trigger followed by a difficult one.
6. Repeat until you feel greater mastery over your triggers.

LIFTING WEIGHTS

Gavin has been smoke-free for six weeks. He has avoided lots of triggers, but now he feels ready to start dealing with them head on. He makes his initial list of triggers and chooses an easy, moderate, and difficult one. He calls his morning coffee trigger a 5-pound challenge, his work-break a 10-pound challenge, and watching a movie at home a 15-pound challenge.

Gavin starts with the morning coffee trigger. Up to now, he has been leaving for work before drinking his morning coffee to keep from experiencing cravings. Today, he sits at his kitchen table, coffee cup in front of him without a cigarette. He finds it mildly difficult, but a little harder than he thought it would be. He notices all the symptoms in his body — tightness in his chest, a feeling of anxiety, a strong craving in the pit of his stomach. He stays seated and continues to notice these sensations as he drinks his coffee. They ebb and flow and eventually decrease.

Gavin needs to continue this work, more morning coffee, more triggers, and longer duration. This work will gradually allow him to increase his sense of competence and help him deal with his cravings and urges.

For some people, exposure to triggers is an important part of recovery. If you can’t build up the strength to resist triggers, you’ll be at risk for relapse. The example of Gavin in the nearby sidebar illustrates a planned exposure to triggers.

Rewarding successes

You’ve had a smoking, chewing, or vaping habit long enough to be thoroughly engrained, or you wouldn’t be reading this book! Each time you inhaled or chewed, you were rewarded.

Now you want to give up something that you enjoy doing and replace it with what? Well, yeah, you want to get healthier and spend less money. But those goals can feel a bit remote. You were getting rewarded instantly for indulging in your habit. You need to set up quicker, concrete rewards for your successes.

In the early stages of quitting, you need to do whatever you can in order to stay the course. Finding good self-rewards is a big part of that picture. It’s even okay to indulge in ice cream every single day you don’t smoke (that is, for a while). Gaining a little weight is much less dangerous than tobacco, and you can work on that issue a bit later (see Chapter 20 for information about dealing with weight).

Use your imagination and come up with a list of ideas for self-rewards. See Chapter 17 for ideas on how to pamper yourself during the first risky months.

You’re saving a small fortune by not smoking. Right now, an average price for a pack of cigarettes hovers in the $6 to $8 range. In other words, most pack-a-day smokers will spend over $200 per month; vapers will incur somewhat less. For the first month or two, consider using a major portion of your savings to reward yourself. Doing so can reinforce your new, nonsmoking habit.