Chapter 17

Getting through the Risky First Month

IN THIS CHAPTER

Bullet Managing irritability

Bullet Getting a good night’s sleep

Bullet Looking forward to the payoffs

You got through the first day. Yeah! In the first week of quitting, you mostly want to do what you did for the first day. Treat yourself like royalty. However, as the days pass, life re-emerges. You can’t avoid every trigger, and early enthusiasm fades a bit. This first month represents your greatest relapse risk (see Chapter 19).

In this chapter, we give you some tips and strategies for making it through the difficult first month. The good news is that withdrawal symptoms from nicotine usually peak within a few days and come down further within two to four weeks. These symptoms will be milder if you’re using nicotine replacement therapy (NRT).

Warning Your withdrawal symptoms may abate during the first month. However, you will probably continue to experience urges and cravings for some time. These are due to the numerous triggers you encounter in daily living. These triggers set off powerful urges, sometimes quite unexpectedly. These associations take time to lose their power.

Managing Your Inner Curmudgeon

Okay, let’s get real here. You’re not going to be the best version of yourself during the first few weeks of quitting, especially if you’re doing it cold turkey without NRT or medication. In fact, you may find yourself:

  • Snapping at your spouse or partner over virtually nothing
  • Lacking patience with others
  • Feeling cranky
  • Experiencing nervousness
  • Wanting to lash out with road rage
  • Feeling easily frustrated
  • Feeling on edge for no apparent reason
  • Experiencing frequent sensations of restlessness
  • Flying off the handle once in a while

Warning There is a common myth that it’s best to express your anger, that left inside, anger will build and eventually explode from the pressure. Nothing could be further from the truth. Numerous studies of this issue have shown that expressing anger (such as screaming or hitting a pillow) leads to more anger. It’s important to learn to control anger and express it in an effective, healthy manner (see Chapter 22). When, and if necessary, expressing anger very carefully and mildly is usually your best course of action. If anger is a significant problem for you, consider checking out Anger Management For Dummies, 2nd Edition, by Charles Elliott and Laura Smith (yes, that’s us).

The next two sections show you various ways of managing your irritability. These strategies keep the temperature down for you and those around you.

Taking a time-out

Much like urges and cravings, difficult feelings of prickliness or touchiness pass after a little time. Try one or more of the following delay tips when you feel edgy (it’s better than smoking or vaping):

  • Take slow, deep breaths. Inhale slowly while you count to three and then exhale as slowly as you can. Repeat at least three times or until your feelings quell.
  • Slowly count to ten. This really works. You may have to count as high as 100, but keep at it until you calm down.
  • Repeat a mantra. Say to yourself, “Calm down,” “Give it time,” “Peace,” or “Chill.” Repeat one or more of these words slowly or choose your own word or phrase. Keep repeating until you feel better.
  • Close your mouth. Don’t let any words escape! They’re likely to make things worse, no matter how careful you try to be. If you actually talk, the odds of your saying something useful while you’re upset are about one in 28 billion.
  • Let it go. Remember that your emotions are transient and will pass. Remind yourself that time is on your side.

One of the most compelling reasons for delaying the expression of your irritability is that withdrawal from nicotine is very likely causing you to perceive things and people around you in twisted, negative ways. Ponder that probability!

Not only are you likely overreacting, but if you do become irritable with others, you’ll likely make things worse not better. You could even annoy the people you’re counting on for support. So, do yourself a favor and take a time-out. Breathe.

Taking anti-curmudgeon actions

We also have a list of actions you can take in order to curtail your inner curmudgeon. Try whichever ones appeal to you. If your first choice doesn’t work, try another one.

  • Suck on hard candy or a mint. Don’t chew! Take the time to slowly dissolve the mint in your mouth. By having something in your mouth, it’s harder to talk and get yourself in more trouble.
  • Go for a walk. Take a brisk five-minute walk. It will give you time to burn off some excess adrenaline. Consider taking your dog with you.
  • Clean up the kitchen counter. Do any brief housekeeping task that can distract you for a few minutes. It will also give you a sense of accomplishment.
  • Try splashing your face with ice water. You can also submerge your hands in ice water for 30 seconds. Or rub ice on your wrists or face. When you’re done, you won’t feel quite so uptight. Maybe a bit chilly, but… .
  • Put on a happy face. This tip is also called “acting as if” — in other words, acting as if you’re not irritated. You can put on a Mona Lisa face — sublime and serene. Your feelings will follow.
  • Play a quick game on your phone. This is another distraction that works pretty well to diminish upsetting feelings. Make sure it’s a game that engages your attention.
  • Apologize and mean it. If you’re the kind of person who finds it difficult to apologize, get over it!

Remember Realize that it’s almost inevitable that you’ll mess up a few times during the first month of quitting. You’ll say some things you don’t mean or you’ll snap at someone without good cause. After you calm down, apologize genuinely. You can then explain what’s causing your irritability. Most people will understand.

Tip Take a few minutes to review your personal quit plan at least weekly during this first month. If any of the strategies mentioned in this chapter work for you, consider adding them to your personal quit plan (see Chapter 15). When distressing emotions or cravings break through, also read your cue cards out loud (see Chapter 16).

Sleeping Through the Night

We know you’re cranky because you gave up one of your favorite companions, smoking. Poor sleep can add to the crankiness. Stopping nicotine often disturbs sleep. And smokers who quit and experience sleep disturbance are more likely to relapse — especially during the first month. Furthermore, exhaustion leads to more irritability.

The good news is that there are ways for helping sleep and indications are that those methods will reduce that relapse problem. But first, we’ll give you the reasons why sleep is important in your quitting efforts. Sleep deprivation leads to:

  • Emotional outbursts
  • Impaired memory
  • Difficulty concentrating
  • Suppressed immune function
  • Weight gain
  • Inefficiency
  • Decreased frustration tolerance
  • Pessimism
  • Impaired moods
  • Impaired ability to cope
  • Inflexible thinking (the inability to see both sides of an issue)
  • Being accident-prone
  • Lack of stamina
  • Road rage

And with all that going on, you’re supposed to quit smoking and resist urges, right? No wonder people trying to quit who experience sleep problems, relapse more often than those without sleep impairment. Sleep problems are important to deal with in the first weeks of quitting — don’t wait.

Even though it’s true that the very act of quitting can mess up your sleep, there are things you can do to address that problem. It’s usually preferable that you don’t start sleep medications as your first strategy. That’s because sleep medications typically should only be used for the short term.

Why just for the short term? Simple. All too often, they lead to:

  • Long-term problems with thinking and memory
  • Addiction and additional sleep problems if you stop them
  • Daytime drowsiness
  • Bizarre wandering at night, including driving without awareness
  • Increased anxiety

So, for now, look at how to improve your sleep quality in other ways. But if you do want to check out sleep medications either now or later, be sure to talk with your doctor and carefully weigh the pluses and minuses of them for yourself.

Tip Melatonin is a hormone that your body produces naturally. Many people find melatonin supplements to be a useful sleep aid. It’s safer than prescription sleep medications, so you may want to start with melatonin.

Getting ready for bed

If you ever had a baby, you probably remember a bedtime routine. You may have had story time, a bath, and a last feeding before putting the infant down for the night with a goodnight kiss. When the routine was followed, for the most part, things usually went as planned. But when a bedtime routine gets disrupted, chaos can occur. That’s why you probably tried to keep to the routine as closely as possible.

Tip If you want to sleep like a baby, set up a bedtime routine for yourself. Start a few hours before bed. Here are some easy things you can do (and a few not to do) to wind down your day before going to bed:

  • Don’t do aerobic exercise within a couple of hours of bed.
  • Exercise earlier in the day — it can help sleep later.
  • Drink chamomile tea or another herbal or decaffeinated tea with relaxing properties.
  • Don’t talk about a highly conflicted issue with your family.
  • Don’t eat a big meal a few hours before bed. Instead, eat a small snack, such as a handful of nuts or some yogurt.
  • Consider a warm bath or shower if you like them.
  • Don’t watch violent, scary, or suspenseful movies or TV shows if they rev you up.
  • Do consider reading a book as long as the themes are not upsetting.
  • Don’t use screens an hour before bed because they can alter your circadian rhythm, although some people find that screens don’t bother their sleep.

Remember After you’ve designed your sleep routine, try to stick with it. Don’t vary it much, especially in the first month of quitting. Your body gets used to it and starts to drop off more quickly.

Making your room rest ready

Tip Your immediate environment matters when it comes to sleep. Once again, associations are key. Here are some of the most important points for associating your bedroom with a restful sleep:

  • Turn the thermostat down. Most people do better in a cool room.
  • Make your room as dark as possible. Consider including new, room-darkening blinds if necessary.
  • If noise is a problem, think about using a sound machine app to generate soothing sounds in the background.
  • Have comfortable sheets. Get some new ones if you’re ready for them.
  • Turn notifications off on your cellphone at night. And above all, don’t get up to look at your screen.
  • Clean and organize your bedroom. Don’t leave stuff lying around you could trip on in the middle of the night. Besides, messiness doesn’t associate with peaceful sleep.

Remember These suggestions could seem trivial to you. But they add up to a more restful setting, and that’s what your mind and body want.

Associating your bed with sleep

You need to associate your bed with sleep. Beds have two major purposes — sleep and sex. Both associations are fine. But if you have a sleep problem, be careful about other associations. Avoid the following:

  • Doing work in bed
  • Watching much TV in bed (a few minutes to wind down could be okay)
  • Reading for an extended period of time in bed (again, that’s if you have a sleep problem)
  • Listening to loud music in bed

If you can’t fall off to sleep within about 20 minutes, it’s best to get up out of bed and do something else. That’s to avoid associating your bed with tossing, turning, and ruminating. Your choice of something else to do should be nonstrenuous and, ideally, a bit boring. Don’t try going back to bed until you feel significantly more fatigued. Get up again if you don’t fall asleep within about 20 minutes.

It’s a pain to keep getting up if you don’t drop off to sleep quickly. But if you put up with a few sleep-deprived nights, you’ll likely get a big payoff.

Tip Sometimes you’re snuggled up in bed, totally relaxed and peaceful, for longer than 20 minutes. We don’t expect you to jump out of bed and do something else in that case. It’s when you’re fully awake and thinking about a long to-do list or worried about something that it’s best to get up. Otherwise, enjoy the peace and quiet.

Avoiding alcohol and other drugs

It’s often tempting to have a nightcap just before bed — and it may help you drop off. Unfortunately, alcohol interferes with normal sleep patterns, and you’re more likely to wake up in the middle of the night, unable to go back to sleep.

The same advice goes for a variety of other medications and over-the-counter drugs — check carefully before taking them to avoid sleep problems. Common cold or allergy medications often contain stimulating ingredients. Finally, avoid caffeine and other foods with caffeine such as chocolate.

Tip Some people even have a problem with decaffeinated coffee before bed — that’s probably due to the association between regular coffee and feeling stimulated. Your brain sometimes reacts to the association and responds as if the decaf coffee actually contained caffeine. If you think that has happened to you, consider dropping that decaf at night.

Making your mind rest ready

Just as your bedroom environment matters, so do the contents in your mind. If you’re stewing about a work problem, sorting out a difficult relationship, or figuring out your monthly budget, you’re not likely to drop off to sleep easily.

Tip Put off your worries until tomorrow. Consider having a notepad and pen to jot down your concerns so you can leave them alone. You may want to spend 15 minutes problem solving on paper, and then set it aside. Ideally, do this several hours before bed. Bedtime itself should be sacred — people rarely come up with brilliant solutions to issues while tossing and turning anyway.

Tip Some people find mindfulness a useful approach to aiding sleep. See Chapter 21 for information on meditation techniques.

Tip If sleep continues to elude you, try to realize that, while not ideal, it’s something you’ve probably coped with before. The more you obsess about your sleep, the worse it will get. If you continue to struggle past the first month or so, read Chapter 18 to see if you have problems with depression or anxiety. Those moods often cause sleep problems. Depression and anxiety after quitting smoking are common but often abate, and when they don’t, they’re fortunately treatable.

Warning You may be tempted to try to make up for lost sleep by staying in bed more hours. That’s a big mistake. Stick to your regular sleep schedule. You’ll sleep better in the long run.

Tip If you try all these sleep suggestions and continue to have prolonged insomnia, talk to your primary care provider about seeing a sleep specialist, particularly a psychologist trained in cognitive behavior therapy for insomnia. Sleep is an important problem to address early.

Tolerating Withdrawal in the First Month

Tip We discuss withdrawal from smoking, vaping, and chewing throughout this book. Your worst problems with this issue will occur during the first month. Be prepared to experience one or more of the following symptoms:

  • Increased cough: Wait a minute, didn’t you quit smoking to get rid of your smokers’ cough? Yes, but when you stop poisoning your lungs, they begin to start cleaning themselves out. So, it’s kind of a good sign that your coughing increases. Expect it to diminish within a couple of weeks — check with your primary care doctor if it doesn’t.
  • Tightness in chest: This could be from coughing too much or having strong cravings. This symptom usually fades within days.
  • Fatigue: Well, we did already mention sleep problems in the previous sections. But fatigue can come on even if you’re sleeping all right. It happens because your body is adjusting to having no stimulation from nicotine, though less if you’re on NRT. This, too, shall pass.
  • Minor sore throat: The nerve endings in your throat start to regenerate and can cause minor irritation for a while. Drink lots of water and suck on lozenges often.
  • Concentration problems: You’ve probably used nicotine to help you focus and concentrate. It takes some adjustment to learn how to pay attention without a cigarette, but your focus will improve.
  • Strong cravings: Hang onto your hat and wait it out. Distract yourself especially with exercise. Unfortunately, this side effect can linger for a while.
  • Dizziness: This symptom usually fades within a few days. It occurs because your body is not accustomed to the increased oxygen that comes from stopping smoking.
  • Increased hunger: You may feel more hungry than usual because cravings feel much like hunger and nicotine suppresses appetite. Try drinking lots of water, chewing gum, and/or having a variety of low-calorie snacks.
  • Constipation: During the first month of quitting, a certain percentage of people experience constipation. It’s important to drink lots of water and increase fiber in your diet.

Remember Withdrawal symptoms are common and expected. So, expect them! Most of these will reduce and disappear before the end of your first month. Things do get better.

Talking Back to First-Month Excuses

The mind is an amazing thinking machine. It solves complex problems and helps you navigate a byzantine world. It’s also quite dexterous in the art of lying and deception. It feeds you false information in a quest to make you feel better in the short run.

In Chapter 2, we explain that you can think of the mind as consisting of two parts. The first is like an elephant that responds to whatever the elephant wants at any given moment, such as food, water, and sex. The elephant tries to avoid danger, pain, or discomfort as well. The second part of your mind is more like an elephant rider that wants to do the right thing in both the short and long term. The rider is more logical and reasonable, but the elephant is more powerful.

In the first month of quitting, the rider is supporting your quit efforts. But the elephant wants nicotine. He’s going to try to get it any way that he can. And he’s strong. His tactic in this case is to convince you that it’s okay to have just a puff, or a couple of puffs, or give up entirely.

Here are some of the things the elephant part of your mind is trying to tell you:

  • I’ve been good this week, just one cigarette can’t hurt anything.
  • I’ll just smoke at this party and get right back on the wagon tomorrow.
  • This isn’t a great time for me to quit; I’ll do it in another month or two.

Remember You can’t have one cigarette and not increase your urges and struggles. Maybe you’ll get away with it, but your odds go down. Tell your elephant that:

  • Cheating does nothing but make it harder.
  • There’s always an excuse not to quit — many excuses, in fact.
  • Stop trying to convince me to do the wrong thing.

The elephant lies. So, decide it’s time to get your elephant under control. Take charge and read your cue cards again (see Chapter 16).

Appreciating Your Payoffs

The average price of a pack of cigarettes is approaching $7 in the United States. If you’re a pack-a-day smoker, by the end of your first month, you’ve saved about $210. Not bad.

But that amount does not take into account the gas money you spend by having to stop at the store, the costs of frequent cleaning of your clothes, and extra visits to your doctor because of your increased susceptibility to various viruses and ailments. Smokers miss work more often and are less productive. Long term, you save at least double the price of the actual cigarettes, probably much more.

And you can’t put a price tag on health. After one month of not smoking, coughing, congestion, fatigue, and shortness of breath will get better. Your sense of taste and smell will begin to return to normal. You’re on the way to decreasing your risk of a heart attack, your circulation improves, and you’re already getting more air into your lungs. Your physical endurance starts improving — you can walk faster or run longer. Physical withdrawal symptoms largely fade by the end of that first month.

Warning All these great physical improvements are something to savor and appreciate. However, don’t let them fool you into thinking that urges and cravings won’t crop up and try to beguile you. You’ve made it through the hardest month! Don’t drop your guard now. Remain vigilant. You’ll be glad you did.

Celebrating the New You

As this first month of nonsmoking goes by, life as a nonsmoker really starts to become new and different. Your world no longer has to revolve around where, when, and how to get your next fix of nicotine. Contrast this new life with your old one by observing other, current smokers.

Watch them gather outside at break time or at someone’s wedding and see how they slink off to sneak a smoke outside. Watch them purchasing their cigarettes at the store. Notice the hassle and the money, and remember the smelly clothes and the stinky breath. Notice the disdainful looks nonsmokers give to smokers, vapers, and those chewing tobacco. Remember and feel the ostracism.

Now, it’s time for the new you. Embrace the joy of knowing that you’re:

  • No longer dependent on finding the right place to indulge your cravings
  • Feeling increased confidence
  • Making the environment better for your loved ones
  • Experiencing a release from the bondage of addiction
  • Feeling proud and accomplished

Let that pride express itself in the way you stand. Walk with greater power and assertiveness. You’re a former smoker now! Give yourself two thumbs up! You’ve met a great challenge head on, and you’re winning!