Chapter 19

Recovering from Lapses and Relapses

IN THIS CHAPTER

Bullet Looking at lapses

Bullet Gaining from lapses

Bullet Getting through lapses and relapses

With a good bit of luck, you’ll be able to skip this chapter. That’s assuming you manage to quit smoking, vaping, or chewing and never slip up. You succeed at quitting and never look back.

But we’re realists. The truth of the matter is, most quitters slip and slide a bit along the way. How you deal with those slips makes all the difference in the world. One way to deal with your slip is to transform it into a temporary lapse. After that short lapse, you get right back on the path to quitting and recovery.

Warning Too many times, a lapse evolves into a relapse. That’s the danger of lapsing. One puff quickly causes urges and cravings to surge and, suddenly, you’re smoking again.

In this chapter, we help you deal with possible lapses and give you the tools for preventing the slip from sliding into a full-blown relapse. But, if a relapse occurs despite your efforts, we show you how to recover and move on from that and get back to quitting again.

Deciding to Lapse

Lapses are shorter and less serious than full-blown relapses. Knowing the subtle differences between these two concepts helps quitters quickly get back on track. A lapse may involve taking a few puffs off someone else’s cigarette or vape pen, or even bumming a couple of smokes at a party. By contrast, a relapse occurs when the smoking behavior returns to a regular pattern similar (but often somewhat decreased at first) to the pattern that existed prior to the quit attempt.

Lapses often occur in situations in which you’ve unexpectedly or inadvertently lost focus and dropped your guard. Quitting smoking is not in the front part of your brain for some reason. Lapses often occur when you’re around other smokers or when drugs or alcohol decrease your inhibitions. Another lapse-triggering situation is when you experience an uptick in strong emotions such as joy or despair. The emotions distract you from the rational part of your mind and — voilà! — a lapse occurs.

Remember Much as this description sounds like something overtakes you in an automatic, unconscious way, it’s also important to realize that all lapses actually involve decisions. You’re only fooling yourself by having thoughts like the following:

  • I couldn’t help it.
  • I did the only thing I could.
  • I did what anyone would’ve done.

The truth is, you made a quick calculus of your situation and decided it would be acceptable to smoke. At that point, you’re not considering the alternative and the implications of your choice. Understandable to be sure. But it helps to realize it’s always a willful, active, conscious decision to smoke. That’s because viewing lapses as conscious decisions helps you recognize that you have more control in these situations than you think you do.

Tip If you feel a sudden, quick urge or craving to smoke, grab hold of yourself and pause the process. Ask yourself if this is the decision that you truly want to make. If you do decide to go ahead and indulge, at least you know you controlled that decision. That makes you realize that you can control other situations by deciding not to cave into your urges.

Tip If you lapse, consider what circumstance set things off. Whether it was a stressful event, a party, or something else from your trigger list, take note of it. Decide how to manage the trigger in a better way the next time it happens. Review what has worked for you to manage that trigger successfully in the past.

Remember In the future, instead of automatically giving in to an unexpected trigger, remember to hit the pause button. Think, think, think.

Profiting from a Lapse

Now you know what a lapse is and its more serious cousin, a relapse. Although lapses and relapses happen, they aren’t desirable. But, as they say, you can always make lemonade from lemons. In other words, use lapses or relapses as opportunities to improve your coping skills.

Two lessons you can learn from a lapse are how to deal with rationalizations and how to dispute common faulty myths about smoking urges. Rationalizations give you permission to lapse in response to specific situations. Myths are more general beliefs about the nature of urges.

Rationalizations and myths are both dangerous and set the stage for lapsing and relapsing. By disputing them and using logic and rational thinking, you can regain momentum for your quit efforts.

Rationalizing and excuse making

Lapses involve rationalizations that move you toward saying yes to a temptation. Your thoughts try to justify a brief lapse. If you’ve had a lapse by now, you no doubt contended with one or more of these rationalizations, whether you thought about it or not.

The following rationalizations are common excuses for a lapse. When you believe these rationalizations, they lead to more lapses that will undoubtedly lead you to a relapse. Then you must start over. Instead, use your logical mind to answer your rationalizations.

Next, we give you some samples to consider, accompanied by a logical, rational perspective for each. Feel free to think of additional rational thoughts you can use to counter your most common rationalizations. When you come up with your own rational thoughts in response to a smoking trigger, write them on paper or a device.

  • I couldn’t say no when my friend offered me a vape. The truth is, you can tell your friend, “No, thanks.” It’s not like you’re obligated to do everything a friend asks you to do. If you were horribly allergic to peanuts and your friend offered you a peanut butter cookie, would you eat it? Try explaining that you’re working hard to quit vaping and you want to keep with your game plan.

    If your friend pushes you, stick to your guns. You don’t want your life to be dictated by peer pressure, do you? The point is to take charge of your own life — don’t be obligated to substances or other people.

  • I just wanted to feel good for a little while; I’ve given up so much. Yes, you have given up a lot. It’s natural to want to feel good for a while. The problem with this sort of thinking is that short, temporary pleasure will come to an end. You’ll be left feeling guilty and having increased urges and cravings.

    What are some other things you could do to feel good? How about watching a movie, taking a long hike, or eating an ice cream cone? Experiment and find out what works for you.

  • It was my birthday (or other celebration). Yes, and, in a sense, you do “deserve” a cigarette on special occasions. But is that truly what will make you feel better? Will it only be just one? Will your cravings go up or down after a lapse like this? You know the answers. You’re going to experience stronger urges. You’re only kidding yourself with this justification.

    Celebrations of all sorts feel like times to indulge. But if you do, you’re likely to feel worse. On the other hand, if you don’t give in, you have even more to celebrate! Another success.

  • It was a horrible day. True. No one is going to deny that you have horrible days from time to time (we all do). The more horrible the day, the more you want to indulge.

    Think carefully about where that goes. How will you feel if you cap off that horrible day with cheating? And now, think how you’ll feel if you end the day with a success.

  • I got sick. Sorry to hear you came down with something. There’s no time like being sick that makes you want to find comfort however you can. That desire goes back to when you were a kid. It’s a tough habit to break. But one of the main reasons you’re quitting is to get healthy and not be sick so often. Adding more toxins to your already sick body doesn’t really work out too well, does it?
  • I was involved in an accident. Gosh, that’s horrible. Accidents can really shake a person up. And when you’re shook up, it’s so tempting to turn to your old friend — tobacco. It calms you down. Gives you something else to focus on. We get it. But instead of reaching for a smoke, try some deep breathing or even that emergency stash of NRT gum you keep around.

  • The traffic this morning was unbearable; I couldn’t take it. Yes, heavy traffic can send the strongest people over the edge. Sometimes it feels like you’re navigating a minefield with explosions ready to go off without warning. Have you ever managed to get through a stressful time without lighting up or vaping? How did you do that?

    Remember that you’ve learned a few tricks on how to manage cravings already, such as calling a friend or chewing a piece of gum. And by the way, caving to temptation won’t make the traffic go away.

  • I found an old cigarette in my drawer at work; how could I not smoke it? Sure. How do you pass up something free that’s right in front of your face? It would only be one after all.

    Are you having thoughts like these? Once again, how will you feel later? Better about yourself and with fewer cravings or just the opposite? You know the answer. Take that cigarette and squash it as hard as you can. Toss it in the garbage can. Then pat yourself on the back.

When you’re dealing with rationalizations like these, recognize that they truly are illogical. The rationalizations are just trying to clear the path for you to return to your old behaviors. You’ve been working hard to quit. Don’t let rationalizations derail your efforts. Use them productively instead. Listen for rationalizations and prepare to use logical answers to refute them.

Tip You have enough willpower to quit successfully. You have the skills to work through urges. If you want more information on how to manage willpower, see Chapter 18.

Rethinking myths about urges

Many people believe faulty myths about their own ability to withstand the inevitable frustration of quitting smoking. These myths can make it easier to lapse and then, when the frustration increases, relapse. Therefore, it’s important to explore the deeply flawed ways of thinking about urges and rigorously dispute them. Then you’ll want to replace these myths with rational, reasonable perspectives.

  • Urges are unbearable — I can’t stand it. Humans love to say they can’t stand things that they really can. You’ve handled numerous urges in the past. For example, we’re pretty sure you don’t eat every dessert you’re offered. You also don’t hit everyone you’re mad at (we hope). And you’ve given up your addiction at least for a while. And you’re still alive — evidence says you did and can stand it, unpleasant though it may be. Besides, most serious cravings don’t last for more than a few minutes.
  • I must use when I have an urge. Obviously, this belief also belies reality. Can you imagine a world in which everyone acted on every urge and the resulting chaos that would ensue? People routinely running red lights, having sex with anyone they found attractive, eating and drinking with abandon … you get the idea. Living in a civilized society requires a reasonable amount of self-control. You have more than you think.
  • Unsatisfied urges are the worst thing anyone ever has to deal with. In reality, as hard as it is, there are many more exquisitely difficult challenges to deal with compared to holding off urges. Think about what it’s like to deal with the unexpected loss of a loved one, serious chronic pain, or the loss of a home to a natural disaster. The next time you think how horrible your urge is, consider comparing it to some of life’s truly difficult challenges.
  • The urge will never go away unless I cave into it. The urge will go away whether you cave into it or not. Next time you think an urge will never go away, try rating its severity on a scale from 1 to 10 every 30 minutes. You’re likely to see significant variability and, eventually, a big reduction if you resist it.
  • I don’t have enough willpower to deal with my urges. As discussed in Chapter 18, willpower is much like a muscle. You can gradually strengthen your reserves if you routinely work out. That means the more you successfully use your willpower, the stronger it will get.

Challenging myths about urges and rationalizations help you stand up to lapses or the inevitable temptations following a lapse. The good news is that lapses do not always lead to relapses. That doesn’t make them okay — it’s the extremely rare person who can occasionally lapse, smoke a few cigarettes once in a while, and not eventually relapse.

Remember Most people who lapse struggle with increased urges for a while. That’s how addictions work. If you’re one of those extremely rare people who can indulge now and then, you probably wouldn’t have become addicted in the first place. However, we don’t recommend giving into urges in order to determine if you’re one of those rare folks who can get away with occasional lapses.

Realizing When a Lapse Is a Relapse

Alas, sometimes, despite your best efforts, lapses, indeed, turn into relapses. You lapsed, cheated once, then started to use more — the beginning of a relapse. So, is there a way to determine whether you can quickly climb out of that emerging relapse and return to your quit plan?

We have two concepts to consider in the following sections. The first one, drifting, involves catching subtle changes in your quitting action plan. The second concept shows you how to snuff out smoke before it bursts into flames.

Drifting from a lapse into a relapse

Your personal quit plan (see Chapter 15) probably has a series of activities that you use to avoid triggers and fill up your time without smoking or using. Your plan may have included increasing healthy activities such as exercising, exploring new types of recreation, relaxing regularly, spending time with a support group (online or in person), or engaging in social activities that don’t involve smoking.

Frequently, it’s those activities designed to support change that begin to fade away before lapsing turns into a habit itself. This tendency to lose focus on activities that you put into place to help support your quit plan can be called drifting.

Drifting starts slowly. You may find looking at your quit-smoking app less interesting and start ignoring it. Or you may find more reasons not to go to the gym — like all that annoying traffic, you need the time for other things, or you just don’t feel like it.

Excuses pile up and you end up having more time on your hands. What better way to deal with that time than by smoking just for tonight? Then, tomorrow, you say yes to an invitation to happy hour, which you know will involve your former smoking friends. You’re drifting into a relapse.

Remember You can catch the lapse turning into relapse cycle if you pay attention to drifting. It’s the loss of quit-supporting activities that serves as your best warning sign. Review your quit plan regularly. Don’t forget that quitting requires vigilance for many months and sometimes years. You’ll be glad you did.

Just because there’s smoke, doesn’t always mean there’s fire

Even after months of quitting, former smokers are at risk for relapse. A brief lapse is usually what precedes a relapse. The smoker who lapses feels guilt, self-doubt, and a reduced sense of confidence. Those feelings can lead the lapsed smoker into the jaws of relapse. That happens because the smoker has the belief that he messed up and might as well forget the whole thing and go back to smoking.

Technical stuff Psychologists love coming up with names for phenomena that mean something to them, but hardly anyone else. In the addictions field, they created what they call the abstinence violation effect (AVE). What does that mean anyway? We prefer to call it the “I blew it effect.” The “I blew it effect” takes what could be a learning opportunity and turns it into a self-fulfilling prophecy; in other words, it becomes true because you think it will. A few thoughts indicative of an “I blew it effect” include the following:

  • I might as well keep on smoking because I’ve already cheated.
  • I blew it this morning, so I might as well consider this a relapse day.
  • This failure means I don’t have the willpower to quit.
  • It’s horrible to cheat; I can’t do this.

So, if you find yourself ensnared in the clutches of an “I blew it effect,” it’s important to view a lapse merely as a mistake, a mistake to be learned from. It’s not a good reason to give up. And it doesn’t mean that you’re a failure. Instead, lapses make you human. So, instead of considering a lapse an “I blew it effect,” think about it as an unwanted experience to grow from. Ask yourself the following questions if you have a lapse and begin to think of it as an “I blew it effect”:

  • What can this lapse teach me?
  • What new coping strategies can I bring into play?
  • How will I react differently if I happen to have another lapse?
  • What’s a better way to respond to the trigger that caused my lapse?

Many people fall prey to the “I blew it” effect, but few realize that it’s happening at the time. Jack’s story (see the nearby sidebar) illustrates what commonly happens and how to change an “I blew it effect” into an opportunity for strengthening resolve.

Moving on from a Relapse

The good news about starting a fresh new attempt at quitting after a relapse is that you already have skills and strategies from your previous quit attempts that you can use again. But this time, you know what worked and what didn’t. Go back to your personal quit plan and tune it up based on that knowledge.

Remember It’s totally unhelpful to dwell on your relapse. Don’t engage in self-abuse or criticism. Like millions of smokers, you had a slip-up. And like millions of smokers, you can try again. Maybe this time you’ll be successful. Meanwhile, remember that every cigarette that you didn’t smoke during the time you quit is a healthy victory.

Your odds of success do nothing but increase if you let the relapse instruct you. Table 19-1 gives you some examples of how your relapses can lead to specific changes in your personal quit plan for the next quit. Review our sample examples, and then do your own.

In the first column, jot down your best ideas for what may have caused you to relapse. Anything at all qualifies, including motivational issues, symptoms you found problematic, and triggers. In the second column, put down changes to your personal quit plan that could address these problematic issues. (See Chapter 15 for ideas to include in your plan.)

TABLE 19-1 Learning from Relapses

Reason for Relapse

Changes to Your Quit Plan

Intense restlessness, poor focus, headache from nicotine withdrawal.

Consider adding NRT or increasing your dose.

Running into unanticipated triggers and now knowing what to do.

Ask your support team for ideas about other possible triggers you haven’t thought of. Add these new triggers to your plan and come up with strategies to deal with them, such as breathing techniques, rehearsal, or avoiding them.

Talking yourself into caving in.

See Chapter 10 for examples on challenging irrational thinking.

Finding your motivation diminishing.

Conduct a cost–benefit analysis of smoking (see Chapter 8). Note the importance of the costs and the benefits more than the actual number of each. If the costs outweigh the benefits, consider beefing up your personal quit plan, especially your plan for rewarding yourself for not smoking.

Feeling overwhelmed by strong emotions like anxiety or sadness.

You may need more help from a mental health professional. See Chapter 18 for information about anxiety and depression and treatment.

Noticing a weight gain of 9 pounds in three weeks.

Review your reasons for quitting. Consider adding strategies for exercising more and gaining control over diet and eating. Appreciate that you’re in this for your long-term health, and the weight gain can be mostly a short-term issue. See Chapter 20 for ideas on controlling weight issues.

Consider this exercise as a foundational piece of your recovery. After you figure out what went wrong, consider what went right; in other words, decide what strategies you want to retain or strengthen.

Getting Some Final Tools for Battling Lapses and Relapses

Earlier in this chapter, in the “Deciding to Lapse” section, we discuss the fact that lapses (and the relapses they too often lead to) are active, conscious decisions. As much as you’d like to blame something or someone else, the ultimate responsibility of lapsing resides within you — not that we’re recommending harsh self-criticism (everyone makes mistakes), but taking ownership of mistakes gives you more control to fight off impulses.

The following questions may help you pause and make better, more rational decisions. Consider writing them on a card or in an app on your phone and carrying them around. Take a look and answer them before you decide to cheat or lapse. Again, the goal is to make your decisions more considered, conscious, and deliberative.

  • How will this decision affect me in good or bad ways?
  • If I decide to take this short-lived few minutes of pleasure, what’s the long-range future effect on my health?
  • Will this brief pleasure justify the feelings I’ll have later?
  • How will I feel about this in a few hours? Tomorrow? Next week?
  • Will this transgression interfere with my long-term life goals? If so, how?
  • How long will it take for me to feel bad about this decision if I decide to vape or smoke?

Tip The temptation of smoking is extremely difficult to resist. The war can be won, but you may lose some battles along the way. Be strong. Fight. Be smart. Win by owning your decisions. Start today!