Stage Three: Preparing to Be Tobacco-Free

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You've considered the benefits of quitting and how it can make a difference in the way you feel. You've pictured yourself being successful. Now it's time to learn and practice skills to help you stick with your goals of not using tobacco.

Making the Most of Your Decision to Quit
This information will help you learn and practice the skills you need to quit for good. It's an easy-to-use guide to a lifetime of being tobacco free. As you work your way through the activities, keep these points in mind:

• Breaking habits takes time. For a health behavior to become routine, you must practice it regularly over time.
• Breaking habits requires support. It's not impossible to quit using tobacco without help from others, but it's much easier if you have the support of family and friends.
• A slip is just a slip. You're striving for long-term success, so focus on your overall patterns and don't dwell on occasional slips.

3 Keys to Success
You'll benefit most if you commit to:

• Print this information and keep it where you'll see it every day for the next 30 days
• Complete each activity
• Review your personal action plan and record your progress daily

Advantages of Being Tobacco Free
Your decision to quit using tobacco could be one of the most important you'll ever make for your future health and well-being. Some benefits of a tobacco-free lifestyle include:

• Feeling better about yourself and becoming a role model for family and friends
• More stamina for work and play
• Whiter teeth and fresher breath
• Cleaner-smelling clothes, furniture, and car
• Decreasing risk of serious illnesses
• Freedom from the restrictions of smoking
• Saving money.

With any behavior change, however, there are adjustments to make in your normal routine. Some are easy, while others may be more challenging. To help prepare for these adjustments, complete the following statements:

• I expect to benefit from being tobacco free in the following ways:

• I expect to make the following changes to quit:

Now, read on to learn more about breaking the habit.

Quitting Makes a Difference in How You Feel
There's good news about stopping, it's never too late. Quitting tobacco has major, immediate health benefits for people of any age. The most important is ridding your body of a harmful addiction. You'll also notice these physical changes:

• Improvements in your senses of smell and taste
• Gradual disappearance of smoker's cough
• More energy.

Quitting tobacco isn't easy. Health experts suggest you:

• Talk to your doctor
• Make a plan
• Set a quit date and gradually phase out tobacco
• Get support from family and friends
• Eat healthy and exercise frequently
• Cut back on alcohol and caffeine
• Reward yourself for reaching goals.

In organizing your strategy for quitting, talk with your doctor and explore tobacco cessation programs in your community. Also review the self-help materials available from the American Lung Association, American Cancer Society, and your local library.

Countdown to Quitting Smoking
What you do in the weeks and days preceding your official quit date is critical to your success. Use some of these strategies to increase the likelihood of sticking to your plan:

• Change your routine
• Begin exercising or start a new activity
• Make healthy food choices
• Reduce or avoid alcohol
• Identify strategies for lowering your stress
• Build a survival kit (sugarless gum/candy, supporters' phone numbers, healthy snacks, relaxing music, etc.)
• Make tobacco use inconvenient
• Clean your ashtray after each use
• Keep track of tobacco use
• Decrease the number of cigarettes you smoke each day as you move closer to your quit date
• Wait 5 minutes before lighting up
• Switch to a brand you find distasteful
• Read about quitting
• Talk with friends and family members who have successfully quit
• Sit in the nonsmoking section of restaurants
• Avoid situations you link with tobacco use
• Discuss quitting aids such as nicotine replacement with your doctor
• Postpone lighting your first cigarette of the day by 1 hour.

What Time of Day Is Best for You?
Quitting won't be easy because cigarettes, chewing tobacco, and snuff contain nicotine — a highly addictive substance. Fortunately, there are more products available than ever before to help you succeed. Most aids work by reducing withdrawal symptoms (insomnia, anger, anxiety, depression, frustration, or lack of concentration) to help relieve your craving.

In most cases, both prescription and over-the-counter aids provide an alternative source of nicotine that lessens gradually. These include:

• Nicotine nasal spray (prescription only)
  • Can cause watery eyes and nose
  • Used at the beginning of an urge to smoke
  • Absorbed quickly to suppress cravings faster.
• Nicotine patch (over the counter or prescription)
  • New patch worn daily
  • Releases steady dose of nicotine absorbed by the skin
  • May cause minor skin irritation.
• Nicotine gum (over the counter)
  • Used whenever you have the craving
  • Absorbed by the lining of your cheek
  • 10-12 pieces a day initially.
• Zyban (non-nicotine medication; prescription only)
  • Used 1 week before quit date
  • Believed to increase dopamine, a chemical that gives a feeling of pleasure similar to that produced by nicotine.

None of these products has been proven more effective than the others in helping people quit. However, studies show that all double your chances of success.

Your doctor is the best resource for helping you decide which may work for you.

Putting Your Plan in Motion
Now it's time to make your commitment to stop. In a moment you'll write specific goals. But first take these small but very important steps toward commitment.

1. Set a quit date. Your decision to stop is a journey. And like every journey it starts at a single point in time. Select a date in the next 30 days to quit. Birthdays, anniversaries, holidays, the new year, a significant day at work or school … all are good. If you're truly ready, pick a day soon, to take advantage of the momentum from your decision. Use the space on your personal action plan to record your quit date and your reason for choosing it.

2. Tell everyone you know. If you're truly committed, you're ready to go public. And while it can cause some anxiety, it shows you're confident about your plan. Telling the world also reinforces your commitment to yourself. And those who care about you can be a great source of encouragement and support. Use your personal action plan to record the names of all you'll tell. Then place a check mark by their name after they know about your plan.

3. Establish priorities. Let's face it, this isn't easy, or you would have quit long ago. But you've decided quitting is important to you. Now you need to give it the time and attention this deserves. That may mean stopping some things you're doing or putting them off until the urge to use tobacco goes away.

4. Choose an option. There is no one best way to quit. Some smokers stop on their own, others want a proven program. Finding something that will work for you is the most critical factor. Some of the options include:
   • Self-help materials, Books, videos, work guides (like this one)
   • Group programs, Sessions that offer a structured/supportive environment
   • Stop-smoking aids, Nicotine sprays, patches, gum, medication
   • Alternative approaches, Hypnosis and acupuncture.

There are many factors to consider when deciding which options are best for you, cost, confidentiality, flexibility, support, and overall success rates. Again, be sure to talk with your doctor about the most appropriate tools to help you quit.

SMART Goals to Stay on Course
A map of where you want to go is the only way to ensure you'll get there. Well written goals are your map to success for personal objectives like continuing to not smoke. But a goal is just a wish if it isn't SMART:

Specific. Be precise. Write down exactly what you expect to achieve.

Measurable. Include amounts, times, days, and other milestones for gauging success.

Achievable. Set your sights on an attainable goal, yet one that causes you to stretch, to go beyond what you're doing today.

Relevant. Although it's nice for your spouse, kids, boss, parents, and friends to want you to be successful, your goal should matter to you, first and foremost.

Trackable. Successful behavior change doesn't happen in a fell swoop — it takes time. Record your progress over days or weeks to see how much you've achieved.

Some examples of SMART goals:

• "Beginning Monday, April 6, I will have at least 4 fewer cigarettes each day."

• "I will go to the gym instead of happy hour 2 times a week."

Record 2-3 SMART goals — your map to success for the week.

And in This Corner…
Supportive relationships are important in every stage of the behavior change process. Seek someone to be in your corner, a nonjudgmental, positive-minded believer in you. Someone working toward similar goals can provide great support, too. Once you've identified friends or family members to support you, list 2 or more things they can do to help.

Working Through Withdrawal
For many people, the hardest part of quitting is withdrawal symptoms. Be alert to symptoms and plan ways to manage them.

• Coughing: Suck on cough drops or sugarless hard candy; try warm herbal tea.
• Sleep problems: Use relaxation techniques such as deep breathing or meditation. Avoid caffeine within six hours of bedtime.
• Headaches: Try a warm bath or shower as well as relaxation techniques.

• Irritability or tenseness: Soak in a hot bath, practice relaxation techniques, and exercise.
• Hunger: Drink lost of water or low-calorie liquids (but limit caffeinated beverages) and snack on vegetables and fruit.
• Dry mouth; sore gums, tongue or throat: Sip ice water or cold fruit juice; chew gum.
• Irregularity: Add fiber to your diet: fruits, vegetables, whole grains; and drink plenty of water (aim for eight glasses a day).

25 Ways to Control Tobacco Craving

1. Take a warm shower or bath
2. Go for a walk
3. Drink a glass of water or milk
4. Call/visit a friend or family member
5. Take a nap
6. Exercise
7. Chew sugarless gum
8. Munch on a carrot or celery stick
9. Puff on a straw or cinnamon stick
10. Take a relaxation break
11. Keep your hands busy (rubber bands, paper clips, a smooth stone)
12. Brush your teeth
13. Go shopping
14. Write a letter
15. Listen to music
16. Schedule meetings or activities when you know your urge to smoke is greatest
17. Find something to make you laugh (movie, comics, joke book, etc.)
18. Prepare a low-fat meal
19. Go to a concert or play
20. Try a new hobby (painting, dancing, sports, etc.)
21. Repeat positive affirmations
22. Read a book or the newspaper
23. Play with your children or grandchildren
24. Mow the lawn or wash the car
25. Go for a drive (unless you typically use tobacco while driving).

Print out the Take-Action Forms Personal Action Plan to create your strategy for success and Controlling Cravings to set goals and record strategies for controlling your cravings.

When you complete the activities in this stage, continue on to Stage Four: Feeling Good About Not Using Tobacco.