Possible Withdrawal Symptoms

Possible Withdrawal Symptoms

Joel
Joined: 18 Dec 2008, 23:57

28 Aug 2003, 19:23 #1

John has a comprehensive article he wrote on the physical and emotional changes that people can experience when quitting smoking. (See http://whyquit.com/whyquit/A_Symptoms.html) I tried to copy and paste the whole article into a post on the Freedom board but it was too big. So I am going to break the article into segments and post it here. This way if anyone ever brings up symptoms we will have a string to bring up that discuss what symptoms are sometimes experienced when quitting. It is important to note though that while some symptoms can occur, it is not safe to assume that any specific symptom is just happening because you have quit smoking. I am going to attach a few comments about this after posting the original article here.


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The Effects of Nicotine Cessation



WARNING

: The below information is NOT MEDICAL ADVICE and you should IMMEDIATELY CONSULT YOUR PHYSICIAN should you experience ANY condition or symptom that causes YOU concern or alarm, including continuing depression. Although we're pretty safe in blaming withdrawal for almost all the effects we feel during the first three days, we need to pay close attention to what our body is telling us! If at all concerned, give your doctor a call! The below symptom information was complied by a nicotine cessation counselor who is not a physician. The information provided is designed to support, not replace, the relationship that exists between you and your physician. Do not rely upon any information at this site to replace individual consultations with your doctor or other qualified health care provider.


We are Nicotine Addicts! - Physical withdrawal and psychological recovery are a temporary period of adjustment during which the body and mind begin the healing process, as they learn to once again live comfortably without nicotine, and fewer and fewer thoughts of wanting to smoke occur with each passing day. It is the period when deeply ingrained psychological habits that were fathered by true chemical dependency are broken. Whether nicotine dependency was established and/or maintained by being smoked, chewed, inhaled, drank, snuffed, sprayed, swallowed, sucked, licked or patched, in the end there is only one way out - no more nicotine!

Every recovery is different! The number and intensity of effects noticed or felt during recovery varies from person to person, and even between each person's own cessation experiences. Many members at Freedom are surprised to find that they experience almost no symptoms at all while others are confronted with multiple symptoms. The number and types of particular feeding habits selected and formed by endless compliance with the mind's chemical demand for nicotine refueling also cause each person's recovery experience to be almost unique.

By understanding some of the symptoms and effects it may be possible, in some instances, to minimize their impact by thought or action. Removing the mystery associated with the sequencing and timing of withdrawal and recovery will hopefully make you feel like you have your very own roadmap to the rich sense of comfort and calmness at the other end of Freedom's Road. We didn't **** tissue destroying tar composed of over 4,000 chemicals including ammonia, formaldehyde, arsenic, butane, hydrogen cyanide, lead, mercury, vinyl chloride, methane or vast quantities of carbon monoxide into our body because we want to watch each puff destroy a bit more of our body's capacity to receive and circulate life-giving oxygen. We did so to get to the nicotine! Is it time for our self-destruction to end?

Nicotine is a colorless, odorless, poisonous, organic-based alkaloid in the same family as cocaine, morphine, quinine and strychnine. Although cocaine and heroin both produce powerfully intoxicating illegal highs, governments, experts and studies are now telling us that neither is as "addictive" as nicotine. The one year success rate for those who go through heroin withdrawal is about 20%, whereas with nicotine it's only 5 to 10%. Except for the type of high experienced and that fact that our stimulant is legal, we truly are drug addicts, just as much as the addicts that fill jails and prisons around the globe. In 1998 tobacco killed 25 times more Americans than all illegal drugs combined (418,690 to 16,926 - U.S. Center for Disease Control).

Don't Talk Yourself Into Having Symptoms - If you have a toothache at the same time you have a headache, the one that will receive the most attention and focus is the one generating the greatest pain or the most discomfort. As soon as the discomfort from your primary concern falls below that of your secondary concern, your focus will immediately change to the other. We do the same type of primary/secondary focusing with the effects of withdrawal and the phases of recovery. Sometimes we don't even notice a particular symptom until the discomfort of a prior one subsides.

Although the intensity of each remaining effect may be far less significant than the one that preceded it, the mind of the drug addict is looking for any excuse to relapse. After the dramatic reduction in overall symptoms and effects experienced within the first 72 hours, recovery remains continuous yet at times may be so gradual that - like trying to watch a rose bud open - almost becomes impossible to notice change. Yet, within just 2 to 4 months the adjustment process transports most in recovery to a point where they experience that very first day where they never once "think" to themselves, "gee, I'd sure like a smoke!" After the first such day they become more and more common. Soon, they become your new norm in life, with the distance between the occasional "thought" growing further and further apart.

Imagine entire days, weeks, months and possibly even years, where your mind never once "wants" to smoke. Imagine living in a constant state of 100% total comfort with no smoking related anxieties whatsoever - none, zero, nil, complete and total tranquility. It's where almost one billion comfortable ex-smokers reside today, none of whom where stronger than nicotine or you! Breaking free doesn't take muscle or mountains of willpower. It takes dreams and honest reasons for wanting those dreams, that are kept vivid, remembered, alive, and in the front-seat of your mind. It takes study, understanding, patience an appreciation for the true power of nicotine, and a bit of love of self or at least "like". It takes following only simple rule - just one day at a time, no nicotine in any form, Never Take Another Puff!

Upon ending my thirty-year and three pack-a-day dependency upon nicotine, my recovery evolved to the point of substantial comfort by about eight weeks, a few weeks earlier than most but later than some. During the first few weeks I worked very hard to maintain a strong positive attitude while refusing to allow negative thoughts to infect my thinking and dreams. While feeding myself large doses of positive thought I also confronted and analyzed those remaining thoughts that kept calling me back, a. Soon, it was no longer a matter of trying to believe what I was telling myself. I did believe in the new nicotine-free me!

Although a couple of times intense, I did my best to remain focused on the long overdue healing occurring inside this body. I saw each and every day as a full and complete victory in and of itself. Today I was free and today I continued to heal! The little gifts along the way - the smells, tastes, energy, extra pocket change, the whiteness emerging in the smile, pride, empty pockets, odorless fingers, hope, endurance, an ashless world, new found time, self-respect, lengthening periods of comfort, freedom and even the few extra pounds - was simply me coming home to meet me! I encourage you not to fight your recovery but to find joy in it! Welcome each crave and thought, and embrace them as a very necessary part this amazing period of adjustment. It's nice never having to quit again! Our prior attempts failed because we lacked understanding but not this time! Our eyes and minds are open and this time we're going the distance! You're going home to meet "you" again!

The problem with symptom lists, such as this, is that simply by reading them we tend to lead our minds to look for and expect symptoms to occur. In fact, mental expectations are capable of generating mental symptoms. This phenomenon - known as psychological overlay - is very real. Most starting home do NOT experience the majority of the symptoms listed below. They are shown here only to educate, allay unnecessary concerns and/or to satisfy curiosity.

Do not sell your mind on the belief that starting your new life needs to be painful or intense. If you relax, maintain a positive attitude, keep your reasons for wanting to break free in the forefront of your mind, abandon the unrealistic standard of "quitting forever" and instead focus on only the next hour, challenge or day (there is no need to see yourself eating the entire elephant when one bite at a time is plenty), drink plenty of fruit juice for the first three days to keep your blood sugar level, don't skip meals, reduce your caffeine intake by roughly half if you're a big caffeine user, this adventure toward meeting the nicotine-free and comfortable you may turn out to be the most enjoyable and deeply satisfying experience of your entire life, even if challenged now and then!

We are what we think. If you think recovery will be difficult then it why shouldn't it be? If you believe that the healing happening inside that body is utterly amazing then it is! If you keep thinking you will fail then chances are you will. If you believe that no force or circumstance on his planet can stop your quest for freedom then nothing can. Victory is in the mind.

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Joel
Joined: 18 Dec 2008, 23:57

28 Aug 2003, 19:24 #2

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Joel
Joined: 18 Dec 2008, 23:57

28 Aug 2003, 19:25 #3

The Effects of Physical Withdrawal

Anxiety, Anger, Irritability, Impatience and Restlessness,
The above are all normal temporary effects of physical withdrawal from nicotine. Our life long roller-coaster cycles of rising and falling blood nicotine levels are now ending. Our body is adjusting. If we remain 100% nicotine free for just 72 hours we'll begin to notice these effects begin to gradually diminish as our brain's neurons begin bathing in nicotine-free oxygen rich blood serum. Although our quickly healing body is now 100% nicotine free and most of the normal symptoms of adjustment have reached their peak, it will take 10 days to two weeks before our mind and body become fully accustomed to the absence of nicotine and many of the other 4,000+ chemicals present in each burning cigarette. The early healing is rapid. Deep breathing with mind relaxation, together with a bit of physical activity, can help diminish anxieties. Adjustment of caffeine intake and limiting sugars can also have a calming effect. Acidic fruit juices, like cranberry, may help accelerate extraction of the blood's remaining nicotine and decease the maximum of 72 hours required for the body to completely metabolize all nicotine.

There is a detailed cessation effects study by Marcia M. Ward, entitled "Self-reported abstinence effects in the first month after smoking cessation," published in Addictive Behaviors, 26 (2001) at pages 311-327. Its findings are fascinating. For example, it may be difficult to believe but, on average, anxieties peak on day one (within 24 hours) and within two weeks return almost to precessation levels. Regarding anxiety, be sure you understand why ex-smokers only need half the amount of caffeine as smokers (discussion link). Irritability, often anxiety's aftermath, seems to peak at about 48 hours while restlessness peaks at 72 hours. According to the study, both begin hovering back around precessation levels within two weeks.

Anger apparently peaks for the average quitter at about 48 hours (day 2) and within 72 hours is beginning to return to almost precessation levels. Find ways to vent your frustrations that won't cause needless hurt to family members, loved ones, friends or co-workers. Walk, run, vent into a pillow, find a punching bag, bend a piece of steel, or even bite your lip for the few hours (less than 72) that it will take before you begin to sense the onset of some relief. Talk about your feelings with family, friends or in your support group. Write yourself a loving letter to be read in a year from now that accurately describes what your chemical withdrawal and early psycholigical recovery experience was like and why you were more than willing to endure it. The mind does not remember pain or the bad times. In fact, you memories of "Glory Week" will rapidly fade within just a few short weeks. Give yourself the present gift of future memory. It may be just the motivation that you'll need to avoid temptation tomorrow.

Occupy your time. Try enjoying your favorite activity, sport or hobby. Celebrate each hour of freedom. Keep a positive attitude and review your reasons for beginning this journey. Clear your mind of all negative thoughts and chatter. Don't allow the seeds of false reasoning to fester and infect your logic or desire. Show yourself courage as you break free from years of slavery to the dictates of your master.
Inability to Concentrate or a Foggy Mind
The feeling that your concentration isn't as good or that your mind now lives in a fog is experienced by almost two-thirds of "starters" (recovery and starting a new life are much more positive thought than "quitting" and will be used throughout this article) to one degree or another. The return of your clearness of mind and concentration levels may seem gradual but within two weeks most begin experiencing concentration levels very close to those of neversmokers.

Poor concentration, focus and thought can also be associated with low blood sugar. It's important to understand that nicotine force fed us stored fats and sugars with each new puff. It's why so many of us could skip breakfast and/or lunch and not feel hungry. Smoking nicotine caused our brain to release adrenaline which in turn prepared us for the "fight or flight mode" by pumping stored fats and sugars into our blood stream (the bad artery clogging fats).

Once we stop putting nicotine into our body the adrenaline fat feedings end. If you continue to attempt skipping meals, your blood sugar will plummet along with your concentration. It isn't necessary to eat more food but only to spread your normal daily food intake out more evenly over your entire day. Women would be well advised to put a very small amout of fuel into their stomach about every three hours and men at least every five. During only the first 72 hours (as it can be fattening ) natural fruit juices (cranberry is excellent) will not only aid with helping stabilize blood sugar but may actually help accelerate the rate at which nicotine metabolizes just a wee bit. Here is a good discussion thread on the subject.

Even if you can't correct the entire problem by stabilizing blood sugar and you're forced to push yourself a bit more than normal in order to live up to your old expectations, concentration improvement appears to be fairly steady and relief won't be long in coming. You may also want to temporarily reduce or avoid alcohol use which reduces brain oxygen, and obviously impairs concentration. Brisk walks or other physical exercise and slow deep breathing will deliver additional focus giving oxygen to your mind. Remember, life giving oxygen is a far healthier brain stimulant than any addictive substance. Trust in you! It's only temporary.

Flash - a new medical study was released in May 2002 indicating that heavy nicotine use may actually destroy brain cells and diminish concentration and memory. Here is a BBC news link and a link to the study abstract. If true, the very temporary concentration effects associated with adjusting to the absence of nicotine might better be seen as a very welcome occurence!
Feeling Tired or Fatigued
Our body is shedding the effects of being under years of dependence upon a powerful stimulant and the process of withdrawal can be emotionally exhausting. We're also experiencing changes in our basic metabolism as our heart rate and respiration have rapidly returned to normal. It isn't unusual to feel a bit drained during the first few days but after that you should begin feeling much better with more energy than you may have felt in years!

Just as recovering from any other illness, the body and mind need time to heal. Moderate exercise can act as a natural pick-me-up and also help us sleep better. We need to allow ourselves additional rest, extended sleep or even a nap. "Glory Week" consumes tremendous energy.

It is not normal to continue feeling tired or fatigued three weeks after starting your journey and there are many potential causes ranging from improper diet, blood sugar problems, medications in need of possible adjustment after ending the use of the 4,000+ chemicals present in tobacco smoke (including nicotine), an underlying condition that was being masked and hidden by those same 4,000 chemicals, or by other coincidental conditions that just happened to occur and have nothing whatsoever to do with ending tobacco or nicotine use. Also, see depression below.
Trouble Sleeping or Insomnia
Nicotine is a powerful drug that affects subconscious thought, brain waves, the depth of sleep, and can even affect dreams. The disturbance of "normal" sleep patterns can occur during physical withdrawal or new patterns may be established as you return to your body's true level of need. You may find that you don't need nearly as much sleep as you did while smoking. Are you still tired or just sleeping less?

It's important to understand that nicotine smokers need twice the amount of caffeine in order to achieve the same effect as a non-smoker. Nicotine indirectly causes caffeine to metabolize (to be depleted) at a rate twice that of non-smokers. If you're a heavy caffeine user who attempts to continue using caffeine at the same amount as you did while using nicotine, you may find yourself not only having difficulty sleeping but probably climbing every wall in sight. Here's a Freedom message thread discussing the issue in far more depth.

Relaxation through mind clearing and slow deliberate breathing can help induce sleep. Mental relaxation can be as simple as slowly clearing your mind of all other thoughts by focusing exclusively on a single object or color. If your sleep continues to be disrupted and is affecting your health, safety or performance then turn to your physician or pharmacist for assistance. Don't allow sleep to be your mind's junkie excuse to destroy your quest to meet and become comfortable as "you" again.
Chest Tightness
Chest tightness is normal, temporary and should not last for more than a few days. Aside from arising from the tension and stress associated with early withdrawal, it can be a component of normal postpartum nicotine blues or be associated with the early cleansing, coughing and healing occurring within our lungs. Any tension or depression induced tightness or muscle stiffness may benefit form relaxation exercises, a warm shower, slow deliberate breathing or moderate exercise. Fluid or ice-water may help with minor discomfort associated with tar and mucus removal or irritation due to coughing. Keep in mind that your lungs need lots of moisture to help with healing and flushing. As a rule of thumb your fuild intake should equal a minimum of one-half your body weight in ounces daily. I now live with a glass of ice-water by my side. If we have any concerns about chest tightness, it never hurts to pick up the phone and give our doctor a call.
Slight Sore Throat
Years and years of smoking while ingesting hundreds and hundreds of chemicals (every twenty to thirty minutes) has irritated our throat, damaged or destroyed millions of cells, has deeply marinated tissues in gobs of tar, and has caused them to become numbed to the tremendous harm being inflicted. As our tissues begin to heal, they may feel temporarily irritated as the cells slowly renew, our tissues begin to breathe and natural moisture levels gradually return. Cool liquids and juices may provide a bit of soothing. Hard sugarless candy or cough-drops may also generate moisture, provide soothing or give relief from minor discomfort.
Coughing, Mucus or Nasal Drip
According to the Ward "abstinence effects: study, roughly 60% in recovery reported coughing on day two, 48% by day seven, 33% by day fourteen, and 15% by day twenty-eight. I hope that those still coughing after a month made an appointment to go for a thorough check-up! Our bronchial brushes or cilia are healing and again engaging in cleaning and clearing. Years of tar build-up is loosening itself and must either be expelled or flushed from the lungs. Mucus and coughing are common but as seen from the Ward study many in recovery often experience neither. If you do experience increased coughing that persists, it is highly advisable to see your physician for a complete checked-up as one of the earliest signs of lung cancer or disease is a chronic cough.

Clearly our lungs will benefit from extra fluids to aid with cleansing and healing. Although the 8 x 8 rule is under attack in some literature, many authorities still advocate trying to drink at least eight glasses of water daily. Try ice to sooth and moisten the mouth and possibly lemon for flavoring and a bit more valuable nicotine extracting acid. Cough syrups or decongestants can also bring some temporary relief from coughing or irritation but if your cough should persist don't hesistate to give your doctor a call. It isn't uncommon to see a smoker's lung function improve by almost a third within just 90 days. That's an amazing pace. I couldn't run 200 feet prior to quitting and truly thought I would never would again. Not too far but today these lungs can run like the wind and amazingly not be winded when I stop. I thought I'd damaged them beyond repair. I'm so glad I was wrong!
Bad breath or a nasty taste in your mouth
Not only will the terrible aroma of healing lungs as they exhale, cough and flush years of tar buildup touch your taste buds or sense of smell, our gums, cheeks and even our tobacco marinated tongue have been impregnated with years of chemical deposits. Depending on how long we smoked it could take some time for these tastes and odors to totally dissipate. Cell healing, time and fuilds will keep our lungs and tissues on the road to maximum recovery. Brushing our teeth more frequently and mouthwash should help control the odors that will continue to rise from our recovering tissues and lungs. As for your gums and possible over-brushing, it's not unusual for an ex-smoker's gums to be more prone to bleeding upon probing. Although the lungs of long term heavy smokers may take years to heal and fully cleanse, the odors and tastes will gradually improve with time.
Headaches
Changing brain oxygen and chemical levels, added anxiety or tension, possible temporary sleep disruption, increased caffeine levels, or diet changes can all result in headaches. According to the Ward "abstinence effects" study, 33% of smokers reported having headaches immediately PRIOR to quitting. Interestingly, those reporting headaches peaked on day three (72 hours) at 44%, dropped to 17% on day seven, and had declined to a low of just 11% on day fourteen.

Within eight hours of commencing recovery, carbon dioxide levels in our blood and brain return to normal but it takes time to adjust. Relaxation, slow deep breathing, extra rest, mind clearing with thought focusing exercises, a warm bath or shower, or exercise may help relieve tension and often brings relief. Aspirin or other headache relievers are available but shouldn't be taken on an empty stomach. If you are a fairly heavy caffeine drinker make sure you understand that ex-smokers only need half as much caffeine as smokers in order to get the same effect, otherwise your caffeine overdose may actually cause your headache. Here is a message board discussion covering the topic in far more detail.
Stomach Pain, Nausea, Constipation or Gas
Nausea was also examined in the Ward "abstinence effects" study. Again, although only averages, 16% of participants reported nausia on day one (as compared to 2% at precessation baseline), 11% on day three, 16% on day seven, 9% at two weeks, and 4% on day twenty-eight.

There are a host of digestive disorders, including cancers, associated with smoking. Intestinal and bowel movements can be temporarily affected while they adjust to the absence of nicotine. Stress, anxiety or postpartum nicotine depression can cause our stomach or GI area to generate pain. Tissues numbed and deadened by years of nicotine use are healing. It isn't uncommon to experience temporary pain. We can aid the healing process by drinking at least eight glasses of water each day. Increasing the amount of leafy vegetables, roughage, whole grains, bran or prunes in our diet will aid our intestines in cleansing and in moving things along. Moderate exercise may also help with circulation and movement. If symptoms persist, we need to consult our physician.
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Joel
Joined: 18 Dec 2008, 23:57

28 Aug 2003, 19:27 #4

Symptoms of Psychological Withdrawal

Cravings, Urges, Yearnings, Desires and Thoughts
The initial powerful cravings that overlay the normal 72 hours of abstinence that the body needs to purge our blood of all nicotine, are more creatures of habit than actual physical nicotine withdrawal. Our cravings are the minds psychological means of reminding us that it's time to ingest nicotine to avoid experiencing physical withdrawal (nervousness, irritability, grouchiness, tension, anger, rage, frustration, sweating, jitters, shaking, inability to concentrate and mind fog).

Like Pavlov's dogs, who he conditioned to salivate upon the ringing of a bell, the nicotine addict's mind has been conditioned to expect nicotine as soon as it begins to feel any discomfort associated with the onset of physical withdrawal. In response to falling nicotine levels, the habitual mind has been conditioned to intensify "desire" in order to cause us to ingest new nicotine and thereby avoid any discomfort. When we smoked, most of us received a gentle "desire" reminder every 20 to 30 minutes. If not satisfied, the desire would build and escalate in intensity to the point of becoming an influential urge or extremely demanding crave. Our mind has stored the means and manner by which it motivates us to ingest another hit of nicotine. Even after all nicotine has left our body (72 hours), our mind's crave generator remains in tact and fully functional.

Our Time Triggers - The foundation for our mind's knowledge of how to escalate the intensity of desire, to cause us to bring new nicotine into our body, is "time." Although the subconscious mind is believed to be incapable of independent reasoning or judgment, our conscious mind has conditioned our subconscious to realize that time depletes our blood nicotine level and that the onset of discomfort can be satisfied with nicotine. When we feel a crave begin to escalate in intensity, it is simply our subconscious turning up the volume control that it has been conditioned to believe will bring the desired result. But in that the subconscious mind is a product of conditioning and not independent reasoning, if nicotine is not ingested after desire's volume or intensity control is increased to maximum, the subconscious simply gives up and quits.

It is extremely important to understand that no single crave lasts for more than a few minutes. While occurring, it may seem like a crave lasts forever. If you think about it, the subconscious mind must make us believe that it will last indefinitely in order to successfully motivate us to ingest new nicotine. But, if you look at a clock and actually time your crave, you will quickly begin to realize that it ends within a couple of minutes - less than three! This psychological mind warfare is the downfall of many as they begin to falsely believe that the only way to end the crave is by means of another fix.
As the body's nicotine level continues to fall during the 72 hours of physical withdrawal, our mind's time trigger will continue to be revisited until all nicotine has left the body. It is then that true and complete reconditioning of our time trigger will occur as our physical symptoms begin subsiding and our mind becomes conditioned to realize that time will no longer produce new nicotine. Withdrawal's peak occurs at the 72-hour mark. The average "starter" will experience approximately six desire attacks or crave episodes on day three. By hour 96 or day four the number of attacks or episodes will diminish to about 3.5. By day ten the average number of daily craves is less than two. In that our time trigger was reconditioned upon depletion of our body's nicotine, we need to explore and understand the reason for our continuing craves.

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Overlaying our time trigger atop physical nicotine withdrawal symptoms can, for some, generate a rather intense 72-hour experience, but it's even more complex than that, as habit triggers are being encountered as well. Very few willing to attempt recovery lack the basic core dream and desire needed to carry them far enough (72-96 hours) to to begin feeling their physical symptoms begin to gradually subside or to watch the number of subconscious crave episodes become reduced by almost half.

With a little self-determination, the battle against physical nicotine addition is over in a matter of hours. It is hard to believe that drug manufactures have sold so many smokers on their "Nicotine Replacement Therapy" (NRT) gradual reduction approach, when they've done nothing more than repackage nicotine. They are telling smokers that the nicotine patch, gum, spray, inhaler, candy or pills will make them more comfortable and they are 100% correct. Nicotine addicts need nicotine to maintain comfort. The question should be, does NRT's gradual nicotine reduction approach help smokers achieve permanent long term abstinence from tobacco? Sadly, even their own studies (the results of which they hide from their public web sites and refuse to share with smokers) show that 93% of over-the-counter NRT users in medical studies - studies designed by pharmaceutical companies to test and prove the merits of their product - relapse to smoking nicotine within just six months.

Our Habit Triggers - Although our basic time trigger served as our mind's foundation for conditioning it to generate desire attacks, we have also conditioned it to expect new nicotine during certain events, at specific times each day, upon experiencing certain emotions or when we engage in specific activities. The mind is a "steal trap." You many not consciously remember what you were doing, feeling or where you were when you fed yourself nicotine in the past, but those memories have been locked away deep within your subconscious.

Each of these emotions, events, specific times or locations will trigger our mind's crave generator to begin pulsating desire when next encountered. Before total comfort can arrive, each trigger needs to be reconditioned. Again, the beauty is that our subconscious isn't capable of true reasoning and that almost all of our trigger links will be disconnected or reconditioned after just one episode where they fail to produce new nicotine. An additional comforting fact is that over time the power and intensity of our desire or crave generator will diminish to the point of becoming almost insignificant.

Almost like a battery gradually losing its charge, after about twelve weeks or 90 days our once powerful craves start becoming nothing more than ordinary "thoughts." Just like the thought of a "nice juicy steak," you will have total control over when you discard the thought. You'll often hear those in "cold turkey" recovery discuss long term "craves" (four or five months down the road) but when you quiz them about it they quickly admit that it was more like dreaming about a "Hot Fudge Sunday" and it came and went like any other normal desire. What's interesting is trying to learn what triggered the desire "thought," as it is usually some activity that was infrequently engaged in, but during which the ex-smoker had previously smoked (weddings, funerals, graduations, births, etc.).

Aside from our basic time trigger that has already been reconditioned, most of our psychological or habit triggers need to be encountered and reconditioned before total comfort begins arriving. Our psychological triggers may include such things as the habit of smoking while talking on the phone, driving a vehicle, working, upon waking, before going to bed, when leaving a store, when around other smokers, while drinking, surrounding romance, when alone, after meals, during celebrations, when sad, during stressful situations, during other specific emotions, or upon visiting specific locations (garage, porch, garden, in-laws, bathroom). You may notice a small crave spike on day seven of recovery as you celebrate your first full week of freedom. Almost all of us smoked as part celebrating. Unless you've developed an extremely healthy attitude, up until now you've probably been doing very little celebrating. When you do first celebrate, expect a visit from your joy trigger, your pride trigger and/or your party trigger.

The most serious trigger is a period of extremely "high stress" such as tremendous financial strain, serious family illness, injury, or the death of a close friend or loved one. It's a cold hard fact of life that each of us will experience the death of someone we love. We need to prepare our mind now to cope with our "high stress" trigger, as it is certain to occur for each of us. If it occurs while our desire or crave generator still carries a significant charge (the first few weeks), it can be used as your mind's unjustified excuse for relapse.

Psychological Relapse - Unlike physical withdrawal, psychological withdrawal is 100% mental and greatly within our ability to control. To understand the process can be power in itself. We also need to realize that just one puff of nicotine from one cigarette will revive all memories and conditioning associated with that particular habit trigger and commence the process of re-establishing your full chemical dependency upon nicotine. Whether immediate or gradual, your freedom is over and you're going back to your old level of nicotine intake or higher. Soon, the millions and millions of smoking memories in the recovered addict's mind will make them feel like they've never tasted freedom. Once an addict, even when we do arrest and trade places with our dependency our probation is conditioned on one simple rule - no nicotine, Never Take Another Puff!
Depression & Sadness
Depression can affect our entire being. Sadness, loneliness, disruption of sleep, fatigue, digestion problems, stomach pains, poor memory, an inability to concentrate, a loss of appetite or weight gain, neglect of our appearance, low self esteem, loss of sex drive, irritability, hopelessness, headaches or even a change in bowel habits can and often do accompany depression. Serious chronic depression is often easily treated but does require medical assistance. That being said, giving up years and years of nicotine dependence is a traumatic event, akin to the death of a close loved one, which is often accompanied by the onset of a temporary state of depression.

Although nicotine is not a close friend or loved one, it is now forever leaving our body and our mind knows that a very close bond is forever being broken. Some degree of postpartum nicotine depression is common and heavy long term smokers seem to experience it a bit more frequently. It is a death of sorts. It is like the end of a marriage or other long term relationship. It is normal to mourn the loss and go through the normal phases of grieving. This is an excellent article by Joel on the emotional loss associated with smoking cessation.

As with the end of any long term relationship, our period of cessation mourning and grieving can be as long or short as we desire. Although it can and often does generate physical symptoms, our underlying conscious thougths are very much within our ability to control. It can become the primary focus symptom once crave trigger re-conditioning diminishes in frequency to the point where you feel somewhat comfortable in managing or coping with craves. This usually happens somewhere between weeks one and three, but may not be noticed until later if any other symptom is receiving higher priority due to continuing discomfort.

The following Freedom message board thread contains an excellent summary of cessation depression issues, and a bit more on the basic difference between underlying organic depression and the emotional loss associated with cessation. In the Ward "abstinence effects" study - Addictive Behaviors, 26 (2001) Pages 311-327 - 39% of smokers entering the study reported experiencing depression on the day before quitting compared to only 19% of the non-smokers in the control group. On day three the percentage in recovery indicating depression peaked at 53%, and had fallen to 33% (6 points below baseline) by day seven and to just 20% by day twenty-eight - just one point above the non-smokers in the control group.

It was once thought that those with depression smoked in order to self medicate but new research is beginning to seriously ask, "which came first, nicotine addiction or depresssion." This thread contains two recent articles and this one discusses the need for possible medication adjustments following cessation.

Education and honesty are the fastest ways to put the postpartum nicotine blues behind us. In reality you've given up nothing of value by stopping the smoking of nicotine. If each reason for feeling a sense of loss is fully explored, we quickly realize that it was only another drug addict's excuse for justifying in our mind why it was ok to continue with our addiction. For example, many nicotine addicts have convinced themselves that tobacco makes their coffee taste better when in truth their coffee's taste won't change at all. In fact, our healed taste buds and increased sense of smell will allow us to enjoy our coffee or tea even more. The science behind why we feel that smoking helps relieve stress, when in truth is doesn't, along with numerous other false beliefs, if learned and understood will help bring an end to any sense of loss. "The truth will set us free."

It should also be mentioned that there are two non-nicotine approved anti-depression medications that, although unnecessary for success, are available by prescription and appear to aid 13% of quitters, after factoring out those within the studies who quit while wearing placebos. Wellbutrin and Zyban are both manufactured by the same company (Glaxowellcome) and contain the same active ingredient (bupropion). It is very important in using either of these drugs that you consult with your physician regarding risks, potential side effects and proper use. You may want to note that although they are identical, Zyban is being marketed to smokers while Wellbutrin is being marketed to people with depression. I mention this as almost all health insurance policies cover medications associated with the treatment of depression, while few cover products marketed for smoking cessation.
Loneliness or Feeling Cooped Up
Akin to postpartum nicotine depression, loneliness is natural anytime we leave behind a life long companion (who in this case was extremely unhealthy and killing us ever so slowly). It's time to recognize a new healing and healthy companion - YOU! We need to climb out of the deep, deep smoker's rut that we've lived in for years. For far too long we've severely limited many of the activities that as smokers we were willing to engage in either because they might have interfered with our need to obtain a nicotine fix every 20 minutes or because our lungs and body did not have the capacity to enjoy them. Start your new life now! Don't wait to gradually learn that you've been missing so much. Alter your outlook, climb from the ditch and open your eyes. One of the interesting parts of recovery is in learning to live life as an ex-smoker. If we want to stay in our rut and keep waiting for something to happen, instead of climbing and learning to enjoy all that we've been missing, we'll continue to feel lonely. If we don't replace our loneliness with the glory of our wonderful new and healthy life, we may eventually talk ourselves into returning to the world we know, our world of fix and fix after fix after fix - until death do we part.
Increased Appetite or Hunger
It's easy to attribute a new found desire to consume large quantities of food to our rapidly healing taste buds and our revived sense of smell. Truth is that many reach for extra calories almost immediately and probably for a combination of reasons. Whether using it as a hand-to-mouth oral crutch or as a replacement feeding for those now absent nicotine induced adrenaline releases that once pumped stored fats and sugars into the blood with each new puff, the net effect is the same - extra body weight. How can the weight gained during quitting be minimized?

Attempting to satisfy an urge for more nicotine with a mouth full of food may serve as a brief coping tool but be extremely careful not to allow eating to become a new habit or serious weight problem which saps your motivation to the point that a 50% chance of a very early grave looks more appealing than the extra weight. If you do find yourself using food as a temporarily early oral substitute (which is NOT recommended) reach for healthy foods like fresh vegetables.

Even if we leave extra food alone it's very common to see some initial weight gain in the first couple of days. Unless you're piling it on, it's usually extra water retention primarily associated with physiological changes. You should see water retention return to normal within two weeks. Minor metabolism changes can account for a few extra unburned calories each day but they can be more than offset by enhanced cardiovascular abilities due to an almost one-third increase in overall lung function within just 90 days and general enhanced performance of the entire body. Not smoking nicotine does not cause weight gain - eating food does!

We often smoked at the end of meals which was a signal to the brain that our meal was complete and eating over. This cue no longer exists. Its absence can lead to continued eating after our normal meal would have ended. If the left-overs keep vanishing you may need to find a new cue that your meal has ended. A toothpic, walk, immediate brushing of your teeth, a stick of sugarless gum, or even a nice big deep breath may be all it takes.

But accept early-on that should they occur, a few extra pounds are acceptable and be patient with yourself. It would take an extra 100 pounds to equal the health risks associated with a single pack of cigarettes. Is your life worth a few temporary pounds? There will be plenty of time to shed them later!


The next few minutes are all that matter and each is entirely doable. There is only one rule - no nicotine today, Never Take Another Puff!


Breathe deep, hug hard, live long,
John R. Polito Nicotine Cessation Counselor
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Joel
Joined: 18 Dec 2008, 23:57

28 Aug 2003, 19:28 #5

I normally tell people who experience wild or bizarre reactions the first few days not to be surprised or unduly alarmed, it is likely from not smoking. But at the same time they should not totally ignore certain symptoms, in case in the long shot that something else is happening just coincidently at the same time as they are quitting smoking. The symptom of muscle tightness is often felt through out the body. Back aches, neck pains such as those experienced from times of extreme stress, even leg cramps can be felt by some. Chest tightness too can be experienced. While quitting smoking is the usual reason behind the reaction, for obvious safety reasons it is prudent to get the symptoms checked with ones doctor. You just don't want to take the chance that you were the exception to the rule, that the chest pain was actually a signal of real heart trouble.

I have literally had over 4,500 people in smoking clinics over a 26 year time period and had only had two people actually have heart attacks within a week of quitting. And they were both people who were quitting because of doctors advice that a heart attack was an imminent danger because of pre-existing conditions. So while I am not trying to say that the risk of a heart attack is high from quitting, in fact your risk of heart attack decreases upon cessation and relatively quickly, there still is a risk as there is with all smokers, ex-smokers and even all never smokers. Ignoring a cardiac symptom is just an unnecessary risk that no one should take. It is better to check in with your doctor and to be safe than sorry. Doctors are often very receptive to work with a person when they are quitting for they often recognize the serious nature of the effort.

So as for symptoms, don't be surprised or alarmed by anything, but be cautious and stay aware. If you experience any symptom that would normally be a reason to get checked out immediately, follow through with the same expedience now. Life goes on without smoking and things can always happen.

Also, once over the first few days, be really cautious of blaming symptoms on smoking cessation. While some reactions can linger, especially coughing and excessive phlegm reactions, other factors can happen too, especially during cold and flu seasons. Pretty much stay aware and follow the normal precautions you followed before while smoking. Unless as a smoker you never did anything, for some smokers are intimidated to go to the doctor when having symptoms for shear embarrassment that the doctor would just chastise them for smoking and tell them to stop. Rather than putting up with the admonishments, they would ignore problems in the past.

As an ex-smoker you won't face the same complications. Again, doctors are often more prone to work with you when they see you working for yourself, and not to ignore symptoms writing them off to a normal smoker's ailments. They are often more supportive when you quit.

So to stay healthy, learn to listen to your body. Smokers are notoriously bad at this, for their body was likely telling them to quit for a long time and they ignored it. But the day the quit smoking was a good indication that they were now working with their body to maintain health. To keep a good partnership going with your doctor, other health professionals, your family, friends and your own body always remember to never take another puff!

Joel
Reply

Joel
Joined: 18 Dec 2008, 23:57

02 Sep 2003, 19:06 #6

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Joel
Joined: 18 Dec 2008, 23:57

03 Sep 2003, 05:08 #7

From: Joel Sent: 8/28/2003 6:28 AM
I normally tell people who experience wild or bizarre reactions the first few days not to be surprised or unduly alarmed, it is likely from not smoking. But at the same time they should not totally ignore certain symptoms, in case in the long shot that something else is happening just coincidently at the same time as they are quitting smoking. The symptom of muscle tightness is often felt through out the body. Back aches, neck pains such as those experienced from times of extreme stress, even leg cramps can be felt by some. Chest tightness too can be experienced. While quitting smoking is the usual reason behind the reaction, for obvious safety reasons it is prudent to get the symptoms checked with ones doctor. You just don't want to take the chance that you were the exception to the rule, that the chest pain was actually a signal of real heart trouble.

I have literally had over 4,500 people in smoking clinics over a 26 year time period and had only had two people actually have heart attacks within a week of quitting. And they were both people who were quitting because of doctors advice that a heart attack was an imminent danger because of pre-existing conditions. So while I am not trying to say that the risk of a heart attack is high from quitting, in fact your risk of heart attack decreases upon cessation and relatively quickly, there still is a risk as there is with all smokers, ex-smokers and even all never smokers. Ignoring a cardiac symptom is just an unnecessary risk that no one should take. It is better to check in with your doctor and to be safe than sorry. Doctors are often very receptive to work with a person when they are quitting for they often recognize the serious nature of the effort.

So as for symptoms, don't be surprised or alarmed by anything, but be cautious and stay aware. If you experience any symptom that would normally be a reason to get checked out immediately, follow through with the same expedience now. Life goes on without smoking and things can always happen.

Also, once over the first few days, be really cautious of blaming symptoms on smoking cessation. While some reactions can linger, especially coughing and excessive phlegm reactions, other factors can happen too, especially during cold and flu seasons. Pretty much stay aware and follow the normal precautions you followed before while smoking. Unless as a smoker you never did anything, for some smokers are intimidated to go to the doctor when having symptoms for shear embarrassment that the doctor would just chastise them for smoking and tell them to stop. Rather than putting up with the admonishments, they would ignore problems in the past.

As an ex-smoker you won't face the same complications. Again, doctors are often more prone to work with you when they see you working for yourself, and not to ignore symptoms writing them off to a normal smoker's ailments. They are often more supportive when you quit.

So to stay healthy, learn to listen to your body. Smokers are notoriously bad at this, for their body was likely telling them to quit for a long time and they ignored it. But the day the quit smoking was a good indication that they were now working with their body to maintain health. To keep a good partnership going with your doctor, other health professionals, your family, friends and your own body always remember to never take another puff!

Joel
Reply

Joel
Joined: 18 Dec 2008, 23:57

10 Sep 2003, 18:57 #8

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Joel
Joined: 18 Dec 2008, 23:57

23 Sep 2003, 07:16 #9

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Joel
Joined: 18 Dec 2008, 23:57

24 Sep 2003, 21:55 #10

I normally tell people who experience wild or bizarre reactions the first few days not to be surprised or unduly alarmed, it is likely from not smoking. But at the same time they should not totally ignore certain symptoms, in case in the long shot that something else is happening just coincidently at the same time as they are quitting smoking. The symptom of muscle tightness is often felt through out the body. Back aches, neck pains such as those experienced from times of extreme stress, even leg cramps can be felt by some. Chest tightness too can be experienced. While quitting smoking is the usual reason behind the reaction, for obvious safety reasons it is prudent to get the symptoms checked with ones doctor. You just don't want to take the chance that you were the exception to the rule, that the chest pain was actually a signal of real heart trouble.

I have literally had over 4,500 people in smoking clinics over a 26 year time period and had only had two people actually have heart attacks within a week of quitting. And they were both people who were quitting because of doctors advice that a heart attack was an imminent danger because of pre-existing conditions. So while I am not trying to say that the risk of a heart attack is high from quitting, in fact your risk of heart attack decreases upon cessation and relatively quickly, there still is a risk as there is with all smokers, ex-smokers and even all never smokers. Ignoring a cardiac symptom is just an unnecessary risk that no one should take. It is better to check in with your doctor and to be safe than sorry. Doctors are often very receptive to work with a person when they are quitting for they often recognize the serious nature of the effort.

So as for symptoms, don't be surprised or alarmed by anything, but be cautious and stay aware. If you experience any symptom that would normally be a reason to get checked out immediately, follow through with the same expedience now. Life goes on without smoking and things can always happen.

Also, once over the first few days, be really cautious of blaming symptoms on smoking cessation. While some reactions can linger, especially coughing and excessive phlegm reactions, other factors can happen too, especially during cold and flu seasons. Pretty much stay aware and follow the normal precautions you followed before while smoking. Unless as a smoker you never did anything, for some smokers are intimidated to go to the doctor when having symptoms for shear embarrassment that the doctor would just chastise them for smoking and tell them to stop. Rather than putting up with the admonishments, they would ignore problems in the past.

As an ex-smoker you won't face the same complications. Again, doctors are often more prone to work with you when they see you working for yourself, and not to ignore symptoms writing them off to a normal smoker's ailments. They are often more supportive when you quit.

So to stay healthy, learn to listen to your body. Smokers are notoriously bad at this, for their body was likely telling them to quit for a long time and they ignored it. But the day the quit smoking was a good indication that they were now working with their body to maintain health. To keep a good partnership going with your doctor, other health professionals, your family, friends and your own body always remember to never take another puff!

Joel
Reply