Today- 31st May is World No Tobacco Day, so we’ve interview Dr Stan Steindl about how a Psychologist may help you give the habit up for good!
1. Generally speaking, how can a Psychologist help a person quit smoking?
Psychologists can sometimes help at three critical stages when a person starts to consider giving up smoking.
First, finding the motivation to quit can be a challenge. A psychologist can help a person to consider what the major motivating factors are for them. Exploring what the person would like to change, why they’d like to change and what makes it important can help create the motivation and willingness to commit to change.
Second, a psychologist can help in the planning and action phase. A discussion around how to make the change, action planning and then confidence building can all help the person take that next step.
Finally, like all behaviour change, relapse is a real consideration. A psychologist can help with relapse prevention, which often involves identifying situations that might trigger relapse and planning ahead to cope better or differently with those situations. Importantly, a person trying to quit smoking has to manage their reaction to any lapses. For example, the Abstinence Violation Effect relates to a person’s feeling of failure and resignation that can come from a lapse, and managing that is an important part of staying on track with quitting.
2. What are some different approaches to quitting smoking that have proven successful with your clients?
The most successful clients seem to be those who have a combination of a medical managed approach and a behavioural approach. For example, nicotine replacement therapy (NRT) and psychological therapy often work well in combination. The NRT helps the person to gradually reduce the nicotine in their body over several days, and the psychological therapy helps develop coping strategies. A vital contribution of psychological therapy relates to the fact that smoking often provides a function for the person, for example, managing stress. If they try to give up without having an alternative method of managing stress, then the chance of relapse is much greater. A psychologist can help the person identify those functions of smoking and develop alternatives.
3. What are some common reasons for relapse once a smoker has quit?
People often have their own unique risk factors for relapse, and identifying them early and planning ahead is the key. For some, it is emotional factors such as stress or anxiety, or even boredom. For others it is social situations and pressures, such as living with a partner who smokes. And for others, simple opportunity and access can be a critical factor. I have often heard people say they thought they could ‘just have one’, and this can put people at a major risk of relapse just by itself.
4. Are there ways to combat a relapse or some self help methods to prevent this from happening?
Effective, evidence-based approaches to combating relapse have been available since the mid-1980s. “Relapse Prevention” is a body of work that covers how people can identify triggers, plan ahead for them, and manage relapses when they occur. More recently, the Relapse Prevention approach has been coupled with mindfulness-based strategies, which are all about dealing with being on autopilot. It seems that being on autopilot and reacting to urges and cravings without thinking is a major risk for relapse, and mindfulness strategies helps the person to be aware of urges and then have the presence of mind to consider what’s important to them and respond accordingly.
5. Is relapse related to the number of years the person has been smoking? (ie- how bad the addiction is)
The severity of nicotine dependence can influence how difficult it is for a person to quit smoking. This does not necessarily just include how long they have been smoking, but also how much they are smoking and how early in the day they have their first cigarette. No matter how long the person has smoked for, and how much they have smoked, it is never too late to quit.
On the flip-side, and although there is no hard and fast rules about this, often time passing of no smoking after quitting does reduce the risk of relapse. In fact, there does seem to be something about the passing of 9 to 12 months that starts to reduce the risk of relapse significantly.
6. Is cigarette addition harder to ‘cure’ in those who have drug and alcohol addiction/substance abuse?
Quitting smoking is a difficult task, and it can be made more difficult when other factors are in the mix of a person’s life. Certainly, if a person is misusing alcohol or other drugs, then quitting smoking can be more difficult. Sometimes a person may wish to prioritise what changes they might make first, and this may or may not be smoking. Other factors might include mental health issues, chronic disease issues, and general life stressors. Where a person is facing multiple challenges with quitting, a psychologist may be of particular assistance in helping them cope.
7. What are five things a smoker should consider when they decide they want to quit?
1. What would YOU like to do about your smoking? What is your preference? How would you like your life to be?
2. What are your personal reasons for quitting smoking? How would things be better as a non smoker? How might things be worse if you continue smoking?
3. What makes quitting smoking important for you? How does smoking really fit with who you want to be? Putting aside what others say, what is the clincher for you?
4. If you were to make such a change, how would you go about it? What might work for you? What sorts of things need to be addressed to up your chances of success?
5. What will you do? What is going to be your next step?