WHILE smoking prevalence is slowly on the decline in Ireland, there are still 15% of people smoking, most commonly in the 25-44 age bracket.
Nicotine is incredibly addictive, making smoking cessation a huge achievement for anybody who manages to quit. Even knowing the health implications, cravings are extremely challenging to overcome, as anybody who has smoked or currently smokes can attest to.
The ‘Prochaska and Declemente Stages of Change Model’ is a helpful way to understand the psychology behind giving up cigarettes, and the process you go through mentally. It’s a circular process, consisting of six stages. Each stage is something to be worked through, and in the case of relapse, you end up going full circle and back to the start of the process.
Reading through each of the stages below, whether you’re a smoker or ex-smoker, can you relate to them? Are they familiar?
1. Precontemplation — this is the time at which giving up isn’t on your radar. You may be fielding health advice from doctors, family, and friends, but you’re not ready to hear it. And until you are, that advice, while well meaning, is futile. You need to be at the next step of the process, willing to hear and consider the reasons for giving up.
2. Contemplation — here is the time that you take to consider the process of giving up cigarettes as a viable but difficult option; the health issues you’re facing because of them, the very real challenge that it will be to give them up, and the potential long term gains.
This step is different from the previous one because mentally you’re ready to hear, ready to potentially decide to make change.
But nothing has been done here yet, and in order to get the ball rolling, you need to make that decision to take the next step.
3. Preparation — at this point, you’ve the decision made to give up. But that doesn’t happen overnight successfully for the most part. Anything that you can do to support that decision is vital.
Things like removing all lighters, ash trays and spare packs of cigarettes from easy reach, or telling friends/family that you’re giving up in order to keep you accountable, or setting up a savings account to lodge the money that you would have spent. Set the date.
4. Action — there have been several steps to get to this point, but once you’ve considered the benefits and personally decided to give up cigarettes, you eventually need to make the leap.
Every day of not smoking is a step towards better health.
5. Maintenance — over time, the enthusiasm for making such a big life change can wane. Life can throw curve balls that increase stress or boredom, and draw you towards the familiar.
This step is the one that is not time limited, and stretches out for as long as you successfully refrain from smoking.
Supporting yourself by engaging with alternative ways to reduce stress, or by distracting yourself when you feel an urge to light up all, help to keep you in this phase. Leaving the guard down though will mean that you end up moving onto the next stage.
6. Relapse — The point at which you stumble during your maintenance stage, and have a cigarette.
It is possible to dip into this stage and pull yourself back again, but much easier said than done. Mentally, there can be a sense of failure, disappointment, and of throwing in the towel, which propels you very swiftly full circle, back to the first stage again of precontemplation; no longer interested in or wanting to give up.
The huge challenge associated with this model is breaking the cycle and holding yourself at maintenance. The best possible way to do this is to set yourself up with the appropriate support in the earlier stages of Preparation and Action.
Applying them to your own experience, are there typical triggers that move you from maintenance to relapse? Are you attempting to jump straight to Action without properly Contemplating or Preparing?
Nicotine Replacement Therapy is available from your pharmacy and comes in many forms (inhalers, patches, gum, etc.) You will be advised based on your own personal situation, and treatment will be tailored to the number of cigarettes you smoke per day, and when you crave your first cigarette.
If you find yourself stumbling early in the process, support like this is certainly worth considering.
Familiarising yourself with the stages of change here can be helpful in assessing where it is you’re at right now, and deciding what you need to do to progress through the stages, hopefully holding yourself at maintenance.
Nicotine is incredibly addictive, making smoking cessation a huge achievement for anybody who manages to quit.
Dr Michelle O’Driscoll is a pharmacist, researcher and founder of InTuition, a health and wellness education company. Her research lies in the area of mental health education, and through her company InTuition she delivers health promotion workshops to corporate and academic organisations nationally. See www.intuition.ie