I met with a few patients this week who have been tobacco-free for periods ranging from 6 months to 24 months or more. However, all of these patients had experienced a lapse recently, having smoked a few cigarettes, or even a pack, due to life stressors.
Our goal for their appointment was to address the reason behind the lapse, and to come up with ways it could be avoided to prevent another such lapse in the future.
Replacing Smoking as a Coping Mechanism
A common theme among these patients is that they all had quit successfully in a number of different ways, but had not developed a contingency plan for the unexpected difficult moments that can come up, such as the loss of a loved one, a stroke, divorce, or similar catastrophe.
In short, they had not found a replacement behavior that served the same function as cigarettes so they didn’t have anything to fall back on when something difficult came up. It is hard to be in these situations without a coping skill that will work to de-stress, and serve to ground you in the moment.
Understanding Lapses vs. Relapses
When you have been tobacco-free for a while, and then go back to an instance or two of use, but are able to avoid reverting back to your normal pattern of use, it is considered simply a lapse. It is only when someone goes back to their regular pattern of smoking (i.e., the amount they smoked on a regular basis for a number of days or weeks) prior to quitting, is it considered a relapse.
This distinction is important because often when individuals experience a lapse, they treat it as though it’s a relapse and feel like they have to start all over again, which can be quite overwhelming. When you treat it as just a lapse, a ‘rock’ in your pathway that has to be removed, or a small setback, you put yourself in the mindset that it is doable to get back on track versus feeling like it’s a huge setback.
The Importance of a Backup Plan
When you move on from cigarettes, or any other tobacco product for that matter, that has acted like a “crutch” and has been “soothing” in tough moments in the past, it is equally important to replace this with something else that functions in a similar way.
When it is not replaced, it increases the risk of relapse when difficult moments come up, as there is no other coping mechanism.
When we are under stress it is easy to want to be soothed, and to forget about our long term goals. This can then leave us with a lack of motivation and strength to uphold the difficult health behavior changes we have been working on. Your immediate need to be comforted then becomes primary in your efforts to cope with the stress, rather than the seemingly less immediate concern about tomorrow and your future.
This is completely normal and everyone goes through these moments at some point. So it’s necessary to plan ahead and develop a back up plan to tackle these moments.
How do you plan on tackling these tough moments without cigarettes? What helps you cope with stress and refills your ‘bucket’ to ‘tackle’ smoking cessation again?
