Dear Ex Community,
Today, I would like to offer a column from the “mailbag.” Some of you asked about anger: “How can people better manage anger as a trigger? How can people better manage anger as a symptom of nicotine withdrawal?”
This is a simple question with a complex answer. I will offer my thoughts to you.
As author Liza Palmer said, “Angry is just sad’s bodyguard.” The “bodyguard of sadness” may have a variety of origins (these are not exhaustive, and you may have your own): 1) our heart is wounded; 2) our rights are violated; 3) our future is threatened; and/or 4) our performance is not accepted.
Working in addiction for 27 years, I submit that quitting tobacco embodies all these potential sources of sadness that turn into anger.
Nicotine is a neuromodulator that may have helped us cope with anxiety and low mood possibly due to past traumatic experiences. Everybody is different, but work could be done to come to terms with these experiences to better cope in the present when we feel like our heart is wounded and need to heal. Identification is the first step.
Quitting tobacco may be perceived as though our “right” to make our own choices (autonomy) is threatened by an external force, such as a health scare or risk, forcing us to give up something that we value. There are a variety of reasons that we may choose to quit, but many of us may be more at the point of seeing a real need to quit.
There is solid research that supports the notion that humans are more motivated by “loss avoidance” (tobacco) than “potential gain” (healthier lifestyle without tobacco). Therefore, there is an opportunity here for us to spend energy focusing on the gains, rather than the losses, and leaning into those.
Quitting tobacco faces us with the notion that our future is threatened when we now feel compelled to give up something that helped us cope with the present. We may ask, “How am I going to be successful in the future when I no longer have what I need today to be successful (tobacco)?”
When we feel our performance is not accepted, we may have a “shame response.” Regarding tobacco, we may now have health issues and we feel like there is nobody to blame but ourselves. If we are trying to quit tobacco, we might set expectations for the people around us that we will do this, and when we do not (relapse), we may feel a sense of failure.
All of these feelings need to find a space in which we feel through them. And then we need to take a deep breath, forgive ourselves, and move forward.
I would be remiss if I did not also mention that anger may be a symptom of tobacco withdrawal. One study suggested that we may need 2 times as much nicotine per day when quitting than we had when we were smoking.
We get about 1 mg of nicotine from a cigarette. So, for example, if we smoked a pack per day (20 mg total), then our nicotine replacement might be 40 mg per day (21 mg patch + 10 x 2 mg lozenges per day = 21 + 20 which is approximately 40 mg). But everybody is different and this needs to be individualized. Furthermore, this is the total calculated dose which does not translate easily into total nicotine exposure since users of the 2 mg nicotine lozenge do not absorb a full 2 mg out of the lozenge.
Between something happening in our world (stimulus) and the anger (response) is a space. In that space, we might find sadness and/or pain. We should be curious about ourselves and take an inventory of that space. We should not push those feelings away but acknowledge them and “feel through them” while accessing all the tools that will help us be successful, heal, and grow.
How have you chosen to deal with issues of anger in the past, and how might this detract from or enhance your path forward as you embark on a tobacco-free life?
