In 1996, the US Department of Health and Human Service, Agency for Health Care Policy and Research, published the Smoking Cessation Clinical Practice Guideline No. 18. The guideline, Treating Tobacco Use and Dependence, was updated in 2008. The smoking cessation program and treatments at Memorial Sloan-Kettering Cancer Center follow the latest proven advances in tobacco use, cessation, and maintenance.
When you come in for an appointment, we will work with you to determine the best way for you to manage cravings, minimize withdrawal symptoms, and understand your personal smoking triggers. In addition, we can teach you effective stress management techniques and help you to develop effective coping skills, including skills to help you remain smoke-free even if you are around other smokers at home, work, or in social settings.
Check out Nicotine Replacement and Other Pharmacological Therapies or take a look at the following behavioral techniques that may be of help to you. Note: While this information is not a substitute for personalized counseling, it will give you an idea of the range of resources and strategies we'll use to help you successfully quit smoking.
Self-Monitoring
Self-monitoring requires the smoker to begin a “diary,” or record of the number of cigarettes smoked at the beginning of the treatment, which he or she will continue to keep over a period of a week or more. In addition, the time, place, activity, mood, and level of desire for the cigarette may be part of the record. Self-monitoring can itself change the smoking rate, particularly among smokers motivated to reduce or stop smoking.
Self-monitoring works by:
- Increasing awareness of smoking behavior and associated patterns so that we can tailor treatment, for example, by identifying high-risk situations (such as social events, times of high stress, while driving, etc.) for relapse
- Providing a baseline against which to measure change
Scheduled Reduced Smoking
Scheduled reduced smoking is a technique in which the smoker follows a schedule, gradually reducing smoking by increasing the time between cigarettes smoked, until only a few are smoked per day. Once the schedule includes only a few cigarettes, a nicotine replacement therapy, such as the nicotine patch, inhaler, or gum, is often added to the treatment. Research has shown this approach to be more effective than quitting “cold turkey,” or just gradually tapering off the number of cigarettes smoked.
Scheduled reduced smoking works by:
- Weakening the link between urges to smoke and lighting up
- Increasing confidence in the ability to quit
- Providing opportunities to practice coping strategies between scheduled cigarettes
- Reducing nicotine withdrawal symptoms and accompanying distress.
Deep Relaxation Training
The stress response is both psychological and physical, and for many people it triggers the desire to smoke. Learning and practicing deep relaxation techniques is one way to reduce feelings of stress. These techniques go beyond other ways to wind down, such as watching television or taking a long soak in the bathtub. While these activities are without doubt relaxing, “deep relaxation” is the most effective in managing the stress response. Deep relaxation results in decreased heart and respiration rates, blood pressure, and muscle tension. With continued practice, deep relaxation can improve your sense of well-being and ability to cope with life stressors.
There are many healthy ways to accomplish relaxation. Deep abdominal breathing, progressive or passive relaxation, meditation, guided imagery, and self-hypnosis are examples of the techniques we can help you to incorporate into your daily life.
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