For many smokers, the decision to quit involves overcoming enslavement to the familiar to risk change. Making this decision has been described as finding "a clear, unified motivation... to replace the old with a better, new way of life." Reaching a "decision to quit" is a pivotal moment, activating smokers to marshal the physical and emotional resources they need to tackle the task itself: quitting for good.
Changing an ingrained behavior like smoking is never just about adapting to a physical change. First, smokers who get serious about quitting "get honest" about excuses they've been using for smoking: stress, frustration or boredom to name just a few. In fact, almost anything will do as an excuse to smoke! Not surprisingly, when they make their decision to quit, they stop looking for excuses, and in the process they stop finding them!
A second feature of the decision to quit comes in dealing with vagueness smokers have about their addiction and its consequences. Sometimes called "denial" or "disconnection," it is the phenomenon of "half-knowing," which means knowing something underneath, but not being willing to admit it fully into awareness. A genuine decision to quit calls for a shift into a new relationship with the hard-edged reality of smoking. At this time of year winter blues and holiday stress, as well as holiday hype and disappointments, provide plenty of triggers for smoking addiction to feed upon. Facing painful realities behind the distraction smoking provides turns out to be the highest hurdle for many smokers.
Finally, making the decision to quit inspires self-reflection and self-exploration. It draws on deep mental and emotional currents which form the root understanding of a person's commitment to change. Once the motivation and commitment to quit are revved up, changing rote smoking behaviors and using medicines such as nicotine replacement therapy (NRT) reinforce and support the emotional commitment to make this change.
From Smokefree in 30 Days, page 27:
Thomas could come up with all kinds of creative rationalizations for smoking on the one hand, but on the other hand he also felt like a "humiliated slave" to his addiction, and so his mind raged back and forth in a kind of civil war. Trying to quit, and asking for outside help to do it, meant waving the white flag on the battlefield, giving up his wish to control his addiction. He realized he had to get honest with himself. When he finally did quit, he said it was honesty, an unflinching willingness to pick apart his numerous excuses to smoke, that made it possible to stay completely smoke-free.
When I work with people who want to quit smoking, I can see a physical change in their demeanor when they make their decision to go smoke-free for good. They may still need NRT as many do. They may still need to work on their automated behavior patterns and emotional or situational triggers to stay on track. It is the decision to quit itself, however, that sustains them in their efforts to free themselves from dependency on smoking. This turning around in the center of the self has been described as an awakening self-love and self-preservation, which allows the smoker to discover a new way of life without smoking.
 Douglas, Donald. "Stopping Smoking: A study on the Nature of Resistance and Use of Hypnosis." In Helping The Hard-Core Smoker, A Clinician's Guide. Seidman, D. and Covey, L., eds. Lawrence Erlbaum Associates, 1999.
 Seidman, Daniel. Smoke-free in 30 Days Simon & Schuster, 2010. Chapter 2.
Dr. Daniel Seidman is director of smoking cessation services at Columbia University Medical Center, and author of Smoke-Free in 30 Days: The Pain-Free, Permanent Way to Quit, with a foreward by Dr. Mehmet Oz (Simon & Schuster 2010). For more details about the book, go to www.danielfseidman.com.
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