Seven Steps To A Smoke-Free Life Provide Road Map To Those Who Want To Quit

July 30, 1998

Prior to the first Surgeon General's Report on Cigarette Smoking in 1964, about half of all American adults lit up. That number has declined over the last 30 years, but about one in four adults still smoke. Many of them would like to quit, so the American Lung Association and a Washington University in St. Louis researcher have written a book to help them.

Called "7 Steps to a Smoke-Free Life," the book, published in May 1998, is based on the American Lung Association's award-winning "Freedom from Smoking" program. Both the book and the program are designed to help smokers better understand their addiction and prepare to quit.

"The more you identify the reasons why you smoke and the reasons you want to quit, the more likely you'll be successful," says Washington University's Edwin B. Fisher Jr., Ph.D. Fisher is a professor of psychology in Arts and Sciences and of medicine and pediatrics and director of the university's School of Medicine's Division of Health Behavior Research.

Most Fail At First

According to the Lung Association, an estimated 46 million Americans smoke cigarettes and more than two thirds -- 32 million -- would like to stop. Each year, 34 percent of smokers actually try to quit. Most fail, at least at first. In the book, Fisher draws on his own experience as a smoker who once faced the prospect of attempting to quit. As a former nicotine addict, he can empathize with those trying to quit now.

"It's a bit like learning to ride a bike. Falling and skinning your knees is often part of the process. When working with smokers, I never say 'it's just a matter of making up your mind to quit,'" he says. "I know that quitting smoking is very hard. It took me 10 or 12 attempts before I succeeded."

Although much new research has been published since Fisher gave up smoking 20 years ago, he says he used many of the strategies outlined in the new book. It's very important, he says, to set a quit date, identify the environmental cues that make you want to smoke, tell friends that it's time to quit and stay upbeat even if the first few attempts fail.

The seven steps form a road map for smokers who want to quit, but not every cessation technique fits every would-be nonsmoker. Fisher says nicotine patches, inhalers, books, videos and group meetings can be helpful, but tools must be tailored to individual needs. These tools fit into the broader framework described by the seven steps:

  1. Recognize your habit and your addiction -- Every smoker has two basic reasons for smoking: nicotine addiction and pleasure. And after smoking has become a habit, it becomes automatic. Simply paying more attention to when you smoke and what makes you light up can teach you a good deal about why you smoke and help you develop strategies for quitting.
  2. Build your motivation to quit -- List the pros and cons of smoking and quitting, thinking about health concerns, social pressures to quit and life events that will encourage you to stop. Then write down your top five reasons for quitting.
  3. Develop a quitting plan -- Would you rather go it alone or with a group? Would quitting cold turkey be preferable to gradually reducing your nicotine intake? Do you want to use medications to boost your efforts?
  4. Set a quit date -- This gives you time to circle a date on the calendar, plan to avoid certain smoking cues and enlist the support of family and friends.
  5. Quit -- Get rid of all of the cigarettes, ashtrays, matches and lighters in the house. Keep your top five quitting reasons with you and refer to it when you crave a cigarette.
  6. Maintain your program for the first two weeks -- The cravings will subside, and you will begin to feel better in a few days, though irritability, nervousness, sleep problems, difficulty concentrating and coughing may last for a few weeks.
  7. Survive the first six months -- The physical addiction subsides after a week or two, but psychological cues can still give you the urge to light up.

"The first six months after quitting smoking are the most difficult," Fisher says. "A person not only has to contend with constant urges to smoke, but also with stressors like putting on weight or bad moods and frustrations that can prompt a relapse. But the person can focus on the tremendous health benefits of not smoking. They'll feel better, have more energy and live longer. And they can always lose the pounds they gain and learn better ways of preventing and dealing with bad moods than puffing on cigarettes."

Why People Smoke

The book lists several mind-numbing statistics about smoking that many people don't consider when they light up. For example, smoking is the greatest source of preventable death in our society.

Smokers die an average of six to eight years earlier than nonsmokers. Eighty-seven percent of all lung cancers are caused by smoking. Every year, more Americans die from smoking-related diseases than from AIDS, drug abuse, car accidents and homicide -- combined.

Payoffs Within Hours Of Quitting

But many who quit simply for the health benefits become discouraged if they don't see the advantages of not smoking in their daily lives. Fisher therefore offers suggestions on how to find the payoffs of smoking cessation within hours of quitting.

Though smokers are at very high risk for cancer, heart disease and emphysema, the risks for heart disease decline within hours of the last cigarette. When smokers quit, their blood can carry more oxygen to the rest of the body, so the heart doesn't have to work as hard. That is significant because smoking kills more people from heart disease than from cancer. And the further away people get from that last cigarette, the nearer their other risks return to those of nonsmokers -- after 10 years, the lung cancer risk for ex-smokers is as low as that for those who never smoked.

Other health benefits allow former smokers to exercise harder and for longer periods of time just a few days or weeks after quitting. And there are obvious economic benefits. At a couple of dollars a pack, smokers can save hundreds of dollars annually by quitting. Plus, with smoking limited in most public buildings, smokers can use the regulations to help them quit.

"The funny thing about quitting," Fisher adds, "is that if you really know why you want to quit, then the rules and regulations that used to bug you will become your assistants. Rather than feeling hassled to do something you know you should do, you'll realize that the rules and regulations support what you have chosen to do for yourself."
Note: For more information, see Fisher, E.B., with Goldfarb, T.L, 7 Steps to a Smoke-Free Life, Jon Wiley and Sons, May 1998.

Washington University in St. Louis

Related Heart Disease Articles from Brightsurf:

Cellular pathway of genetic heart disease similar to neurodegenerative disease
Research on a genetic heart disease has uncovered a new and unexpected mechanism for heart failure.

Mechanism linking gum disease to heart disease, other inflammatory conditions discovered
The link between periodontal (gum) disease and other inflammatory conditions such as heart disease and diabetes has long been established, but the mechanism behind that association has, until now, remained a mystery.

New 'atlas' of human heart cells first step toward precision treatments for heart disease
Scientists have for the first time documented all of the different cell types and genes expressed in the healthy human heart, in research published in the journal Nature.

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.

Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.

Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.

Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.

New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.

Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.

Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.

Read More: Heart Disease News and Heart Disease Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to