I saw a patient last week who has been through a recent health crisis, but now is gradually improving. She had been a smoker for many years, and as her health crisis grew in its intensity, she spontaneously quit smoking. She told me that she was simply too sick to continue to use cigarettes, and so she stopped smoking over 6 months ago. She went through a long hospitalization and a long rehabilitation afterwards. But now as her health was improving, she was smoking again a few days a week. When I asked her what she was planning to do with cigarettes she simply shrugged and said she didn't know.
What puts someone at risk for relapse to smoking after such an extended period of not smoking at all? As I dug a little deeper by asking her more questions it was clear that she was having frequent and nostalgic memories of her past use of tobacco even though it had caused many health problems. Research has shown that one of the greatest risks for smoking relapse after six or more months of smoking abstinence is having frequent thoughts about the enjoyment of smoking. In the case of my patient, rather than recalling how sick she felt when she smoked several months prior, she could only recall how good smoking made her feel-- having fond recollections about smoking rather than the painful truth.
Almost all research on smoking relapse has concluded that the longer someone remains abstinent from smoking, the lower the risk of relapse. Most strong urges disappear with time, and as people develop new habits and new patterns of living, the opportunity for strong smoking triggers and cues diminishes. However, there is one thing that seems to predict relapse even after months or years of abstinence, and that is having frequent thoughts about the enjoyment of smoking. Having these thoughts seems to reduce one’s ability to manage the craving that inevitably follows such thoughts. And, of course, experimenting with having a cigarette “now and then” virtually always ends with full relapse to daily smoking.
So how do you protect yourself from a late relapse to smoking, even after many months of success? It starts with your thought life. When you become aware that “fond recall” about smoking is creeping in, counter those thoughts with others such as” not even a puff,” “never again,” “I am not going to give cigarettes that power in my life.”
Your future hinges on just a thought.
Dr. Hays
Photo by Milad Fakurian
