- Dr. Ray Baker

If you are a member of that shrinking visible minority, smokers, and you are sick and tired of feeling defensive and guilty, take heart. This is a great time to quit! With the stress and overindulgence of the holiday season finally over, you can harness those feelings of guilt to make the New Year a time to start fresh, to invest in a longer, healthier life. Here are some proven suggestions to improve your chances of success.

The greatest cause of relapse is inadequate preparation. By committing to a definite quit date, and preparing for that deadline you are more likely to follow through. So how should you prepare?

Many smokers are planning to quit in the near future but feel ambivalent. They are struggling with the discomfort of knowing the bad things about smoking, but are not yet ready to give up their relationship with tobacco or the comforting rituals of handling and putting something in their mouths. Here is some homework that might help. Make a couple of lists. Write down all the negatives of smoking and beside it make another list of all the benefits or positives you can think of. Only if you can convince yourself that the consequences outweigh the benefits will you have the motivation to do it right. Next make another double list, this time outlining the pros and cons of quitting.

While you are preparing to quit, keep track of your smoking: when do you light up? What's going on and how are you feeling at the time? This will help you choose other ways to handle those times and feelings. It will also flag some situations you might want to avoid early on.

It helps to have a support group. Find a buddy or two to join you in quitting so you can encourage each other. Don't keep your plan secret. Tell friends, family and workmates. (It makes it easier to apologize later for being grumpy.) Your family physician can be helpful for advice on health benefits and the choice of medications, such as the patch, gum or bupropion, the new pill. Combining medication with counselling and social support results in the highest success rates. As the date approaches, get rid of ashtrays, lighters and any hidden stashes of tobacco. Consider getting the upholstery in the house and car shampooed.

For a few days you will likely feel irritable, sleepy, have poor concentration and you might crave sweets. Plan on drinking plenty of low-calorie fluids (avoid alcohol for a while) and keep your fridge filled with sliced vegetables and fresh fruit. Start a gradual aerobic exercise program. It will improve your emotional state, burn off irritable energy and take away some of the craving while combating the weight gain. Although weight gain will be minimized for those prescribed bupropion, dieting during the initial stages of quitting is not a good idea as it has been shown to increase the risk of relapse.

Within 24 hours of quitting you may pat yourself on the back because although you don't yet feel terrific, you have already decreased your risk of heart attack. Other health risks will also decline with time. The subtle changes in the neurochemistry of the brain of a smoker gradually normalize with time but the danger of relapse from indulging in just one tiny puff is always there.

Come on, take the plunge, join us ex-smokers so that you can look forward to a longer healthier, happier life.

Congratulations in preparing for the most important health decision any smoker could possibly make!

Dr. Ray Baker is Assistant Clinical Professor in the Faculty of Medicine at the University of British Columbia. He has been awarded fellowships in both Family Medicine and Addiction Medicine. He has been a practicing physician for over 23 years. From 1993 to 1997 he represented Canada on the Board of Directors of the American Society of Addiction Medicine, North America's credentialing body in this specialized area of medicine. His area of special clinical expertise is in assessment and treatment planning of the worker disabled by one of the "invisible disabilities", stress, depression, chronic pain syndrome or substance use disorder.

Dr. Ray Baker, BSc (Hon), MD FCFP, FASAM