How to Start a Quit Smoking Journal

"Is another prescription all that you expect from a doctor?", I asked my patient.

She had been struggling with respiratory symptoms for nearly 3 months. And in spite of taking medications including antibiotics and cough syrups, her symptoms were not completely relieved.

Every time she visited, the first thing I asked her was his progress… Not the progress of the symptoms but the progress of her efforts to stop smoking.

But it seemed like she only expected me to give her a prescription of new medications and she believed that would take care of all her symptoms.

This is when I asked her, "Is another prescription all that you expect from a doctor?"

As a doctor, I prefer giving advice regarding healthy lifestyle habits that would help my patients avoid the need to take any medications in the first place. Unless you quit your unhealthy habits including smoking; no medication and no prescription is going to give you permanent relief.

Like her, there are many patients who struggle to quit smoking. They know that this habit is affecting their health in many ways. Yet, they are not able to give up smoking.

And this is when I advise them to start journaling. It may come as a surprise to you. But, in my 15 years of clinical practice, I have repeatedly witnessed how keeping a quit smoking journal has helped patients stop smoking and stay off cigarettes over the long-term.  

If you have finally decided to quit smoking but need a little guidance, read on to learn how you can create a plan, maintain a journal, and drop the nasty habit of smoking for good. 

Step 1: Understand WHY Quitting is So Difficult

I always advise my patients to understand and accept that quitting smoking is not an easy process. I have seen a number of patients who started smoking perhaps in their teens in spite of knowing the health risks this habit can cause.

And once the habit kicked in, quitting became really tough!

Whether you are a pack-a-day smoker or an occasional smoker, quitting could be tough. I advise my patients to write a journal about why they think quitting this habit is hard.

Most of them have already tried it. Some patients I consulted had a history of trying to quit smoking 8 to 10 times. They usually have a rough idea of what prevented them from stopping the habit completely. I ask them to maintain a journal and write in it what made them start smoking again each time.

The reason could be a request by a friend to join him. It could be due to a particularly stressful phase you were passing through at the time. Or it could be the withdrawal symptoms.

Writing down these factors is a great way to prepare yourself to tackle them when you try the next time. If you are aware of the things that can prevent you from getting and staying on the no-smoking path, you will naturally be prepared to avoid them the next time around.

Step 2: Prepare A Customized Quit Smoking Plan

Once you have written down the things that could prevent you from sticking to your no-smoking rule, the next step is to make your personalized strategy.

Remember no one knows you better than yourself.

Your journal could be your assistant or your friend to help you in the process of knowing yourself better. Reading through your journal carefully would help you identify more factors that could prevent you from quitting the habit. Based on what worked for you earlier and what didn’t, you can prepare a plan to help you wean yourself off nicotine.  

One very important point I always tell my patients here is the plan should span across at least 6 to 8 months. Stopping this habit is a long-term process. Although JournalOwl can help prepare you with a 21-day kick starter challenge, the journey towards a smoke-free lifestyle is much longer. You must give yourself that much time to be able to come out of this dark zone successfully. Hence, you must have a long-term strategy.

Step 3: Identify Good Company vs. Bad Company

People including your family, friends, colleagues, and neighbors could play a significant role in your efforts to quit smoking. And this role could be both positive or negative.

Some of my patients who have tried the journal approach have told me that they found it was often one particular friend who encouraged them to smoke. Unless you write a journal, it would be difficult for you to identify that “friend”.

Once you know who exactly is trying to tempt you back into smoking, you must take steps to avoid him or her as much as possible. And of course, there will be some good people too who will help you through your journey towards a healthier life. In most cases, I have found that the family of the patient is supportive of the plan.

Your journal would make you realize how a good friend of yours or a caring colleague had advised you against smoking several times in the past. Once you know who cares for you and wants you to stop this bad habit, it is the time to develop lasting relations with them.

For example; having a caring colleague accompany you during a short break at the workplace would help you avoid the temptation to try smoking.  Additionally, you can also confide your feelings in your friends, family, and colleagues. You can share with them the withdrawal symptoms you are experiencing when you quit smoking. And I am sure, they would be eager to help you out so that you stay strong in your determination.

Step 4: Use a Journal to Wean Yourself from Nicotine

To decide that you want to stop smoking is the first positive thing you have done to quit this unhealthy habit. However, it is important to find out different ways to stop smoking and know what works for you. Basically, there are 2 methods to quit smoking. The first method is weaning off gradually and the second is called cold turkey.

I advise patients to try the first method as the chances of success are higher when people try to stop this habit gradually. Research studies have shown that nicotine in cigarettes is just as addictive as alcohol and recreational drugs like cocaine and heroin.

Your body becomes accustomed to the daily intake of nicotine it receives when you smoke. Nicotine produces a sense of pleasure, though temporary and false, making you feel better. It could calm you in a situation of stress and anxiety.

However, over a period of time, as the body gets used to nicotine, you need to smoke more cigarettes more frequently to derive the same amount of pleasure or calmness. This is a sign that your body has got addicted to it and has got used to receiving its daily dose of a false 'high'.

Now that you have decided to let go of this unhealthy habit, you need to prepare your body for it. And this forms the crux of the gradual weaning method. When you stop smoking gradually by reducing the number of cigarettes you smoke every day, you let your body enough time to adjust to the lower doses of nicotine it will receive.

However, for this method to be successful, you need to have an action plan in place to keep a check on how much you smoke every day and in how many days you plan to quit completely. A journal could come in handy in such cases to track your progress against the plan.

You can write in the journal how many cigarettes you will smoke on a day-to-day basis leading up to your quit date. Once you start with the plan, you will know you are allowed only so many cigarettes on that day. This would help you avoid smoking too many times and ensure better compliance with your strategy to wean off gradually.

If you prefer this method to quit smoking, you may try using nicotine patches or other similar treatments that could help minimize the withdrawal symptoms.

Step 5: Or Prepare for a Cold Turkey Quit

The cold turkey method involves cutting off all nicotine at once. While it could be extremely difficult for chronic smokers to quit the habit abruptly, research studies have shown otherwise. There is clinical evidence that suggests quitting abruptly might increase your chances of stopping the habit for good.

Your body may begin to reap the benefits of quitting the smoking habit in just 30 to 40 minutes of your last cigarette. However, the withdrawal symptoms could be more intense.

Yet, I have seen a large number of patients being able to stop smoking completely when they adopt this method. I have observed that what usually works in such cases is the assurance and determination. Also, though the withdrawal symptoms are more intense in this case, they are temporary. The worst symptoms, I have noticed, tend to improve in just 5 to 10 days.

I advise my patients to maintain a diary to increase their chances of complete withdrawal. I ask them to write the exact symptoms they experience when they quit smoking along with their intensity and duration. I also advise them to note down the benefits or positive changes in their mental and physical health they experience with each passing day.

This has proven to be a great tool to help patients quit smoking. When they write their progress in the journal, it works as a proof that they are on the right track. It helps them to understand that the intensity and duration of withdrawal symptoms are reducing with each passing day. It makes them feel more confident, reduces their anxiety, and increases the determination to quit smoking.

At the same time, writing down the benefits makes them aware of how their efforts to quit smoking are yielding positive results. This motivates them to continue with their efforts.

Step 6: Accept the Withdrawal Symptoms

In my clinical practice, I have come across a number of patients who have already tried giving up smoking many times unsuccessfully. So, most of them already know of the withdrawal symptoms. And they also know that it is the withdrawal symptoms that have prevented them from quitting the habit so far.

Well… I often suggest to my patients to KNOW the withdrawal symptoms even better, even if “they think” they already know what it will feel like.

I mean being aware of which withdrawal symptoms can occur is not enough. It is the analysis of why and when these withdrawal symptoms occur that could help you avoid them in a more efficient way.

Also, you should know why withdrawal symptoms occur in the first place.

Once you quit smoking, your body stops receiving nicotine that it has gotten used to. This is why; your body reacts in an unusual manner as if to get your attention.

Some of the common nicotine withdrawal symptoms include:

• Increased craving for cigarettes
• Anxiety and nervousness
• Irritability and anger
• Difficulty in concentrating
• Increased appetite
• Restlessness
• Frequent headaches
• Loss of sleep
• Tremors in fingers
• Fatigue and weakness
• Constipation or indigestion

I ask the patients to be aware of these symptoms so that they are prepared when they experience them. They can also write in the journal the specific withdrawal symptoms they experienced the last time they tried to quit smoking.

They should also mention the time, duration, and intensity of the symptoms on a scale of 1 to 10. This would help them analyze which symptom occurs at what time, lasts for how long, etc.

Writing a journal helps to brace yourself for the challenges you will be facing. For example; if you know you may develop the withdrawal symptoms at a specific time, you can adjust your routine to avoid more stressful work at that time. Similarly, if you know the approximate duration of the withdrawal symptoms, it would ease your anxiety knowing the unpleasant sensation would get over soon.

The benefits of keeping a quit smoking journal will play a huge role in your long-term cessation success from cigarettes.

Step 7: Time to Execute – Implement Your Plan

The steps you learned so far were meant to prepare yourself for the quitting process. Once you have decided on the method you want to adopt to quit smoking, it is the time to put your plan to action.

I usually advise my patients to choose a date for the implementation of the plan within the next 2 weeks. They need at least 2 weeks to figure out how they want to go about with the process.

Also, the 2 weeks is the time they can utilize to introspect why they want to quit smoking. This period also helps them to prepare themselves mentally to quit smoking.

Writing a journal during this phase is important to be able to identify negative triggers. It can also be a learning phase for most patients. They can find out more about the alternatives to smoking like nicotine patches to help them ease the withdrawal symptoms. They can also find out the natural therapies like meditation and yoga that would ease mental stress and anxiety during this phase.

However, I make sure this period of preparation is not extended beyond 2 weeks... Or a maximum of 3 weeks!

If you postpone the date to start your Quit-Smoking plan further, you may lose the motivation. So, 2 weeks is what I recommend my patients as a period to prepare the plan to quit smoking.

Here are a few things I advise them to do during this preparation period:

• Inform the family and friends about your plan to stop smoking. Tell them you would need their encouragement and support.
• Find a “Quit Buddy” who can join you in your Quit Smoking plan. You can help each other to get through the rough phase.
• Anticipate the challenges you might face while quitting. As discussed earlier, your journal could be a great tool for you to identify who and what could create obstacles.
• Most importantly, remove cigarettes and all other tobacco products from your home, workplace, and car.
• Make sure you also throw away the lighters, matches, and ashtrays. Wash your clothes and car to freshen up anything that might smell like smoke.

Step 8: Avoid Your Smoking Triggers

Once your actively quitting smoking, you need to be extra alert of the smoking triggers. This is a crucial phase that can increase the chances of your success, provided you are able to avoid the triggers. The most efficient way to identify and avoid the triggers is to make a note of them in the journal.

You must have already made a note of the possible triggers in your journal during the preparation period. Now is the time to stay alert so that you can prevent them from spoiling your plan once again.

And you must also be ready to identify and avoid other factors that may emerge newly during this period. For example; the project you have been entrusted with recently at your workplace may cause anxiety. The mental stress may tempt you to smoke a cigarette. You must be able to identify such new triggers throughout your journey towards a healthier and smoking-free lifestyle. 

Based on my clinical experience, let me share with you some of the common triggers that could create obstacles in your plan:

· Alcohol: many patients have told me that they have a habit of smoking when they drink. Well... If that’s the case, it's important that you quit not just smoking but also your alcohol intake. You can try switching to non-alcoholic beverages or drink only where smoking is prohibited. Alternatively, you can try chewing on a cocktail stick or snacking on nuts instead of smoking.

· Other smokers: When your friends or co-workers smoke around you, it could get too difficult for you to give up. This is why; I advise my patients to talk about their decision to quit smoking so that people around them know they should avoid smoking when you are taking a coffee break together or are in the same car.

· End of a meal: ending a meal often involves lighting up a cigarette for most patients. In fact, several patients have told me that they experience indigestion when they do not smoke after meals, especially dinner. I advise them to try healthier alternatives to improve digestion like increasing the intake of dietary fibers and drinking plenty of water. I ask them to note down the changes in their bowel habits or digestive complaints when they adopt healthier methods instead of smoking. And most often, they come back saying, the improvement is better than they expected!

Step 9: Write Down Your Craving Intensity

A journal, to be specific a craving journal, is what you will need at this stage to zero in on your specific triggers and patterns. For the first few days leading up to your final quit date, you must keep a log of your cravings to smoke.

You can also note the time when you crave a cigarette with different parameters such as:

• What you were doing at the time of craving
• The intensity of the craving on a scale of 1 to 10
• Your feelings and emotions or the symptoms of withdrawal you experienced
• People present around you
• Your experience after smoking

Every day, you can read through your journal to find the common triggers such as the specific time of the day, a person accompanying you, or the situation. If your journal indicates you tend to get a craving at say 5 pm, you can make sure you keep yourself busy with a pleasant activity at that time. And if there's a person involved, you know you have to avoid him or her.

If your journal shows that the craving comes up during specific situations or when you experience any emotions like stress, anxiety, or loneliness; you need to work out on this more carefully.

For example; when you have had a hectic day, it may seem like a cigarette would relieve your tension and help you feel better. But do not forget that as much comfort as a cigarette may provide you, there are always more effective and healthier ways to feel better. These might include walking in a park, exercising, meditating, simple breathing exercises, or even playing games with your kids.

Step 10: Employ Tactics to Manage Cravings

There are various strategies that could help you control your cigarette cravings. Learning the best ways that work for you could ensure you are able to quit smoking completely in a shorter duration than planned.

Fortunately, in most cases, cravings do not last longer than about 5 to 10 minutes. If you are able to control your urge for this short duration, the craving would soon pass leaving you feeling better and more confident.

It definitely helps to be prepared by having some strategies handy to cope with the craving. Based on my experience, let me share with you some of the best ways to avoid the craving to smoke:

· Distract yourself. You can take a shower, do the dishes, watch a television show, or call a friend. If you keep yourself busy at the time the craving is expected to come, it would become easier for you to get your mind off smoking.

· Motivate yourself. Reminding yourself why you want to quit smoking could encourage you to control the urge. You can focus on the reasons for quitting such as the chronic cough you are experiencing due to the unhealthy habit. You can also think of the benefits you expect by quitting smoking. It would help lower your risk of heart diseases, and lung cancer, save your money, and enhance your self-esteem.

· Get out of the situation. Changing the stressful situation to a pleasant one would help you avoid the craving.

· Reward yourself. Positive reinforcement would encourage you to stick to your plan and motivate you to control the urge. You can reward yourself with a healthy treat after each successful lap like after one week or so.

· Find a substitute. Several patients have told me that this trick works well and helps them avoid the craving. When you get an urge to smoke, pop a substitute in your mouth like mints, celery or carrot sticks, chewing gum, nuts, or seeds.

· Brush your teeth. This may sound weird. But it actually works. The just-brushed teeth could banish the cigarette craving as you may no longer feel like smoking and spoiling your clean oral cavity. The refreshing fragrance of toothpaste might also take your mind off the craving.

· Drink water. Smoking a cigarette could be likened to drinking a glass of water if you can manage to mimic the actions. When you slowly drink water in small sips, it would create a similar effect as if you are smoking a cigarette. This might trick your brain into thinking you have been smoking and thus, control your urge. Additionally, this would improve your hydration and minimize the symptoms of withdrawal.

However, not every strategy to control the craving works for everyone. It all depends on what your triggers are. If you want to control your craving more effectively, you must try different methods and note down your response to each in the journal. This would help you analyze which trick works better for you. This would go a long way in helping you to quit smoking successfully.

Step 11: Try Medications and Therapies

There are several different methods that could help you quit smoking. I advise patients to try medications or alternative methods or a combination of treatments to support their efforts.

Nicotine replacement therapy is one of the best smoking cessation treatments you may try. It involves “replacing” a cigarette with a nicotine substitute like nicotine gum, patches, inhalers, lozenges, or nasal spray. It would relieve the withdrawal symptoms to some extent and help you stick to your plan more efficiently.

These substances are believed to work by delivering small but steady doses of nicotine into the body without any poisonous gases or tar found in cigarettes. This would help you focus on breaking the dependency or psychological addiction by allowing you to concentrate on learning healthy coping skills.

I also recommend behavioral therapy to patients who develop excessive anxiety or depression due to nicotine withdrawal.  Behavioral therapy focused on learning and adopting new coping skills could help you break the habit without developing more serious withdrawal symptoms.

It's possible to quit smoking if you plan it like it’s a project. Just like you manage a project by breaking it down into smaller milestones and foreseeing the obstacles, you also need to work out a plan to quit smoking.

You can note down the steps and different stages of your quit-smoking plan in your journal and track your progress. A journal would help you identify and remind yourself of the triggers and the best ways to control cravings.

A journal can also help you analyze what works for you and what doesn’t. This would be a great way to ensure you are able to quit smoking completely and live a healthy lifestyle.  

HEALTH DISCLAIMER

This blog provides general information and discussions about health and related subjects. The information and other content provided in this blog, or in any linked materials, are not intended and should not be construed as medical advice, nor is the information a substitute for professional medical expertise or treatment.

If you or any other person has a medical concern, you should consult with your health care provider or seek other professional medical treatment. Never disregard professional medical advice or delay in seeking it because of something that have read on this blog or in any linked materials. If you think you may have a medical emergency, call your doctor or emergency services immediately.

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