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Forget the gum. Mindfulness can stop you from smoking

cravingtoquit.com
An image from the Craving to Quit website showing how to track progress on your mobile device.

Imagine for a moment that Marlboro Man Sam Elliott is sat down by his doctor and instructed to stop smoking. What would he do? Would he scoff and keep puffing like "Thank You for Smoking" Sam Elliott would do? Or would he listen carefully like the hippie "Parks and Recreation" Sam Elliott would and try the new-agey stuff?

If he was smart he'd be "Parks and Recreation" Sam Elliott. Mindfulness is proving to a powerful new tool in getting people off their bad habits.

“Mindfulness is all about changing the loops in your brain that say you want something,” says Courtney Baechler, a physician with the Penny George Institute for Health and Healing at Abbott Northwestern, which is part of the Allina Integrated Medical Network. “It shows that what you’re feeling is just a sensation, that you don’t actually need a cigarette. You just need to ride out a craving.”

Baechler is one of the leaders in Allina's "Quit to Live Well" program, which offers a menu of treatment options like drug therapy, counseling, acupuncture, aromatherapy, and an app. Yes, an app.

Allina uses the Craving to Quit” app,  developed by Dr. Judson Brewer, a psychiatrist with the Yale Therapeutic Neuroscience Clinic. The program aims to get smokers off nicotine in just three weeks. And the data on the app's effectiveness, which just went live earlier this year, is showing remarkable success. It's twice as effective as the leading curriculum in tobacco cessation protocol up to now, the American Lung Association's "Freedom From Smoking" program.

In the app there are screens for identifying habit loops, as well as animations that explain your body's reaction to cravings, and RAIN exercises, which stands for Recognize, Accept, Investigate, Note. There are also plenty of opportunities for peer support and postive affirmation. The program uses many techniques developed by Jon Kabat-Zinn, whose Mindfulness-Based Stress Reduction program is known to be effective but a hefty eight-week commitment. The innovation here is that you get some of that Kabat-Zinn comfort but in smaller doses. Baechler maintains that a little bit of mindfulness can go a long way.

“There’s data that shows that even nine minutes a day of training can result in therapeutic outcomes,” says Baechler.

Dr. Judson Brewer
Dr. Judson Brewer

She gives an example of working with a single mother who came to Allina with three kids, a nasty tobacco habit, and no time. She had tried many first-step therapies — nicotine replacement, Wellbutrin, stimulus control — but she didn't like the way she felt. She was despondent but determined. A month later she was tobacco free.

Now that alone is a great triumph. But there were additional benefits.

"One of the things that she told me that was so impactful was that she felt she had changed as a person," says Baecher. "She had not only stopped smoking but had gotten to the root cause of her habit. She felt like she was a different person and had more tools to deal with the busy life that she felt was causing the craving. So it was a win-win."

Courtney Baechler
Courtney Baechler

And the thinking goes that if it works with tobacco addiction, which is considered by Brewer and many to be the most difficult addiction to break, it should work with other addictions.

"They're working on apps for food and alcohol right now," Baechler says, while noting that mindfulness is so powerful in fostering wellness it should be integrated into one's life as preventative care.

“Let's face it, we're all busy and lead stressful lives. Nine minutes a day of mindfulness exercise would do us all good,” she says.

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Comments (5)

I quit smoking 10 years ago

using the same technique as "mindfulness." After a two-pack a day habit that I had for 35 years since my days in the Navy, I managed to quit cold turkey by telling myself, "you don’t really need a cigarette, you just need to ride out this craving for a few more minutes.” If you can keep riding out the cravings like that for about a week or two, you'll be cured.

I imagine it would work for losing weight too. "I don't really want that donut, I just need to ride out the craving for another 5 minutes.”

I really think that nicotine replacement products and gradual withdrawal strategies make it harder to quit because you're sending mixed messages to yourself. Smoking sometimes, simply less often, wouldn't work for me. You're either quitting or you're not.

I thoroughly enjoyed smoking. I just love the taste of tobacco smoke. I told my wife the other day that if I was given a month to live, I'd start smoking again because I loved it so much. But my point is, if you're gonna quit, then quit.

Congrats, Dennis

For some people, the gum and patches work. For others, it's tougher. In any case, I'm glad you were able to kick the habit.

I went the cold turkey route, too. Back in the day, we didn't have many other options.

February 3, 1990

For a change, Mr. Tester and I are near total agreement on something.

I quit smoking, after 29 years, on February 3, 1990. It could be called "mindfulness," with much the same sort of dialog with myself that Mr. Tester describes. Or it could be called "a control issue." I was already enrolled in a "quit smoking" program with my employer. That program had me scheduled to quit a week later, but I wanted to quit when *I* decided to quit, not when *they* decided I should quit. Either way, I got through the weekend in much the same fashion Mr. Tester describes, and when I went back to work, I had the good fortune of having some supportive fellow-employees. In about a week, I was craving-free, and I've never had a relapse in the 25 years since.

I'm finding that a similar approach works reasonably well for me in a dietary context. In common with many other Americans, I was recently diagnosed with Type 2 diabetes. The doctor wants me to avoid sugar, and keep weight, blood sugar and cholesterol levels below parameters he established. I have to monitor blood sugar daily, and while I never weighed myself more than about once a year previously, I now do that several times a week. I'll find out about cholesterol levels at the end of the month, but otherwise, I'm finding that same mental approach I used for smoking seems to be working OK with food and diet, too. Weight and blood sugar have been reduced to the levels the doctor set, and I've been able to maintain them there.

I, too, enjoyed smoking, and there was a time, perhaps 15 years ago, when I even shared Mr. Tester's approach to starting again if I were given a "month to live" diagnosis of some fatal condition. Now, however, I don't think I'd do it. The control issue is still there, for one thing, but equally important (for me, at least) is that, on a retiree's limited income, it would be prohibitively expensive. If I only had a month left, there are other things I'd rather spend my paltry savings on.

The Gum Has Its Place

I quit smoking so many times I finally got really good at it. The last time around, I decided to go with the gum. At that time (about 15 years ago) it didn't come in "flavors" -- it was the yellowish-brown of a used cigarette butt, and tasted like one too. But it had nicotine in it! So I bought a big box of the gum and told myself "Okay, from now on, if you need nicotine so badly it's making you crazy, you get GUM, not a cigarette."

Strangely enough, I found the gum much easier to resist. Had I been resisting cigarettes, I'd have been a goner the first day, but I knew I could get any needed nicotine from that icky gum, and the thought of it made the nicotine seem much less desirable.

Cut to the chase: After three months with no cigarettes, I gave the unopened box of gum to a friend. Tobacco-free for, um, 17 years now.

Tobacco addiction?

I like to read articles where it is evident that the author can tell the difference between smoking tobacco and nicotine addiction. There seem to be few of those.

Nicotine replacement therapy had always involved a tapering dose until the advent of e-cigs. Now Big Pharma is offering maintenance doses of NRT to compete. I wonder why it costs so much for a few patches though compared to buying a rechargeable refillable e-cig and refills and having control of the dose, like with smoking.

90% of schizophrenics are addicted to nicotine and most smoke tobacco. There is little hope they will ever give up nicotine. It seems to help their symptoms.

The same is true for other mental illnesses. In Utah, genetic studies have pointed to a genetic predisposition for nicotine addiction. If nicotine addicts are 'born this way' there may be a future time when the sin/redemption model's requirement for nicotine abstinence only, and the avoidance by the medical community of advocating harm reduction methods for nicotine addiction will be seen as illegal discrimination against people with disabilities.

The poor and people who experience trauma also find it difficult or impossible to quit nicotine addiction.

I have an idea. Why don't we get these unrepentant sinners to pay for the new Vikings stadium! Oh wait. That wasn't my idea.