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New Content Added: To update the content we have added Addiction/Substance Abuse and Smoking and Pregnancy information found at the end of the Table of Contents.
Consider using the "Why Test" in the back of the manual that accompanied this course to identify the reason your client smokes. After initiating treatment, however, how do you help your client become successful at breaking smoking patterns and ultimately quitting smoking? You might consider playing this track during your next session with a tobacco dependent client.
As you listen to this track, consider playing it for your tobacco dependent client. He or she will have the opportunity to hear about menstrual cycle scheduling, reducing caffeine consumption, inequality in genders, and mental gremlins. Also, consider your tobacco dependent client in relation to the case studies on this track. How do these case studies reflect your client’s experiences?
#1 The Menstrual Cycle Scheduling Technique
Jean stated, "I tried quitting during my period. That was hell!" Jean found that it was more difficult to quit smoking in the premenstrual phase of her cycle or during her period. The technique here I have found helpful to my female clients who are trying to quit smoking is scheduling a time to quit in relation to her menstrual cycle. Therefore, Jean scheduled her next quit attempt at the end of her period, or beginning of her cycle. Jean later stated, "The withdrawal symptoms weren’t quite as bad this time." Do you have a Jean? Could your female client benefit from timing her quit date to be at the end of her period?
#2 Reducing Caffeine Consumption
I have found, however, that clients can benefit from reducing caffeine intake by about half. The reason for this, according to Benowitz, Hall, and Modin, is that cigarettes reduce the effects of caffeine. The result is that smokers require about twice as much caffeine as a nonsmoker to get the same effect. When Brian quit smoking, his body began to normalize its response to caffeine. Brian stated, "I felt like coffee was making me sick. I got nervous, irritable, and I had a lot of tension." Brian was experiencing symptoms of caffeine overdose, even though his caffeine intake remained the same as it was before he stopped smoking.
These symptoms, like a woman’s menstrual cycle, can mimic or increase smoking withdrawal symptoms. Therefore, would you agree that, by reducing his caffeine consumption, Brian could begin a possibly successful quit attempt? When Brian drank the same amount of caffeine but had decreased his nicotine intake, he became more irritable, with his irritability from the caffeine, he wanted nicotine. The technique here is to ask your client how much caffeine he or she intakes via coffee, tea, chocolate, etc. As they decrease their nicotine intake, ask them to consider decreasing their caffeine intake to avoid creating a nicotine trigger; due to the magnified effects of the caffeine.
#3 Inequality in Genders
For example, Louise, age 39, didn’t understand why it was so much harder for her to quit than her husband Jim. Louise stated, "I can’t make it three days without a cigarette. Jim goes about five or six until I complain so much that we both start smoking again." I explained to Louise, "Women seem to metabolize nicotine slower than men. This slower metabolic rate may indicate you have higher levels of nicotine than your husband. The result is a higher nicotine dependence and more intense withdrawal symptoms for you than Jim."
By recognizing the differences in gender regarding how nicotine affects the body, Louise was less frustrated when Jim experienced more success. Do you have a Louise? Could your tobacco dependent female client benefit from recognizing the differences in gender regarding how nicotine affects the body, especially if they have a partner who is trying to quit as well?
#4 Mental Gremlins
Damon continued, "After that cigarette, I started thinking, ‘Everything gives you cancer these days. It’s even in the water! So why should I quit smoking!?’" Damon’s second mental gremlin allowed him to rationalize his habit by minimizing the health consequences of smoking. The result of listening to these gremlins was relapse. Had Damon recognized these thoughts as mental gremlins, do you agree that he may have been able to avoid relapse?
Some mental gremlins can promote continued smoking by providing positive notions about smoking while minimizing the harmful effects. Consider asking your tobacco dependent client if any of the following positive gremlins sound familiar.
Negative gremlin voices also encourage relapse. If your client experiences negative gremlins like Damon did, then he or she may have thought that they don’t have the willpower to quit or that they get so irritable when they attempt to quit that people won’t want to be around them anymore. Is your client faced with mental gremlins? How does he or she defeat gremlins? We’ll discuss more gremlins and techniques for defeating them on the next track.
On this track we have discussed initiating treatment. Three steps can affect the initialization of tobacco dependency treatment. These three steps are acknowledging addiction, wanting to quit, and identifying the reasons why the client smokes. We also discussed the four keys to success. These four are menstrual cycle scheduling, reducing caffeine consumption, inequality in genders, and mental gremlins. Do you have a tobacco dependent client that would benefit from listening to this track during your next session?
On the next track we will discuss defeating mental gremlins. We will examine early and late relapse gremlins, or mental filters which tobacco dependent clients may use to justify smoking or minimize the harmful effects of tobacco.
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