Dear Therapist:

I took my first cigarette in 9th grade. I have been smoking steadily for the past 15 years. If I am honest I realize that it is a big health risk but that doesn’t seem to motivate me to stop. I guess I kind of “want to want” to stop. It certainly would make my wife and parents happy.  My questions are: 1. Do you have any suggestions as to how to become more motivated to quit?  2. Are there any specific methods that you recommend more or less for quitting (i.e. cold turkey, slowing down, switching to an e-cigarette, hypnosis, medication, psychotherapy, etc.)? I would appreciate your input. Thanks.

Response:

It’s great that you’ve been thinking about the harm that cigarettes can cause. You seem at least somewhat motivated to stop. This can be very difficult after 15 years of smoking steadily. As you pointed out, there are many ways to try and quit smoking. Each one can be effective depending on many personal factors.

Generally speaking, in order for any method to properly work there needs to be a clear decision to quit. This should be accompanied by constant reinforcement of this decision and focus on the goal. In addition to the obvious gains (like better overall health, lowered risk of medical problems, and making yourself and others happier), you can introduce your own incentives. You might treat yourself to something after not having smoked for a week, or a month. Interim goals like these can also make the prospect of quitting seem easier.

Particular forms of quitting are specific to each individual. Some people have been able to go cold turkey focusing on things like those mentioned above. Others find that e-cigarettes help them to slowly changes their smoking habits until they no longer smoke at all. Yet others wind up smoking e-cigarettes long-term.

I wouldn’t use hypnosis until significant underlying problems and needs related to smoking are ruled out. This is because hypnosis doesn’t take into account possible emotional issues that are being “treated” with a compulsion to smoke. Psychotherapy can help to rule these out—or to uncover underlying issues, helping to decrease the need to smoke.

Regardless of your decision, identify triggers both in normal, daily situations and in avoidable circumstances. Common everyday triggers include post-meals, driving, break times, and stressful situations. Avoidable circumstances can include time spent with other smokers, using stores that sell cigarettes, and being in places where cigarettes are available.

A psychotherapist can help you to identify your specific needs and triggers, and can help you work on goals, motivation, and incentives. Good luck!

-Yehuda Lieberman, LCSW

  psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317

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