Quitting Smoking by Cutting Down: 3 Basic Tools for a Gentler Process

A ton of research shows that the most effective way to quit smoking is to just go cold turkey. But stopping all at once can be particularly hard for people with chronic illness, because the physical and psychological impacts are a huge body slam.

If you have a chronic illness with pain and fatigue, like an autoimmune disease that already makes you feel like you have the flu, the flu-like feeling of smoking withdrawals can feel like too much. If you are struggling through depression or anxiety treatment, the intense spike in psychological symptoms can make it seem like quitting is harmful instead of helpful.

And, even though the physical nicotine withdrawal symptoms only last about 3 days (hence the standard advice to just quit all at once and get past those), the brain changes with addiction. It takes 2-4 weeks for most smokers to start to feel better, and a month can seem like an intolerable eternity to folks who are already taxed by underlying conditions.

Personally, the last time I quit successfully 11 years ago, I noticed it got better in waves: much better after a week, much better after a month, much better after a season, and much better after a year. But, for me, the first month is a doozy. And now that my diseases have progressed, the first week cold turkey is simply too much to allow me to stay with it. After failing 8 times in 3 months to quit all at once (cold turkey, with various types of nicotine replacement, by reading Alan Carr, and with my doctor’s and therapists’s support), I started to feel hopeless.

I also started to fear that I was teaching myself to STAY a smoker by developing a smoking crisis cycle: getting very motivated to quit, experiencing intolerable withdrawal effects, getting scared of the quitting experience, and going back to smoking.

And yet, I have ischemic changes to the white matter in my brain, so I cannot keep smoking either.

I decided to try cutting back, in spite of all of the articles I’ve read saying that cutting back doesn’t work because each cigarette becomes “too precious.” As logical as it sounds to quit cold turkey, I had to accept that it wouldn’t work best for my body, and start to get creative about what could work.

Which tools?

I found 3 tools that have worked well for me, to cut down quickly from about a pack a day to 5 a day. And my confidence is going up instead of down, so I can see that I’ll go from 5 to 1 to 0 in no time.

(1) The basic timer!

Since most of us carry our phones 24/7, we have a timer on us at all times.

When you have a smoke, set your timer for a manageable break between cigarettes.

Don’t start with a longer period of time than you can be successful with, even if it’s just 5 minutes!

For me, it was starting with 1 hour at a time.

As I learned to become very comfortable with letting an hour elapse, I gradually increased my timer to 90 minutes, 2 hours, 4 hours, etc.

If the timer goes off and I’m not craving a smoke yet, I don’t have one. But then later when I do, I just set the timer again.

Do I have cravings during my “off smoking” times? Sure. But they are so much more manageable when I can just peek at my timer and say, “Ok, about 3 more hours. What can I redirect my attention to for this short period?”

Thinking about redirecting my attention for the rest of my life is overwhelming, especially if I’m already feeling overwhelmed by symptoms of my disease, but redirecting my attention towards something healing for a short time is not only doable, I begin to teach myself new habits of pleasant or healing things to do instead of smoking.

Hands down, the timer element has been the most helpful part of this process, but here are two more key tools.

(2) LIVESTRONG MyQuit Coach

There are a lot of apps for quitting, but this is the one for cutting back.

It’s free, so it’s easy to check out the features for yourself, but one of the best things this app does is allows you to enter a time period for how long you want to take to quit, and then gives you a weekly schedule for how many you’ll have each day in the process.

For me, the timer function is really the main way I get the number down, but also logging the times I do smoke keeps me conscious of what I’m doing and allows me to see, over time, how well I’m doing in my progress.

It has other functions, like “community,” which may be helpful to some, but I like this app mostly because it’s simple, quick, and stays out of my way, so that I can really focus my attention AWAY from smoking and away from the quitting process, and TOWARDS the new habits I’m developing to replace cigarettes.

(3) The Shift Necklace

If you take one look at a $115 breath control necklace and think, “Well, that’s ridiculous,” I wouldn’t blame you.

The Shift Necklace, advertised for anxiety, seemed pretty obnoxious to me when I first saw it floating around social media about a year ago.

But I couldn’t help but notice that the size and shape seemed much like a cigarette, and I knew I was looking for a physical tool to help replace my hand-to-mouth habit, as well as the more relaxing deep breathing I tend to do while smoking, but I didn’t want to use a replacement like vaping, candy, etc., etc., that might just compound my situation.

So, I decided to just give it a try, and holy moly.

Basically ALL this little guy makes you do is breathe out more slowly. You take a normal inhale and then breathe out through the tube, which gives resistance. It slows your exhale, and that doesn’t sound like much, but after 3 breaths in a row, the muscles of my entire body completely relax. If I do it for several minutes, it feels like I’m going to fall asleep.

Their website has a lot of info about how and why they claim it works, but for me, it just does. I use it randomly while watching TV or whatever, just to keep my baseline relaxation in a good place, or when cravings hit to at least take the panic out of the situation and get back into my head.

The Shift might not be the exact tool for you, but I think it’s key to add in some kind of physical replacement that feels like it helps with whatever your biggest annoyance is in not having the physical object of the cigarette.

That’s not all the tools

Certainly there are a million other tools and tricks you could put together to make a plan that is responsive to your own style, but keeping it simple is working for me.

I’ll add that these few other things certainly don’t hurt:

  • Make smoking boring. Don’t smoke while holding your phone or doing anything stimulating. The point of cutting back is to let your brain heal gradually, and a huge part of that healing is bringing the balance of brain chemistry back to nonsmoking.
  • Make smoking uncomfortable. Don’t sit in a comfy chair and get all relaxed, enjoying your cigarette after having waited for your timer to go off. Service the addiction at the stage in the process you’re in, but remember the point is to move towards building in ways to enjoy the time when your timer is on, rather than enjoying the times when you’re smoking.
  • If you like it, take a lot of CBD. I personally like Rosebud brand, especially now that they’ve started to make an amazing chocolate. For me, starting the day at a nice, relaxed baseline gives me a real leg up.
  • If you’re satisfied after a few puffs, just put it down. The addiction is sometimes just so much about having that “permission” to light up. But the less you actually take in, the better for your health, and potentially the quicker you heal your mind into realizing you don’t actually need to be smoking at all.
  • If you can exercise, get all the exercise possible. Right now I’m in a very difficult flare, so my idea of vigorous exercise is taking a few steps and doing a few stretches, but the moment I can do more, I do. Exercise helps more than anything else to heal the brain, it certainly makes you feel better, and it’s a healthy habit to put into your “off times” when not smoking, to start moving towards a lifestyle of healing.

Hair repair during home workouts

Just before I turned 40, I started to have major problems with my hair thinning.

I’ve always had periods of hair falling out to a noticeable degree, usually after surgery or when my body goes through other periods of intense stress like autoimmune flares or divorce.

It tends to grow back, and I’ve tried a lot of things to try to actually make the hair grow back at at root, but I’m not sure topical regrowth oils, etc. work for me. And the jury is still out on supplements.

Expensive candy

Lord knows I wanted SugarBearHair to work because those gummies are delicious! I gave them a solid 5 month try and saw no change, but a lot of people swear by them, and their customer service is pleasant.

Check out SugarBearHair here.
Meanwhile

Meanwhile, Hair, Skin, and Nails from Nature’s Bounty has a similar cult-level following (and they have a gummy version) and I’m about 2 months in to giving them a shot.

pretty

I definitely have about a zillion more baby hairs, but I’m not sure whether that’s coincidence, since my hair does go through natural cycles of thinning and thickening.

I’m also seeing a lot more length, but that could also be an illusion because I’m not playing with my hair a lot during this pandemic, and I might be noticing changes more because more time passes between major styling sessions.

However! My nails are growing like crazy, and that’s easy to gauge because I paint them once a week. I can see the regrowth easily at the cuticle line, and they’re now noticeably grown out in less than a week. They’re also now already strong enough for me to feel like I can wear non-gel polish without breaking or peeling risks.

Definitely try these pretty little things. Full ingredient list is here.

So, the obvious nails difference definitely makes me think the hair changes are more than just my imagination.

Keep the hairs I have

There’s a lot I do to try to protect the hairs I still have, including using

this dope SILK PILLOWCASE from Slip.

But one of the easiest thing I’ve started doing during the pandemic is treating my hair while I’m working out.

I only do this when I know I’ll be showering after and when I won’t be doing sorts of sessions that will involve putting my head on the floor, because the oils, etc., here can get a little messy. If my hair was long enough for a top knot, it would be fine.

This really only takes 10 seconds longer than pulling my hair into a ponytail would anyway

I just:

  1. Brush it out straight back with my Tangle Teezer (the holy grail of detangling brushes)
  2. Put some of the super-expensive-but-it-might-work-so-why-not Initialiste Scalp & Hair Serum from Kérastase into the hairline and thinnest areas. I love this stuff because it’s water-based, so you can apply it after showering and your hair still styles as usual.
  3. Add a little of the Living Proof Dry Scalp Treatment, since it’s winter and I figure a hydrated scalp is a healthy scalp.
  4. 2 pumps at a time, I smooth some Ouia Hair Oil onto the ends and a lot of the mid-shaft. I use 2 pumps at a time so that I can control the application, but I usually get about 6 pumps onto the hair.
  5. Apply about a quarter-size amount of Living Proof Repair Leave-In just onto the ends. I don’t LOVE the texture of this leave-in conditioner because it feels almost waxy, but I use it for this because I think it seals the cuticle.
  6. I “Invisibobble” in the pony since the plastic won’t get ruined by the treatment, and let’s be honest: these are the best darn hair ties in the world.

All the links to buy (or learn more about these) are below

Thank you for being you, Invisibobble

Since the scalp products are both water-based, I don’t worry about them clogging my pores while I get sweaty.

Who knows if it helps over the long run, but I definitely feel like I can see a big difference after having this in and then washing it out with a gentle shampoo and bonder conditioner like Olaplex.

Emotional Eating & Hunger After Having my Colon Removed

I have to imagine that most people eat emotionally, at least to some extent, but probably to a large extent.

It seems reasonable that everyone gets hangry sometimes, and that the dysfunction of “emotional eating” is a spectrum, where some people far to one side comfortably eat ONLY for nutrition 100% of the time, and some people far to the other side eat (or do not eat) ONLY for emotional reasons 100% of the time.

Those for whom food is totally emotional might also tend to fall into the clinical diagnosis of an eating disorder, though a professional would have to determine that based on a lot more than just whether food is emotional.

Feelings inspire eating (or not eating) and eating (or not eating) inspires feelings

It seems reasonable that all people fall somewhere between the extremes of never eating when bored, sad, happy, mad, etc., and always feeling emotionally attached or provoked or relieved by food. And, most people lose their appetite or forget to eat due to life stressors from time to time.

It also seems reasonable to imagine that most or all people experience some degree of psychological or emotional discomfort in response to being “deprived” of food; even if that “deprivation” is just normal hunger that develops when we haven’t eaten for several hours and mealtime is approaching.

And, conversely, that most or all people feel comforted by eating. We are biologically made to feel discomfort of hunger and comfort of satiety, so that we keep ourselves fed and alive.

What hunger feels like to me, a person without a colon

I had my entire colon removed 7 years ago, due to severe Ulcerative Colitis. In place of the colon, my surgeon used small intestine to create a new mini-colon, called a j-pouch, which makes my digestive functioning relatively normal, especially considering my disease. Thanks to the j-pouch, I don’t have an ostomy bag outside my body, like many who have had colectomies.

Side note: I think the j-pouch diagrams are slightly freaky (although cool and amazing), so I’m not including one here, but if you’re curious what the anatomy of people like me looks like, definitely google “colectomy with j-pouch diagram” to have a peek.

One major change, however, due to my now very short bowel, is the transit time for my food is only about 6-10 hours, where the Mayo Clinic says it takes about 2 days for a normal body to digest and eliminate eaten food as waste.

Some people who have had surgeries like mine develop something called “short bowel syndrome,” where they have a difficult time gaining any weight or even maintaining a normal weight.

I’ve wondered why I don’t have a weight loss “problem,” since it’s obvious to me that I don’t digest everything I eat with such a quick transit time, but I know there is a psychological component for me:

During the initial four years of having Ulcerative Colitis, I was in extreme pain, it was difficult to eat, and I was often placed on NPO (Nil Per Os, meaning “nothing by mouth,” not even water!) for days or sometimes weeks, to allow my intestines to heal from ulcers.

During those years, I often lost huge amounts of weight very quickly, and since that experience was coupled with often life-threatening medical experiences and tremendous pain, I think I was surely traumatized; I associate weight loss with dying. I vividly remember the discomfort of having nothing to eat for 5 or 6 weeks. It’s a unique kind of emptiness that is tinged with fear, and I’m sure that’s a natural biological response to starvation.

Since the process of getting back on my feet after surgery, and back to eating normally, took several years, I very gradually adjusted to my feelings about having been so extremely ill, having lived in the hospital for so many years, and now having a very different anatomy to get used to working.

I was pretty constantly on high doses of prednisone and other steroids, which, as anyone who has ever taken them knows, caused me to gain huge amounts of weight. Over my illness period my weight fluctuated from about 135 to below 100 to over 175.

So, when I started to stabilize about 5 years ago, I was around 170 pounds at 5’0”, and having a lot of trouble finding foods I could eat comfortably with my new pouch. The best kinds of foods for my tummy were soft things like mashed potatoes and applesauce, and other carbs, but I wasn’t worried about losing weight quite yet.

In fact, I noticed that I was afraid of losing weight.

For the first year I was stable, I was definitely feeling fragile and vulnerable from the war I felt like I had been inside of for about 5 years at that point. I was jumpy and had trouble sleeping, and I started thinking that every little twinge or ache might mean something was an emergency. At this same time, I started developing troublesome fibromyalgia (intense fatigue and body aches, much like the flu), which makes sense; many researchers believe fibromyalgia comes on after a physical or psychological trauma, and my illness had definitely been both.

I wanted to keep weight on so that I wouldn’t experience the terrifying sensation of wasting away to a skeleton before my own eyes, while I had no control over anything in my life, trapped in a hospital.

And I started feeling a strange new kind of hunger. I am sure that it was partly biological: since my system empties quickly, I do feel a deep kind of hunger when there is nothing in my GI tract, and I think that’s normal.

But, the hunger I have had since my colectomy must also be psychological because when I get hungry, I feel it so strongly that it takes over my consciousness. It is very difficult for me to think about anything at all when I’m experiencing hunger, to the extent that I can’t even concentrate on a fun movie or maintain a normal conversation. I also wake early in the morning with intense hunger pains that keep me from sleeping as long as I want to.

That’s been hard, and it’s something that I know delayed my desire to start a weight loss plan. Even though I want to get back to my pre-illness, super fit, 130 pound body, I convinced myself that I was perfectly comfortable at 170 lbs and sedentary, because (a) I was at least relieved to be alive and stable, and (b) I didn’t know how I was going to do battle with the new form of hunger I was (and am) experiencing.

My medical doctors have all been so wonderful through my entire illness, and now, as I continue to deal with occasional pouchitis (similar to colitis, but inflammation of the new pouch), inflammatory arthritis, and fibromyalgia, but they’re not very concerned with my sense of extreme hunger on a medical level. That makes sense to me; I think it is primarily psychological.

I have a great therapist I’m working with, but I haven’t started talking about the hunger yet. I think I will, soon, but I think that in the same way I haven’t wanted to fight with this hunger, I have been reluctant to bring it to therapy where I will have to really look at it. Once I start to look at the hunger, I’m going to have to unravel all of the painful emotions and gory memories I’m carrying from the scary years of the most dramatic parts of my illness.

I need to face that, and I’m almost ready.

Basic Factors that Cause Emotional Eating

In the meantime, I’ve been learning about emotional eating.

One very brief resource from Healthline gives a succinct explanation of how emotional eating works for us:

Negative emotions may lead to a feeling of emptiness or an emotional void. Food is believed to be a way to fill that void and create a false feeling of “fullness” or temporary wholeness.

Other factors include:

  • retreating from social support during times of emotional need
  • not engaging in activities that might otherwise relieve stress, sadness, and so on
  • not understanding the difference between physical and emotional
    hunger
  • using negative self-talking that’s related to bingeing episodes. This can create a cycle of emotional eating
  • changing cortisol levels in response to stress, leading to cravings.

A Process for Addressing these 6 Contributors to Emotional Eating

Something I like to do when I’m trying to improve something about myself, or develop new skills, is to take things in parts. Particularly for lists like the one above, I like to take each item and assess whether/how it applies to me and to identify a strategy for addressing that element.

You can go through this same process by identifying the unique way you relate and a strategy that works for you.

So, here we go:


1. Negative emotions may lead to a feeling of emptiness or an emotional void. Food is believed to be a way to fill that void and create a false feeling of “fullness” or temporary wholeness.

How do I relate?

If I’m being honest, I often do feel empty emotionally. Even though I have a job I love and friends I love, being chronically ill involves a lot of grieving over things I want to do but can’t do. I try not to focus on the negative, and it’s possible that by forcing myself to always be cheerful and push those sad feelings out of my mind, I’m making them show up in my belly as a feeling of physical emptiness.

Strategy:

  1. Be mindful of the fact that I need to face my grief, and I need to look for other sources of emotional emptiness, through journaling and through working with my therapist.
  2. Find more things that genuinely fill my life with joy and satisfaction! There are many hobbies and activities that give my life meaning that I put to the side because I’m “too busy.” If I want to feel less empty, I need to fill my life with authentic positivity, either by adding new things or by amping up my gratitude practice, so that I can become more aware of how full my life really is.

2. retreating from social support during times of emotional need

How do I relate?

Well, this is definitely a big one for me! I didn’t feel like I had a strong support system as a child, and I think I just closed myself to some extent from the idea that other people could help me. I also sometimes feel like my chronic illness is burdensome or boring for others. Not that anyone makes me feel that way at all, but I know it must be hard for my loved ones to really relate to an illness that never clears up. So, I’ve gotten in the habit that I think the majority of chronically ill people fall into: putting on a happy face and failing to be authentic.

Strategy:

The easy answer to this one is: stop retreating from social support during times of emotional need!

But, of course, if it were that simple, it wouldn’t be a problem to begin with.

So, I think the right strategy is to focus on what makes a good genuine friendship (with a friend, family, spouse, or anyone): being authentic, caring unconditionally, and sharing life.

Of these three elements, I can ask myself to consider myself in the PROCESS of being more authentic, by testing out sharing more about my real life. I can see how it feels to share a little more about how things really go for me, and I’m sure that will give me more confidence that my friends really do want to support me, the way I support them.


3. not engaging in activities that might otherwise relieve stress, sadness, and so on

How do I relate?

Another big one. I have limited my activities over the course of my illness to preserve my energy, but I’m not always sick. I’m underestimating what I can do; an activity to relieve sadness can be as easy as watching a funny movie!

Strategy:

I’ll create a list of difficult emotions and then create a list of healthy (and accessible) activities that help me cope with those emotions.

For example, I think the biggest emotion I tend to eat because of is fear/anxiety.

Some healthy and accessible activities that help me with anxiety are:

  • Take a bath
  • Walk the doggo (if I’m feeling up for that)
  • Meditation
  • Sometimes I’m only anxious because I’m overworked and under-rested, so: take a nap
  • Call a funny friend
  • Watch a “safe show.” I have a handful of standby TV shows (such as The Office) that never fail to calm me down
  • Play with my chihuahua!
Look how much he wants to play

4. not understanding the difference between physical and emotional
hunger

How do I relate?

This one is interesting, and probably worth pondering for most people. How do we KNOW whether we understand the difference between physical and emotional hunger if the sensation is the same?

There are a lot of articles about physical hunger vs. emotional hunger, but this one is from the reputable source of the Cleveland Clinic: “Decoding Your Hunger: Are You Really Hungry or Not?”

Strategy:

This element is complex for me and I feel like a beginner when it comes to really being able to tell the difference. So, my initial strategy is to study the article above and do some more research about how I can teach myself to tell the difference.


5. using negative self-talking that’s related to bingeing episodes. This can create a cycle of emotional eating

How do I relate?

I don’t, really relate to this. If I give into a craving and eat more than I want to, I accept it and feel fine. Probably much too fine!

As I was learning to eat again after such a long period of intestinal illness, I celebrated being able to eat, and placed no limitations on myself.

Strategy:

While I certainly don’t want to start down a path of negative self-talk about over-eating, it is time to rethink how much I have come to accept emotional eating as perfectly normal, or even “good.”

I’m definitely aware of when I’m indulging an emotional craving—I did it just yesterday as a “reward” for a stressful day at work—so, I can take a moment to pause when I’m deciding whether to get some food to soothe myself.

“Reward” sushi

Instead, I can stop and ask myself: “What could you eat to nourish and love your body with nutrition?”


6. changing cortisol levels in response to stress, leading to cravings.

How do I relate?

I’ve thought about cortisol a lot over the past decade, since my doctors tell me stress leads to cortisol which leads to inflammation which leads to disease flares.

Strategy:

Reducing stress is a huge part of my life now, but it’s not easy with everything going on in the world and in my life. Here are some things I try to do every day:

  • Exercise. Even if it’s 10 minutes. Every day.
  • Nap
  • Any kind of arts/crafts are amazing for stress
  • Talk with fun friends
  • Sex
  • Playing with my dog as much as humanly possible
  • Writing, like I’m doing here
  • CBD oil
  • Talking with kindness to myself
  • Keeping a routine

Keeping a routine is definitely my biggest challenge, especially working from home during this pandemic. But I can’t even blame it on the circumstances. It’s about cultivating the discipline and deep-down will to actually put my needs first in life

All of these elements are huge challenges, but the first step is concretely understanding what they really are.

Week 1 Weight Loss: 3.6 lbs!

From the Runcobo scale & app

According to Weight Watchers, I’m supposed to aim to lose 1-2 pounds a week, but I think it’s pretty common for people to lose a little more in their first week due to what’s probably usually a big lifestyle change.

For me, those changes have been:

  1. Avoiding processed foods
  2. Joining Weight Watchers (but barely tracking anything!)
  3. Exercising every day (which is a really big deal since I’ve been sedentary for about a decade)
  4. Eating primarily whole foods plant-based, with a little dairy like yogurt (& a fish-oil supplement)
  5. Starting Persona vitamins (I think these make a huge difference in my energy and clarity)
  6. Taking a nap every day (I know this sounds weird, but I think it’s helping me sleep better at night and keeping me from being fussy enough to get hangry)
  7. Taking Rosebud CBD oil twice a day (Same reason as the nap: less anxiety = better results for me)
  8. Thinking about a low-sodium diet (I’m not to the point where I’m perfectly tracking my sodium, but I’m not adding salt to what I’m eating, and real talk: it’s no fun, but gotta do it)

I’m not exactly feeling skinny at about 160 pounds and only 5’0”, but I’m definitely feeling tighter and stronger from my workouts.

All I’m doing for exercise is:

  • Richard Simmons Sweatin to the Oldies “videos”! Search around on YouTube for a bunch of gems. I love this one.
  • Walking my teeny chihuahua for about 30 minutes.
  • Sex (duh)
  • Yoga, especially Yoga with Adriene. A lot of her stuff is perfect for beginners like me. I’ve been scared to get back to yoga with my arthritis and abdominal surgeries, but I’m loving these videos.
scootin’

The most important thing for me was to just get started. I’m glad I lost a good amount in the first week, but I’m really impressed with myself that I’m actually making this life change!

This is Week 1 of 52 weeks. This is a marathon and not a sprint. Heck, maybe I’ll be able to run a marathon by the end of this “marathon.” I’m not impatient; I’m just absolutely determined to see myself with a healthy BMI (which means losing 35.8 pounds and getting to 125 lbs) before a year goes by. I’m absolutely determined to put my autoimmune disease into remission and have some freedom from the intense fatigue and pain of fibromyalgia. It WILL happen.

Nothing about this first week of my transformation has been perfect, but the point is: I’m moving forward each day, and it’s about PROGRESS not PERFECTION.