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Where there is smoke there is desire

Posted on 21. Jul, 2010 by neilcrump in Communications, Health, People

I want to share my insights on the crazy world of smoking and the business of getting people to stop, officially known as smoking cessation. I am well placed to write this post because not only did I work on a prescription smoking cessation medicine and its European launch for two years, I also supported the communications for an international stop smoking programme in conjunction with the World Health Organization, but most pertinently I have been a smoker for 18 years and a successful quitter for the last seven months.

Being smoke-free: a decision to quit

So let me first tell you that being smoke free is an absolute joy, I cannot say that I feel a whole lot healthier, in fact I’ve gained a load of weight as I no longer have my magic appetite suppression sticks to play with. The joy comes from not undertaking an activity that was guaranteed to shorten my life, more precisely being free from the daily sneaking fear of a self enforced early death.

Weirdly for me in the last two years, as The Fear escalated, so did the smoking (I was almost up to 40 a day), there was no ‘reduce to quit’ strategy going on for me. The big driver was thinking about my funeral and constantly replaying what people might say before, during and after, as they learnt of my demise: “…oh it is such a shame, but he was a smoker”. With this as my background head noise and after the third bout of chest pain and on the day of my second chest x-ray at the hospital (in as many years) I decided, as I hung around waiting my turn for the radiographer, that it was time to stop.

This was reinforced as I hurried away from the hospital and saw a very (very) sick looking middle aged woman in a dressing gown sat in wheel chair smoking (using the same hand that had an i.v. drip going into it). That was NOT going to be me and that day in early January this year, I accepted The Fear had to be overcome and I stopped smoking.

What a smoker loses

I had to deal with three days of the nicotine withdrawal. For those never-smoker readers this is like having a rat gnawing away at you and constantly goading you to stop the feeling with another blast of nicotine.  The urge itself is in your brain, but also links somehow through your shoulders, into your stomach and then goes through to your finger tips. It is basically the urge that every smoker gets when they need a nicotine top up, and this normally low level urge rumbles on.  It doesn’t escalate and get louder it just keeps on going and can make you feel really unstable and constantly close to tears. You feel frustrated that you cannot make it stop. This is why quitting is initially so hard because if you give in and have a cigarette this upsetting feeling disappears immediately, making you instantly feel much better, much happier. I got over this – it really wasn’t all that bad.

The next hardest thing to overcome is the routine of smoking and working them out of your day: the breakfast one(s), the walk to the office one, the popping to the shop for a diet coke one…, you get the picture – and actually these ones are not too difficult to deal with either.

The more difficult to handle are the cigarettes (known colloquially here in the UK as ‘fags’) linked to both positive and negative emotions such as the ‘under pressure’ fag, the ‘difficult decision time needed’ fag, the ‘I am feeling stressed’ fag, the ‘didn’t we do well’ fag, the ‘I am feeling so chilled’ fag. The NEFSS (negative emotion fag support structures) are the really tough ones (especially tricky in the nicotine withdrawal phase) and continues to be challenging for a good long time after quitting. I still now, seven months later, in response to only a medium level of stress, move to reach into my bag to grab my cigarettes and lighter and want to exit the room for some ‘me time’.

This last point is really important. Smokers get ‘me time’. I’ve never (thankfully) worked in a place that allowed smoking. However since the smoking in public places ban a smoker has to remove themselves from a group and indulge their habit, often in solitude.  Do you know what? I used to LOVE this bit of smoking, this, for me, was the best thing about it. I would punctuate my working day with minutes here and there when I got ‘me time’, stepping away from everyone to think. I do miss this and am often found wandering around the building, normally with my mobile attached to my ear, chatting away, for MTRP (Me Time Replacement Therapy).

What is gained?

Apart from losing my (annoying) throat clearing cough, the real big benefit of not smoking is that I don’t smell anymore. Now if you are a never-smoker then you simply won’t get that a smoker cannot smell what they smell like. They think they do though. I was sure that I could smell cigarette smoke on me and mask it with a teeth clean, a few mint sweets and a dousing of eau de toilette. I was wrong. Every smoker is wrong. It smells so bad and keeps pouring out of those lungs for hours. Smoking smells terrible and thankfully for me just a whiff of it makes me feel nauseous and reinforces the joy on not having to do it anymore.

The vicious circle

That is an interesting thing that I just wrote: ‘not having to do it anymore’, because for many smokers that it what it is all about. You might enjoy two or three of the cigarettes that you have in a day, the rest you HAVE to smoke, the majority you just don’t enjoy. Smokers think that enjoy them and do this unconsciously by associating them as a remedy to solve a negative feeling or emotion etc. This is what being a smoker is like and often it feels like a burden.

However a smoker commits to smoking, focusing on it often 20 or more times a day, they are stoical, they are strong, they are friendly and sociable, they know all the office/company/building gossip, blah, blah, blah.  If we smoke we kid ourselves that we are in control of the situation. This is why it is such a tough addiction to break; it is easy to quit, but easier to keep smoking, and a smoker tells themselves that because it is easy to stop, they will quit another day: the vicious cycle continues.

So I have become the annoying ex-smoker who hates smoking with a passion, right! Well sort of yes, but I don’t hate smokers, I don’t feel sorry for them. I want to offer everyone encouragement that they can, if they want to, stop smoking. They just need to find a reason to quit, realise that it really isn’t that bad to quit and that being out the other side is better.

Staying a quitter is tough

So I’ve shared what it was like for me to be a smoker and a quit attempt that I feel is The One. Keep in mind that I have attempted quitting numerous times before.  I’ve stopped for about two days before and I did an Allen Carr NLP course and smoked within a few hours!  Having spent nearly £40,000 on the habit, I have thought (and talked to other smokers) about quitting a lot of times I inhaled smoke from an estimated 131,400 cigarettes (HOW SHOCKING IS THAT NUMBER!). So why is this quit The One?

Well I’ve had a number of ‘high stress’ situations to handle and while my immediate reaction was “smoke now”, I didn’t. Even alcohol hasn’t clouded my judgement and made me a smoker again. I do however derive a lot of reinforcement from people saying how great it is that I have stopped and that they cannot believe how strong I have been. This might sound a bit weak of me, I mean I quit by myself so why wouldn’t I just get on with it?

Well a chap that I hugely respect and a recently gained friend said to me: “you will always be a smoker Neil”. This comment hit me hard and really made me think (and worry) that at any point that I might fall off the wagon and start again. The fact is this is true and statistically speaking I am likely to become a smoker again.  So therefore I need this constant reinforcement that I made a great choice back in January 2010.  One thing I have done is join (‘Like’) NHS Smokefree on Facebook – the facts and figures filled status updates about smoking reinforce to me that I did the right thing (see you knew I would get a social media tip in here somewhere!).

So there you go reader, my insights on the world of smoking and cessation. Having worked in the smoking cessation communications market I am brimming with ideas on how to harness the mindset of smokers and what could be done to help them.

The direction of cessation marketing

Over the years I have tuned into and assessed probably hundreds of quit campaigns, this is because A) I work in health communications, B) I have worked on stop smoking campaigns, C) I was the target audience. Many of them fail dismally on the insights and you can just tell that they have been put together by never-smokers, or at least the smokers and ex-smokers just haven’t got their genuine insights on the table. Campaigns depicting isolated people, ‘poor’ smokers huddled smoking in the wind and rain, the immediately healthy fresh quitter kick boxing giant cigarettes, ex-smokers who are ‘still’ really sexy having quit. This is all easily derided by a smoker, easy to scoff at, easy to ignore – it isn’t insightful, it doesn’t resonate – at least not with me and any smoker that I know.

My desire was to not have a self enforced early death, but more deeply and importantly for me, was not to be seen as an idiot after my death. That was The Fear. That for me was too much to handle. This is the type of desire, highly emotional and difficult to find truth, which can motivate a motivated smoker to attempt a supported quit, in whatever guise that support takes.

I think that where there is smoke there is desire. It is just a case of finding what an individual smoker, who might like to quit, desires and supporting them in the lead up to, and during the quit attempt, and most importantly of all afterwards.

The Aurora team would love to work in this area again so give us a buzz if there is an opportunity to do so. It is a really important area and it would be a pleasure to help smokers and support quitters.

Tags: disease awareness, public health