Smoking and health I m giving it a go. A step-by-step guide for people who smoke and want to cut down or quit

Transcription

1 A step-by-step guide for people who smoke and want to cut down or quit

2 A step-by-step guide for people who smoke and want to cut down or quit This booklet has been developed by the Tobacco and Mental Illness Project, and Quit SA (a joint initiative of Cancer Council South Australia and the National Heart Foundation - SA Division). The Tobacco and Mental Illness Project and Quit SA are funded by Drug and Alcohol Services South Australia, SA Health. Printed 2004 Revised and reprinted 2011 Resources on smoking and mental health are available from Quit SA. PO Box 929 Unley BC SA 5062 Telephone: (08) Fax: (08) Quitline: quitsa@quitsa.org.au The information in this booklet is of a general nature. For more information about your specific health concerns, you should consult your doctor or health worker. If you take medications, talk to your doctor as the chemicals in cigarettes can change the way some medications work. page 1

3 Contents Introduction...3 Did you know?... 3 How much does smoking cost?... 4 Likes and dislikes... 5 Step 1. Making the decision...6 Your decision... 7 Step 2. Getting ready...8 How will it affect your mental health?... 8 When do you feel like smoking?... 9 Getting to know when you feel like smoking Managing your triggers Coping with cravings The 4 Ds Coping with withdrawal symptoms What will happen when you cut down and quit? Ways to cut down and quit Nicotine replacement therapy Choosing a date and time Step 3. Giving it a go...16 Coping with stress Managing difficult feelings Being with smokers Rewarding yourself Smoking and your lifestyle Weight control A healthy and balanced diet Support Staying quit or cut down page 2

4 Introduction Some people find quitting or cutting down very difficult and need extra information and support to give it a go and to get there. This guide was originally written specifically for people living with mental illness, but it can be useful for anyone who wants to address their smoking. It includes information about how to look after your mental health while tackling tobacco something that is relevant for anyone who smokes. This guide can be used as a step-by-step guide if you are working on your own, or as a workbook to use with the support of someone else or as part of a group. More than 800 people with mental illness have participated in the Tobacco Free groups run by the Tobacco and Mental Illness Project and this guide includes many of their comments and ideas. The Tobacco and Mental Illness Project and Quit SA have developed other resources, which are available from Two resources have been developed specifically for people with mental illness: > >Are you sick of smoking? a brief guide for people with mental illness > >How can I support someone to address their smoking? for family, friends and health workers. I d smoked heavily for 28 years and tried to quit many times. I have schizophrenia and wanted to quit. The quit tobacco group gave me the confidence and support to try again. Now I haven t smoked for over two years and I have a lot more money for the things that I want and really need. I ve saved up for a trip to see my friend in Katherine in the Top End. At the bottom of most pages in this guide are quotes from people who were involved in Tobacco Free groups. Many thanks to all those who gave us their ideas, wisdom and experience. page 3

5 Did you know? Tick the ones that you didn t know before... Every day more than 40 Australians die from a disease caused by smoking. That s about 15,000 people every year. Smoking causes diseases such as emphysema, lung cancer, other cancers and heart disease. Smoking is a slow way to die. It causes a strain on your body, which may lead to years of suffering. Tobacco smoke contains more than 4000 chemicals including nicotine (this causes the addiction), tar (the black substance that sticks to the lining of your lungs), ammonia (found in floor cleaner), arsenic (found in rat poison), lead (linked with brain damage) and many others. Smoking reduces your fitness. Smoking stains your teeth and causes brown nicotine stains to develop on your fingers. It makes your clothes, hair and breath smell. It also makes you age more quickly. Smoking reduces fertility in women and men may experience impotence. Smoking near others can harm them. Most people with mental illness are concerned about their smoking and want help to quit. Quitting tobacco helped me to know I can take control and positive steps in all areas of my life. It doesn t matter if you are 85, you can still live longer if you quit smoking. page 4

6 How much does smoking cost? How much money do you spend each day or week on smoking? Use the chart to work out how much you could save if you quit. Day Week Month 1 year 10 years $2.00 $14.00 $60.00 $ $7, $4.00 $28.00 $ $1, $14, $6.00 $42.00 $ $2, $21, $8.00 $56.00 $ $2, $29, $10.00 $70.00 $ $3, $36, $12.00 $84.00 $ $4, $43, $16.00 $ $ $5, $58, $18.00 $ $ $6, $65, $20.00 $ $ $7, $73, How much could you save in one year? Make a list of things you could buy with that amount Being a smoker can mean going without things you really need or would like to have for yourself. Many people find that when they quit it really helps relieve financial stress. I ve bought a microwave and a new mat. I m saving to visit relatives in England and my doctor is thrilled. I m smoking a lot less than I used to and the other day I had a pizza, a coke and some garlic bread. I haven t been able to afford that for years. page 5

7 Likes and dislikes If you are a smoker, it is a good idea to take some time to think about what you do like about smoking and what you don t like. Weighing up what you like and don t like helps to build a picture of what smoking means to you. Things I like Things I don t like If you are thinking you might like to quit or cut down, this guide will give you some information to help you make the decision. I don t want to smoke because I have asthma and it makes it difficult to breathe. I want to quit because my boyfriend said he didn t want to kiss an ashtray. page 6

8 The three steps Many people find quitting or cutting down difficult but with the right information and support they find they can do it. If you decide that you want to make changes to your smoking, here are three steps that can really help: 1. Making the decision 2. Getting ready 3. Giving it a go Becoming a non-smoker can feel like a big change, but if you take each step at a time it will be easier. I used to smoke heavily and I tried six times to quit. Now I haven t smoked for more than seven years and I think it was the best thing I ever did. When I quit, my medication was reduced, I lost weight and I now have lots more energy. page 7

9 Step 1. Making the decision Think carefully about the reasons you like smoking and the reasons you don t like smoking and make your own decision. Find out as much as you can so you can make a good decision. You may want to find out more about how quitting or cutting down will affect your body. You may want to know more about how it will affect your mental health. Write down anything else that will help you to make your decision. Where can you find out more? You will find some answers and useful information in this guide. You could also: > >telephone the Quitline >>go to the library >>look up information on the internet >>talk to your doctor or health worker. I ve been smoking for a long time, but it s never too late. My doctor really wants me to quit. I rang the Quitline and they sent me some information. page 8

10 Your decision Now you have thought about the pros and cons of smoking and you have some information about some of the good reasons to quit or reduce your smoking, you may feel you can make a decision. You may decide: >>you want more information >>that now is not the right time, you will think about it later >>you want to cut down the number of cigarettes you smoke >>you want to be a non-smoker. Spend some time thinking about your decision and remember it is your decision. Only you can make it. Write your decision here: The bigger your no to smoking, the easier it is to stop smoking. I don t know if I ll be able to quit, but you don t know until you try. page 9

11 Step 2. Getting ready If you have decided that you would like to give it a go, spend some time planning and getting ready. Here are some ideas that may be helpful: >>Find out when and where you most feel like smoking and make plans for how you will manage these times without a smoke. >>Learn about the withdrawal symptoms. It will be easier if you know what to expect and prepare yourself to deal with them. >>Find out about how others have made a change to their smoking and think about the best way for you to do it. >>Find out more about nicotine replacement therapy (NRT). >>Think about where you can get support. >>Think about your own plan and allow yourself enough time to prepare and get ready. Some of these points are covered in more detail later in this guide. It is a good idea to talk with your doctor or health worker and call the Quitline for more information and support. Other people with mental illness have managed to quit, so it s possible. I want to quit because smoking doesn t make sense. page 10

12 How will it affect your mental health? Many people have been able to cut down their smoking or quit, especially if they have good information and support and take one step at a time. Most say when they quit smoking they feel much healthier, both physically and mentally, they feel better about themselves, and have a better quality of life. Here are some tips for those who want to make a change to their smoking. Some may be especially important if you have a mental illness. Talk with your doctor or health worker If you have a mental illness or other health issue, it is important to talk with your doctor or health worker about your plan to change your smoking and ask for help to achieve your goal. Mental health When you first make big changes to your smoking you may feel more anxious or unhappy than usual and you may have difficulty concentrating. These feelings are normal and may be related to nicotine withdrawl. They are likely to pass but you need to be prepared. Talk with your health worker or doctor if these feelings worry you. A few people experience an increase in symptoms of their mental illness. They may feel more agitated or become depressed. If this happens: >>you may find it will pass as your body adjusts to the change >>you may want to cut down more gradually >>you may want to take time out from other activities and rest. If these feelings persist, it is important to talk to your doctor or health worker. Overall my thinking is clearer quitting has been positive for my mental health. I feel much better since I quit smoking. My skin has improved and it has boosted my confidence. I was really introverted before, now I have found a voice. page 11

13 Medication Some medications are used by the body more quickly by smokers than by non-smokers. This may mean that when some smokers quit or significantly cut down their smoking, their medication needs to be reduced. If you are taking any medication, it is important to talk to your doctor or health worker about it and work together to monitor if any changes are needed. Stress Plan to change your smoking when there is less stress in your life and your mental health, finances and relationships are all fairly settled. Some people smoke more when they feel stressed and need to plan other things to do at stressful times. Many people believe that smoking helps them relax. This is not really true and there are much healthier ways to relax. You can read more about this under Coping with stress later in this guide. Hospital or becoming unwell Many people with mental illness start smoking when they go into hospital or become unwell. It is important to get support to remain a non-smoker, or to stay in control of your smoking and not to start to smoke more. Ask your health worker, doctor, family or friends for support. Group support Most people need support to make a big change. Ask the Quitline , your health worker or doctor if there are any support groups available. Slip-ups Many people find they can stop smoking for a time but then have a slip-up and go back to smoking. This can be a normal part of becoming a non-smoker. Be prepared for this and don t be hard on yourself. Have another go when you are ready. I haven t smoked for 30 days and I m coughing up lots of black stuff but my asthma is better, I can breathe. I ve just finished work and I m feeling good. It s hard not grabbing a smoke when I feel stressed but I know it doesn t help and it s making me sick. page 12

14 When do you feel like smoking? There are three main reasons why people feel like smoking. 1. The addiction Nicotine is a highly addictive substance. As the level of nicotine in your body gets lower you will have cravings and feel like smoking. Your body will take some time to get used to not smoking. 2. The habit If you have been a smoker for a long time, you will have built up some smoking habits. There are likely to be places and situations in which you usually smoke and when you quit smoking these situations will feel strange without a smoke. They are called trigger situations. For example, waiting around, finishing a meal, talking on the phone, being with friends, having a coffee. 3. The feelings If you have been smoking for a long time, you may feel like smoking when you have certain feelings. You may feel like smoking when you are feeling sad, bored, relaxed, tired, lonely, angry or stressed. These are called trigger feelings. Everyone has different trigger situations and feelings. Find out the times that you feel like smoking so you can learn more about when you are most at risk of wanting to smoke. Think about how you can manage these times. First thing in the morning used to be the hardest. I really felt like having a smoke when I drank coffee, so when I quit, I gave up coffee for about a month and it helped me get through. page 13

15 Getting to know when you feel like smoking Over a 24 hour period write down every time you feel like smoking. What time is it? - 1pm What are you doing? - waiting for the bus What are you feeling? - feeling annoyed Make a list of the situations and feelings that make you want to smoke These times are your triggers. Before you try to change your smoking you need to make some plans to help you cope with your triggers. I went for lots of long bus rides when I was quitting. The triggers were an eye opener to me. I had triggers that I had not even thought of. page 14

16 Managing your triggers Make a list of your triggers and come up with ideas on how you will deal with them. Trigger - talking on the phone Plan - I will chew gum instead The hardest cigarette to give up was the one in the morning. I would have a shower and get some breakfast - quick. I did other things to take my mind off the cravings - chewing gum, PlayStation. page 15

17 Coping with cravings When you feel like smoking and the craving is really strong, it helps to do something to take control of the situation. Here are some ideas: Sweep the craving out of your mind >>go for a walk >>take some deep breaths >>recite a poem, song or nursery rhyme >>think about what you would do if you won $100,000 >>put a rubber band on your wrist and ping it when you feel like smoking. Visualise yourself as a healthy non-smoker >>picture yourself not smoking >>imagine your body feeling really healthy and clear of smoke. Remind yourself of the reasons you want to quit smoking >>think of all the reasons that were important to you >>carry a card with you to remind yourself. Get some support >>call or visit a friend or family member who is supportive and ask for support > >call the Quitline Talk to yourself >>be your own best coach, give yourself a pep-talk. Dealing with difficult days >>some days will be more difficult than others, be prepared and patient. Think of some other ways of coping with the cravings and write your ideas down. The toughest times are the most productive. Every time you get through a strong craving, you are a step closer. The cravings seem to come in waves. I kept thinking about all the reasons why I wanted to quit and told myself that the cravings would pass. page 16

18 The 4 Ds Here are some useful tips to use each and every time you have a craving. Delay Delay having a smoke - wait a while. After five minutes the urge to smoke will become weaker and your will to quit will become stronger. Deep breathe Breathe in slowly and deeply, then breathe out slowly. Do this three times. Drink water Get a drink of water and then sip it slowly, concentrate on the taste and feel of the water. Add some ice and lemon if you want to. Do something else Take action, do something different: >>listen to music >>go for a walk >>do anything that will help you to think about something else. It was difficult morning, noon, afternoon and evening to begin with, but it s six months now since I had a smoke. If I can do this for 22 days, I can do this for the rest of my life. page 17

19 Coping with withdrawal symptoms Most people will experience some withdrawal symptoms when they start to cut down the number of cigarettes they smoke. These symptoms are signs that your body is recovering from smoking, the nicotine is leaving your body and you are becoming healthier. The withdrawal symptoms will gradually become less intense. Most will disappear within the first two weeks. Withdrawl Tips Feeling restless, tense, angry or shaky Having difficulty sleeping Feeling sad Constipation or diarrhoea >>Breathe deeply >>Do some relaxation exercises >>Go for a walk, do something physical >>Listen to music or have a bath >> Relax >>Listen to music or have a bath >>Have a hot drink of milk with Milo or honey >>Exercise during the day >> Relax >>Go for a walk, do something physical >>Listen to music or have a bath >>Give yourself time >>See your doctor or health worker >> Drink 8-10 cups of water each day >>Eat more fruit, vegetables and cereal I ve gone all day without a smoke, why should I crack now? I think I am doing a good job. It s hard, but I ll just keep at it. The first two or three days were pretty bad, but after that it was OK. page 18

20 Withdrawl Having trouble concentrating Coughing or tightness in your throat Feeling hungry and putting on weight Feeling tired Headache or dizziness Tips >>Do something easy >>Make lists >>Go for a walk, do something physical >>Give yourself time >>Drink water >>Suck on a throat lozenge >>Give it time, it will ease >>Eat less fat and sugar >>Do some exercise >>Drink more water >> Breathe deeply >>Do some relaxation >>Have a rest >> Breathe deeply >>Do some relaxation >>Have a rest >>If necessary use pain relief, or see your doctor Remember: all of these are signs your body is recovering from smoking. All will pass - hang in there! I used to walk a lot, my dogs got really fit when I was quitting. I slept a lot for the first few days. It helped me to get through the withdrawls. page 19

21 What will happen when you cut down? When you cut down you will notice some improvements to your health and to your finances. However there will continue to be nicotine in your body and you will continue to experience cravings. Many people find it very difficult to remain cut down for a long time and often find that, gradually, the number of cigarettes smoked each day increases and before long they are back smoking the same number as before. When you have cut down to 10 or 15 cigarettes a day, think about quitting. Many people find it easier to quit altogether than to stay reduced. What will happen when you quit? When you quit smoking you will begin to feel the benefits straight away. The healing process begins and noticeable changes occur. After two hours The nicotine is out of your system. After two days Your taste buds and your sense of smell will improve. Your breath, hair, fingers, teeth and clothes smell better. Your lungs are recovering and beginning to remove the mucus. You may start to cough up mucus that may be black and full of tar. After 12 months Your risk of sudden death from heart attack is down to almost half that of smokers. You have reduced your risk of dying from a stroke, lung disease, heart disease and many other types of cancer. If you were spending $10 a day on cigarettes you will have saved $3, My asthma has really improved. I m not using as much medication and I m finding it easier to breathe. I will never go back to smoking. There was no way that I could cut down, I found it too stressful watching the clock, I m an all or nothing person. page 20

22 Ways to cut down If you cut down the number of cigarettes smoked each day but keep smoking a few, the cravings and withdrawal symptoms will continue for longer and it is likely to become more difficult. When you quit smoking completely the withdrawal symptoms and cravings will eventually fade. Once you have cut down to 10 to15 cigarettes a day, think strongly about quitting altogether. It may feel like a big step, but most people find that once they have taken the last step, it is easier than trying to cut down further. Some people use nicotine replacement therapy to cut down and then quit. Ways to quit There are different ways to quit and different ways suit different people. Going cold turkey This means one day you smoke and the next day you don t. For many people this is the most successful method. You will need to plan ways to cope with the triggers, cravings and withdrawal symptoms. Cutting down If you smoke more than 20 cigarettes per day you may want to cut down and then quit. Have a plan and stick to the plan, for example, cut down by five cigarettes per day for the first week. Then the following week cut down by another five cigarettes per day. Keep doing this until you have cut down to 10 to15 cigarettes per day. Then plan to quit. Delay Make the time you have between smokes longer each day. For example, if you have a smoke every hour, cut down to one every two hours for a week and then one every three hours for a week. Then think about quitting. Cutting down was a really good reality check for me. It made me question why I was smoking and why I smoked as much as I do. When I was cutting down I used to keep thinking, when can I have my next cigarette. When I quit I could just forget about it, but at first it was scary. page 21

23 Nicotine replacement therapy Nicotine replacement therapy (NRT) provides your body with some nicotine while you are quitting. This helps to ease the withdrawal symptoms. It is a good idea to talk to your doctor and pharmacist about NRT before using it as it is not suitable for everyone. Nicotine chewing gum, lozenges and tablets Ask your pharmacist how to use them properly. Once you have stopped smoking and feel more confident you can reduce the gum, lozenges or tablets gradually until you no longer need them. Nicotine patches Nicotine patches come in three strengths, and it is suggested that they should be used for about 8 to 12 weeks. They are easy to put on, just like a band-aid. In some people they may cause mild skin irritation. The 24-hour patch can cause sleep disturbance, vivid dreams or nightmares because you are getting nicotine while you are sleeping. Inhaler The inhaler looks a bit like a cigarette and contains nicotine and menthol. You place it in your mouth and inhale. It is useful as it gives you something to do with your mouth and hands. After 6 to 8 weeks of not smoking, you can start to cut down the number of inhalers you use each day. Zyban and Champix These medications do not contain nicotine but they can help by reducing the desire to smoke. A doctor must prescribe them as they can affect some people s mental health and interact with some medications. When I put it on (the patch) it takes one to two hours to kick in and in the morning it s hard because that s usually when I smoke. I put on a patch when I wake up then stay in bed for a while. I didn t think I could do it but I did. There is no use using a patch unless you are really determined. It s a waste. page 22

24 Choosing a date and time Select a date that suits you best. It is a good idea to choose a time when you are not too busy or stressed with other pressures. Make sure you are well prepared. Remember don t leave it forever, your health is important. Here are some ideas that may be useful Prepare your environment >>Remove all smoking items, such as ashtrays and lighters from all areas and have a good clean up. > >You may like to put up smoke free stickers. Prepare your body >>Go to the doctor and talk about your plan. >>Reduce your caffeine, alcohol and other drugs prior to quitting. >>Get plenty of rest. >>Drink plenty of fluids, especially water and fruit juice. Prepare your feelings >>Keep reminding yourself why you want to quit. >>Write positive messages to yourself. Prepare your time >>Plan enjoyable activities for the first week after quitting. >>Think of things to occupy your hands. Prepare others >>Prepare your friends and family and ask them for support. >>Talk with other smokers who you have contact with. >>You may like to ask them not to offer you cigarettes or leave them around. >>You could ask others not to smoke anywhere near you. My life is always up and down. I felt like there was never going to be the perfect time, sometimes you just have to do it. Having a mental illness can be a real downer. Quitting cigarettes is easily the best thing I have ever done. It has improved my money, health, self esteem, stress levels, concentration and looks - it has just transformed me. page 23

25 Step 3. Giving it a go Look after yourself while you are quitting. Get plenty of sleep, eat well and do some exercise. Take one day at a time and give yourself rewards and encouragement. Remember, every day without a smoke is a great day for your body. The urge to smoke will gradually lessen, but be prepared to deal with the cravings that may come at any time. If you have a slip-up >>If you do have a cigarette, remind yourself that it can be just a slip-up and go back to your plan. >>You don t have to finish the cigarette, you don t have to finish that packet. A slip-up doesn t make you a smoker again. >>Keep trying, it will get easier. If you go back to smoking >>Most people have to try a few times to quit and each time helps them to learn more about themselves, why they smoke and what they need to do to quit. >>If you think about what you have learnt this time, you will be better prepared next time. >>Give it another go as soon as you are ready. I ve had a few slip-ups, but I am getting better at not smoking. The main thing is that I keep trying, then I will get there in the end. It will only last a few weeks. It will pass, then I will feel great, on top of the world. I had a couple of smokes and then put the rest of the packet under the tap. I went fishing with my mate and had one and then started smoking again. page 24

26 Coping with stress Some people believe that smoking helps them to relax and deal with stress, but this is not actually true. People often have a break or take time out to have a smoke and it is the behaviour around the cigarette that is helping you relax (having the break, thinking about something different and the breathing). When you are addicted to nicotine and you haven t had a cigarette for a while, the levels of nicotine in your system are reduced and you may be experiencing some symptoms of nicotine withdrawal. This can feel like you are stressed and when you have a cigarette the feeling eases. Many smokers get into the habit of smoking more when they are feeling stressed. You will need to find new things to do when you feel stressed and this will take practice. Here are some ways to help you to relax Breathe deeply Take three slow deep breaths. Concentrate on your breathing. Tense and relax Lie down or sit comfortably. Close your eyes and take a few deep breaths. Gradually work through all the muscles in your body, tensing then relaxing. Wait a moment and open your eyes. Rest your mind Lie down or sit in a comfortable place, close your eyes and take a few deep breaths. Visualise somewhere relaxing and peaceful, like a beach, a forest or somewhere nice and calm. Do something different Sometimes doing something different helps you to relax. Exercise Doing some exercise that you enjoy can help you to relax. The time after you quit is less stressful, because you are not having to worry about where are you going to get your next smoke, you don t have to pick up butts or bludge. Once I re-learnt how to cope with stress without smokes my stress levels actually went down. page 25

27 Managing difficult feelings Lots of feelings come up when you are making a big change to your smoking, and some of these feelings can be difficult. Here are some feelings that may arise and some tips that may help you deal with them. Depression and loneliness It may feel like you have lost something >>Practise positive affirmations and stopping negative thoughts. >>Ask for support and if it worries you, seek professional help. >>Talk to a friend or family member. Panic It can feel scary, like it is just too hard >>Take each moment at a time and practise relaxation. Anger and resentment You may feel angry or like blaming someone else >>Do some relaxation and use positive self talk. >>Think about why you decided to make a change. >>Exercise, for example, go to the gym, play sport or go for a walk. >>Take time out from others and find a quiet place to settle down. Boredom Boredom can be a reason that causes some people to smoke >>Make a list of things you enjoy doing and plan to include them in your day. >>Phone a friend and walk around to their place. Doubt It is common to have doubts when you are making a change >>Take one step at a time and practise positive thinking. Remember these feelings are normal and are likely to pass. If they don t pass and they worry you, talk to your doctor or health worker. page 26

28 Being with smokers At first it can be very difficult being with other smokers. Just seeing someone smoking can trigger the desire to smoke. The smell of tobacco can make you want to have a cigarette. Some other smokers may be friends who you have spent lots of good times with, sharing a cigarette and a coffee, or just chatting. It can feel really strange being with these friends, without having a cigarette. Here are some suggestions that may help >>Tell others about your plan and ask them for support. >>You might like to ask others to: not smoke in front of you not give you a cigarette be encouraging. >>You might choose to avoid being with some smokers at first. >>If you spend time with smokers try to think of places that don t involve smoking, such as the movies, the shopping centre or on the bus. Some other smokers may actually want you to keep smoking. They might have enjoyed smoking with you. Sometimes you may need to be strong about your decision, say no and really stick up for yourself. Here are some tips that might help you say no >>Be honest, direct and confident. >>If you are not being listened to, change the subject or move away. >>At first avoid situations where you may find it hard to say no. >>Think of something you can do to help you avoid having a cigarette. Mental health services Some mental health services are still places where people smoke together and they can be difficult places when you first become a non-smoker. >>You may need to plan how you will cope when you are in these centres. >>You may want to ask staff for their support. page 27

29 Rewarding yourself Quitting or cutting down tobacco is challenging. Every time you succeed in resisting the urge to smoke you should congratulate yourself. It is a good idea to think of rewards that you can look forward to and enjoy. Nurture or treat yourself and ask others to congratulate you. Here are some ideas Make a list of rewards that work for you I ve bought an aquarium, a lawn mower, and a new bike and as well as that my medication has been reduced. It will be eight years next week that I haven t had a cigarette. That s thousands of dollars that haven t gone up in smoke. page 28

30 Smoking and your lifestyle Other factors in your life can make it easier or harder to quit smoking. Alcohol and other drugs Alcohol and other drugs tend to weaken your resolve, so some people relapse when drinking and using other drugs, especially in the early stages. It is best to avoid alcohol when you are first trying to stay quit and it is safer not to use illicit drugs. Physical exercise Physical exercise is helpful when you are changing your smoking because it helps with feelings like sadness and anger, reduces weight gain, and relieves boredom and improves sleep. Boredom If you were a heavy smoker, when you quit you will notice that you suddenly have more free time. You may need to think of things to do with your new time. Make a plan for something to do each day. Some people find it useful to have something to do with their hands like doing a puzzle, playing patience, doodling on some paper or making a list of things that start with one letter of the alphabet. It can take a while to get used to not smoking. After a while you will find things that you like to do instead of smoking. Be patient while you get used to your new, healthier way of life. I asked my care worker to smoke outside and I put smoke free stickers on my door. I avoided the pub for a few weeks because I knew I wouldn t be able to handle it. I let a friend know that I wasn t smoking, and when I visited his house he smoked outside, which I thought was a really nice thing to do. It s more difficult when I have a joint. page 29

31 Weight control Some smokers worry about gaining weight if they quit or cut down smoking and for some people this can stop them from giving it a go. Only about a quarter of smokers put on any weight after they stop smoking and in most cases this will disappear after 12 months. If you do more exercise and have a healthy diet you are less likely to put on weight. Be careful about eating unhealthy foods in place of smoking. Here are some important things to remember if you are worried about putting on weight >>Avoid foods that are high in fat, such as fried foods, take away food, butter, cream, potato chips, pies and pasties. >>Avoid food with lots of sugar, such as cakes, pastries, lollies, chocolate, desserts and biscuits. >>Avoid unhealthy snacks such as chips, peanuts or take aways. Find some healthy treats such as some fruit, a salad sandwich or a sugar-free lolly. >>Eat a balanced diet with more fruit, vegetables and cereal. >>Drink between 6 and 8 glasses of water each day. >>Do some exercise everyday. >>Avoid soft drinks and milk drinks that are high in sugar. >>Avoid drinking more alcohol. I put on a little bit of weight when I quit, my taste buds changed and food tasted better, but I feel fitter and I m able to do more things. Better for my health, better for my pocket. I ve stopped eating licorice allsorts. page 30

32 A healthy and balanced diet Eat most Eat moderately Eat less I need to be careful not to drink too many iced coffees. I remember having a lasagne after I had quit, I couldn t believe how good it tasted. page 31

33 Support Everyone needs support to change their smoking. You may need to tell family and friends how to support you. People can provide support by: >>listening to you talk about your feelings >>giving you practical help at this difficult time >>giving you lots of encouragement >>reminding you why you want to quit or cut down >>going with you to non-smoking places such as the movies, the footy or the library >>rewarding you for giving it a go. Think about the support that would be most useful for you and let others know how they can help. Other places to go to get support Quitline provides counselling and support to anyone who is thinking about quitting or cutting down. They can provide written information, advice and regular phone calls while people are changing their smoking. Many of the advisers have had a lot of experience helping people with mental illness. SANE Australia have produced some useful resources about tobacco for people with mental illness and supporters and some guidelines for GPs and health workers. For more information visit the website at Your doctor, local pharmacist or health worker can provide support and encouragement. Your local library and the internet can be a good place to go for information and ideas about quitting tobacco. It can be hard to deal with depression at the same time as quitting. Support made a big difference - support from my group, my doctor and my friends. My doctor changed my medication a bit. Doctors should encourage you to quit, because the whole of me matters, not just my head. page 32

34 Staying quit or cut down When you have cut down >>Keep a close check on the number of smokes you have each day and don t let it creep up again. >>Most people find it hard to stay reduced, so it s a really good idea to take the next step and make a plan to quit altogether. When you have quit >>Start thinking of yourself as a non-smoker. >>Remember the urge to smoke will become less intense as each day passes. However a craving can come when you least expect it, so stay prepared. >>If you feel the urge to smoke, use all the skills and strategies that you have learnt to get through. >>Congratulate yourself, give yourself a reward. If you have a few cigarettes >>Remind yourself slip-ups can be just another step in learning how to change your smoking. >>It is best to plan to get back on track as quickly as you can and keep trying. If you go back to smoking >>Don t despair and don t give up on yourself. >>Remember most people have to try a few times. >>Think about what you have learnt and plan another attempt as soon as possible. Good luck and keep trying! When I quit, my psychiatrist asked me how I did it so I told him and last time I saw him he hadn t had a smoke for three weeks. I told the bloke in the deli that I was quitting. He would ask me how it was going every time I went there, it helped to keep me going. It s been hard and it s still hard at times, but I m going to keep going because I want to be healthy, I want more money and I want to be a non-smoker. page 33

35 Quitline This booklet has been developed by the Tobacco and Mental Illness Project, and Quit SA (a joint initiative of Cancer Council South Australia and the National Heart Foundation - SA Division). For more information Tobacco and Mental Illness Project Tapleys Hill Road Seaton SA 5023 Telephone: Fax: If you do not speak English, request an interpreter from SA Health and the Department will make every effort to provide you with an interpreter in your language. Department of Health, Government of South Australia. All rights reserved. Printed January