Why can't I stop crying since I've quit smoking?

Intense, non-stop crying can be a sign of depression, which is also a nicotine withdrawal symptom. It can also be a sign that you need to learn how to deal with your emotional connection to smoking. Most likely it is a combination of both.

Not only is quitting smoking a physical journey but it is an emotional one too. Often quitters under estimate the strength of that emotional connection. Smoking offers the illusion of being able to go through life with the least amount of pain and the greatest amount of pleasure because it enhances positive emotions like pleasure and happiness and suppresses negative emotions such as stress, anger, sadness and loneliness.

My last challenge to ending my relationship with cigarettes was learning how to deal with anger without smoking.

I had been quit for about three months when I got into a fight with my father. I had never been so angry at him before. He was an alcoholic and a prolific drunk dialer. He had been a  real estate broker for most of his life and I was now selling real estate. I'm sure in his mind he thought he was being helpful when he decided to drunk dial the manager of the office I was working at and identify himself as "Santa Claus". Lucky for me his call was intercepted by a sympathetic secretary.

I blew up and headed straight for my local convenience store and bought a pack of my favorite cigarettes - Marlboro 100's. I wasn't kidding myself about only going to smoke "just one", I knew I was going to chain smoke the whole pack and I did.  As I smoked each cigarette what I was really doing was "smoking at" my father and suppressing my anger.

This relapse only lasted a few weeks. After having cancer I knew it was stupid of me to go back to smoking. I had been trying so hard for so many years to quit, that I made the decision that no matter what I was not going to smoke ever again. That meant I had to learn how to deal with not only my anger but all of my emotions.

Almost all smokers start as teenagers, so at an early age we learn to associate smoking with emotions. They help us celebrate the good times and commiserate during the bad. No wonder it feels like we are losing our best friend when we quit.

There are four ways of dealing with emotions: express, suppress, escape and release. With anger I needed to learn how to release it in a healthy manner without smoking, instead of using nicotine to suppress it. I did have help with this from a professional therapist who I had been seeing to deal with the stress of going through cancer treatment.

The best place to start is to talk with your doctor about cessation medication to lessen the withdrawal symptoms. The use of bupropion, which is an anti-depressant, may be a suitable choice. It can also be used in combination with nicotine replacement products. Next, if professional therapy is not an option, join a support group such as nicotine anonymous, or on an online group such BecomeAnEx.org. It helps to share your emotional journey with others who can relate how they are dealing with the same issues.

Realize that smoking has been numbing you to the full range of the emotions of life and without smoking you are just beginning to experience the richness of life. Nicotine is not a best friend but a saboteur and an enemy who doesn't want the best for you but only wants your money.

The #1 secret to quitting smoking

I'm asked all the time what is the one thing I would say to smokers who want to quit. The answer I want to say is to tell me more about the smoker and I will tell you what that smoker wants to hear but everybody is different. Every smoker is connected to their cigarettes in different ways and it will take different methods to become successful.

However, what every successful smoker has in common is that they truly desire to become smoke-free and quit smoking. They don't feel they have to, no one is forcing them, they are quitting because they WANT TO.

Which is the key to success: want to quit smoking more than you want to continue smoking. I can already hear you saying, "But I really do want to quit!" But is there that small voice in your head saying, "But I enjoy smoking too."?

Smokers often have a love/hate relationship with cigarettes. It is like any other bad relationship: sometimes it seems easier to stay than to go through the process of changing. So with cigarettes it is time to make the decision for a divorce.

Make two lists: things you enjoy about smoking and things you enjoy about being smoke-free. Spend time thinking about what being smoke-free means to you. More time to spend with your family or doing things you enjoy instead of constantly being a slave to your cigarettes. More money to spend. More freedom. No more searching for a place to smoke or feeling like a pariah. What are your values? is smoking preventing you from really embracing your values: as a parent and role model, as someone who values the ability to be physically independent, valuing freedom and the right to make your own decisions instead of being controlled by nicotine?

On the other hand, what do you truly enjoy about smoking? Do you enjoy the stench of stale tobacco smoke? Spending money only to burn it up? Lying to yourself that it relieves your stress when actually all it is doing is relieving your withdrawal symptoms and adding to your stress.

Once your reasons to be smoke-free are more important that another cigarette, you will find the method that will work for you. It will also get you through the months ahead when nicotine is calling you again for just one more time.  But when wanting to quit is the more important, you can tell that cigarette that you've moved on and there is no going back.

Why is it so hard to quit smoking?

Becoming smoke free can be one of the hardest changes one makes in their life, but why is it so hard?

For true change to happen it is only possible when the desire to become smoke-free is stronger than the desire to continue smoking and when the smoker has the tools, skills and self-knowledge, that build self-confidence, to take effective action.

Every former smoker will tell nobody quits until they really want to quit, until then it's a struggle. Yet 70% of smokers will say they "want to quit" but in reality, what they want is to continue getting their perceived benefits from smoking (stress relief, enjoyment) and want to avoid the negative consequences (cancer ete.). They want their cake and want to eat it too--but you can't have both. The popularity of the e-cig is that this is the promise they are making. The only problem is they can't back up their promise because no one knows the long term health effects from using the e-cig. To build desire the "WHY: of becoming smoke-free is most important.

When the benefits from smoking are compared with the negatives of trying to quitting, the cigarettes win out but when becoming smoke-free is MORE important than continuing to smoke, the method will appear because the smoker will seek out the tools, skills and self-knowledge that are needed to go through the process of changing to a life of being smoke-free. 

After having a strong "why", the next part is the "how-to" part. Often smoking is considered part of our "self-care" especially when dealing with stress, fear, anxiety. When everything is falling apart, our "friends" are still there to offer comfort. Smoking is a low-effort coping strategy and if like most smokers you have started as a teen--you haven't developed other effective coping strategies because smoking has always been there and has worked. Part of the struggle is to develop other "self-care" techniques but often they require more effort than just lighting up. This differs for every smoker and the tools, skills and self- knowledge.

Allan Carr's book, "The Easy Way to Quit Smoking" is great for motivation because he takes every argument used to continue smoking and rips it apart. He works on the WHY to quit, but not the HOW to quit. In over 20 years of working with smokers, as soon as the WHY to quit is stronger than the desire to continue to smoke, the rest is just gaining the tools, skills and self-knowledge.  This builds confidence and when a smoker feels they have the ability to succeed, they will take effective action. 

Effective action means having a plan in place to deal with the many different aspects of smoking and not relying on just one method to quit. Some smokers are more physically addicted than others and may need medicinal therapy. Habit cigarettes require behavior modification, stress cigarettes require effective stress management. 

As a Tobacco Treatment Specialist, my job is to help a smoker develop the desire, figure out what tools, and skills are needed through self-knowledge and how to develop an effective action plan. 

Relapsing at Superbowl Parties When Trying to Quit Smoking

Superbowl is one of the biggest sports parties of the year and a time when many former smokers will relapse. A huge social event with plenty of food and drink, with cheering and socializing and a slippery slope for those who have quit smoking. A cigarette seems to fit into this party atmosphere and many will rationalize that one won't hurt. But most people underestimate the power of nicotine--You're a Puff Away From A Pack A Day.
But those trying to quit, don't have to forge the party, nor do they need to relapse, what is needed is a game plan to avoid having that first cigarette. Here are some suggestions:
1. Avoid the alcohol which seems to go hand in hand with that cigarette and with each drink, the inhibitions go down.
2. Sit by the non-smokers or when talking with smokers, excuse yourself when they light up. (You don't have to explain that you don't want to be around the cigarette, go refill your soda, grab some low cal veggies, or go to the bathroom-just get away from the temptation).
3. Don't kid yourself that "One Won't Hurt". Instead say, "That's something I used to do, but it's not a part of my life now".
4. If the temptation to smoke becomes overwhelming, excuse yourself and protect your commitment to remain smoke free and leave the party. You don't need to make a big deal about it, quietly slip away or if you need to make an excuse, just tell the host or hostess, that something didn't agree with your stomach.
5. If you do slip, don't awfulize the situation but learn from it. Don't shame yourself into going and buying a pack for yourself but recommitment to becoming a former smokers.
The next Superbowl won't be for another year, but there are other positive social situations like this that will tempt you, and use this as learning experience

Are you Physically Addicted to Nicotine?

This will indicate whether you are dependent upon nicotine and may indicate whether you will need medicinal support for withdrawals when you quit.
Answer each question in the list below, giving yourself the appropriate points.

1. How soon after you wake up do you have your first cigarette?
a. within 5 minutes
b. 6-30 minutes
c. 31-60 minutes
d. After 60 minutes
2. Do you find it difficult to refrain from smoking in places where it is forbidden, such as the library, theater, or a doctor’s office?
a. yes
b. no
3. Which cigarette would you most hate to give up?
a. the first one in the morning
b. any other
4. How many cigarettes a day do you smoke?
a. 10 or less
b. 11-20
c. 21-30
d. 31 or more
5. Do you smoke more frequently during the first hours after waking than during the rest of the day?
a. yes
b. no
6. Do you smoke if you are so ill that you are in bed most of the day?
a. yes
b. no

Scoring:
1. a: 3 b: 2 c: 1 d: 0
2. a: 1 b: 0
3. a: 1 b: 0
4. a: 1 b: 2 c: 3 d: 4
5. a: 1 b: 0
6. a: 1 b:0

A total score of 7 or greater indicates that you are very dependent on nicotine and are likely to experience withdrawal symptoms when you stop smoking. A score of 6 or less indicates low to moderate dependence.
For a highly addicted smoker, there are 7 firstline and 2 second line medications approved for nicotine dependence, so there are lots of choices to finding the right combination for you. If you choose not to use medications, then it is important to take care of yourself physically while you go through withdrawals. The tings that you can do to help is to drink more water, do deep breathing exercise, avoid alcohol, and exercise.

(The Fagerstrom Test for Nicotine Dependence)

Using Cigars to Quit Smoking Cigarettes

Jim quit smoking cigarettes almost two years ago but he has started smoking mini-cigars that are the shape of a cigarette. Many men switch to cigars thinking that this is a safer alternative to smoking cigarettes because "you don't inhale" with cigars. Research has shown that when a cigarette smoker switches to cigars, that they do inhale, it is an automatic response, plus cigars, depending on the size, can have more nicotine than a cigarette, which can making smoking it even worse than sticking with a cigarette.

But it is not a matter whether it is safer or not. The issue is that the need for nicotine or addiction to nicotine is still there. A smoker always gets something from the cigarette that they are not getting somewhere else. The trick is to figure out what it is that the smoker really needs and it's not the cigarette, it is what the cigarette represents.

When a smoker quits, they go through different phases. The first phase is the physical addiction which is very intense for a week and then tapers lasting about 3 to 4 weeks. the next phase is dealing with habit cigarettes which takes a month to reverse a habit. The next phase deals with strong emotions and stress which can last a lifetime. By talking to a smoker and asking what is the longest period of time they have quit smoking for and what happened that caused them to pick up that first cigarette after quitting, I can determine what issues this smoker needs to deal with. If a smoker can't quit for more than a couple of days, then I know they are probably highly physically addicted and their issue is to deal with this. For someone like Jim, mostly likely his return to smoking cigars is to deal with underlying stress or strong emotions.

Finding out what the underlying issues are, and developing a strategy for dealing with the issue is the key for long term success.

Parental Influence on Adolescent Smoking

Condensed version: Most smokers start as a teenagers and if they become addicted, they become lifelong smokers and have a high risk of dying from smoking. The teen doesn't become addicted with the first cigarette but follows a path that can lead to addiction. The first step is thinking about trying a cigarette, then experimentation, a cigarette every now and then, which progresses to a regular pattern of usage, whether one every day after school, one every Saturday or one every time with a friend that smokes. Once this pattern is set, addiction is already being conditioned for structural brain changes that lead to addiction. Parents can influence whether their child will progress from one step to the next, those teens who are at greatest risk of continuing to smoke have parents that are uninvolved with the teens life, have friends or older siblings that smoke. Unfortunately a large number of teens that smoke are at risk for mental disorders such as depression, conduct disorder, ADHD, schizophrenia and future substance abuse.

For the full text reading:
Parental Influence on Adolescent Smoking

Smoking is one of the most preventable causes of death in the United States. Every day approximately 6000 adolescents will try smoking a cigarette for the first time, half will become a habitual smoker as an adult (U.S. Department of Health and Human Services, 2000; cited in Abroms, Haynie 2004). Over one quarter will die from the effects of their habitual smoking. (Orleans & Slade, 1993). Almost ninety percent of adult smokers started before they reached the age of 18, with 30% (Flay 1993) to 71% (U.S. Department of Health and Human Services, 2000) being habitual smokers before they were legally able to purchase cigarettes. The U.S. Department of Health and Human Services, (2000) estimates that only 7% of adult smokers who try to quit are still smoke free after one year.

It would be unethical to conduct experiments with adolescents and nicotine to assess exactly how long it takes to become addicted to nicotine after the adolescent is exposed to nicotine for the first time or exactly the changes that smoking has on the developing brain of a adolescent, however it is clear that adolescents do smoke and a large percentage will become addicted and this will decrease their life expectancy. This is the reason why it is important to look at adolescent smoking to develop strategies to prevent youth from becoming a smoker in the first place and to develop effective intervention techniques to stop the escalation into habitual adult smoking. Understanding who will quit as an adolescent and who will become an adult smoker is also important in developing these prevention and intervention strategies.

There are many reasons why an adolescent may start smoking such as peer pressure and marketing techniques of the tobacco industry. The purpose of this paper is to present a limited number of peer reviewed articles that discuss the influence of parents on adolescent smoking.

Differences have been identified as to how an adolescent relates to cigarettes and stages have been identified as to the progression of smoking which is called a tobacco trajectory.A tobacco trajectory is identified as the several stages or sequences of events that lead to the adoption of smoking by adolescents (cited in Flay, 1993, Avenevili & Merikangas, 2003): Preparatory, initiation, experimentation, regular use and nicotine dependence.The preparation stage happens when an adolescent or child begins to think about cigarettes and what meaning the cigarettes have for this child. Influences can be marketing by the tobacco companies, information about the health effects and the smoking status of parents, peers and siblings.The first one or two attempts at smoking are the initiation stage. Often there are unfavorable physical sensations such as coughing and dizziness. The next stage is experimentation, which can last for many years. It is the use of tobacco on an irregular basis. Maybe a few times a month or only with certain peers but no regular habit has been established.Regular use is the repeated use of tobacco on a regular basis whether by day, week, on weekends or just after school but with a predictable pattern.

It is important to study if parental influence is different at these different stages and to determine what truly is effective.Avenevoli & Merikangas (2003) did a literature search of published studies to see if whether parents who smoked had an influence on whether their children would smoke. They reviewed articles written after 1980 and which were mainly written in the United States. The age range was from six years old to college age, and were mainly school-based studies with predominately Caucasian subjects.The results they received are inconsistent as to whether the smoking status of a parent influences their adolescent. Several reasons were cited such as lack of standardized definitions, and the absence of adolescent that are not in school. Adolescents who drop out of school may have a higher smoking rate than those who complete high school. They did find that parents of European and Asian decent who smoke, may have an effect of their children. Significant findings were found with mothers who smoked a pack a day of cigarettes, influencing their daughters especially. More consistently they found that having an older brother or sister who smoked was predictive of both current and lifetime smoking. Having friends who smoked was an even greater predictive factor across all stages of the smoking trajectory than either having parents who smoked or older siblings whereas parental smoking was predictive in the regular use stage.

A genetic influence from twin studies (cited in Avenevoli, 2003) may lead to nicotine addiction but was not predictive for initiation.Many of the studies that Avenevoli et al (2003) reviewed did not use the stages of the tobacco trajectory so it is not known whether the effect of parental smoking may be different at different stages or whether the adult had been a former smoker or a current smoker. However, Adalbjarnardottir & Hafsteinsson (2001) did find that parental smoking was predictive of whether an adolescent became a daily smoker.Adalbjarnardottir etal (2001) looked at four different parenting styles and their influence on adolescent smoking. The four styles studied were authoritative, authoritarian, indulgent and neglectful. Theirs was a longitudinal study of 347 adolescents that they followed from age 14 to 17 in Iceland. Their results showed that adolescents whose parents were authoritative, authoritarian or indulgent were less likely to experiment with smoking at age 14 than adolescents who parents were labeled neglectful. By age 17 though, the influence on parenting styles had no effect on whether the adolescent was a daily smoker. They did exclude the daily smokers at age 14 from this progression. With cultural and attitudinal differences between the United States and Iceland it may be difficult to generalize from this study.Miller & Volk (2002) also found significant predictors among parenting styles. They used data from the National Youth Survey, which was a national longitudinal study over seven years with adolescents aged 11 to 17 with the initial information from 1976 with four subsequent follow ups. Miller et al (2202) did find that family relations were more predictive of daily use than for either the earlier stages of initiation or experimentation. Unlike Adalbjarnardottir, Miller et al (2002) did not find any significant findings when looking at how a parent disciplined their child nor their level of honesty.

The activities that Miller et al (2002) found predictive of daily smoking by the age of seventeen were: “Negative labeling of the child by the parent, perceived lack of value towards parental relationship, perceived importance of family activities, lack of time spent with one’s family, average number of weekday evenings spent with the parent and frequency of participation in family activities in the last year”. They also found that having an older sibling who smoked increased the chance of becoming a daily smoker and there was more experimentation with smoking. Miller et al (2002) also concluded that positive family relationships may reduce the risk that the adolescent becomes a daily smoker even if they have passed initiation and experimentation on the tobacco trajectory. However, the data for Miller’s study are from the late 1970’s through mid 1980. Social norm changes towards smoking and current laws against smoking may render these data outdated.In a more recent study, Simons-Miller, Chen, Abroms & Haynie (2004) also concluded that parental relations continue to influence both directly and indirectly whether an adolescent moves along the tobacco trajectory to become a daily smoker.Simon-Miller et al (2004) used data from 1996 from 1320 students in one Maryland school district with racial break down of 66% Caucasian, 25% black and 9% other for subjects. The aspects they studied were peer affiliation, parental influences and smoking stage progression. (Simons-Morton et al, 2004).They found that parental involvement, monitoring and expectations decreased the chance of child progressing forward on the tobacco trajectory but that these traits needed to be sustained over a period of time and not just exhibited at the initiation stage to be protective. They also found that parental influence had an indirect effect in protection against stage progression.

Simons-Morton et al (2004) found that adolescents that start out higher on the tobacco trajectory at earlier ages, tend to have more friends who smoke and the number increases over time. Adolescents who smoke are more likely to want to associate with other adolescents who smoke. Parents who place limits on the friendships formed with these new adolescent friends that smoke indirectly influence their adolescent’s progression . This may be limited to early adolescence since at this age many do not smoke and as the adolescent ages exposure to others who do smoke either on a regular basis or through experimentation increases. Stanton, Flay, Colder and Meta (2004) hypothesized that the escalation of smoking along the tobacco trajectory may be different than just at the initiation stage. They identified six stages: early rapid escalators, late rapid escalators, late moderate escalators, late slow escalators-smokers, stable puffers, and late slow escalators-puffers. The different stages depending on the age the adolescent started smoking and if the smoking increased quickly or over a longer period of time.The data used was from a longitudinal study from the Dunedin Multidisciplinary Health and Development Study in New Zealand. The subjects were interviewed at ages 9, 11, 13, 15, and 18 for a total of 306 subjects with 96% being Caucasian.Early predictors of future smoking at ages 11-13 included attention deficit and conduct disorders. At age 15, behavioral problems, depression scores and change of address were predictors. By age 18, poor school performance, not belonging to organized clubs and attachment to friends were predictors of smoking behavior. Intention to smoke or preparatory stage was indicated for future puffers at age 9 but not leading into rapid escalation of smoking behavior. However, the mother’s psychological symptoms when the child was 9, were an early predictor of smoking behavior. However, all of the factors mentioned may not be related to smoking specifically but may be indicative of underlying problems in the family unit.

The purpose of this paper was to investigate whether parents have an influence on whether their adolescent smokes or not. Although some parental factors do influence their adolescent no pattern was observed and it is not apparent which factors have the greatest influence.It is evident that there are inherent problems with studies in this area, due to lack of standardized definitions and inability to conduct double blind studies due to ethical reasons. Even the studies mentioned suffered from attrition of subjects, which may under estimate actual smoking rates and behaviors because most data are collected from schools. This eliminates those adolescents who do not attend school or who were absent when the initial testing was done. Adolescents who have dropped out of school, have frequent address changes or absenteeism may have higher smoking rates than students that are able to be followed for longitudinal studies. It may be that students who are stable enough to be followed, may have a more stable family life also which may influence smoking behavior.Further studies could be structured to show gender, racial and social-economic differences. Of further interest is the reason why smoking mothers influence their daughters but not their sons (Avenevoli et al 2003).Another avenue for research could look at these different factors along with social norm changes that have happened with smoking over the past decade and whether these changes affect adolescent smoking. Another area could be whether a parent has been a never-smoker or a ex-smoker or a current smoker struggling to quit, how this may influence the preparatory stage.This area of study is important in understanding how an adolescent moves from one stage of the tobacco trajectory to the next and what influences the progression and how parental influences changes with the different stages. This can lead to better prevention and intervention techniques, which over a life time will reduce the death toll from smoking.
References:
Adalbjarnardottir, S. & Hafsteinsson, L. G. (2001). Adolescents’ Perceived Parenting Styles and Their Substance Use: Concurrent and Longitudinal Analyses. Journal of Research on Adolescence, 11 (4), 401-423.Avenevoli, S. & Merikangas, K. R. (2003). Familial Influences on Adolescent Smoking. Addiction, 98 (Suppl 1), 1-20.Flay, B. R. (1993). Youth Tobacco Use: Risks, Patterns, and Control. In C. T. Orleans & J. Slade (Eds.), Nicotine Addiction, Principles and Management, (pp 365 – 384). New York: Oxford University Press.Miller, T. Q. & Volk, R. J. (2002). Family Relationships and Adolescent Cigarette Smoking: Results form a National Longitudinal Survey. Journal of Drug Issues 0022-0426/02/03, 945-972.Simons-Morton, B., Chen, R., Abroms, L. & Hanyie, D. L. (2004) Latent Growth Curve Analyses of Peer and Parent Influences on Smoking Progression Among Early Adolescents. Health Psychology, 23 (6), 612-621.Stanton, W. R. Flay, B. R., Colder, C. R. & Mahta, P. (2004). Identifying and Predicting Adolesecent Smokers’ developmental trajectories. Nicotine & Tobacco Research 6 (5), 843-852.U.S. Department of Health and Human Services. (2000). Clinical Practice Guideline: Treating Tobacco Use and Dependence. Public Health Service.

Different Reasons Why We Smoke

I have personally quit a total of nine separate times for at least 3 months each time. This is not counting the numerous attempts of a day here or a day there. Each time I have quit, I have learned something else about how I was connected to my cigarette. The first time I quit, it seemed easy, too easy and I thought I could control my smoking. But I was wrong, I needed to learn about relapsing and how just one cigarette can lead to a whole pack.
Another time it was important to learn what to do with my hands and the hand to mouth motion. Chewing on coffee stirrers worked for me. Other times, it was learning how to handle social situations without smoking and having a cocktail. I used to run a social club and often smokers would come up to me with a cigarette in their hand and want to talk. I would excuse myself and say that I would be right back. As soon as they put out their cigarette, I would return and them tell them that I had recently quit and it was difficult for me to be around a lit cigarette. That put the emphasis on me changing, not on changing or making them wrong.
The last time I quit, I needed to learn to control my strong emotions. I had started again because I was so angry at someone else that I had no outlet to vent and I saw no option except to smoke. Each time I quit, I develop another tool for my toolbox in dealing with my addiction to nicotine. Just like a carpenter needs many different tools for different jobs, a smokers needs different tools to handle the many different way they are connected to their cigarettes.
Since I've quit at least 9 times, this also means that I relapsed 8 times before I was finally successful. Most smokers would have given up before that because we want to make it easy to quit, we just want it over with but for some people like me who are truly addicted to nicotine, we need all the help we can get--which is developing more tools for your toolbox.

Many Reasons Why We Smoke

There are many reasons why people smoke, these are just some, see how many apply to you


STIMULATION:
I smoke cigarettes in order to keep myself from slowing down, such as in the late afternoon.
I smoke to stimulate myself, to perk myself up or to wake up in the morning.
I smoke to give myself a “lift”
Smoking helps me to concentrate when I am reading or studying.

BOREDOM:
I smoke a lot when I am alone.
I smoke when I have extra time on my hands.

HANDLING:
Handling a cigarette is part of the enjoyment of smoking it.
Part of the enjoyment of smoking comes from the steps I take to light up, from packing the tobacco to lighting it up and holding the cigarette in my hand.
When I smoke, part of the enjoyment is watching the smoke as I exhale or blowing smokerings.
When I don’t have a cigarette to smoke, I feel awkward because I don’t know what to do with my hands.
When I smoke, I enjoy the feeling of the cigarette and the smoke on my tongue and lips.

PLEASURABLE RELAXATION:
Smoking cigarettes is pleasant and relaxing.
I find cigarettes enjoyable.
I light up a cigarette most when I am most relaxed and comfortable.
Smoking helps me relax quickly when I feel tense.

REDUCE STRESS AND NEGATIVE EMOTIONS:
When I am trying to solve a problem, I light up a cigarette.
When I feel “blue” or want to take my mind off cares and worries, I smoke.
When I feel uncomfortable or upset about something I smoke.
I light up a cigarette when I feel angry about something.
Few things help better than cigarettes when I’m feeling upset.
When I am faced with troubles of some kind, smoking a cigarette seems to help me face them more easily.

PHYSICAL ADDICTION/CRAVING:
I smoke at least one pack a day.
I smoke within 30 minutes of getting up in the morning.
I need to smoke at least one cigarette every hour.
I am very much aware of the fact when I am not smoking a cigarette.
I get a real gnawing hunger for a cigarette when I haven’t smoked in a while.
Between cigarettes, I get a craving that only a cigarette can satisfy.
When I run out of cigarettes I find it almost unbearable until I can get them.
I go on smoking even though I find the taste rather unpleasant

HABIT:
I smoke automatically without even being aware of it.
I always smoke in certain situations such as answering the phone, getting in the car or with a drink or with coffee.
I have found a cigarette in my mouth and didn’t remember putting it there or I light up and find one already burning in the ashtray.
There are specific times during the day when I regularly smoke.
Right after lighting a cigarette, I put it out because I realize I don’t really want it.
I smoke a lot when I am talking to friends.

When quitting, it is important to have many different tools to deal with the different cravings. What works for a "habit" cigarette, may not work for a "stress" cigarette.