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.

I just quit smoking, when will I feel better?

Most smokers feel better in three to four weeks. By this time the nicotine withdrawals have subsided or are being effectively managed and "habit" cigarettes have gone away.

Nicotine withdrawal is the main reason why smokers relapse the first month they quit. Physical withdrawal symptoms are: Cravings, depression, anger, irritability, insomnia, hunger or weight gain, fatigue, restlessness and frustration. For some smokers these symptoms can last up to six months.

There is no reason why a smoker should feel uncomfortable during this first month because there are seven FDA approved cessation medications to help with physical withdrawals. Often a combination of medications works better than using one. A recent study showed that the combination of Chantix with the Nicotine Patch worked better and had higher quit rates than using either of them alone. A professional tobacco treatment specialist can help a smoker figure out what combination of medications may work best.

Habit cigarettes are often seen as the hardest to quit. The one with your morning coffee, in the car on the way to work, or the one at break time. The cigarettes are a conditioned response. Your brain has associated different activities with the jolt of nicotine. This is the same conditioning as Pavlov's dogs. The dogs were taught to associate the ringing of a bell with food. Every time they heard a bell, they started salivating because they knew food was coming. A smokers brain is exactly the same - you smell the coffee and your brain immediately thinks of a cigarette. You get into your car and your brain immediately thinks of a cigarette.

What most people are not aware of is that Pavlov also taught the dogs to stop anticipating food when they heard the bell. It's called "extinguishing the condition". It takes about three to four weeks or about 30 different times where you have a cup of coffee without a cigarette. After this amount of time, your brain no longer anticipates getting a cigarette.

When nicotine withdrawals and the habit cigarettes are no longer an issue, a smoker will feel "normal" again. This is when a smoker may think they have the problem beaten. They have mastered their addiction. But they have only mastered two parts and the tools used for withdrawals and habit cigarettes are not the same tools needed to overcome what is needed to overcome the reasons for long-term relapse: stress, weight gain, emotional triggers, alcohol and being around other smokers.

So just because you feel better soon, don't let your guard down but develop new tools and strategies tostay quit for forever.

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)

Myths About Nicotine Replacement Products

Many smokers believe that medicinal nicotine is just as harmful as getting nicotine from smoking but that is not true. Inhalation is the faster way for nicotine to enter into the brain because the smoke goes from the lungs to the heart and is pumped directly to the brain. It only takes about 7 to 10 seconds for nicotine to reach the brain. Inhalation of smoke give a higher concentration of nicotine with the fastest delivery possible. Medicinal nicotine takes much longer to get to the brain and give no way near the amount of nicotine that you get from smoking.
Another myth is that medicinal nicotine doesn't work. the truth is that most individuals who use nicotine replacement products don't use enough, they under dose themselves so that the withdrawals never do get under control or the quit using it before they should. The Mayo Clinic in their Tobacco Treatment Specialist Program suggest dosing to the level of addition. They will use a combination of the patch and oral nicotine on an as needed basis. The dose of the patch should match the amount of cigarettes smoked. 20 cigarettes = 21 mg patch. 40 cigarettes = 2 21 mg patches. Then they advocate the use of oral nicotine, the lowest dose gum or lozenge on an as needed basis, when a particularly difficult craving arises. Medicinal nicotine can be used with Zyban (bupropion is the genetic label) for those that are extremely addicted and where one product has not been enough to control withdrawal symptoms. Medicinal nicotine should not be used with Chantix (varenicline is the genetic label) because the two products work on the same receptor sites in the brain and would work against each other instead of together.
Another myth is that if you smoke when you have the patch on, you will have a heart attack. This is not true. Smokers are at a higher risk for heart disease and the best thing they can do for their heart is quit smoking but using medicinal nicotine and smoking together may give the smoker a stomachache or a headache because they are getting too much nicotine.
Medicinal nicotine can help a quitter deal with the withdrawal symptoms of quitting while they are learning to deal with all the other connections to their cigarettes such as breaking habit cigarettes, learning new coping strategies for stress and strong emotions. Tapering off medicinal nicotine is not the same as coming off of nicotine that has been inhaled, the amount of medicinal nicotine is not even close to the dosage from smoking and doesn't reach the level for addiction. Besides, nicotine is addictive but it's not the most dangerous drug in smoke.
Using medicinal nicotine can also help with post cessation weight gain.

Bad Support for Quitters-What Not To Do

When Frank, a two pack a day smoker, came home from work after his first day of not smoking, his wife asked him how it went. Frank admitted he smoked one cigarette. His wife blew up at him yelling “You’re supposed to be quitting. How can you be so weak?”
Lee’s husband was always nagging her to quit. Finally he threatened to take away her new car can cancel their vacation if she didn’t stop smoking. When she succeeded for three days, he went around and told everyone how HE got her to quit. It was no surprise when she started again to spite her.
When Stephanie told her boyfriend she was going to quit smoking he just looked at her and said sarcastically, “Again, how many times does this make?”
If you’ve never smoked, you can’t begin to know how difficult it is to quit. Plain and simple…cigarette smoking is an addiction.
It’s bad enough that society is nagging smokers to quit, they don’t need to hear it from you too. In fact, there isn’t a smoker around, except for the executives at the tobacco companies, who don’t tell themselves:
• I need to quit.
• Smoking is bad for me.
• It’s bad for the people around me.
Anyone who smokes knows they need to quit. There isn’t anything you can say to a smoker about quitting that he doesn’t say to himself regularly. Confrontations, threats, put-downs or preaching are not the ways to help. What they need is plenty of support and they need it from you.
Tell you loved one that during this difficult transition, he can call on you for support at any time. Make yourself available, but let the smoker dictate if he or she wants to talk about smoking or not. It’s best just to say “How are you doing?” and let him take the lead.
The decision to quit smoking is a big one. It’s the first step to becoming a non-smoker. Because the addiction to nicotine and cigarettes is both a physiological as well as psychological it may take more than one attempt to break the dependency.
Help your loved one stay away from other smokers and cigarettes. Understand if they decline an invitation where other smokers will be. It’s worth the inconvenience and trouble to avoid a situation where it would be easy for them to “just have one.”
Encourage activities that are inconsistent with smoking, such as hiking, walking, swimming, and tennis, or go to places where smoking is not allowed, the movies, museums, church.

WHAT TO EXPECT
Please keep in mind that your loved one is going to experience both physiological withdrawal.
Physiological withdrawal requires about two weeks to run its course. Nicotine is efficiently eliminated through the kidneys so it’s a good idea for your non-smoker to drink large amounts of water and other liquids. Headaches, irritability, muscle cramps and aches, anxiety and visual and sleep disturbances are common symptoms of withdrawal. The degree to which these symptoms are experienced is highly individual. Some fortunate quitters have no symptoms while others will experience them all.
The psychological withdrawal from cigarettes is hardest during the first 2 to 3 months after quitting. Nicotine is so physically addicting that someone who gives into craving to have her just one will most likely start smoking again.