Back to the November Issue
Smoke and Stress
Break the LInk
By Rachel Morse
For more than 35 years, Cindy W., a 50-year-old student at Creighton University in Omaha, Nebraska, smoked about a pack a day.
“I smoked for stress relief,” she says. “I didn’t smoke to lose weight, but the idea of gaining weight if I stopped kept me from quitting earlier than I did.”
After turning 30, Cindy noticed smoking was impacting her health. She caught colds more frequently. She found it difficult to participate in some cardio sports.
She tried several times to quit, using cinnamon sticks, lots of gum, and knitting as a distraction and for stress relief, but each time she went back to cigarettes.
“After nicotine patches came out, I started using those, but could only go about three months before some stress in my life or work would push me to smoke again,” Cindy says. “When I started playing tennis again and found I could not keep up, I never picked up a cigarette again. Exercise has taken over for stress relief, and it is also my way to make sure I do not gain very much weight.”
Cindy made the same decision that 65 percent of smokers made last year: the decision to quit. According to the Centers for Disease Control and Prevention’s 2011 Morbidity and Mortality Report, the number of ex-smokers has been higher than the number of current smokers since 2002. So, what are some obstacles to people quitting successfully?
The Spark
Dr. Andrea Villanti, a research investigator at the Schroeder Institute for Tobacco Research and Policy Studies at the American Legacy Foundation, says that while there has been an overall decline in smokers over the past ten years, young adults have been smoking at higher levels.Deanna Farsakh, the health educator at Fullerton College in California, notes that when the school did the National College Risk Behavior Study in 2010, smoking among students there was up from 2007 by about 2 percent. The number of social smokers, who have the occasional cigarette when going out with friends, had risen from 23 percent to about one in four students.
Rochelle J., a student at Montana State University in Billings, says she smokes in social settings to get a “relaxing feeling,” but it’s not something she does every day. As she explains, “Every time I’m stressed out I [don’t] smoke.”
Farsakh says that while many smoke to relax, the nicotine in cigarettes can actually increase your blood pressure and make you feel more stressed.
The Flame
Regardless of frequency, it’s the physical and behavioral addiction that causes even the most casual smokers to increase how much and how often they smoke, and Dr. Villanti says nicotine addiction is something that happens early on.Research from the National Institute on Drug Abuse describes the effects of nicotine on the body like that of an “award system.” It increases the amount of the neurotransmitter dopamine in a smoker’s brain. Dopamine is responsible for those good, satiated feelings you have after eating, or engaging in a stress-reducing activity. Smoking creates those same pleasant feelings, and the dopamine levels of a smoker can permanently change the brain over time, resulting in addiction.
Plus, Dr. Villanti says smoking can also be associated with things you do (and enjoy), causing a behavioral addiction along with the physical one.
You Can Quit
Any health professional will tell you that now is the best time to stop smoking. With the American Cancer Society’s Great American Smokeout and the BACCHUS Network’s corresponding Collegiate Smokeout coming up, there is plenty of support to stop smoking.So, how do you do it?
Alternatives to Smoking
A 2010 Yale University study looked at the associations between stress and smoking, and found that cigarettes are a way to “self-medicate.” Meaning, a hit of nicotine reduces the negative physical and psychological impact that stress can have on the brain, the body, and your emotions. It becomes a way to achieve homeostasis.So not surprisingly, a recent Student Health 101 survey of students across the country found that stress is the primary reason students say they smoke.
Farsakh and her colleagues see 6 to 7 students a week who are trying to stop smoking. During her one-on-one sessions, she emphasizes stress management techniques to take the place of smoking, including deep breathing, getting enough rest, regular exercise, healthful eating, and drinking plenty of water.
“If you’re trying to quit, try to do things that increase pleasure—even if it’s just watching a funny movie or playing Wii®,” she says.
Patricia Marling, coordinator of health services at Tarrant County College–Northeast Campus in Hurst, Texas, says that for adult students, realizing how smoking affects their families can be a great motivator to quit.
“[If you have] kids or a spouse, realize that [your] secondhand smoke can affect the health of [your] family,” she says. “Smoking can aggravate asthma.”
Marling recommends that smokers try to avoid their “triggers.”
“If you normally smoke right after a meal, then try to fill that time with something else, like taking a walk or some other ritual,” she says. “You could make some healthy snacks with your kids [to] take the place of reaching for a cigarette, and grab them when needed. Encourage your family members to remind you why you want to stop and have them be your cheering section.”
Dr. Villanti agrees that the biggest success comes when smoking is disassociated from the situations and activities that trigger your smoking, such as social activities.
Brittany B., a former smoker at Oklahoma City University, says that one way she stopped seeing cigarettes as a part of her everyday life was to make a rule that she would not smoke in her car. She stopped letting driving and smoking be her “escape route.”
Dr. Villanti explains that having a cigarette provides people with a “designed break.” In most cultures, it’s acceptable to take a pause from work or other situations to go have a cigarette.
Emily S., a student at Radford University in Virginia, notes, “Where I work, smokers get a 5-10 minute break every two hours, while the non-smokers are continuously working. If the non-smokers were to go outside for 5-10 minutes they would probably get in trouble.”
Kristin W., a graduate of Yale University in New Haven, Connecticut, explains that to quit while in school, she cut out some of her “down time.” Rather than arriving someplace 10 minutes early, allowing time to smoke, she would schedule herself to arrive exactly on time so she couldn’t have a cigarette.
Without a substitute, though, it’s very tempting to return to something that works, even if it’s an unhealthy choice. So, if smoking is your way to deal with stress, find some alternatives and start integrating them into your life. What if, instead, you got up and took a walk or did some deep breathing exercises if tension is building?
Many people find that when they have a craving for a cigarette, they’ll get out and exercise. This keeps them occupied and also accomplishes their goal of staying fit. It also provides motivation to stay healthy, since physical activity is more challenging as a smoker.
No Need to Be Alone
Dr. Villanti says the first thing a person should do when trying to quit smoking is to seek support from a health care provider, friends, and family. One of the greatest challenges for students is the perceived need to quit cold turkey: all at once, with no support.
The Centers for Disease Control and Prevention’s 2011 Morbidity and Mortality Report indicates that getting advice from a professional not only increases a person’s number of attempts (and motivation) to quit, it also ups rates of success for cessation. It’s smart to work toward eliminating cigarettes from your life gradually, and with the help of medical resources like a nicotine patch and/or cessation counseling. Check with your campus health center or health care provider to see if a smoking cessation program is offered.
According to BecomeAnEx.org, a Web site designed to help people quit smoking, 97 percent of people who try to quit without any outside help fail within the first six months. Luckily, there are numerous Web sites, hotlines, and other programs that provide strategies for smokers to get through the cravings. Your school’s health center or health plan may offer medical resources and cessation support from a health educator and/or counselor.
Finding activities that offer healthy alternatives to smoking is definitely possible. Brittany discovered that opening up to friends is the best way to relieve her stress, rather than smoking by herself. Another student says she takes a shower to relax after a rough day, and spends her time with people who encourage her with healthier habits.
No matter what path you choose to quit smoking, there is always someone there to help. In addition to your school or health plan’s resources, all states have a cessation quit line, and there are numerous organizations dedicated to helping smokers become ex-smokers. Free of cigarettes, you’ll have more time, energy, and money to spend doing things that truly take care of your needs.
“Quitting is hard, but if you can focus on why you want to quit, it can help you get past those triggers that normally send you back to the habit,” says Cindy. “And just because you didn’t succeed the first time, don’t give up. As Mark Twain said, ‘Quitting is easy, I’ve done it many times.’ I never gave up and it worked.”
Take Action!
- Think about the reasons you smoke. Do you use cigarettes for stress-relief, to manage your weight, or when socializing?
- Consider the reasons you’d like to quit. These can help motivate you to create a plan.
- Find healthier alternatives for meeting the needs cigarettes fulfill.
- Seek support. You’ll have much more success than if you try to quit alone.
- Family, friends, and health professionals are all important resources. You can also consult state and national quit lines and Web sites.
RACHEL MORSE is a senior at Oklahoma City University, where she is the school newspaper’s multimedia editor.
Manage Stress
Stress is a normal part of life. If you smoke to let off steam or quiet your mind, try one of these healthy ways to relax.- Meditate. This can be as simple as sitting quietly and focusing on taking slow, deep breaths.
- Get moving. Exerting yourself physically is one of the best ways to let go of tension. Find an activity that gets you pumped and having fun.
- Talk with friends. Being around other people (who don’t smoke!) will keep you occupied and also trigger your brain to relax.
- Take a soothing bath or shower. You can’t smoke under water… and the warm steam and water flow will ease your muscles and mind.
- Hug. Being close with other people releases brain chemicals that make you feel happy (much like nicotine).
- Enjoy some healthy, crunchy food. Things like carrots, arugula, and nuts will keep your mouth busy. Eating stimulates the neurotransmitters responsible for feeling satisfied, just like nicotine. Mindful munching—where you pay attention to your chewing and the taste, texture, and smell of the food—will also help you relax your mind.
Maintain a Healthy Weight
Smoking helps suppress the appetite because it satiates the same neurotransmitters as food. If you’re hungry and you eat, your brain says, “Thanks, that feels good.” If you smoke instead, you trick your brain into that feeling. Try these strategies for maintaining a healthy weight without smoking.- Eat small, nutritious meals throughout the day. Your body will have a consistent release of fuel and it will prevent sudden drops in blood sugar, which can trigger the desire for sweets, or a cigarette.
- Carry healthy snacks. This will stave off the desire to eat something you don’t really want, and will also give your mouth something to do instead of smoke.
- Keep busy. Always having something to do, especially if you look forward to the activities, will reduce opportunities to sit and eat mindlessly. Feeling engaged and occupied will also distract you from the desire to smoke.
- Get physical. As Olivia Newton John famously suggested, movement makes us feel good, and it burns calories too.
- Allow yourself some treats. Depriving yourself of the pleasure of rich flavors and textures is a recipe for strong cravings. Instead, have a bit of dark chocolate or your favorite indulgence; studies have shown that three bites of a desired food are all it takes for you to feel satiated. In moderation, this will satisfy the “pleasure center” in your brain, therefore reducing the desire to go overboard—or have a cigarette.
