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I’m not certain that I’m ready to quit

Stop Smoking Workbook

© 2011 Homewood Human Solutions™. This workbook accompanies the e-course Stop Smoking: Get Your Life Back! and is for the exclusive use of clients and customers of Homewood Human Solutions™.

Stop Smoking: I’m Not Certain That I’m Ready To Quit

© 2011 Homewood Human Solutions™2

I’m not certain that I’m ready to quitQuitting smoking is a process that starts with making a decision to quit. Not certain you’re ready? That’s good to know. If you try to quit smoking without feeling ready, you might get frustrated and start smoking again as soon as you encounter your first craving.

There are no instructions about quitting smoking in this workbook (though there are some suggestions about how you can cut back if you want to give that a try). Instead, the workbook will help you decide whether or not you should quit smoking and help you build confidence that you can quit smoking.

After completing the workbook, if you decide you want to quit smoking, and stay quit, feel free to try the section of this course “I’m Ready To Quit.” Whether or not you try quitting smoking right away, or sometime in the future, you’re going to be a step closer to quitting smoking and getting your life back!

Not ready to quit?There could be many reasons why you’re not ready to quit smoking. Which of these describes you?

� I don’t believe that smoking is truly as harmful as the media and health community say it is.

� I know that smoking is harmful, but I don’t believe that it is harmful to me.

� I enjoy smoking too much to quit.

� I’m addicted to smoking and am worried that I’ll fail if I try to quit.

� I don’t know how to quit.

� I don’t have the willpower to quit.

� I tried quitting before and it didn’t work (note: If this applies to you, do the section of this course labelled “I’m Ready To Try To Quit Again”).

� Do you have other reasons? List them here.

*This course focuses on smoking cigarettes. The same techniques apply to other forms of consuming tobacco.

You’ve probably changed many things in your life that you weren’t certain you could do at the time.

Quitting smoking could be the next successful change!

Want personalized coaching?

Ready to quit and need help with your quit-smoking plan? We can help! We have trained specialists available to help coach you.


© 2011 Homewood Human Solutions™ 3

Some facts about smoking—and quittingWithout question, smoking causes significant harm. This is one of the most well-researched areas in healthcare and the odds are stacked so high against a smoker that it is unquestionable that continued smoking can have disastrous personal consequences. And it doesn’t end there. Smoking is expensive! Damn expensive! The average smoker in Canada spends about $2000-4000 each year. That same amount of money would pay for a child’s university education (several times over), or a vacation each year for the duration of your life, or a more comfortable retirement, or a significant contribution to a charity, or a small apartment or house!

If you know smoking is harmful but enjoy it too much to quit, try weighing the costs of smoking against the benefits you receive. The exercise in the next section will help you do this.

If you are worried about how hard it will be to quit, there are a couple of things to consider. First, it might not be as hard as you think! With the right plan, support, and possibly some medication (to counter withdrawal effects) you chance of success is high. Second, you’ve probably accomplished more changes in your lifetime than you give yourself credit for. The exercise in this workbook (“What have you changed successfully in the past”) may surprise and enlighten you.

If you don’t have the willpower to quit you’re using the wrong reason to stop yourself from trying to quit. Quitting smoking is not about willpower. It’s about setting a goal, committing yourself to putting a plan in place to reach that goal, and creating conditions where you are more likely to succeed than not. Willpower is nice, but a plan is better.

If you don’t know what’s involved in quitting smoking, here it is: build your commitment and confidence, set a quit date, identify the circumstances that trigger your smoking so you can change or avoid them, use a nicotine replacement product (e.g. patch), obtain support from other people, prepare an emergency plan in the event you start smoking again, and keep at it. These steps are outlined in detail in the section labelled “I’m Ready To Quit.”



Weigh the costs and benefitsWeighing the costs and benefits of smoking may help you decide whether or not to quit, and whether or not this is the time to try.

1. What are the benefits you get from smoking? What do you like about it? What does it do for you? List everything you can think of (e.g. it’s a social thing, it helps me manage my weight, I like the taste and feel of a cigarette).

2. Has smoking caused any harm to your health? If it hasn’t, what harm will you likely encounter in the future if you continue smoking? If you’re not aware of the health impact of smoking, visit any of the suggested resources in the section “Quit Smoking Resources” to learn more.

3. What does smoking cost you each day? Each year? If you were saving this money instead of spending it, what could you buy at the end of a year? Ten years? Fifty years?

4. How does your smoking hurt those who are close to you (e.g. spouse, children)? Consider every bad effect you can think of (e.g. I am using money I should spend on my family, secondhand smoke can give my child asthma and other health problems, I snap at my family when they criticize my smoking, I smoke more than they know and I am living a lie, etc.).

5. If you quit smoking, how would you benefit personally?

6. If you quit smoking, how would your family and loved ones benefit?

7. What would it feel like to successfully quit smoking?

8. What would it take for you to try to quit smoking?

You don’t have to make any decisions now, but it’s important to keep the costs and benefits of quitting smoking (or not quitting smoking) very fresh in your mind. What can you do to keep these benefits fresh in your mind?



What have you changed successfully in the past?Have you ever tried changing something about yourself before? Think about all of the challenges and personal growth that you’ve experienced in your life and how you adapted to these challenges to get where you are today—relationship changes, job and career changes, changes in schooling, changes in living circumstances, and more.

� When you set your mind to accomplish something do you usually achieve it?

� When you are faced with a challenging situation, can you find the courage and conviction to meet it head-on?

� When you face setbacks at something you really want, do you keep trying until you succeed?

� If you don’t succeed at something you try, are you able to learn from the experience and try again with your new learning in mind?

� With the support of another person, have you solved a challenging situation that you’ve faced?

If you answer YES to any of these, you can try to quit smoking. It may be far easier than you imagined because you have the life experience to bring to the challenge! And with the right plan and the right support, your chances of succeeding are very, very high.

I’m concerned about withdrawal symptoms

Everyone experiences withdrawal symptoms when they quit smoking. Sometimes these are minor; sometimes more troublesome. But all withdrawal symptoms can be managed. Sometimes it’s a small change (e.g. drinking more water) and sometimes medication helps (e.g. a nicotine replacement product like a patch).

I’m concerned about gaining weight

Some people (about 1 in 5) gain weight when they quit smoking. Weight gain may be due to changes in metabolism or eating patterns. The solution? Make sure your quit-smoking plan includes regular exercise, low calorie snacks, and a balanced diet.

I’m concerned about how much stress I will feel

Any stress you feel after you first quit smoking is likely due to your cravings and your change of behaviours. As time passes, your body will start becoming more and more relaxed, your heart rate will slow, you will start sleeping better, and your body will use oxygen more efficiently.

I’m concerned about losing my friends

You don’t have to lose anything when you quit smoking except smoking itself. Yes, you might need to avoid friends who smoke until you are strong enough to not light up with them, but eventually you will rejoin them. If you encourage them to spend time with you doing activities that don’t involve smoking, you won’t have to spend time away from them at all. You might even be a good role model for these friends, inpsiring them to quit smoking with you.

I’m concerned that I will fail

Occasional setbacks are part of the quit-smoking process. The only failure is never trying again. As long as you keep your commitment high and you adjust your quit smoking plan to reflect what you learn from setbacks, you will be a success!

What are your concerns about quitting smoking?Any concerns you have about quitting smoking are roadblocks to trying. The solution? List your concerns and educate yourself about them. When you create your quit-smoking plan, you can include specific steps to address these concerns.

1. What are your concerns about quitting smoking? List them here.

2. For each of your concerns, what can you do to address them?

Still have concerns? Sometimes you need to take action despite them. Ask yourself: “What step can I take right now to make my commitment to quit smoking stronger than any concern that I have?” (e.g. talk to a friend who successfully quit smoking, remind yourself of successful changes you’ve made in the past).



Cravings. Cravings usually peak during the first few days after quitting smoking. You have three options that you can use alone or in combination—(1) wait out the craving (they only last a few minutes), (2) reduce the craving (breathe deeply and slowly and/or use a nicotine replacement product), or (3) distract yourself (get active, focus on work, run an errand, etc.).

Headaches, nervousness or irritability. Remind yourself to stay calm and use relaxation techniques (e.g. deep breathing). Drink lots of water and juice to flush the nicotine and other by-products of smoking out of your body faster. If your headache gets too bad try a mild painkiller. Cut your caffeine intake by at least half (caffeine is absorbed much faster when you are a smoker so when you quit smoking, that same amount of caffeine can feel much too strong).

Cough, dry throat or nasal drip. In order to clear your breathing passages, your body starts ridding itself of mucus. Drink plenty of fluids, use lozenges, chew sugar-free gum.

Constipation, gas. Your intestinal movement may slow for a brief period after quitting smoking. Drink plenty of fluids, add more fibre to your diet (fruits, vegetables, whole-grains) and exercise regularly.

Low mood. Do activities you enjoy, talk to friends and family. If your low mood persists or becomes troublesome, visit your doctor.

When you first stop smoking, your body and your mind take time to adjust. Consequently, cravings and other

withdrawal symptoms can occur, usually peaking in the first few days after you quit and lasting for a few weeks beyond

that. Here’s what you can expect—and what you can do.

Difficulty concentrating. Plan your workload and commitments accordingly and avoid additional stress during the first few weeks after quitting.

Dizziness. As your lungs become healthier, they will be more efficient at moving oxygen into your bloodstream which can cause a few seconds of dizziness once or twice a day for a few days. Change positions slowly and sit or lie down until the dizziness subsides.

Fatigue, tiredness. Nicotine is a stimulant. Without it, you can feel tired until your body adjusts. Nap as needed, don’t push yourself too hard, and consider trying a nicotine replacement product.

Hunger. Cravings can be confused with hunger. Drink water and low-calorie fluids. Have low-calorie snacks available.

Insomnia or disrupted sleep. Nicotine can influence your sleep pattern so when you quit smoking your sleep patterns needs to adjust once again. Limit caffeine intake, use relaxation techniques to help you sleep, do not exercise or have a big meal within a few hours of going to bed, and stick to a regular sleep/wake schedule (including weekends).

Concerned about withdrawal?A good quit-smoking plan will include steps to make quitting as comfortable as possible.



Visualize yourself as a non-smokerHow great will it be when you quit smoking? Can you visualize what it will be like?

Top athletes, entertainers, and businesspeople use visualization as a way of making their goals clear in their minds, which in turn strengthens their commitment to reach those goals. Similarly, many successful ex-smokers say that visualizing themselves as a non-smoker was one of the keys to reaching their goal.

1. For the next 5 or 10 minutes, close your eyes and visualize yourself in the future as a non-smoker.

2. Imagine everything as if you are watching a movie...in vivid detail. Where are you? What are you doing? Who are you with? How do you feel?

3. Visualize yourself without any cigarettes and without any desire for a cigarette…having fun with friends and family…solving a stressful problem…feeling stronger and healthier...feeling relaxed and confident.

When you’re finished with the visualization, write down what it feels like to be a non-smoker. Here are some ideas.

• I feel in total control;

• I am proud of myself;

• I have a lot of energy and feel strong;

• I can breathe deeply without coughing;

• I have extra money to save

or spend.

What happens when you stop smoking?

Positive changes will start happening soon after you quit smoking. Some of these changes are subtle and others are more obvious.

After 20 minutes your blood pressure and pulse rate drop to normal.

After 8 hours the oxygen and carbon monoxide levels in your body return to normal.

After 1 day your lungs work better and you can breathe more easily. Your chances of heart attack and stroke start decreasing.

After 2 days your senses of taste and smell start returning to normal. Nicotine by-products start leaving your body.

After 3 days your lung capacity continues to improve and breathing continues to become easier.

After 7 days blood flow to your hands and feet improves.

After 1 month your blood circulation improves and you start experiencing more energy.

After 1-3 months your lung function increases by up to 30% and your energy level continues to increase.

After 1-12 months you cough less, your sinuses clear, you aren’t as short of breath.

After 1 year your risk of dying from a heart attack is reduced by 50%.

After 2 years your body’s ability to heal itself after illness and injury greatly improves.

After 3 years your risk of heart attack is about the same as someone who has never smoked.

After 5 years your risk of developing cancer of the mouth, throat and bladder are all reduced by 50%.

After 5-15 years your risk of stroke is now the same as someone who has never smoked.

After 10-15 years your risk of developing heart disease is the same as someone who has never smoked.

After 15 years your life expectancy is now the same as someone who has never smoked!





If you try to quit smoking, who will you ask to be your support person? Who might want to try to quit smoking along with you?Once you’ve identified someone who could be a support for you, consider giving them a copy of the next section in this workbook “I’m thinking about quitting smoking.” Talk it over together. From there, you might feel more confident about quitting smoking.

Choose your support personIf you were to quit smoking, you wouldn’t have to do it alone. In fact, part of a good quit-smoking plan is identifying a person who can be there as your support during the process. This could be a friend, family member or co-worker who agrees to be available to keep your confidence level high, help you change your routines so that they don’t involve smoking anymore, and just listen to you when you want to talk about what you’re experiencing. Even better, you could choose to ‘buddy up’ with someone who wants to quit smoking along with you. There’s no reason to do this alone! In fact, the best quit-smoking programs strongly recommend that you have support. You can also get support from a counsellor or quit-smoking coach!



I’m thinking about quitting smoking. Can you help?To:

I’m thinking about quitting smoking. It’s a big decision and I’m not sure I’m 100% committed yet, so I’m just exploring how I can go about it the best way possible. One thing I do know is that it would be great to count on you if I try quitting smoking.

1. Would you agree to be my support person if I try quitting?

2. Would you be willing to give me the occasional reminder about why I’m trying to quit?

3. Would you be available if I tried to quit? The first couple of days after I quit smoking would probably be the most challenging, so I’d want to be sure you’d be around then.

4. Would you help me celebrate my successes? If I was smoke-free for a day, a week, a month, I’d want to celebrate!

5. Would you be able to think of some things for us to do that help distract me from smoking? Some new routines that I could try so that I find it easier to quit smoking?

And if your friend is a smoker...

Have you considered trying to quit smoking yourself? Would you like to try together?

I, _________________ (support person) promise that if you decide to try to quit smoking, I’ll be your support person. I’ll do everything I can to give you the support you need to quit smoking successfully!

Signature: (person quitting) Date:

Signature: (person supporting) Date:



Changing your thinking might boost your confidenceIf you’re not certain that quitting is right for you now, you can boost your confidence by telling yourself positive and encouraging things. This is called “self-talk.” Remember that quitting smoking is more than quitting the physical addiction. You need to mentally prepare yourself to change your routines, to keep yourself encouraged, and to distract yourself if you have a craving.

Think about positive things

There are many things you can say to yourself that will boost your confidence and help you quit smoking. Some examples:

• Remind yourself why you are quitting smoking.

• Think “I can do this” and remember other times in your life when you successfully changed something about yourself.

• Think “I’m well prepared and I can handle anything that comes my way.”

Changing your psychological addiction to smoking is as important as changing your physical addiction.Changing your thinking is a key to success.



What is your level of addiction?Some research suggests that the more addicted you are to nicotine, the more important it is to try a nicotine replacement product. The following test from the Canadian Cancer Society can help you determine your level of addiction;

Answer yes or no to these questions:

� On average I smoke 15 or more cigarettes each day.

� I usually smoke within 30 minutes of waking up in the morning.

� I find it difficult to go for more than four hours without smoking.

� When I try to quit or cut back on the amount I smoke, I experience irritability, difficulty concentrating, trouble sleeping, dizziness, frustration or changes in my appetite.

If you answered NO to all of these questions you probably have a low level of addiction to nicotine and you might not benefit from a nicotine replacement product. There’s no reason for you not to try one, but it may not be necessary.

If you answered YES to 1 or 2 of these questions, it probably means you are moderately addicted to nicotine. A nicotine replacement product may be useful as part of your quit-smoking plan.

If you answered YES to 3 or 4 of these questions, you are probably highly addicted to nicotine. You should definitely include a nicotine replacement product (and likely a prescribed product) as part of your quit-smoking plan.

Educate yourself about nicotine replacement productsThere are many products that can help reduce your craving for nicotine and increase your chances of successfully quitting smoking. These products use various forms of nicotine delivery to replace the nicotine you obtain from smoking. Consequently, they can help manage cravings, reduce withdrawal symptoms, and/or make smoking less pleasurable. They are intended to be used in combination with a quit-smoking plan (like this one). Some of these products are listed below.

Talk to your doctor or pharmacist about nicotine replacement products. Talk to friends who may have tried them to quit smoking. Visit a drugstore and look at what is available on the shelf, research these options using the internet, and talk to a pharmacist. If you want to try a prescription medication, speak with your doctor. The more you know, the better prepared you will be to include a nicotine replacement product as part of your quit-smoking plan, if you choose to put that plan into action. The use of some nicotine replacement therapies (e.g the patch) may be covered by your benefits plan. Be certain to check with your plan advisor.

Nicotine patch. The nicotine patch releases a constant amount of nicotine. Similar to adhesive bandages, patches are available in different shapes, sizes, and amount of nicotine replacement.

Nicotine gum. Nicotine gum is not designed to be chewed like normal gum but instead to be chewed for a few moments and then left in place between your gum and cheek (called “parking” the gum).

Nicotine inhaler. Inhalers deliver nicotine via small particles that are absorbed into your body through the back of your throat. Because inhalers are held between your fingers like a cigarette, they can help you gradually overcome the habit of holding a cigarette that you associate with smoking.

Prescription pills/tablets (Chantix). Chantix® (varenicline) is one of the newest prescription medications for use as part of a quit-smoking plan. The drug reduces the pleasure of smoking and also reduces withdrawal symptoms.

Zyban® (bupropion) is another prescription medication and has been around longer than Chantix. Both of these medications can be helpful, but one may be preferred over the other. Talk to your doctor and educate yourself before making a choice.

NOTE: As with any medication, it is important to follow the directions for any nicotine replacement product you choose. As well, you must use these products in combination with the techniques in this course or some other form of smoking cessation counselling. These products are not meant to be used without a quit-smoking plan. Remember, quitting is more than stopping the addiction. It is also mental and behavioural.



Reduce the amount you smokeMaybe you aren’t ready to quit smoking altogether, but have you tried to cut back a bit? This step will help build confidence that you can reduce the amount you smoke. The more familiar you are with what to expect if you try quitting, the more confident you will feel. These are samples of ways to reduce the amount you smoke (adapted from the Canadian Cancer Society).

Do one or more of the following.

• Delay your first cigarette of the day by at least 30 minutes. For example, if your first cigarette is at 8 am, delay it until 8:30 or later.

• Reduce your daily intake of cigarettes by one-quarter.

My current daily intake of cigarettes is _________ divided by 4 is ________ (no. of cigarettes you will cut out of your day)

My new daily intake of cigarettes is: ___________

Example:

My current daily intake of cigarettes is 20 divided by 4 is 5.

My new daily intake of cigarettes is 20-5 = 15.

• Develop a strict schedule for smoking that involves no more than one cigarette every hour or two hours. When you have each cigarette, remember that it must be in isolation, separate from any routines you associated with smoking in the past.

• Draw a line in the middle of each cigarette. Only smoke to the line. This will cut your intake in half.

Not ready to quit altogether? Try cutting back a bit. Small steps can lead to big changes.



From this day forward...Congratulations on working through this workbook! Just getting this far is a sign that you are open to the idea of quitting smoking even if you’re not ready to start yet. To keep the momentum going, keep the following in mind:

• Think about how you and your family will benefit if you quit smoking.

• Think about the money you will save if you quit smoking, and what your savings will allow you to do.

• Talk to people who have successfully quit smoking. Ask them why they quit when they did, what they did that helped them, the mistakes they made and what they learned from them, and how they feel about having quit smoking now that they’ve done it!

• Remind yourself about successful changes you’ve made before.

• Educate yourself about nicotine replacement products, different ways to quit smoking, and all of the resources that are available to you (quit smoking groups, helplines, internet-based programs, coaching, etc.).

• Keep yourself informed about the health impact of smoking by visiting websites like those offered by the Canadian Cancer Society or the Canadian Lung Association

Ready to take the next step?

Try the next section of this course: “I’m ready to quit!”.



Quit Smoking ResourcesThe following is a list of helplines and resources. New resources are continually available, and the contact information for some of these resources may change. For the most up-to-date information, do an internet search for “quit smoking programs.”

Provincial Smokers’ Helplines

• British Columbia (1.877.455.2233)

• Yukon (1.866.221.8393)

• Nunavut (1.866.877.3845)

• Northwest Territories (1.867.920.8826)

• Alberta (1.866.332-2322 and alberta.quitnet.com)

• Saskatchewan, Manitoba, Ontario, New Brunswick, Nova Scotia (1.877.513.5333)

• Prince Edward Island (1.888.818.6300)

• Quebec (1.866.527.7383)

• Newfoundland, Labrador (1.800.363.5864)

Resources For Youths

Quit4Life (www.quit4life.ca) is a Health Canada program for 12 to 18 year olds.

Smoke-FX (www.smoke-fx.com) is Ontario-based and has many useful resources to aid in quitting smoking as well as an advocacy tool kit.

Smoking Zine (www.smokingzine.org) is a University of Toronto smoking cessation program for teens.

Other Resources

Inventory of Canadian Tobacco Cessation Programs and Resources (http://www.hc-sc.gc.ca/hl-vs/pubs/tobac-tabac/ictcpr-rrpcrt/index-eng.php). A listing of smoking cessation programs that are available nation-wide or province-wide.

Health Canada (http://www.hc-sc.gc.ca). Health Canada has numerous resources to help smokers quit. Search the “It’s your health” section of the Health Canada site or use the A-Z index to find out about the latest programs and information they offer.

Canadian Cancer Society (www.cancer.ca or 1.888.939.3333)

Canadian Lung Association (www.lung.ca)

Heart and Stroke Foundation of Canada (www.heartandstroke.ca)

National Clearinghouse on Tobacco and Health (www.ncth.ca/NCHweb.nsf )

Non-smoker’s right association (www.nsra-adnf.ca)

Physicians for a smoke-free Canada (www.smoke-free.ca)

Conseil québécois sur le tabac et la santé (www.cqts.qc.ca)

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