Helping your loved one stop smoking

Did you know using tobacco products is a preventable cause of death? In the United States, it ranks No. 1 as a cause we can prevent through behavioral change alone.

Almost 500,000 American smokers die each year. Another concern is the health care cost; smoking-related illnesses cost nearly $300 billion a year.

You can be a key part of smoking cessation for someone you care about. Research tells us that people are in different stages of readiness to quit.

The University of Alabama's Dr. Alice March offers some suggestions for you to help your loved one with tobacco addition.

Pre-contemplation—This means your loved one is not even thinking about quitting. This can be from not having enough information about the consequences of smoking. If you have not already done so, start a discussion about the effects of smoking on them and on those around them. If you have done this, or are worried that you will be "nagging," leave written information around. This is a tough stage, but be diligent about watching for clues that indicate contemplation.

Contemplation—In this stage, people think about quitting, but they aren't ready just yet. They are weighing the pros and cons of this action. You can help by gently encouraging them to consider important reasons to stop. Again, written information about the strongly negative effects of smoking should be provided, but be sure to follow this up with honest and open discussion about how important this is to you (and others who love this person). Ask how you can help them make this decision and commitment. This stage can be short or long. Either way, watch for signs that your loved one is preparing to quit.

• Preparation – In this stage, your loved one has made a decision to act in the very near future, usually within a month or so. Heap praise on them for this important decision, and help them plan strategies to quit. For example, make an appointment for an office visit to a healthcare provider if medication is the strategy your loved one has chosen. Talk about what to do with the "extra" money from not buying cigarettes. Help them consider what to do when they have challenges or setbacks. Set a mutually agreed upon quit date, and be ready for action.
• Action – This stage is exactly what you think—action! In this stage, the smoker actually quits tobacco use. For some people, this stage is easier than they expected. For others, it is much harder. Here's what you can do. Be sure there are NO tobacco products available. It really doesn't help to have a pack "just in case." Make access harder. During this stage (which is like a withdrawal), there are repetitive urges to smoke. They generally pass fairly quickly, but having cigarettes close by grants immediate access. If the product can only be obtained by going to the store, the urge may pass before they get there. Throw away all ash trays, and consider having all carpet in the home and car professionally cleaned. Then- praise, praise, praise. It is very hard to stay quit.
• Maintenance – In this stage, your loved one will be making lifestyle and behavioral changes to prevent relapse. Many people start smoking again in conjunction with alcohol use. You can help by not putting your loved one in a social situation where this is expected. This changes over time, and they become less and less tempted. Help them gain confidence in their ability to stay smoke free. For example, during a stressful event, provide encouragement to not pick up that first cigarette. Deep breathing exercises can be very effective. Some people even "smoke" a pen or pencil. After successful avoidance during a stressful event, celebrate this by doing something meaningful and fun!

As time passes, the urges to smoke come less and less often, and the power of the urge diminishes. But, ultimately, nearly half of people who quit the first time will return to smoking. The good news is that with each quit attempt, your loved one is likely to learn something and gain some skills that can be applied the next time.

The most important thing to remember is that tobacco use is a very powerful addiction and, like most addictions, it takes more than one attempt to quit and stay quit. Positive praise and constant encouragement are key strategies to use.