Wellness Wednesday - Tobacco use and relapse

by Chuck Brown, UNMC public relations | September 16, 2009

picture disc.The first time Tom Klingemann, Pharm.D., tried to quit smoking, he learned he had to find new ways around town because he couldn't drive by his favorite convenience store and not stop for cigarettes.

The second time, he learned he'd have to stop going for drinks with friends who smoked for awhile.

The third time, he found that a quitting strategy that had him increase the time between cigarettes wasn't for him.

"I just kept looking at my watch to see if it was time to smoke again," said Dr. Klingemann, a pharmacist at The Nebraska Medical Center and a tobacco cessation expert. "It was horrible."

Finally, on his sixth attempt, he succeeded.

What he later realized was the relapses taught him lessons needed to kick the habit for good.

Other stories

Below is a schedule of stories in this series on tobacco cessation.

There are essentially two types of relapse -- a short-term version that comes in the initial days of a quit attempt -- and a long-term relapse, which occurs after a user has gone months or years without tobacco.

Long-term relapses generally occur for two reasons, Dr. Klingemann said, stress and/or over confidence.

Acutely stressful situations, such as deaths, a new child or job troubles, can lead tobacco users back into addiction.

Another common relapse scenario plays out as such: a former user goes some time without tobacco, heads out with friends one night, decides he or she can "just smoke one" only to find he or she cannot.

Short-term relapse is more common as users are overwhelmed with triggers -- behaviors or actions that spark the urge to use tobacco -- and the physical withdrawal of nicotine addiction.

Dr. Klingemann urges his patients to plan ahead and account for triggers and urges. He has them learn their patterns of tobacco use and ways to change them.

"Tobacco addiction is a subtle enemy that is often underestimated," Dr. Klingemann said. "If you plan to confront the various pitfalls, you may not have to go through the struggles many of us did to quit."