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Section 7
Tobacco Craving

CEU Question 7 | CEU Test | Table of Contents | Addictions
Psychologist CEs, Social Worker CEUs, Counselor CEUs, MFT CEUs

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On the last track we discussed relapse.  Because relapse is highly individualized, we discussed two situations that cause relapse as well as the three rules of relapse.  Two situations that cause relapse are emotional upset and boredom. 

As you know, tobacco dependent clients generally attempt to quit smoking prior to a successful quit attempt.  Therefore, to successfully overcome tobacco dependency, clients may need help quitting for good.  Therefore, this track attempts to provide practical information regarding coping with cravings, charting progress and staying focused.  If your tobacco dependent client could benefit form hearing this track, you might consider playing this track at your next session.

3 Keys to a Successful Quit Attempt

#1 - Coping With Cravings
First, let’s discuss coping with cravings.  Samantha, age 42, had experienced failed quit attempts several times in the last five years.  Samantha stated, "It always seemed like I could only make it through the first two days of quitting.  That’s about it.  By the third day, I couldn’t take it anymore and felt like I had to smoke just to maintain my sanity!"  I replied, "How did you fight the urge to smoke and finally make it past the third day?" 

Samantha listed five coping skills that she found helpful.  As you listen to these five skills for coping with cravings that Samantha used, consider how your client can implement them.  Could he or she break smoking patterns with these skills? 

Samantha's 5 Skills for Coping with Cravings :

  1. Never forget why you quit smoking.  Samantha explained that when she felt the urge to smoke, she could look at a list of the reasons she had decided to quit.  Samantha stated, "The reasons I quit are the same reasons that there’s no way I’m gonna start again!"
  2. Know when you’re rationalizing.  Samantha stated, "I really do miss smoking, but I’m not going to let myself get fooled that smoking somehow makes my life better, because it doesn’t."
  3. Don’t get cocky.  Samantha explained that cigarettes are tricky.  "It’s almost like they can hook you all over again.  The worst thing I did is think, ‘Oh, I can have just one.’"
  4. Think positive.  Samantha stated, "When I start getting a craving, I remind myself that I’m not a smoker, I don’t want to smoke, and that putting myself down won’t help.  Positive thinking will."
  5. Relax.  Samantha referred to the coping skill of relaxing as ‘meditative breathing'.  Samantha stated, "Instead of lighting up, I just take a long, deep breath, count to five, and release it.  And I just keep doing that until I calm down.  The whole time, I try to think of how much better the clean air is for me."

#2 - Charting Progress
As Devon, age 46, cut down on the number of cigarettes he smoked, and eventually quit, I encouraged him to chart his progress.  Devon began charting his progress by examining the frequency and duration of his cravings.  Eight weeks into his treatment, Devon stated, "I’m really not having as many withdrawal pangs or cravings as I used to."  Devon and I reviewed his records.  Devon was currently experiencing an urge to smoke for about ten minutes every couple of hours.  Devon stated, "That means I’m doing just fine for 110 minutes out of every 120!" 

By charting progress, clients like Devon can verify improvement, which helps validate their success.  However, a second aspect of charting progress is rewarding milestones.  For example, Devon had outlined milestones of one month, three months, six months and one year.  Devon stated, "When I get to three months, I’m going to buy a new TV with the money I’ll save."  By rewarding milestones, would you agree clients like Devon can increase their chances of success in overcoming tobacco dependency?

#3 - Staying Focused
In addition to coping with cravings and charting progress, the third aspect of quitting for good is staying focused.  You already know the importance of a tobacco dependent client staying focused on the goal of staying smoke free.  However, many clients report that quitting smoking is one of the hardest things they’ve ever done. 

Robin, age 38, stated, "I think back on it and wonder, ‘Why was it so hard to quit smoking?’  I mean, I like not smoking!  Food tastes better, I can breathe easier and I have more energy.  My wife says I smell better, too.  But I invested a lot of time and effort into quitting.  It was hard not to light up.  I kept losing sight of my goals and why I wanted to quit.  But I didn’t do it alone.  I kept coming back to my treatment plan, and reminding myself why I was quitting.  I just got stronger every day." 

Do you have a client like Robin, who successfully quit smoking?  Was staying focused important to your Robin?  Would playing this track be productive for your tobacco dependent client?

On this track we have discussed quitting for good.  This track provided practical information regarding coping with cravings, charting progress and staying focused.  Do you have a tobacco dependent client that would benefit from listening to this track during your next session?

Promising Strategies to Reduce Substance Abuse

- U.S. Department of Justice. (2000). Promising Strategies to Reduce Substance Abuse. Office of Justice Programs.

Peer-Reviewed Journal Article References:
Arndt, J., Vail, K. E. III, Cox, C. R., Goldenberg, J. L., Piasecki, T. M., & Gibbons, F. X. (2013). The interactive effect of mortality reminders and tobacco craving on smoking topography. Health Psychology, 32(5), 525–532. 

Evers-Casey, S., Schnoll, R., Jenssen, B. P., & Leone, F. T. (2019). Implicit attribution of culpability and impact on experience of treating tobacco dependence. Health Psychology, 38(12), 1069–1074.

Lape, E. C., LaRowe, L. R., Zale, E. L., Gellis, L. A., Park, A., & Ditre, J. W. (2021). Tobacco cigarette smokers who endorse greater intolerance for nicotine withdrawal also report more severe insomnia symptoms. Experimental and Clinical Psychopharmacology. Advance online publication.

Palmer, A. M., & Brandon, T. H. (2018). How do electronic cigarettes affect cravings to smoke or vape? Parsing the influences of nicotine and expectancies using the balanced-placebo design. Journal of Consulting and Clinical Psychology, 86(5), 486–491.

Sayette, M. A., & Dimoff, J. D. (2016). In search of anticipatory cigarette cravings: The impact of perceived smoking opportunity and motivation to seek treatment. Psychology of Addictive Behaviors, 30(3), 277–286.

Online Continuing Education QUESTION 7
What are five skills for coping with cravings? To select and enter your answer go to CEU Test.

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