healing A 2 - Nicotine Dependence Clinic Director FNQLHSSC. Healing from smoking ... (Transference)...

Healing fromsmoking

Produced and adapted by:FFiirrsstt NNaattiioonnss ooff QQuueebbeecc aanndd LLaabbrraaddoorr HHeeaalltthh aanndd SSoocciiaall SSeerrvviicceess CCoommmmiissssiioonn250, Place Chef Michel LaveauWendake, QuebecG0A 4V0(418) 842-1540Isabelle VerretTechnical coordinator First Nation and Inuit Tobacco control strategy

Originally written by:© Merryl Hammond, Ph.D. Smoking Counsellor, Montreal.

Design by:Siamois graphisme

Illustration by:Martin Aubry

Original Nunavik version funded by:National Literacy SecretariatNNuunnaavviikk RReeggiioonnaall BBooaarrdd ooff HHeeaalltthh aanndd SSoocciiaall SSeerrvviicceess

Current version funded by:First Nations and Inuit Health Branch (FNIHB)MMiinniissttèèrree ddee llaa SSaannttéé ddeess sseerrvviicceess ssoocciiaauuxx dduu QQuuéébbeecc

ISBN: 2-922764-21-4April 2005

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Thank youFirst of all, I would like to thank all of the health

workers who took part in the development, the

adaptation and the production of this manual.

Their valuable collaboration allows us to foster

the improvement of our First Nations health.

I would also like to thank in advance all the

people who will support and encourage

smokers in their decision to quit smoking;

their continued efforts are essential to the

success of such a challenge.

Finally, I would like to underline the courage of

our members who have taken up or will take up

the challenge of quitting smoking. Having been

a smoker myself for several years, I can

appreciate what quitting smoking means in

terms of determination and willpower, and I can

only applaud the women and men who decide

to gain back their health and allow the people

around them to live smoke-free.

In peace and friendship,

Garry CarbonnellExecutive DirectorFNQLHSSC

Healing from smokingCongratulations! You have already made a first step to quit smoking. The very act of reading this manualrepresents a fundamental asset on your way to get rid of tobacco. Healing from smoking is not an easydecision, but this is a challenge you can meet.

Our ancestors used tobacco during traditional andsacred ceremonies. It is considered a present from theCreator. Tobacco is also an excellent medicinal plant. It isonly when used excessively or in a non-traditional waythat tobacco can have harmful effects on your health.

For First Nation people, tobacco use can cause anumber of serious health problems such as cancer,respiratory difficulties and lung problems, asthma,sudden infant death syndrome, etc. Non-traditional use of tobacco is one of the most important healthproblems facing First Nation people.

You are not alone in your desire to quit smoking.Everyday, many young people, adults and pregnantwomen have to face their addiction. However, forseveral years, health stakeholders have beenoutstandingly active in informing people on the harmful effects of tobacco use. As a result, more and more people are willing to quit smoking.

I know that smoking is one of the most difficultaddictions to overcome and I am deeply convinced that this manual, Healing from smoking, developed by and for First Nation people, will give you theinformation and support you need to quit smoking.

You are already on your way to a smoke-free life and it is up to you to take up the challenge!

Nadine Gros-Louis

Health coordinatorFNQLHSSC

II

ContentsThank you ...................................................................................................IHealing from smoking..............................................................................II

Introduction .............................................................................................1

Step 1: Learn about smoking, addiction & recovery...............3Quiz ...................................................................................................4History of tobacco in First Nations communities ......................5The situation in First Nations communities today .....................9Health effects of smoking ...........................................................10Smoking is an addiction...............................................................15

What is an addiction?.............................................................15Smoking as an addiction .......................................................16What does it mean to be addicted?....................................17We smoke to cope .................................................................17Treatment for emotional pain................................................18From parent to child ..............................................................20Switching addictions (Transference)...................................20

Recovery ........................................................................................21What is recovery? ...................................................................21Recovery and emotions ........................................................21Relapse is part of recovery...................................................23Quitting smoking: a kind of grieving ......................23A - 23B

Summary and self-assessment ................................................24Closing quiz .............................................................................26

Step 2: Prepare your mind ...........................................................27Quiz.................................................................................................28Why did you get addicted?........................................................29Reasons for smoking ..................................................................30What does smoking do for you? ...............................................31Keep a “smoking record” ...........................................................33Reasons to recover .....................................................................35Send positive messages ............................................................36Imagine yourself smoke-free.....................................................38Summary and self-assessment ................................................39

Closing quiz .............................................................................40

Step 3: Prepare spiritually .............................................................41Quiz.................................................................................................42Think about your own spirituality ...............................................43Build your spiritual life ..................................................................44Have faith in yourself ...................................................................45Summary and self-assessment ................................................46

Closing quiz .............................................................................48

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Step 4: Prepare your body..............................................................49Quiz.................................................................................................50Exercise every day .......................................................................51Eat healthy food ...........................................................................52Drink lots of water ........................................................................53Drink less tea, coffee, pop and alcohol....................................54Think about using a chemical aid (patch, gum, or pill) ..........55Sleep more....................................................................................56Summary and self-assessment.................................................57

Closing quiz .............................................................................59

Step 5: Prepare socially ....................................................................61Quiz.................................................................................................62Assess your friends and family members ...............................63Tell key people that you want

to recover and ask for help ..................................................65Be assertive ..................................................................................66Cut down on stress .....................................................................68Build a smoke-free social life .....................................................69Make a smoke-free home and workplace..............................70Poster: Smoke-free home...........................................................71Until you quit, be a “safer smoker”............................................72Summary and self-assessment.................................................75

Closing quiz..............................................................................77

Step 6: Plan your recovery..............................................................79Quiz.................................................................................................80Learn from your past experience ..............................................81Set a recovery date......................................................................81Choose your method of quitting...............................................83Use easy quitting tips ..................................................................84Know about withdrawal symptoms..........................................85Prevent a relapse.........................................................................88My recovery plan ..........................................................................91Make a daily action plan .............................................................94Summary and self-assessment.................................................97

Closing quiz .............................................................................99

Conclusion ..........................................................................................100

Notes .....................................................................................................101

Resources ..........................................................................................102

IV

Introduction

You want to heal from smoking?

That’s good news!

Are you nervous? If so, that’s normal. It is scary to think about notsmoking. But you are not alone. With this guide, and with supportfrom people in your community, you can recover.

Have you ever tried to quit before? Did you know that onaverage, smokers try 4 or 5 times before they quit for life?Some people do it on the first or second try. Others takemany, many tries. Never stop trying until you finally quit.

But you can give yourself the best chance of recovery by preparing yourself well. Here are 6 easy steps to help you.

H e a l i n g f r o m s m o k i n g 1

Healing from Smoking:6 steps

1. Learn about smoking, addiction & recovery

Think about the traditional use of tobacco in First Nations communities.Learn about the health effects of smoking. Understand that smoking is an

addiction. Learn about recovery.

2. Prepare your mind

Think about why you got addicted. Think about why yousmoke, and when. Think about your reasons to recover.Send positive messages to your brain. Imagine yourselfsmoke-free.

3. Prepare spiritually

Think about your own spirituality. Build your spiritual life. Have faith in yourself.

4. Prepare your body

Exercise every day. Eat healthy food. Drink lots of water. Cut downon tea, coffee, pop and alcohol. Think about using a chemical aid (patch,gum, or pill). Sleep more.

5. Prepare socially

Assess your friends and family members. Tell key people that you want to recover, and ask for help. Be assertive. Cut down on stress. Build asmoke-free social life. Make a smoke-free home and workplace. Until you quit, be a “safer smoker.”

6. Plan your recovery

Learn from your past experience. Set a recovery date. Choose yourmethod of quitting. Use easy quitting tips. Know about withdrawalsymptoms. Prevent a relapse. Write your recovery plan. Make a daily action plan.

Each of these steps is discussed in a new chapter of this book.Not all people who quit use all six steps. But the more steps

you use, the sooner you will recover. Read on. Then youcan choose which ideas to use in your recovery plan.

H e a l i n g f r o m s m o k i n g2

Step 1Learn about smoking,

addiction and recovery

• Think about the traditional use of tobacco in First Nations communities.

• Learn about the health effects of smoking.• Understand that smoking is an addiction.• Learn about recovery.

When we misuse anything we get out of balance. Addiction is being out of balance with ourselves, our environment, our Creator. Everything is related.

— Elder Abe Burnstick


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QuizPlease check T for true or F for false, or fill in the blank space. Then check your answers at the bottom of the page and fill in your score.

1. First Nations people have traditionally used tobacco for hundreds of years.

T F

2. Native children often start smoking at a younger age than otherCanadian children.

T F

3. Rates of smoking in First Nations communities are higher than theCanadian average.

T F

4. The must common form of cancer caused by smoking is cancer of the _______.

5. When people smoke inside a house or building, even non-smokers can get sick.

T F

6. The addictive drug in tobacco is called __________________.

7. Nicotine is even more addictive than heroin and cocaine.T F

8. When an addict switches from abusing one substance (e.g. alcohol) to another (e.g. tobacco), this is called __________________.

9. A big part of recovery for many addicts is learning to live with their __________________.

10. Relapse is when a smoker quits for a while, then starts smoking again. T F

Score: _______/10


Answers:1.True.2.True.3.True. Smoking rates are especially high for First nations youth aged 15 to 24.4.Lung.5.True: second-hand smoke causes many health problems.6.Nicotine.7.True.8.Transference.9.Emotions or feelings.

10.True.

History of tobacco in First Nations communities

Think back to times long, long ago. Our ancestors were alive, living out on the land or in traditionalsettlements. At that time, did our people smoke like today?

No. But our ancestors definitely did cultivate and use tobacco traditionally (an indigenous variety called Nicotianarustica). There is evidence that tobacco was cultivated by

First Nations people eight thousand years ago!

I remember that my grandparents never smoked. However, they always kept tobaccofor traditional rituals. My grandfather used tobacco to calm rough waters and to ensure safe passage. He would sprinkle tobacco in the water before a journey, and would also pray to the Creator. Tobacco was used as an offering, as a thank-you to the Creator for his many blessings and gifts.

TOBACCO IS A SACRED PLANT

Nicotiana rustica is a sacred plant. Historically, it was the mostimportant plant in native spiritual practices. The smoke of tobaccocarries our thoughts to the spirits, and our prayers to the Creator.

Tobacco is one of the four sacred plants (with cedar,sage, and sweetgrass) of the medicine wheel. It is the

sacred plant of the East, the source of all knowledge. Itis a gift from the Creator, and is used in ceremonies,rituals and offerings (sometimes it is burned, sometimessprinkled on the ground or on water) to give thanks, or to ask for protection, strength, healing or help.


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The only time tobacco was “smoked” was when people shared a sacred pipe to communicate with the spirit world.

Back then, nobody smoked for relaxation or stress reduction like today. Tobacco was used only for

ceremonies and feasts. This is what one elder remembers:

Not so long ago, there was a huge forest fire threatening the community of Waswanipi, with no rain in the forecast. My dad heard that the people were being evacuated, and that the community was going to burn down. He insisted that he visit the community. When we got there, the whole village was filled withsmoke, and people were worried about their homes. My father talked to the Chief, and asked for some pipe tobacco. When we got back to Mistissini, he went off into the bush with the tobacco and his pipe. He was gone for an hour or so. When he came back, he said that he had asked the Creator to provide rain over Waswanipi. It rained for three days, and put out the fire.

- Solomon Awashish

USE TOBACCO TO GIVE THANKS EVERY DAY

Creator gave us seeds to grow tobacco Use it to give thanksThanks for giving us morning, so we can see the dayThanks for the sun rise, for grandmother moon and grandfather thunderThanks for lightning to help keep all bad spirits undergroundThanks for the wind to clean the air Thanks for heat and for shelterThanks to trees, roots and water for making our medicineThanks for food, wild animals and fish who give up their life for usThanks for everything that you seeThanks for our healthOffer tobacco so no harm comes to youAlso for taking care of people, families, children and communitiesUse tobacco to get direction and guidance in your lifeTo purify your senses, mind and bodyTo take away your stress, to have a better focusIt’s a small thing to do to say thank you and to help you develop the gift that the creator gave you

Alex Sony Diabo, Kahnawake


IMPACTS OF COLONISATION

When Aboriginal people in North America first came into contactwith Europeans, everything began to change: our customs,

beliefs, rituals, way of life, language, culture.

Tobacco started to be used as an item for trade, and peoplesaw how Eurpoeans liked to use tobacco recreationally. A commercial variety of tobacco was imported, Nicotiana

tabacum. We gradually started to abuse tobacco, like theEurpoeans were doing, using it in non-sacred ways,

becoming addicted to it, and of course we began to get sick as a result.

Given the extent of the changes all First Nations peoples experienced during the periodof contact and then colonisation, and the devastating impacts of these processes onour communities, we should not be surprised to learn that today we have much higherrates of tobacco addiction (and other addictions) than among the colonisers. (See statistics on page 9.)

Think about how the process of colonisation has affected your family, going back many generations. Think how it affects you, to this day.

THE TOBACCO INDUSTRY

The tobacco industry is a major economic force today. It includes:

• farmers who grow commercial tobacco for mass consumption;

• huge multinational companies that manufacture anddistribute cigarettes, cigars, pipe tobacco, and chewing(spit) tobacco;

• scientists who do experiments to figure out which additives (e.g. flavours, chemicals to slow the burning of tobacco, treatments toincrease the nicotine levels in cigarettes to make them more addictive, etc.) will makea certain brand of cigarette more attractive to consumers;

• clever advertising companies that produce ads that will manipulate smokers and potential smokers; and

• lobbyists who spread misinformation (e.g. “Nicotine isnot addictive” or “Tobacco companies do not want tosell tobacco to youth”).


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Remember: the tobacco industry is only interested in making a profit.The more cigarettes they sell, the richer they get. They do not careabout the sacred use of tobacco. They do not care about our health.

They do not care about our culture. Every time we misuse the sacred plant of tobacco, we only do ourselves and our culture harm...

Think: Which images of smokers have influenced you? How have the tobaccocompanies benefitted from your addiction? How much money have you “given” to them over the years?

How do you feel now that you have read this section about how ourancestors used the sacred plant of tobacco and how recreationalsmoking was introduced and marketed to First Nations? Use the spacebelow to express yourself. You can draw, or write a poem, song, letter,insight, or prayer.


The situation inFirst Nations communities today

Today, many adults and young people in our communitiessmoke. Can you guess how many out of 10 First Nationsadults smoke?_________ (See answer below.

1)

About 45–55% of our pregnant women smoke2; 55–65% of our youth smoke2; and as we saw,

about 60% of adults3.

Remember what we said about the impact of colonisation, so thesehigh statistics should not shock us... In general, First Nations smoke at about three times the rate of non-First Nations.

Many First Nations children start smoking or using smokeless tobacco (e.g. snuff, chewing tobacco)

very young, even at 8 or 9 years old. Many families havelost a loved one to lung cancer or another sickness causedby smoking.

Smoking is a major cause of serious health problems in our communities. That’s why we encourage you to heal from smoking. So you will be healthier.

So you can live longer. We want the best for you!


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1. About 6 out of 10 (60%). In Inuit communities, the rate is even higher, at about 70%.2. Tobacco use among Aboriginal Children and Youth, Canadian Paediatric Society, 1999.3. First Nations Regional Health Survey, 1997.


1. Lung cancer.2. Cancer of the mouth, lip, throat, pancreas, bladder, and cervix.3. Emphysema (can’t catch your breath) and chronic bronchitis (lung infection).4. Stroke, heart problems, asthma, poor circulation of blood to arms and legs, stomach ulcers, problems during

pregnancy (especially low birth weight), crib death (Sudden Infant Death Syndrome or SIDS), and house fires andburns. Also see the diagrams on the next pages for more details.

5. Second-hand smoke.

Health effectsof smoking

What lung disease kills many smokers?1

_______________________________________

Apart from lung cancer, can you think of two or three other cancers that are more common in smokers?2

_______________________________________

Apart from lung cancer, can you name two other lung diseases caused by smoking?

3

_______________________________________

Do you know of any other diseases or health problems caused by smoking?4

_______________________________________

Smoking is not only harmful to smokers themselves. When cigarette smoke goes into the air, it is called:

______________________________________5

I think I’m lucky not to be a smoker because it would aggravate my condition. Being tobacco-free makes it easier for me to fight other conditions such as asthma.

Anne St-Onge, Bestiamites

Children and others inhale smoke, and get sick from it. For example, children in smoke-filled homes suffer from

more otitis (ear infections), coughs, asthma, cancer, crib deaths and other problems.

Second-hand smoke contains about 4,000 chemicals, about 50 of which (e.g. tar, carbon monoxide, formaldehyde,benzene, lead, cyanide, mercury, arsenic)can cause cancer. Please refer to thepamphlet “Second hand smoke” in thepocket at the back of this book for moredetails.

Recently, people in many First Nations communities have learned about the dangers of tobacco and second-hand smoke. Some have quit smoking. And many now have smoke-free homes to protect their children and their loved ones. This is good news!

On the next three pages, you will see drawings of a smoker’s body, a pregnant smoker, and a child exposed to second-hand smoke.

See how many health problems smoking can cause.


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How smoking can harm our health


Smelly hair

Wrinkled skin

Can’t smell well

Lip cancer

Dental problems

Yellow teeth

Gum disease

Can’t taste well

Bad breath

Breathing problems

Pancreatic cancer

Stained fingernails

Infections of reproductive tract

Bladder cancer

Osteoporosis (weakbones) and fractures(broken bones) inolder women (aftermenopause)

Stroke

Mouth cancer

Throat cancer

Esophageal cancer (tube to stomach)

Chronic bronchitis

Emphysema, Asthma

Lung cancer

Heart problems

Stomach ulcers

Menstrual disorders(painful or irregular

periods)

Early menopause

Cervical cancer (mouth of womb)

Poor circulation inarms and legs

* Can also cause male impotence

How smoking can harm a pregnantwoman and her unborn baby

(Please see page 12 for health effects on non-pregnant smokers)


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Childhood cancer

High blood pressure

Baby does not gain weight well

(low birth weight)

Born too soon(premature)

Stillbirth

Death during first yearof life (especially fromSudden Infant Death

Syndrome)

Ectopic pregnancy(baby grows outside

the womb in mother’sabdomen)

Delayed development of

psychomotor skills

Bleeding duringpregnancy

Less oxygen goes to baby’s body

Smoke affects baby’sstomach, bladder andnervous system

Decreased fetalbreathing

Damage to placenta(afterbirth)

Nicotine crosses theplacenta and entersbaby’s blood

Early rupture ofmembranes

In the pocket at the back of the book, there is a pamphlet called “Our smoke free pregnancy”

which gives more details about this topic.

How second-hand smoke can harm children


May start smoking at ayoung age (rolemodels are smokers)

Ear infections (otitis)

Red, runny nose and eyes

Asthma

Childhood cancer or leukemia

Developmental delays

Language difficulties

Eye problems

Chest infections

Death during first yearof life, especially fromSudden Infant Death

Syndrome

In the pocket at the back of the book, there is a pamphlet called “Second hand smoke”

which gives more details about this topic.

Smoking is an addiction

There is no shame in being a smoker. No blame. Smokers arewonderful, special people who just happen to be addicted. Many

smokers started off just experimenting with tobacco, either tryingto “fit in” with friends, or to “be cool”.

One cigarette a week soon becomes one a day, and thenseveral each day... Very few people ever intended to get

“hooked” or to remain a smoker for many years... But onceyou start using an addictive substance, it’s really hard to

stop!

WHAT IS AN ADDICTION?

How would you define an addiction? (What is the difference between an addiction and any other activity, pastime, or hobby?)

1

_______________________________________

What are some of the main addictions people in your community suffer from?2

_______________________________________

Please look back at the quotation on page 3 for Elder Abe Burnstick’s definition of an addiction.


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1. An addiction is an unhealthy relationship with anything (e.g. a person, event, activity, experience or substance) thataffects our mood and causes major problems in our life.

2. Maybe you mentioned alcoholism as the main addiction. Other addictions include sniffing, use of drugs like hash,cocaine, and heroin, and even activities like gambling, video games, watching too much TV, over-eating, work, and sex.

SMOKING AS AN ADDICTION

Let’s look more closely at the definition. An addiction is an unhealthy relationship withanything (e.g. a person, event, activity, experience or substance) that affects our moodand causes major problems in our life.

1. Do I have an unhealthy relationship with cigarettes? For example, does the idea of giving them up make me upset? Do I feel like I couldn’t live without them? ___________

2. Does smoking, or not smoking, affect my mood? ___________

3. Will tobacco cause money, health, or other problems in my life? ___________

If you answered yes to all three questions, then you are addicted to tobacco.

Do you know what the addictive drugin tobacco is called?

1________________


1. Nicotine.

Did you know thatnicotine is evenmore addictivethan heroin andcocaine? Everyculture on earth hasbecome addictedwhenever commercialtobacco wasintroduced. Thesedays, tobaccocompanies add extra nicotine tomake cigaretteseven moreaddictive! Newsmokers now getaddicted evenfaster than before.

Feeling guilty to bea smoker or beingnervous about theidea of quitting.

Stopping a conversation to have a cigarette or becoming isolated because you refuse to see your friends in a smoke-free environment.

Taking cigarettebreaks at regular

intervals and losingyour concentration;

poor role model for clients.

Feeling tired or getting shortof breath during exercise;

coughing; chronic diseases.

Children and spousecomplaining about yoursmoking and asking youto go outside; guilt; poorrole model for children.

Feelingdisconnected from yourspiritual source.

ADDICTIONS AND ASPECTS OF YOUR LIFE

LET’S SEE HOW YOUR RELATIONSHIP WITH TOBACCO CAN AFFECTSEVERAL ASPECTS OF YOUR LIFE.

WHAT DOES IT MEAN TO BE ADDICTED?

We may start smoking to be like our friends or family. But soon we get addicted. Wefeel we can’t get through the day without it. Think about these two statements bysmokers.

• Cigarettes are my best (or only true) friend.

• My addicted brain keeps dragging me back, even though I really want to quit.

What does your addiction mean to you?

____________________________________________

____________________________________________

In my community, there are many people undergoing palliative care, and among them,people who have smoked all their life, who are dying under an oxygen tent, on abreathing machine.

Their addiction is so strong that they pull out their oxygen tube, quickly smoke a couple of cigarettes and go back to their tent. It is sad to seepeople dying from smoking who are unable to quit.

It is terrible to see such a powerful addiction to tobacco. This person told me: “I should never have started smoking”.

Lionel Whiteduck, Kitigan Zibi

WE SMOKE TO COPE

Smoking is what smokers do in response to all the ups and downs of life. If someonedies, we smoke to mourn. If a baby is born, we smoke to celebrate! Whatever happens, good or bad, smokers smoke.

The non-addicted people, on the other hand, do other things. When they are sad, theycry, or talk to a friend. When they are happy, they laugh, phone a friend, or sing a song...

Learning to live without tobacco means learning new ways to cope each day.

How have you used tobacco to cope?

____________________________________________

____________________________________________


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TREATMENT FOR EMOTIONAL PAIN

For many smokers, tobacco is like a medicine for emotional pain. We smoke to “forget” a problem, to “fill a hole” or cover over an emotional pain. It may be an ugly memory, fear, disappointment, or other negative feeling.

As long as we use the addictive substance, we “forget” the pain a bit. But as soon as we stopusing it, the pain inside us comes up to the surface.We can’t stand it. We want relief. We want to forget,to “bury” our pain.

Many smokers, like other addicted people, have to facevery painful issues. For some, it’s memories of childhoodabuse or neglect, or the death of a parent at an early age. For others, it’s the pain of an unhappy or violent family life right now. Deep down, many smokers don’t feel well-loved.

Two-thirds of the last generation to attend residential schools has not survived. It is no coincidence that so many fell victim to violence, accidents, addictions and suicide. Today, the children and grandchildren of those who went to residential schools also live with the same legacy of broken families, broken culture and broken spirit.

—Chief Councillor Charlie Cootes, Uckucklesaht First Nation


Part of the healing process for manysmokers is crying. Let the tears come. It’snormal. Before, you kept your emotionalpain under a blanket of smoke. It wasbearable. Without that “blanket”, the pain willcome up to the surface. It may seemoverpowering.

If you ever feel that you just cannot go on, or ifyou ever start to think about suicide, please gethelp. Some burdens (e.g. bad memories, bitterlosses) are too big for us to bear alone. We need to reach out for support as part of our recovery.

Many smokers quit for a short time and thenrelapse. Often, they have not really faced upto their problems, and they go back to

covering them over with a “blanket of smoke”.

Please think about these statements by smokers. • Cigarettes keep me from feeling too much pain.• I never seemed to get enough love. Can I learn to love myself enough?

Do you think you may be smoking to cover anemotional pain or emptiness of some kind?

___________________________________________________

If so, how can you deal with that pain in otherways, so that when you quit smoking, you will not relapse so easily?

___________________________________________________

___________________________________________________


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FROM PARENT TO CHILD...

Often, a child “learns” or “gets infected with” an addiction from the parents. Children like to copy adults. But it can

go much deeper than this. Some addicted parents are unable to give the love and care a child needs.

Then that child also escapes into addiction. Instead of depending on the parent, the child

depends on the drug... This is called “intergenerational transference.”

I feel deeply concerned about young people smoking. We must change young people’sopinion that smoking is cool! When you know all the harmful effects that smokingcan have on your body, it is far from being cool!

Adopting a moralizing attitude is ineffective. It is important to emphasize the benefitsof a smoke-free lifestyle.

What really influences young people is their parents’ attitude. Patterns are veryimportant for young people.

Alexandra Awashish,Wemotaci

The good news is that recovery can also be passed from parent to child, or from child to parent! Often, when one smoker quits, it encourages others in the family to work on their recovery, too. In this way, you can help break the cycle of smoking in your family.

SWITCHING ADDICTIONS (TRANSFERENCE)

Apart from parents passing on their addictions to their children, thereis another way addicts may “transfer” their addictions. They maychange from one addictive substance or activity to another. For example, some people quit cocaine but start abusingalcohol. Or they quit smoking but start over-eating. In otherwords, they are still burying their pain. Deep healing is needed to truly recover from an addiction and avoid transference like this.


RecoveryAddictions can be treated. We can recover! We can learn to livewithout tobacco.

My life is totally, totally, completely and absolutely different. I wake up, bright and early, go to work, don’t say things that I used to say, don’t gossip anymore. I try to do meditation.... I pray.... I look at myself in the mirror and appreciate what I see. I have a new outlook on life, oh yes, for sure.

— Sanngijuq, quoted in Maracle, pg. 261

WHAT IS RECOVERY?

Recovery from tobacco addiction is more than just quitting smoking. For many, it is a deep healing process.

We need to heal emotionally. In recovery, we discover who we really are. We get to know our unaddicted selves.

RECOVERY AND EMOTIONS

Addictions control our emotions. Strong feelingslike anger, bitterness, jealousy, loneliness, fear,sadness and grief can be controlled a bit easierwith a cigarette.

Even strong positive feelings like happiness, joy, love and excitement can be controlled. A big part ofrecovery is learning to live with our emotions.

Which emotions (positive and negative) do you usually control with smoking?

___________________________________________________


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Painful emotions are part of life. But don’t get stuck or “drown” in them. Forgive. Let go. Move on. Be positive. Laugh. Love. Some people like to talk to a trusted friend or elder about their emotions. Others prefer to write in a journal or draw. Others go to a sweat lodge or attend church to find peace. Find something that works for you...

Here are some more thoughts from ex-smokers:1

• “Admitting I am addicted is the starting point for recovery.”

• “I can do it: not without pain, but without fear.”

• “Recovery is a process of living one day at a time.”

• “In recovery, I reclaim my true identity, my original self.”

• “Recovery is getting my feelings back.”

• “Smoking has been a survival strategy for me to cope with my life. Now it’s time to learn new tools for survival and win back freedom.”

• Please add other ideas of your own: _______________________________________

RELAPSE IS PART OF RECOVERY

Relapse is when we quit for a while, but then start smoking again. Relapse is a normal part of recovery for many smokers. It is not a “failure”. Rather, it is a step on the path to healing.

Each step towards recovery is a positive step that we can learn from. Each time we try to quit, we get one step closer to our final goal, recovery.


1. These quotations are taken (or slightly adapted) from New Tools for Survival: Recovery Manual for Smokers by M. Kelly & K. Smith.

TESTIMONIES FROM MASHTEUIATSH

Hi,Let us introduce ourselves: my name is Guylaine (used to smoke 15 to 20 cigarettes a day) and this is Tony, my husband (used to smoke half a pack a day). We’ve beenmarried for 20 years and are both ex-smokers. Here’s our little story: we both startedsmoking as kids. Seven or 8 years ago, we decided to quit and we managed to stay smoke-free for a year.

One evening, during a party, I, Guylaine, had a couple of smokes. Then, I didn’t toucha cigarette for several days, until another party, and another… I thought this was allright as I considered myself a social smoker.

Later on, I completely lost control. I started smoking again and my husband, too. Later we stopped smoking again, and we’ve been smoke-free for 4 years.

The most important reason why we decided to quit was our health, of course, but it isour daughters who really encouraged us to stay smoke-free. I can tell you they werevery proud of us.

In the beginning, it was really hard to stay smoke-free. On the other hand, we knewwhat to expect because we had already been through the process. Moreover, bothquitting at the same time was easier because we encouraged each other. We both quit smoking without pharmaceutical help.

It was quite easy for us to quit smoking because our minds were ready. Despite someside effects, we managed to keep going thanks to the people who encouraged us.Today, we are proud to have overcome our addiction to smoking.

Guylaine and TonyEx-smokers and proud of it.

Mashteuiatsh

Hi, I quit smoking last August after 33 years, with the help of nicotine patches. I’m quite surprised to see how easy it is to overcome my addiction. I had the chance to be able to quit thanks to all the support and information that was made availablethrough the Blue Light campaign in my community. I’ve been tobacco-free for 2 months. I have no intention to resume smoking despite all the side effects of wearing patches and I know that in the end, it will be a good thing for me.

Joanne Robertson, 45Mashteuiatsh


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Summary and self-assessment

Please check off the items on this list that you agree with. If you need torevise something, feel free to turn back to the pages indicated.

I remembered my smoke-free ancestors (see pages 5–7).

I know that smoking kills many native people (page 9).

I have considered the health effects of smoking (pages 10-14).

I have a better understanding of addiction (pages 15–17).

I understand that I am addicted to nicotine (page 16).

I understand that for many smokers, tobacco helps them to cope with emotions and emotional pain (pages 17-19)

I want to break the cycle of addiction in my family (page 20).

I want to learn to live without tobacco (page 21).

I can accept all my emotions, both positive and negative (pages 21-22).

I know that relapse is often a normal part of recovery (page 22).


Please use the space below to draw or write something about what you havelearned from this chapter. What made the biggest impression on you? What are your hopes and fears? How do you feel?


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Closing QuizNow that you have read this chapter, please re-do the quiz to see howmuch you have learned. Compare your score now with what you got onpage 4.

1. First Nations people have traditionally used tobacco for hundreds ofyears.

T F

2. Native children often start smoking at a younger age than otherCanadian children.

T F

3. Rates of smoking in First Nations communities are higher than theCanadian average.

T F

4. The most common form of cancer caused by smoking is cancer of the _______.

5. When people smoke inside a house or building, even non-smokers can get sick.

T F

6. The addictive drug in tobacco is called __________________.

7. Nicotine is even more addictive than heroin and cocaine.T F

8. When an addict switches from abusing one substance (e.g. alcohol) to another (e.g. tobacco), this is called __________________.

9. A big part of recovery for many addicts is learning to live with their __________________.

10. Relapse is when a smoker quits for a while, then starts smoking again. T F

Score: _______/10

Answers:1.True.2.True.3.True.4.Lung.5.True: second-hand smoke causes many health problems.6.Nicotine.7.True.8.Transference.9.Emotions or feelings.

10.True.


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Step 2Prepare

your mind

• Think about why you got addicted.• Think about why you smoke, and when. • Think about your reasons to recover. • Send positive messages to your brain.• Imagine yourself smoke-free.

It was hard to quit, but not nearly as hard as I feared it would be. I wish I had known this before,because I would have quit years ago!

—Ex-smoker


QuizPlease check T for true or F for false. Then check your answers at thebottom of the page and fill in your score.

1. The real cause of an addiction is often found in a person’s childhood or youth.

T F

2. Some addicts can recover on their own, but most need counselling or other support to break their addiction.

T F

3. Most smokers smoke for the same reasons.T F

4. Deep breathing can be used either to wake up or relax.T F

5. Some people smoke much more when they are with friends, having a good time.

T F

6. It is a waste of time to keep a record of when you smoke and why.T F

7. Most smokers think good things about themselves. They have high self-esteem.

T F

Score: _______/7

Answers:1.True.2. True.3. False. There are many different reasons for smoking. Smoking meets many different needs.4. True. For energy, breathe in for 4 seconds, and out for 3. To relax, breathe in for 4 seconds,

and out for 6.5.True. This is called a “social smoker.”6. False. A “smoking record” will teach you a lot about your patterns of smoking, what triggers

you to smoke, and what needs smoking meets in your life. Then you can plan your recoverywith this information in mind.

7. False. Most smokers put themselves down. They have low self-esteem.

Why did youget addicted?

People start experimenting with tobacco for many reasons. Peerpressure, or wanting acceptance by friends, are common ones. Somepeople can quit smoking quite easily. Others have a really hard time,because they have deep emotional reasons to stay addicted. This firstexercise will help you understand the deep causes of your addiction.

Think back to when you were a young child. What kind of childhood was it? What feelings do you remember? (Happy? Insecure? Afraid?)___________________________________

Now, think about your teenage years. What happened at that time? How did you feel? (For youth: what is happening? How do you feel now?)___________________________________

For adults: Think about your adult life. What has happened? What are your main feelings now?___________________________________

Now, think about your addiction to tobacco.Why do you think you gotaddicted? Are there emotional reasons for it?

___________________________________

If you think you need counselling, please ask a trusted or trained person in the community for help.

What have you learned about your addiction from this exercise?

___________________________________________________


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Reasons for smokingLet’s look at the reasons why people smoke. Please check off any thatare true for you.

To cover an emotional pain

To control my emotions or feelings

To “forget” bad memories

Because I’m addicted

To cut down on stress

To get a break

For pleasure

To cut boredom; to pass the time

To “reward” myself

To control my weight

To assert myself

To look or act more “grown up”

I’m too scared to quit

I don’t know how to quit

I am scared of change

I had alcoholic, neglectful or abusive parents

I had an unhappy childhood or youth

I was or I am sexually, physically or emotionally abused

I did not feel well-loved as a child

I do not feel well-loved now

My parents or relatives smoke

Most of my friends smoke

My friends encourage me to smoke (peer pressure)

I feel spiritually empty

Other reasons: _______________________________

What have you learned about your main reasons for smoking?

___________________________________________________


What does smoking do for you?

This quiz will show you some of the needs smoking meets in your life,and some of the reasons you keep on smoking each day.1 Please write arating in the box next to each bold statement. Use these scores:

1 = Never2 = Sometimes3 = Often

Then go back and read the unbold print under those statements where you scored a 2 or 3. This will give ideas about healthier ways you could meet these needs.

1. I smoke to keep myself from slowing down, to wake up, or to get a lift.Try these ideas instead of smoking. Wash your face, brush yourteeth, drink water, suck ice, go for a walk, shower, sing, dance,take a nap, stretch, exercise, breathe deeply to get energy(breathe in for 4 seconds, out for 3).

2. I love holding a cigarette and getting ready to light up. I like the ritual of lighting up.Make a new ritual: light a candle or sweetgrass.To keep your hands busy, draw, knit, carve, docrafts, squeeze a small ball, play with beads, keys,coins, or elastic bands. To keep your mouth busy,drink water, chew gum, eat fresh fruit orvegetables, kiss someone!

3. Smoking relaxes me and makes me feel good.Smoking calms and feels good to you. Exercise, dorelaxation exercises, breathe deeply (breathe in for4 seconds and out for 6), count to ten, go for awalk, pray, meditate, get a backrub, take a longbath, nap, treat yourself, invite a friend over, watcha TV comedy, sing, listen to music.


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1. This exercise is adapted from Wilson, D.M.C., Lindsay, E.A., Best, J.A., et al. “A smoking intervention for family physicians.”

4. I smoke when I am stressed, angry, or toforget problems.Smoking controls your emotions. Talk to a friend ortrusted elder, write in a journal, express your emotionsthrough art, assert yourself (see pages 66-67 fordetails).

5. When I don’t have cigarettes with me, it’s torture; I get terrible cravings.You are physically addicted to nicotine. Chemical aids (see page 55) may help. Drink a lot of water,exercise, sleep more, keep busy, change yourroutine (see page 69, “Build a smoke-free social life”for details).

6. I smoke without even knowing I’ve lit up;sometimes there’s one burning in theashtray when I light another.Smoking is automatic for you; you light up withoutthinking. Keep a “Smoking Record” (see next page).Put an elastic band around your pack so you have tonotice each time you take a cigarette. Ask: “Do I really needto smoke right now?”

7. I smoke more when I’m with othersmokers, or having a good time at a party.You are a social smoker. Tell friends that you arequitting. Change some of your social habits for a whileto avoid risky situations. For example, don’t visit with afriend who always smokes in the house. Don’t go toBingo hall if people smoke there.

What have you learned from this quiz?

___________________________________________

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Keep a“Smoking Record”

Use this page to write down every cigarette you smoke for two or threedays.1 For each cigarette, record the date and time, what you were doingat the time, how you were feeling, and how strong the craving for thatcigarette was. In this way, you will learn about why you use tobacco inyour life: when you smoke, and where. Use a blank sheet of paper whenthis sheet is full.


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Date &Time

Place, activity, people

e.g. 1) at home alone, eating; 2) at work, coffee break with Edna;3) at parents, visiting; 4) on the land, fishing with Mary; 5) in the bar, drinking with George; 6) at Bingo with Minnie.

Feelings

e.g. happy, OK, relaxed,bored, sad, angry, tired,frustrated, scared, tense,excited

Strength of craving

1= mild 2= average 3= strong

1. Adapted from Stop Smoking! A special program for pregnant women. Produced by the Regional Municipality of Ottawa-Carletonand the Ottawa-Carleton Health Department.

A smoking record will teach you a lot about your smoking patterns. (If your smoking pattern is different on weekends, be sure to keep a record of that, too.) After keeping a smoking record for afew days, answer these questions.

1. Which people trigger me to smoke?

___________________________________________________________________________

2. What places, sights and smells trigger me to smoke?

___________________________________________________________________________

3. What times of the day will be hardest for me when I quit?

___________________________________________________________________________

4. What activities should I avoid while I am quitting?

___________________________________________________________________________

5. What strong emotions does smoking help me to control?

___________________________________________________________________________

6. What needs does smoking meet in my life?

___________________________________________________________________________

7. How can I meet those needs without smoking?

___________________________________________________________________________


Reasons to recoverLook at the list below and check off any reasons to recoverthat apply to you.

To set a good example to someone (e.g. my child)

My partner, spouse, parent, friend or child wants me to quit

To be healthier

To prevent illness in the future

To live longer (and see my children and grandchildren grow up)

To prove to myself that I can do it!

To save money

To stop being addicted to a chemical; to be free

To smell better

So I don’t have to stand outside in the cold to smoke

I am pregnant and want to protect my unborn baby

To prevent wrinkles, yellow finger nails, bad breath, etc.

To reduce the risk of a house fire and burns

I love myself, I deserve the best

I want to get to know my true self

Other reasons: _______________________________

Keep your list of reasons to recover somewhere where you’ll see it often. It will motivate you. Or do a drawing about your reasons to recover.

What is your main reason to recover?

___________________________________________


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Send positivemessages

Many smokers send negative messages to themselves.They put themselves down. They don’t think much ofthemselves. They don’t recognize their strong points.Their self-esteem is low. And, of course, they keep on smoking...

To become a non-smoker, send positive messages to yourself.

We have filled in some examples in the table below. First, underline any negative messages in the firstcolumn that you send to yourself.

Second, choose a positive message from the secondcolumn to send to yourself instead.

Finally, use the blank spaces at the end of the table to fill in other negative messages you tell yourself, and think of positive messages to use instead.

Negative messages Positive messages

I’ll never be able to live without tobacco.

I’m useless.


I will recover; I choose freedom. I deserve to be free from tobacco. I can survive without tobacco.I was born free; I will live free.

I’m addicted, but I am going to change that. I can recover.


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I will turn my life around. I am committed to my recovery.I can do this!

I am lovable. I am worthy of love. I deserve love. I love myself.

I have done many good things in my life,and I will do many more in the future.Everyone makes mistakes sometimes.

I forgive So-and-So. I will heal that pain.I will not be bitter about the past.

______________________________

______________________________

______________________________

Negative messages Positive messages

I never get anything right.

No-one likes me.

I’m a failure.

It’s all So-and-So’s fault.

Please fill in your own ideas:

______________________________

______________________________

______________________________

Write your favourite positive messages on a piece of cardboard thatyou take with you everywhere. Decorate it, if you like. When youquit, carry these messages with you instead of a pack of cigarettes,or frame your list and hang it on the wall.

What positive message will you send to yourself as you recover?

___________________________________________

Imagine yourselfsmoke-free

Many ex-smokers say that it was much easier for them to quit once theycould imagine themselves as non-smokers.

Close your eyes and think of yourself in different situations where you normally smoke. Then, imagine yourself there but with no cigarette.

Keep trying to “see” yourself as a non-smoker. Tell yourself: “I can be a non-smoker.” Convince yourself. Soon you will be one!

Use the space below to write a poem, song or prayer to help you imagine being a non-smoker. Or draw yourself in your favourite place, smoke-free and at peace.




I have thought about my childhood, teen and adult years to try to understand why I got addicted (see page 29).

I have thought about my main reasons for smoking (see page 30).

I have analysed what smoking does in my life (see pages 31-32).

I have studied my smoking patterns by keeping a “Smoking Record” (see pages 33-34).

I have thought about my reasons to recover (see page 35).

I will send positive messages to myself (see pages 36-37).

I can imagine myself smoke-free (see page 38).

Please use the space below to draw or write something about what you have learnedfrom this chapter. What made the biggest impression on you? What are your hopesand fears? How do you feel?


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1. The real cause of an addiction is often found in a person’s childhood or youth.

T F

2. Some addicts can recover on their own, but most need counselling orother support to break their addiction.

T F

3. Most smokers smoke for the same reasons.T F

4. Deep breathing can be used either to wake up or relax.T F

5. Some people smoke much more when they are with friends, having a good time.

T F

6. It is a waste of time to keep a record of when you smoke and why.T F

7. Most smokers think good things about themselves. They have high self-esteem.

T F

Score: _______/7


Answers:1.True.2. True.3. False. There are many different reasons for smoking. Smoking meets many different needs.4. True. For energy, breathe in for 4 seconds, and out for 3. To relax, breathe in for 4 seconds,

and out for 6.5.True. This is called a “social smoker.”6. False. A “smoking record” will teach you a lot about your patterns of smoking, what triggers

you to smoke, and what needs smoking meets in your life. Then you can plan your recoverywith this information in mind.

7. False. Most smokers put themselves down. They have low self-esteem.

Step 3Prepare

spiritually

• Think about your own spirituality. • Build your spiritual life.• Have faith in yourself.

Addictions are deeply rooted in our spiritual life. It is this part of ourselves that we must examine, heal, and love.

—Ex-smoker quoted in Kelly & Smith


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Note: this step is not necessary for successfulcessation, but may certainly be useful.


1. Spirituality is the same as being religious.T F

2. Spending time with certain people or doing certain activities can helpyou feel more in touch with spiritual issues.

T F

3. Some people find it easier to think spiritual thoughts at certain times of the day.

T F

4. A spiritual person prays every day. T F

5. Many recovering addicts use prayer as an important part of their recovery.

T F

6. It can be helpful and inspiring to get advice from recovered addicts.T F

Score: _______/6


Answers:1.False. For some people, there is a close link between spirituality and religion, while not

for others. How we express our spirituality is deeply personal.2. True.3. True. 4. False. Although many spiritual people do pray every day, some use other spiritual

practices apart from prayer.5. True. 6. True.

Think about your own spirituality

People have many different ideas about spirituality. Some see a close linkbetween religion and spirituality. Others do not. Some people findChristianity or other organised religions very helpful; others follow a pathof native spirituality, or are trying to re-connect with their traditions; yetothers explore both.

Spirituality is deeply personal. There are no “right” or “wrong” answers.Each of us needs to make our own choices. Whatever you find spirituallycomforting will surely help you on your healing journey. Many recoveredaddicts tell us that what helped them most was becomingstronger in spirit...

Which people nourish your spirit?

_______________________________

What activities help you to remember that you are a spiritual being (e.g. praying, making an offering, drumming)?

____________________________________________

What places make you feel more spiritual? (By the lake, church, sweat lodge, etc.)

________________________________

What times of the day and days of the week do you use for spiritualpractices?

_______________________________________

What changes, if any, would you like to make in your life so you can spend more time caring for yourself spiritually?

__________________________________________________________________


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Build yourspiritual life

People build their spiritual lives in different ways. Thinkabout what would be helpful for you, and follow

your heart.

Many people who have healed from addictions—tobacco, alcohol, or drugs—say they pray every

day. For example, they pray for guidance andstrength. They pray for relief when they get a craving.

They pray for deep healing and they ask others to pray forthem, too.

Apart from praying, there are many other ways to be spiritual as well. Here are some ideas:

• Talk to a religious or spiritual leader about your recovery plans.

• Perform a traditional ritual, make an offering, visit the sweat lodge.

• Read inspiring and spiritual books.

• Use spiritual songs and music to motivate yourself.

• Talk about spiritual matters with a trusted elder, relative or friend.

• Light a candle or sweetgrass instead of a cigarette.

• Attend a church service, Bible study or Mass, take communion.

• Meditate.

• Add other ideas: ______________________________________________

Recovery is a time of personal growth and renewal. For many ex-smokers, it is a very spiritual time. We encourage you to explore spiritual ideas and practices

as part of your recovery plan.

How will you include spiritual growth in your recovery plan?

___________________________________________


Have faith in yourself

Have faith in your ability to live smoke-free. Remind yourself that you were created to be free, not addicted.

Think back to the days of our ancestors, long ago. Tobacco had a sacred role in First Nations culture (see pages 5–6). Wouldn’t it be good to re-learn the smoke-free way of life?

Speak to others who have broken their addictions. Get inspiration from them. Tell yourself that if they could do it, you can too.

Spend time with people who have faith in themselves. Learn from them. Let their positive energy influence you. Stay away from people who put you down or make you feel negative or low.

Make a list of all the hard things you have done in your life. Now, imagine the day you can add, “I recovered from smoking!”

to that list.

I have faith in myself because...

________________________________________


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Please check off the items on this list that you feel confident about now.If you need to revise something, turn back to the page next to that item.

I have thought deeply about the link between addiction and spirituality (see the quotation in the box on page 41).

I have ideas about how to take better care of myself spiritually (see page 43).

I will include spiritual growth as part of my recovery plan (see page 44).

I get strength from the fact that my ancestors only used tobacco for ceremonies (see page 45, and pages 5–6).

I am inspired by others who have recovered from their addictions (see page 45).

I will spend time with people who are positive and make me feel good (see page 45).

I have faith in myself (see page 45).




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1. Spirituality is the same as being religious.T F

2. Spending time with certain people or doing certain activities can helpyou feel more in touch with spiritual issues.

T F

3. Some people find it easier to think spiritual thoughts at certain times of the day.

T F

4. A spiritual person prays every day. T F

5. Many recovering addicts use prayer as an important part of their recovery.

T F

6. It can be helpful and inspiring to get advice from recovered addicts.T F

Score: _______/6


Answers:1.False. For some people, there is a close link between spirituality and religion, while not

for others. How we express our spirituality is deeply personal.2. True.3. True. 4. False. Although many spiritual people do pray every day, some use other spiritual

practices apart from prayer.5. True. 6. True.

Step 4Prepare

your body

• Exercise every day.• Eat healthy food. • Drink lots of water. • Cut down on tea, coffee, pop and alcohol.• Think about using a chemical aid (patch, gum or pill).• Sleep more.

I go to sleep at a reasonable hour...I eat normally, that’s like three meals a day. I take vitamins now.

— Sanngijuqquoted in Maracle p.261


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QuizPlease check T for true or F for false, or fill in the blanks. Then check youranswers at the bottom of the page and fill in your score.

1. Exercise gives a “natural high”.T F

2. Exercise may cause a smoker or recent ex-smoker to cough more.T F

3. Dried meat is a healthy snack.T F

4. Smokers should eat a lot of treats and junk food when they quitsmoking, to “reward” themselves.

T F

5. We should drink about 1 litre of water each day. T F

6. The addictive drug in tea, coffee and pop is called _______________.

7. There are two kinds of nicotine replacement: nicotine _________________ and _________________.

8. Nicotine replacement is recommended for heavy smokers.T F

9. The pill to control withdrawal symptoms is called _________________.

Score: _______/9


Answers:1.True. 2.True. But this is a sign of healing. Coughing cleans out the lungs.3.True. 4.False. This would cause weight gain. Eat healthy treats like fresh fruits

or natural or traditional foods instead.5.False. We need 2 litres each day.6.caffeine.7.patch and gum.8.True.9.Zyban.

Exerciseevery day

Exercise gives a “natural high.” It cuts stress and makes you feel relaxedand happy. It also makes you feel better about yourself. The more youaccept and love yourself, the less you will need to “hide” behind smoke.

As you feel stronger in your body, you will feel morepowerful as a person; more able to live withoutcigarettes. Having an exercise program is often a key part to recovery. Don’t neglect it!

Exercise may motivate you to care for yourself in other ways, too. You will drink more water. And you may want to eat healthy food,not junk food.

At first, when you exercise you will cough a lot as you clean outyour lungs. That can motivate you to quit or stay quit.

What kind of exercise is best? Take a brisk walk. Dance. Play a game of lacrosse, hockey, soccer, or basketball. Jog. Work out with an exercise video. Climb up and down stairs.Do anything that makes your body work hard enough to sweat.

And do it every day!

Note: Before starting any physical activities, please consult a healthprofessional.

What exercise will you include in your recovery plan?

___________________________________________


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Eathealthy food

Try not to eat fast food or snacks such as chips, chocolate bars,candies, and cookies. Avoid pop and frozen desserts. Rather,choose fresh foods. Traditional food, wild meat, fresh, frozen orcanned vegetables and fruits are excellent choices.

Are you worried about weight gain when you quit? Most ex-smokers do gain weight. This happens because yourappetite improves without nicotine. Your taste buds heal, so foodtastes delicious, too. In some cases, a smoker does not trulyrecover, but just transfers the addiction from tobacco to food(see page 20). Be careful!

I was afraid of quitting because I didn’t want to put on weight.But after my stroke, I was forced to stop smoking. I started to eat healthier and to exercise and actually it was not that hard to do.These changes will prevent me from having another stroke. Further more, eating healthier helps me not gain weight.

Monique Jeannotte, Gaspeg

You may want to keep your hands and mouth busy with food insteadof cigarettes. Try these ideas instead: chew sugar-free gum. Snackon fresh foods. Drink a lot of water. Squeeze a stress-ball. Play withan elastic band. Then you won’t gain too much weight. Don’t letyourself get too hungry while you try to quit. You may relapse and

start smoking again.

For more information about healthy foods for smokers andnon-smokers, please see the pamphlet “Healthy tips” inthe back pocket of the book. Or ask a health professional.

What will you do to eat healthier?

_____________________________________


Drink lots of water

Water will flush the chemicals from cigarettes out of your body. Many people find that a glass of water can flush away a craving for a cigarette, too!

Drinking water is also a way to keep your hand and mouth busywithout having a cigarette. Carry a water bottle with you instead of apack of smokes! Try drinking from a straw or sucking on a waterbottle with a pop-up spout. It feels good!

Drink 8 full glasses of water every day. That’s 2 litres. You could fill anempty 2-litre pop bottle with water each morning. Make sure it’s halffinished before you eat lunch, and empty before you go to bed at night.

In case you were wondering... Yes, you will run to thewashroom a lot when you drink all that water! You cantake a “washroom break” instead of a “smoke break.”Water really helps people recover.

How will you be sure to drink more water every day?

___________________________________________


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Drink less tea, coffee, pop and alcohol

Why should you cut down on tea, coffee, pop and alcohol while youwithdraw from nicotine?

First, because these drinks often act as a “trigger” tomake you crave a cigarette. When you see, taste orsmell tea, coffee, or alcohol, you may suddenlycrave a cigarette.

Second, the caffeine in coffee, tea andpop makes withdrawal symptoms worse.You will get bad headaches if you keepdrinking caffeine while you withdraw.

Also, when people use or abuse alcohol, their willpower will weaken. Many people relapse when they use alcohol or drugs.

It is only for the first few weeks or months as you quit that youshould cut down on these drinks. Later, you can enjoy themagain as a treat. For now, you can enjoy other new pleasures:long walks, naps, healthy snacks.

How will you change your use of tea, coffee, pop and alcohol as you withdraw from nicotine?

___________________________________________


Think about using a chemical aid(patch, gum, or pill)

Nicotine replacement (nicotine gum or “the patch”) gets nicotine intoyour body without you having to smoke it. Either you chew gum thathas nicotine in it, or you get the nicotine through your skin from a patchthat is like a big Band-Aid. In this way, you can break the “habit” ofsmoking first, and then wean off the addictive drug (nicotine) later.

If you use the patch, the nicotine goes through your skinall day long. It is really important not to smokewhile the patch is on your skin. You could get an

overdose of nicotine, and consequently get really sick oreven die. Using the gum is different. You can just replace individualcigarettes with pieces of gum.

For many people, it is easier to quit with a nicotine replacement. They don’t suffer so many cravings. And studies show that they are more likely to quit for good.

• Do you smoke a pack a day or more?• Do you smoke within the first half-hour after you wake up?If so, you might find nicotine replacement very helpful. Ask your health professional about it.

In 1998, a pill called Zyban was introduced to help smokers cope withwithdrawal symptoms. You need a prescription for Zyban, and youstart taking it about 2 weeks before you quit. Because Zyban doesnot contain any nicotine, you can use it together with either thepatch or the gum. Please ask your health professional for moredetails, and about assistance to pay for these products.

Will you use a chemical aid to help you quit? Yes/No. If yes, which one?

___________________________________________


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Sleep moreThe first few weeks of recovery are hard. It takes a lot of energy to heal from smoking. It takes energy to fight the cravings. Even worse is the fear. Fear of living without cigarettes. Fear of strong emotions. Fear of relapsing.

So if you can, sleep more than usual for the firstweek or two when you quit. Take a nap in theafternoon if possible, and give yourself an extrahour or two of sleep each night.

Please don’t let yourself get too tired. Many people relapse when they are over-tired.

How can you be sure to get enough sleep?

___________________________________________

Can you think of other ideas to prepare your body for recovery from smoking? If so, please add them here.

_______________________________________________________________

_______________________________________________________________



Please check off the items on this list that you agree with. If you need torevise something, feel free turn to back to the pages indicated.

I understand why exercise is such an important part of recovery for many addicts(see page 51).

I have decided what exercise I will do as I recover (see page 51).

I know which foods are healthy, which I should eat more of, and which to avoid (see page 52).

I know how to avoid gaining too much weight as I recover (see page 52).

I know why it is important to drink a lot of water as I withdraw from nicotine (see page 53).

I commit to drinking 2 litres of water a day (see page 53).

I know that certain drinks can “trigger” cravings for nicotine, and will avoid them (see page 54).

I know that caffeine makes withdrawal symptoms worse, and I know which drinks contain caffeine (see page 54).

I understand how nicotine replacement works to help smokers wean off nicotine (see page 55).

I know about the pill, Zyban (see page 55).

I have considered using a chemical aid to help in my recovery (see page 55).

I know why recovering smokers need extra sleep (see page 56).

I commit to getting the sleep I need as I recover (see page 56).


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Closing QuizNow that you have read this chapter, please re-do the quiz to see how muchyou have learned. Compare your score now with your score on page 50.

1. Exercise gives a “natural high”.T F

2. Exercise may cause a smoker or recent ex-smoker to cough more.T F

3. Dried meat is a healthy snack.T F

4. Smokers should eat a lot of treats and junk food when they quitsmoking, to “reward” themselves.

T F

5. We should drink about 1 litre of water each day. T F

6. The addictive drug in tea, coffee and pop is called _______________.

7. There are two kinds of nicotine replacement: nicotine _________________ and _________________.

8. Nicotine replacement is recommended for heavy smokers.T F

9. The pill to control withdrawal symptoms is called _________________.

Score: _______/9


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Answers:1.True. 2.True. But this is a sign of healing. Coughing cleans out the lungs.3.True. 4.False. This would cause weight gain. Eat healthy treats like fresh fruits

or natural or traditional foods instead.5.False. We need 2 litres each day.6.caffeine.7.patch and gum.8.True.9.Zyban.

Step 5Prepare

socially

• Assess your friends and family members.• Tell key people that you want to recover,

and ask for help.• Be assertive.• Cut down on stress.• Build a smoke-free social life. • Make a smoke-free home and workplace.• Until you quit, be a “safer smoker.”

I have relapsed many times, but this time – one breath at a time – I will be clean and free from tobacco addiction with God’s help and friends... All my friends, even those who smoke, are encouraging me. Thank God.

—“Phyllis” quoted in Stringam, page (i).


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1. When you tell your family and friends that you plan to quit smoking,everyone will be pleased and will offer support.

T F

2. It is best to stay away from unsupportive friends when you first quitsmoking, to avoid a relapse.

T F

3. Smokers need and deserve help as they start to recover.T F

4. Being assertive means speaking your mind.T F

5. Most smokers are very assertive.T F

6. It is best not to change anything else in your lifestyle when you startyour recovery.

T F

7. There are very few smoke-free homes in native communities.T F

Score: _______/7


Answers:1.False. Some may feel threatened or upset by your decision.2.True.3.True. 4.True. 5.False. 6.False. It will in fact be easier to recover if you change several things at the same

time (for example, start exercising, eat healthier, drink a lot of water, etc.).7.False. Many people now smoke outside to protect their loved ones.

Assess your friendsand family members

Family and friends can be a great support. But some people may not be pleased to hear your plans to recover.

Some may not want you to suffer through withdrawal. Somemay find you easier to live with when you are passive and calm asa smoker. Others may feel threatened. They may thinkthat you want them to quit, too.

Think about who you can really trust to support you, and who youmay need to stay away from for a few weeks while you quit. Who

can help your recovery? Who may harm it?

Stay away from people who don’t respect your recoveryplans. Explain to them that you will be “taking a break” for ashort time while you quit. Then, later when you feel strongas a non-smoker, you can spend more time with themagain.

Here is an exercise to help you assess your friends and family members. We give someexamples first, and then there are spaces for you to fill in.


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Who will support my recovery?1


1. This exercise was inspired by pages 81–82 in Murray Kelly & Kendra Smith, New Tools for Survival: a recovery manual for smokers.

Name of friend or family member

Supportive or dangerous?

What I can say

Maina (mother, non-smoker)

Very supportive "I’m ready to quit, but Ineed your support, Mom.Could I ask you to help mewith the children while I amin withdrawal?"

Galey (friend, ex-smoker) Supportive "Can I phone you when Ineed to talk? And couldyou come with me toBingo so I won’t relapsethere?"

Eli (teenage son, smoker) Dangerous "I won’t pressure you toquit, Eli. But now that Iwant to quit, it’s hard towatch you smoke, and to smell it. Will you pleasesmoke outside from now on?"

Tell key people that you want torecover & ask for help

Once you have assessed who will support your recovery, tell those people aboutyour plans to quit. This will help you commit to your recovery.

Ask them to support you in specific ways. Forexample, ask your father to baby-sit your children for a few hours on your quit day so you can take a nap. Ask your mother to cook supper.

All smokers need support and help as they start to recover. Ask for it. Expect it. You deserve it! Maybe a friend or relative will even decide to quit with you!

Who will you ask for help?Make a list in the table below.

Name: Could help me with:


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Be assertiveBeing assertive means accepting our feelings, and telling people how we feel. We speak up. We face our problems with honesty.

Many smokers don’t speak up very often. When we get angry,for example, we don’t tell the person who made us angry. We justlight a cigarette! And the person never knows that what they didor said made us angry...

When someone makes us sad or upset, we don’t tell her or him. We smoke. When we feel frustrated, we don’t talk about the problem. We try to smoke it away!

Instead, we can assert ourselves with our child by saying:“When you leave your clothes lying around like that, I getupset. Hang them up, please.”

To a partner, we can say: “When you stay out late and don’t tell mewhere you are, I worry. Will you please phone next time you are late?”

Many of us smoke when we face problems. But does smoking solveour problems? No. It actually causes more problems, like sickness,

worry, guilt, lack of money. Does smoking remove the cause of ourpain? No. It only offers a shallow escape for a short time.


It’s not easy to be assertive at first. But you need to learn toassert yourself if you are going to get through each day withoutcigarettes. Being assertive is a key skill. Start practising now,and your recovery will go much smoother.

Fill in the spaces below to answer these questions:1) Who do you need to assert yourself with? 2) Over what issues?3) Give examples of things you could say to each person to assert yourself.There is one example provided.


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1. Who? (Name) 2. Issues 3. What to say toassert myself

Mary (mother) How I raise my child. "I know you think I shouldsmack Jeannie, but she is mychild and I don’t agree withusing physical punishment. Iuse other ways to disciplineher. Please respect mydecision about this."

Cut downon stress

We often smoke to reduce stress, and to control our emotions. How can wecope with stress and emotional ups and downs, without smoking?

Many people use these ideas instead of smoking:

• be assertive with family, friends and colleagues (see page 66)

• discuss your problems with a trusted friend

• phone someone you love

• express your anger with non-abusive words

• pray or ask for spiritual help

• make time to do things you enjoy

• play sports, do exercise, or do physical work every day

• write down your worries in a diary or letter to a friend

• be creative (e.g. carving, arts or crafts, music, poetry, knitting,sewing, etc.)

• listen to relaxing music

• sing, hum or whistle every day

• dance

• laugh and play “like a child” again

• ask family or friends to help you out (e.g.by cooking, or baby-sitting)

• notice when you start to feel stressed,and then work to reduce stress before itbuilds up

• do breathing deeply to relax (breathe indeeply while you count to four; then breathe out slowly for six)

• get extra rest and sleep

• other ideas: _________________________________________

Which of these ideas will you use to cut down on stress as you recover?

___________________________________________


Build a smoke-freesocial life

Plan a social life that will support your recovery. For example, don’t stay up drinking with friends all night—

you will be tempted to smoke! Exercise and visitnon-smoking friends. Knit, sew, do beadwork,or carve to keep your hands busy.

Some smokers find it easier to recover whenthey make many changes in the way theylive. Here are some ideas we have already

mentioned to make recovery easier:

• Exercise every day (walk, play sports, etc.).

• Don’t watch a lot of TV or movies: keep active instead!

• Eat healthy food, not junk.

• Don’t drink a lot of tea, coffee, pop or alcohol.

• Don’t let yourself get too hungry, angry, lonely, or tired.

• Ask friends or family to support and help you: don’t be shy!

• Do deep breathing exercises.

• Develop your spiritual life.

Change other things in your life at the same time as you recover from smoking. It will beeasier to quit, and all these other changes are good for you—your body, mind, and soul!

How can you build a smoke-free social life?

___________________________________________


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Make a smoke-free home and workplace

These days, many people know that second-hand smoke is harmful. Many First Nationspeople smoke outside to protect children andothers. This is excellent.

People also know that it is hard for ex-smokers to quit if they are always around smokers.Seeing people light up and smelling the tobaccomakes it harder. It is only fair for smokers to gooutside to smoke so they won’t tempt ex-smokers to relapse.

If people still smoke inside in your home or workplace, please discuss the need for asmoke-free building with your family or co-workers. Show them the pamphlet aboutsecond-hand smoke in the back pocket. Also in the pocket, there is a “Smoke-freehome” sign like the one on the next page. Display it on your front door.

And remember, smoking outside even protects smokers. They only breathe inchemicals from inhaling, not from their own second-hand smoke as well.

What will you do to make a smoke-free home and workplace?

___________________________________________

Second-hand smoke is more dangerous than directly inhaled smoke.To keep your loved ones safe, just don’t smoke around them.

Bonnie Jacobs, Kanhawake



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Until you quit, be a “safer smoker”

“Safer smoking” is the responsible way to smoke these days. Smokers no longerexpose themselves or others to second-hand smoke. Here are some ideas abouthow to be a “safer smoker” until you quit.

Let’s smoke outside so we won’t pollute the air our family and co-workers breathe.

Smoking outside also protects smokers from their ownsecond-hand smoke. We only breathe in what we inhale fromour cigarette, rather than the pollution the cigarette puts in the air!

We don’t smoke near a pregnant woman, so that the chemicals in our smoke won’t

hurt her and her unborn baby.

If we are with a friend who has quitsmoking, we move away to

smoke. Then he won’t crave too much.

We encourage our friends who want to quit. We offer support to people who are quitting. Our support can help them continue.


We never offer cigarettes to children. We don’t want themto get addicted. (Just two or three smokes a week for onemonth is enough to get a child hooked!)

We never buy cigarettes for kids, or send them to buy smokes for us.

Let’s complain to the store manager if we see someone sellingcigarettes to a child. It’s against the law, and it’s so bad fortheir health.

Let’s tell our children that we want to quit and that we wish we’d never started. Then they won’t thinksmoking is good.

Let’s not leave butts lying around outside. It’s a mess, and children pick them up to smoke.

We let our butts burn right down. Then other peoplecan’t smoke them.


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We don’t leave our packs lying around. Then, kids and people who are trying to quit

won’t be tempted to take a cigarette.

Can you think of any other ways to be a safer smoker?

_______________________________________

Until you quit, will you be a safer smoker?

Please look back at all these ideas about how to be a safer smoker, and mark off all the ones that you will try for yourself.




I understand that some of my friends and family members may not support myplans to recover (see page 63).

I have assessed my circle of family and friends. I know who may support me andwho to avoid as I recover (see page 64).

I have decided who to tell about my recovery plans (see page 65).

I will ask people to help me as I recover (see page 65).

I will assert myself more as I recover (see pages 66–67).

I know how to be more assertive with key people in my life (see page 67).

I have chosen new ways to reduce stress (see page 68).

I have a plan to build a smoke-free social life (see page 69).

I will ask my colleagues to make ours a smoke-free workplace (see page 70).

I will put up a “smoke-free home” sign (see page 71 and back pocket).

I understand what being a “safer smoker” means (see pages 72-74).

I commit to being a “safer smoker” until I quit (see page 74).


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Closing QuizNow that you have read this chapter, please re-do the quiz to see howmuch you have learned. Compare your score now with your score onpage 62.

1. When you tell your family and friends that you plan to quit smoking,everyone will be pleased and will offer support.

T F

2. It is best to stay away from unsupportive friends when you first quitsmoking, to avoid a relapse.

T F

3. Smokers need and deserve help as they start to recover.T F

4. Being assertive means speaking your mind.T F

5. Most smokers are very assertive.T F

6. It is best not to change anything else in your lifestyle when you startyour recovery.

T F

7. There are very few smoke-free homes in native communities.T F

Score: _______/7


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Answers:1.False. Some may feel threatened or upset by your decision.2.True.3.True. 4.True. 5.False. 6.False. It will in fact be easier to recover if you change several things at the same

time (for example, start exercising, eat healthier, drink a lot of water, etc.).7.False. Many people now smoke outside to protect their loved ones.


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Step 6Plan your

recovery

• Learn from your past experience. • Set a recovery date. • Choose your method of quitting. • Use easy quitting tips. • Know about withdrawal symptoms.• Prevent a relapse. • Write your recovery plan. • Make a daily action plan.

We do not quit smoking. We become someone who can live in this world without tobacco.

— Kelly and Smith, page 60


1. It doesn’t help to think about past attempts to quit smoking.T F

2. A recovery date should be set months in advance.T F

3. “Cold turkey” is a very effective method of quitting.T F

4. Some people get itchy skin as a withdrawal symptom.T F

5. Ex-smokers stop coughing within a few days of quitting.T F

6. Withdrawal symptoms are at their worst for the first 3 or 4 days.T F

7. Each craving for a cigarette will only last about 15 minutes. T F

Score: _______/7


Answers:1 .False. You can learn a lot from your past experience.2.False. You may lose motivation if the date is too far away. Usually about two

weeks is enough time to prepare yourself.3.True.4.True.5.False. You may cough more for many weeks as your lungs clean themselves out.6.True.7.False. It lasts only 3–5 minutes.

Learn from your past experience

Have you ever tried to quit before? If so, when and what did you learn thenthat might help you now? For example, what worked well? What would you do differently this time? What caused you to relapse?

What have other ex-smokers told you about how theyquit? Which of their ideas do you want to try?

Set a recovery dateA recovery date (quit date) is the day you will start your new,non-smoking life. On that day, you will wake up in the morningand not smoke. Rather, you will do healthy things like exercise,drink water or say prayers.

Choose a day that is less stressful for you. For some people, a weekend is easier: no school, no work, and so on. But formothers, a Monday morning when your children go back toschool may be better. Think about your daily patterns, and then

decide.


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Don’t set your recovery date too soon, or you may not be well-prepared. But don’t delay so long that you lose motivation.

Usually about two weeks to prepare yourself is enough.

Write the recovery date you choose on the line below,and circle it on a calendar where you will see it often.

My recovery date is:_________________

If you make excuses to delay setting a date, that’s normal. Your addictedmind panics at the idea of quitting. You may think: “I can’t quit thenbecause my uncle is coming. And the week after there is a big party...Maybe I should wait until summer... or next year... or never!”

If this happens to you, just laugh at the addiction. Remember, you are the boss now, not nicotine!

Go ahead and set a recovery date right now.

Your mind will try to play these same “dirty tricks” on you even after you have set arecovery date. You may have bad dreams about it too. That’s a normal part of recovery.Just stay focused on recovery. Laugh at your addiction.


Choose your method of quitting

There are two main ways to quit. One is called “cold turkey.” That means you smoke your normal amount until your recovery date, and then stop suddenly. You might go cold turkey and use nicotine replacement (see page 55) and/or Zyban, or you may not use any chemical aids. It’s your choice.

The other method is called “weaning,” which means cutting down slowly. For example, you might cut out one

or two cigarettes each day for two or three weeks leading up to your recovery date. Many smokers wean

off with nicotine gum (see page 55), replacing one or two cigarettes each day with a piece of the gum until

eventually all cigarettes have been replaced.

More people who manage to quit use the coldturkey method. But you can choose either. Choosewhat feels right for you now.

If you decide to wean off cigarettes, use thesame strategies we mention on the next page(“Use easy quitting tips”) to help you cut down.

Which method of quitting will you use? Why?

___________________________________________


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Use easy quitting tipsHere are a few ideas to add to the ones you have already read about in previoussections.

• Keep all the money you save as you cut down or quit smoking. Put it in a jar and save it up to treat yourself to something special. You deserve it!

• Live one day at a time. Just get through today withoutsmoking. Don’t worry about tomorrow yet! (For the first few days, live one hour or even one minute at a time!)

• Make your home smoke-free.

• Throw away all ashtrays and cigarettes.

• Ask others not to smoke near you for a few weeks.

• Have healthy snacks ready to eat. Don’t eat junk food! And don’t transfer your tobacco addiction to foodaddiction.

• Relax in a hot bath or shower.

• Do deep breathing and gentle stretching exercises to reduce stress.

• Take a nap.

• Write down your thoughts and feelings in a journal, or talk to a trusted friend aboutyour problems. Remind yourself that smoking will not make a problem go away!

• Discuss your problems openly with your parents, partner or friends.

• Please add other ideas: _______________________________________

Which of these quitting tips will you use?

___________________________________________


Know about withdrawal symptoms

Not everyone feels the same during the first few days without nicotine. If you are usingnicotine gum, the patch, or Zyban (see page 55), you won’t have the same withdrawalsymptoms as someone who quits without these treatments.

Which withdrawal symptoms have you heard people talk about?

_______________________________________

Which withdrawal symptoms are you most afraid of? Why?

________________________________

You might feel very nervous and irritable for afew days, until all the nicotine is cleaned out of your body.

Many people find that they can’t focus on their work or studies for a while. They keep thinking about cigarettes. But it gets better after a while.

You might feel a bit dizzy. That’s from all the healthy oxygen you breathe now. (Smokers breathe in a lot of carbon monoxide and less oxygen!)


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Some people get headaches for a few days. Your headaches willnot be so bad if you stop drinking tea, coffee and pop for thatfirst week when you quit. (The caffeine in those drinks causesheadaches when you are withdrawing from nicotine.)

Others have trouble sleeping at first, and havea lot of bad dreams about smoking. Butthen, once the first week is over, you willstart to sleep like a baby!

Expect to feel very tired for the first week. Nicotine is a stimulant, so when you stoptaking it, you will feel tired for a while. Also, you may be emotionally tired from resistingcravings and fearing a relapse, but that gets better each day.

You might have an upset stomach. Some people get diarrhea, and others get constipation but it doesn’t last long.

Some people feel hungry all the time! Your skin may get veryitchy as you clear the nicotine out of your body and your bloodcirculation improves.


You might cough a lot more than usual. The little hairs, called cilia, in theair passages leading to your lungs start to heal once you quit. Their job isto clean out your lungs. It’s good to know that your coughing now, as anex-smoker, is actually a sign of healing, not sickness!

You may get a sore throat, and your mouth may have a raw feeling for a few days.

The withdrawal symptoms are at their worst for the first three or four days, and usually go away after about two weeks.

Remember, each craving for a cigarette will only last about 3–5minutes. Focus on getting past each craving, one at a time.

Breathe deeply, or drink water, or sing a song until itpasses. Just do whatever you can to make yourself

feel better. Take a nap if you are tired. Asksomeone to watch your children for you to

give you a break. Eat healthy snacks if youare hungry. Go for a walk if you can’t focuson your work or studies.


Did you know?The Immediate Benefits of Quitting

Smokers die 10 years earlier than non-smokers. The good news is that a smoker who quits smoking before the age of 30 years old will have the same life expectancy as non-smokers.

The immediate benefits of quitting are:In less than 20 minutes: blood pressure returns to normal.In less than 8 hrs: carbon monoxide and oxygen levels in the blood return to normal.In less than 24 hrs: nicotine is eliminated from the body.In less than 48 hrs: chances of a heart attack start to diminish, improvement of sense of smell and taste.In less than 72 hrs: bronchial tubes relax and make breathing easier, improvement of lung capacity.In less than 2 weeks to 3 months: improvement of blood circulation and lung capacity increases by up to 30%.In less than 6 months: cough, sinus congestion, fatigue and shortness of breath improve.In less than 1 year: cigarette-related risks of heart attack are reduced by half.In less than 10 years: odds of dying from lung cancer reduce by half.In less than 15 years: the odds of dying from a heart attack are the same as those of a person who has never smoked.

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Prevent a relapseFrom time to time, long after you have become anex-smoker, you may feel a craving to smoke. That’snormal. But what are you going to do with the craving?How can you let the craving pass and not relapse?

Try the 4 Ds:• Delay: the craving will go

away in 3–5 minutes.• Deep breathing.• Drink water.• Do something else!

If you get desperate for nicotine, chew nicotine gum. But don’t smoke!

But what if you “slip” and have a puff or even a whole cigarette? Don’t panic. It was just a slip. You are an ex-smoker, but you had a slip,that’s all. Don’t be too hard on yourself. Don’t think of yourself as a“smoker” again. Don’t give up the struggle.

A slip is a normal part of recovery for many smokers. Recovery is aprocess, and a slip or two on the way is normal. The trick is not to leta slip become a true relapse (where you start to smoke regularlyagain).

After I started smoking again, I knew I had to quit because I immediately felt theharmful effects of smoking on my health: sore throat, headaches, bad smell on my hair and clothes.

It is possible to control your cravings, it is just a matter of minutes. When youmanage to get through these cravings, you feel proud and it helps you keep yourmotivation high.

Francine Vincent, Wendake


Learn from your slip. Think about the situation you were in when you slipped.

• Where was I when it happened? ____________________________________________________

• Who was with me? ________________________________________________________________

• How did I feel (what emotion) just before I smoked? ________________________________

• Why did this slip happen?___________________________________________________________

• What did I do to try to stop myself from smoking? (4 Ds?) __________________________

• Had I planned for this type of situation? _____________________________________________

• What will I do next time this type of situation happens? ______________________________

Most women tend to slip in stressful situations or after a loss of some kind. Be extra careful at those times.

Most men slip in positive situations (e.g. relaxing with friends, at a party,

in a bar, etc.). So beware!

On the next page, there is a checklist of danger zones that mayapply to you once you are an ex-smoker.1 Check off each situationthat may tempt you to smoke. Then, plan something you could doinstead of smoking.


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1. Adapted from the the kit How to talk about smoking with high-risk pregnant mothers: a guide forsupport providers, Council for a Tobacco-free Ontario.

I am still tempted to smoke when: Instead of smoking, I could try:

I feel stressed or anxious __________________________________________

I feel sad or get bad news __________________________________________

I feel angry or annoyed __________________________________________

I am lonely __________________________________________

I am bored or waiting around __________________________________________

I am talking on the phone __________________________________________

I am with smokers __________________________________________

Someone offers me a cigarette __________________________________________

I am drinking tea or coffee __________________________________________

I am drinking alcohol __________________________________________

I am at a party, the bar, or bingo __________________________________________

I have eaten a good meal __________________________________________

I have just woken up __________________________________________

I am watching TV __________________________________________

My hands feel empty __________________________________________

I am out on the land __________________________________________

I take my break at work __________________________________________

It’s a special celebration __________________________________________

(Please add other risky situations you might have to face:)

______________________________________ __________________________________________

If you find that a slip leads to a real relapse, don’t give up. Each relapse bringsyou one step closer to recovery. Re-focus. Set a new recovery date, and tryagain.


Failure is not relevant when you are fighting for your life.You may stumble, you may fall, but if you learn from eachexperience, eventually you will go smoke-free

— Stringam, page 64

My Recovery PlanPlease note: the numbers in brackets refer to the pages in this book where a topic was discussed.

Name:________________________ Date:______________________

1. My Recovery Date (pg. 81-82): _____________________________

2. I will be a safer smoker until then (pg. 72–74). Yes No

3. I will make my home smoke-free (pg. 70–71). Yes No

4. I will ask co-workers to make a smoke-free workplace (pg. 70). Yes No

5. Method of quitting (pg. 83): Cold turkey Weaning

6. I will use these easy quitting tips (pg. 84): _____________________________

7. I will use these chemical aids (pg. 55):

Nicotine patch Nicotine gum Zyban None

8. I know about withdrawal symptoms (pg. 85-87). Yes No

9. I will cut down on stress by:

Exercising, dancing, etc. (pg. 51)

Drinking less tea, coffee, pop and alcohol (pg. 54)

Getting enough rest and sleep (pg. 56)

Being assertive (pg. 66–67)

Singing, humming, drumming, or listening to music.

Doing deep breathing and relaxation exercises.

Expressing my emotions in a journal or through art,poetry, etc.

Other ideas (pg. 68): _____________________________


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10. I will control weight gain with:

Daily exercise (pg. 51)

Healthy foods (pg. 52)

Drinking lots of water (pg. 53)

11. I am committed to deep healing so I don’t just “transfer” my addiction fromtobacco to another substance or activity (pg. 20). Yes No

12. The emotional needs I will need to meet without using tobacco are (pg. 17–20):

__________________________________________________________________________________

13. I will use the following spiritual approaches to recover (pg. 43–45):

__________________________________________________________________________________

14. I will tell others that I plan to quit (pg. 65). Yes No

If yes, who?______________________________________________

15. I have thought about and learned from my past experiences trying to quit (pg. 81).Yes No Not applicable.

If yes, what have I learned?

__________________________________________________________________________________

16. I will learn from others who have recovered (pg. 81). Yes No

If yes, who?______________________________________________

17. I know that relapse is a normal part of the recovery process for most smokers (pg. 22). Yes No

18. I will prevent a relapse using these ideas (pg. 88-90):

__________________________________________________________________________________

19. In my social life, I will avoid the following problems as I recover (pg. 63–70):

__________________________________________________________________________________


20. At home, I will avoid the following problems as I recover (pg. 63–70):

__________________________________________________________________________________

21. At work, I will avoid the following problems as I recover (pg. 70):

__________________________________________________________________________________

22. When I need to re-motivate myself, I will think of:

how our ancestors were all smoke-free for thousands of years (pg. 5–6)

the links between colonisation and tobacco abuse (pg. 7)

how tobacco companies manipulate smokers (pg. 7-8)

how smoking is killing many First Nations people (pg. 9)

how smoking harms our health (pg. 10–14)

why I became addicted (pg. 15–17, 29–30)

what I can do to heal myself (spiritually, emotionally, etc.)

how I could influence others to quit or not to start smoking (pg. 20)

my reasons to recover (pg. 35)

positive messages I deserve to hear (pg. 36–37)

my life as it will be when I am smoke-free (pg. 38)

using spiritual resources to aid recovery (pg. 43–45)

23. Other issues/ideas for my recovery:

__________________________________________________________________________________


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Make a daily action plan

Now that you have made your recovery plan, you can make a daily action plan. Thinkof new, healthy ways to get through each day without a cigarette. Here is an example.

(Note: this action plan is adapted from page 88 in New Tools for Survival: a recovery manual for smokers by MurrayKelly and Kendra Smith. Pauktuutit published a different version of it on page 47 in the Aniqsaattiarniq–Breathing EasyTobacco Recovery Resource Materials.)


Time of day My old (smoking) routine

New smoke-free routine

Wake upWake at 8am. Smoke in bed.Make coffee. Smoke. (No breakfast.)

Wake at 7.30 am. Pray. Stretchingexercises. Go for walk. Return at 8.30 am for breakfast. Drink juice & water (no coffee/tea).

Morning Phone friends. Smoke.Go to the store onsnowmobile. Smoke.

Invite non-smoking friend to my home.Serve healthy snack. (No tea or coffee.)Talk. Drink lots of water.

Lunch Smoke. Eat fast food lunch.Smoke. Eat healthy food. Drink more water.

AfternoonVisit smoking friends.Smoke. Cook.

Walk to store. Do laundry. Take a nap.Eat fruit. Drink water. Cook.

Dinner Smoke. Eat. Smoke.Dishes. Smoke. Drink water. Eat. Go out for walk. Dishes.

Evening

Watch TV. Smoke. Shower.Smoke.

Visit non-smoking friend to watch TVwith her. Shower. Sing. Deep breathing.Do stretching exercises. Pray: "Thankyou for helping me through a smoke-free day!"

SleepSleep at midnight. Wake at2 am. Smoke. Sleep.

Sleep at 11pm. If wake up, breathedeeply and drink water. Sleep.

My daily action plan: weekdays

On this page and the next, there are two blank sheets for you to fill in: one forweekdays and one for weekends when your daily routines may be different.


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Wake up

Morning

Lunch

Afternoon

Dinner

Evening

Sleep


My daily action plan:weekends



Wake up

Morning

Lunch

Afternoon

Dinner

Evening

Sleep



I have learned from my past experiences with quitting (see page 81).

I have set my recovery date (see pages 81–82).

I know that I will feel nervous or even panic as my recovery date gets closer, and I commit to staying focused on recovery (see page 82).

I have chosen my method of quitting (cold turkey or weaning) (see page 83).

I have chosen some easy quitting tips to use (see page 84).

I know what withdrawal symptoms to expect and how to deal with them (see pages 85–87).

I know how to prevent a relapse (see pages 88–90).

I know what to do if I “slip” (see pages 88–89).

I have made a detailed recovery plan (see pages 91–93).

I know how to write a daily action plan (see page 94).

I have a daily action plan for weekdays and for weekends (see pages 95–96).


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Closing QuizNow that you have read this chapter, please re-do the quiz to see how muchyou have learned. Compare your score now with your score on page 80.

1. It does no good to think about past attempts to quit smoking.T F

2. We should set a recovery date months in advance.T F

3. “Cold turkey” is a very effective method of quitting.T F

4. Some people get itchy skin as a withdrawal symptom.T F

5. Ex-smokers stop coughing within a few days of quitting.T F

6. Withdrawal symptoms are at their worst for the first 3 or 4 days.T F

7. Each craving for a cigarette will only last about 15 minutes. T F

Score: _______/7


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Answers:1.False. You can learn a lot from your past experience.2.False. You may lose motivation if the date is too far away. Usually about two

weeks is enough time to prepare yourself.3.True.4.True.5.False. You may cough more for many weeks as your lungs clean themselves out.6.True.7.False. It lasts only 3–5 minutes.

ConclusionCongratulations!You have now prepared yourself by working through this guide. If possible, discuss your recovery plan with a health worker orfriend who will support and encourage you.

Join a support group for smokers who want to recover, if there is one in your community.

Don’t let fear stop you. Don’t delay. There is never an “ideal” time to quit. There are always many “reasons” to keep on smoking. You can do this! Take the leap. Commit to a recovery date. Join the millions of ex-smokers around the world who are so proud and so pleased to be smoke-free.Together, we can keep the circle strong.

Good luck!


Notes

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______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________


Resources

Arnaviapik, Simon. 1998. “Remembering old times” in Moses, D. D. & Goldie, T. (eds.) 1998. An Anthology of Canadian NativeLiterature in English, second edition, Oxford University Press, Toronto.

First Nations Regional Health Survey, 1997. First Nations of Quebec and Labrador Health and Social Services Commission.

Kelly, Murray & Smith, Kendra. 1995. New Tools for Survival: Recovery Manual for Smokers. Our Glass Publications, Ottawa.

Maracle, Brian. 1993. Crazywater: Native Voices on Addiction and Recovery. Viking, Toronto.

Moses, D. D. & Goldie, T. (eds.) 1998. An Anthology of Canadian Native Literature in English, second edition, Oxford University Press, Toronto.

Pauktuutit Inuit Women’s Association. 2000. Aniqsaattiarniq–Breathing Easy Tobacco Recovery Resource Materials. Ottawa.

Royal Commission on Aboriginal Peoples. 1995. Choosing Life: Special Report on Suicide among Aboriginal People. Canada Communication Group Publishing, Ottawa.

Stop Smoking! A Special Program for Pregnant Women. Regional Municipality of Ottawa-Carleton and the Ottawa-Carleton Health Department.

Stringam, Jean. 1996. Tobacco: addiction and recovery – a spiritual journey. Nechi Institute, Edmonton.

Thrasher, Anthony Apakark. 1998. “Playing with girls is a sin” in Moses, D. D. & Goldie, T. (eds.) 1998. An Anthology of Canadian Native Literature in English, second edition, Oxford University Press, Toronto.

Tobacco use among Aboriginal Children and Youth, Canadian Paediatric Society, Paediatrics and Child Health 1999, 4 (4) : 282-286, Reference No. II 99-01.

Wilson, D. M. C., Lindsay, E. A., Best, J. A., et al. “A smoking intervention for family physicians” in Canadian Medical Association Journal, 1987, Vol. 137 No. 7: pages 613–619.



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Quitting smoking: A kind of grieving

For many people, quitting smoking is like mourning or grieving. People who quit may gothrough the stages of grieving: denial, anger, depression and acceptance. Grief involvesa critical process of detachment. It is an adjustment process to a loss, because ex-smokers need to break their emotional attachment to smoking and an adjustmentperiod similar to mourning is generally necessary. However, losing or giving somethingup may affect people in different ways.

Generally speaking, grieving is a rather long process. There are some losses that areeasier to cope with than others, but coping with loss and grieving generally involve thefollowing steps:

Denial:This stage is often a way to detach yourself from emotions that would be too difficult tocope with. Denial gives people time to adjust. For instance: “I am not a heavy smoker, I know much heavier smokers than me…” or “I am not really addicted to tobacco. Icould quit anytime!”.

Anger:This stage is necessary because it is a way of

expressing your frustration over the loss of yoursmoking habit. People who have quit smoking often say

that they were much more irritable and impatient in thebeginning of the cessation process.

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Depression:It is during this stage that you start realizing that you are graduallyaccepting the loss while a part of yourself still has difficulties to copewith reality. For instance, you may, from time to time, suffer from

depressive effects during which you believe you will never be thesame person. Or you may feel: “I’ll never survive without tobacco!”.

Acceptance:It is during this stage that you start accepting you willnever smoke again and that the process of quittingbecomes less emotionally charged. For instance, youcome to realize that smoking is no longer necessaryin stressful situations or social activities duringwhich you used to light up.

As soon as you decide to quit, the grieving process begins. Quitting is more difficult forsome people than for others. No matter how long it takes, you must be convinced thatyour grief will not last forever. One day, you will eventually know how great it feels to besmoke-free. You will be free!


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healing A 2 - Nicotine Dependence Clinic Director FNQLHSSC. Healing from smoking ... (Transference)...

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Transcript of healing A 2 - Nicotine Dependence Clinic Director FNQLHSSC. Healing from smoking ... (Transference)...