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In the last section, we discussed the SALES approach to overcoming tobacco dependency. The SALES approach is a technique that attempts to maximize the effectiveness of a client’s quitting partner. Clearly, SALES is an acronym for speak, abstain, link, empathize and solve. We also looked at a three step problem solving process regarding smoking cessation.
In this section, we will discuss smoking triggers. This section intends to provide practical information and techniques for dealing with four common smoking triggers. The four smoking triggers we will look at in this secti are places, people, time, and feelings.
As you listen to this section, you might consider your client and evaluating the techniques in this section to decide if they are applicable to your practice. You might consider playing this section during your next session with a tobacco dependent client.
Four Common Smoking Triggers
♦ #1 Places
As you are aware, many tobacco dependent clients smoke in their homes. You may give clients who are triggered to smoke at home advice regarding changes at home. For example, the client can throw away the ashtrays, rearrange the furniture, or sit in a different room.
Another private place that triggers smoking in clients may be the car. Janet, age 24, smoked frequently in her car. During one of Janet’s quit attempts, she tried to avoid smoking by hiding her cigarettes in the trunk. Janet stated, "Whenever I would go anywhere, I’d promise myself that I wouldn’t smoke. I’d throw my cigarettes in the trunk, and take off. One day, I was on the highway and got an awful craving. I pulled over, got my cigarettes, and lit one right there on the shoulder of the highway. I was about halfway through my cigarette when a state trooper pulled up to find out what I was doing. When I explained the situation to him, he just laughed at me. I felt so stupid!" Obviously, clients cannot avoid their homes or their cars, but clients who successfully break smoking patterns often do so by avoiding high risk places that may lead to relapse.
♦ #2 People
First, Gino tried cutting down on the number of cigarettes he smoked to see if Donna’s intake also decreased. Second, Gino asked for Donna’s support. At a later session, Gino stated, "I let her know that I was working on quitting. I asked her for help, but she wasn’t willing to help. I think she felt like I was pressuring her to quit with me." Gino had made it clear to Donna that he was not asking her to quit, but instead just wanted her to support him in quitting. Gino was specific about what he wanted from Donna, but she avoided helping him reach his goals.
A third option For Gino was trying to spend time with Donna engaged in activities not conducive to smoking. I stated to Gino, "Maintain the underlying message that you love Donna and want to be with her, but don’t want to spend time with her while she is smoking because you become tempted to smoke."
At a later session, Gino stated, "Nothing works with this girl. There is no way I can be with her and quit smoking. It’s really unfair that I have to choose between our relationship and my health." I replied, "You might just take a break from each other so you can stop smoking. In the long run, the relationship might be over, but maybe it will be strengthened and regained." Gino stated, "Whatever. Either way, I’m doing what I need to do for my own health and well-being."
♦ #3 Time
For example, Eric’s self monitoring sheets revealed that he smoked between four and seven cigarettes between 7 a.m. and 10 a.m. These numbers almost doubled during the weekends. Clearly, for Eric, having free time in the morning led to frequent smoking. Do you have a client like Eric? What could he or she do in the morning to avoid smoking?
♦ #4 Feelings
However, positive feelings were Lane’s strongest smoking trigger. Even the satisfaction he felt after sex triggered Lane’s cravings. Lane stated, "I call myself a happy smoker. I love to smoke when I feel content and happy." What feelings lead your client to smoke? Clearly, Lane was not willing to part with happiness or sex, so we worked out a technique for avoiding relapse during happy or content moments called the "Empty Pack" technique.
♦ 3-Step "Empty Pack" Technique
Second, whenever the urge comes to light up, take out the paper. Focus on how long it’s been since you last smoked. Use positive self talk to reassure yourself that if you’ve gone that long, you can keep go longer.
Finally, smell the inside of the pack. It’ll smell like stale tobacco and remind you of the way you used to smell." Lane agreed to try this technique. Think of your Lane. Could the "Empty Pack" technique work for your client? Later in this section, you’ll hear some other techniques that worked for Lane.
♦ Other Triggers
Regardless of the smoking triggers your client experiences, here are two general tips that he or she might find useful. Lane found these two tips productive.
Do your clients reward themselves with cigarettes? Could managing smoking triggers help your client begin to successfully break smoking patterns?
In this section, we have discussed smoking triggers. This section intended to provide practical information and techniques for dealing with each of the four common smoking triggers. The four smoking triggers discussed in this section are places, people, time, and feelings. Do you have a tobacco dependent client that would benefit from listening to this section during your next session?
In the next section, we will discuss relapse. Because relapse is highly individualized, we will discuss two situations that cause relapse as well as the three rules of relapse. The two situations that cause relapse are emotional upset and boredom.