Confessions of a closet smoker

(Dr. Virginia Barlow is a family practice physician who was associated with Coudersport Family Practice at Charles Cole Memorial Hospital for several years. She is relocating this month from Coudersport to a hospital in Potsdam, N.Y.)

I once loved smoking. It was my solace. It gave me comfort. It was the only thing that could calm my frazzled nerves at the end of a stressful day.

My life was consumed by making sure I had an adequate supply of cigarettes and making sure that none of my patients ever saw me buying them. I lived for that first long, languid inhale that would put me in nirvana. It was blissful.

But, inevitably I would wake up coughing and hacking and reeking of smoke. I'd begin each day vowing never to smoke again, only to succumb to temptation.

I hated the smell, the expense, the sneaking around and the morning cough. I hated the stigma and I hated the hypocrisy I had to live with day in and day out.

But what I hated most was knowing I had developed a habit that completely controlled me. I was powerless over the addictive qualities of nicotine.

Then, on the evening of March 13, 2006, I put out my last cigarette. I woke up the next morning and literally could not breathe. I could not get air into my lungs and what little I managed to get in, I couldn't get out. I felt like I was slowly suffocating to death.

I ended up in the hospital and for the first time in my life, I came face to face with my addiction. On that day, I chose to live. I chose to breathe.

I am writing this now for all of you who are still struggling with nicotine addiction. One of the reasons you smoke is because of a built-in mechanism that has been with us since birth. The very first thing we learn to do when we come to this earth is to selfsoothe.

The simple act of bringing the hand to the mouth stimulates the vagus nerve, which is located in the middle of the chest. This slows down our heart rate, lowers our blood pressure and gives us a profound sense of calm and comfort.

As babies, we suck our thumbs or drink from a bottle. As we get older, those actions are replaced by eating, drinking and/or smoking. Stress and anxiety drive us to activities that allow us to bring the hand to the mouth as much as possible.

It is the psychological addiction to smoking that creates the biggest obstacle to becoming tobacco-free. Did you know that it takes only three to five days for the body to no longer be dependent on nicotine?

What causes us to fall off the wagon after we've moved beyond the physical addiction? Patterns of behavior and stress. Our brains have enormous power when it comes to creating habitual behavior.

Through repetition, your brain lays down memory tracers so that repetitive actions become automatic. So if you always smoke a cigarette with your morning coffee, then the next time you have your morning coffee, your brain is going to send a powerful automatic impulse urging you to reach for a cigarette.

In order to successfully quit smoking, you have to re-train your brain and go through what I call a series of "firsts." Those could include the first time you drive without smoking, the first time you eat without smoking afterwards, the first time you talk on the phone without smoking and so on.

The point is that once you make it through that first cup of coffee without a cigarette, each time thereafter just gets easier.

It takes months to fully get through all of your "firsts," but the cravings are usually gone within 30 days. So make a list of all the things that you associate with smoking and start knocking them out one by one.

The other obstacle to becoming nicotine free is stress. When we are stressed, we all revert back to behaviors which previously gave us comfort.

Fortunately, those impulses last only about 20 minutes. During that time, take a few deep cleansing breaths. Create a mantra to say over and over. Mine was, "I choose to breathe. I choose to breathe."

Another trick is to brush your teeth. Nothing kills a nicotine craving like fresh minty breath. Exercise also helps the cravings to pass quickly.

If you can follow these tips, you'll be able to put down your cigarettes for good and reclaim your life. No matter how long you have been smoking, it is never too late to quit.

If you would like, drop me a line to let me know how you are doing. My email address is drvbarlow@hotmail. com. Good luck!