Setting target goals and plans

Topic Health Behaviour Change – Quitting Smoking Behaviour

To live a healthy life with the peaceful body it is essential to quit habits that create unnecessary stress and disease in the body. Cigarette smoking is one such habit that gives birth to unwanted diseases in the human body (Babb, 2017). My purpose of getting indulge in health changing behaviour task is to quit this habit of smoking as it is a dangerous, unnecessary, unreasonable and addictive habit.

Target goals and plans not help us to quit a habit rather they help us to stop quitting and maintain a schedule to reach set purpose (Eysenck, 2012). Therefore, I established short-term and long-term goals to reach my purpose behaviour change of quitting cigarette. By following the information provided in Guydish et al. (2016) studies, the initial step was to determine a reason of quit, set a quit date and the times of maximum smoking because this shall help to remain focused towards my act. I selected a sooner date rather than a later one, my target was to quit smoking in 9 weeks. According to Kalkhoran & Glantz (2016) studies a sooner quit date is better than a later one for smokers. Further, I made everyone near me (friends, family, colleagues) informed about my plan of quitting cigarettes to get help and motivation.

The first initiative was to determine some short-term motivations goals that can help to achieve an attitude of focussing on health priorities. The very first short-term goal was getting indulge in ‘Smart Walks’, these are basically small walks that a person should take in the morning or times when the craving for cigarettes is maximum. These random walks help to divert once attention from smoking habit (Xu, Bishop, Kennedy, Simpson & Pechacek, 2015). I planned to take small walks in the morning before my cup of tea, as my craving is maximum at this time.

Jamal et al. (2015) identified some logical goals or steps that can make you smart while eliminating a smoking habit from your schedule. These steps are ‘writing about triggers’ and ‘removing reminders’. There are certain triggers in your daily schedule that are as people, feelings, activities etc. for e.g.- friend circle involved in smoking activities. I worked to identify my triggers and manage a way to deal with them. Further, smoking reminders like ashtrays, matches, lighters, cigarettes etc. were removed from my living zones.

Short-term motivation goals

According to Urquhart, Jasiura, Poole, Nathoo & Greaves (2012) studies ‘counselling’ from a professional counsellor, doctors or people close to someone surely work as a remedy to overcome the desire of bad habits like smoking. I implemented this counselling practice as a long-term goal to quit my smoking habit. I consulted with local GP to get counselling whenever I needed it during my period to quit smoke. My GP helped me with the best methods to quit smoke as per my personal health. I am maintaining the practice of counselling even after completion of the smoke quit cycle. Further, getting indulged in ‘regular exercise and medication’ helps to overcome smoke triggers like stress, anger, getting involved in substance abuse etc. (Villanti, Bover Manderski, Gundersen, Steinberg & Delnevo, 2016). According to Agaku, King & Dube (2014) studies regular exercise and medication helps to overcome the weight issue that is a major side-effect of quitting the smoking habit. I implemented the habit of regular exercise and medication as a long-term strategy to control negativity developed because of quitting as well as a method to overcome weight issues.

Further, I made changes in my eating habits because Biener & Hargraves (2014) mentioned in their study that some foods have potential increase capabilities of staying smoke-free and some food also makes it hard to let go over the smoking habit. Therefore, my goal was to ‘eliminate the triggering foods’ from my diet and implement foods that help me quit smoking. The intake of fruit, vegetables, lean protein, dairy helps to quit smoking whereas elimination of high fat, sodium and sugar is beneficial to maintain the habit of quitting smoke.

Carter et al. (2015) indicated that it is a tough job to quit smoking in the initial few weeks. Use of alternatives and quit smoking medication is recommended to avoid initial consequences. These ‘medications and alternatives’ also help to maintain the habit for a long duration. I implemented the use of quit smoking alternatives like gums, smoke patch and sprays for some time. A combination of nicotine replacement alternatives (gums, patches) with varenicline medicine was the best coping strategy I followed for a long time.

Pros	Cons
Better health	Weight gain
Enhancement of time, energy and money	Constant feeling of irritation, and dissatisfaction.
No more smelling from mouth, clothes and surroundings.	Nicotine craving episodes with seriously missing smoking habit.
Better tasting of food Improvement in confidence, presentation and awareness level.	Disturbance in concentration due to the craving for cigarettes.
Betterment in the relationship with close once.	Depression due to withdrawal syndrome.

Quitting smoking habit came with a baggage of certain health changes that were negative as well as positive. At the personal level, I also experienced these health changes during my duration to quit the smoking habit. In initial days, there was a little weight gain with times experiencing irritability, withdrawal syndrome and depression. I was not able to concentrate on my work feeling stressed out all the time. According to Beard, West, Michie & Brown (2016) studies, people facing withdrawal syndrome release stress by more sleeping or eating habits. I also got indulged in more sleep and eating habit increasing my level of depression with time.

Logical goals or steps

Likewise, health changes, the changes in lifestyle also included the positives and negatives. As a consequence of quitting smoke, I made huge changes in my lifestyle that gave me better health, more confidence and better relationships with time. But, in initial days, psychological disturbances and weight gain created a huge problem in my lifestyle. I was not able to concentrate on work, improper communication with people etc. However, with time the impact of quitting smoke was positive on my lifestyle. I started indulging with good companions, enjoying with family, better health, better attention, concentration and presentation at the work place.

The below provided account details my personal journey experience on quitting smoking habit from being a smoker to ex-smoker. I took me 9 weeks to plan, manage and implement this behaviour change and at last till 8^th week I was an ex-smoker. However, Carreira, Pereira, Azevedo & Lunet (2012) studied that quitting smoking habit can take from few weeks to months depending on the willpower of individual involved in the process. It is assumed that as quickly as a person quits smoking, there is possibility of getting indulged quickly in smoking again. Therefore, quitting smoking or being an ex-smoker is also a habit to develop that requires a lot of effort.

According to Chaiton et al. (2016) studies, the most common barriers faced by smokers in quitting smoking process are weight gain (25% smokers), irritability (29% smokers), craving (6%), stress (6%), no disadvantage (0% smokers). This data indicates that one has to face certain specific barriers while getting indulge in smoke quitting practice. Personally, I also confronted many physical and psychological barriers in my smoke quitting cycle. Even I am getting a miserable feeling while writing about my past few week experiences. It was a depressing task to quit the smoking habit that was an important part of my relaxation. It was very stressful to imagine every morning about the stressful process one has to go through while implementing this change of behaviour.

According to Villanti et al. (2016) study, 90% of smokers believe that cigarettes help them to relax by reducing their regular stress on the nervous system. I was also a believer in this fact. The very first barrier to my behaviour change cycle was to accept the fact that smoking is a bad habit. Smoking directly impacts on heart rate and blood pressure leading to increased stress level on nerves rather than relaxing them.

Counselling and medication

In the first week of quitting cycle, there were feelings of Goosebumps, stomach worms, unnecessary hunger and insomnia. As a result, a weight gain of about 4pounds was observed while completing my first week of quit. Tian, Venn, Otahal & Gall (2015) mentioned in their study that weight gain is the most common barrier to quitting smoking. Around 50% people involved in quitting smoke can gain weight up to 10 pounds. I was worried about this sudden weight gain and underwent psychological depression. However, lifestyle modifications and counselling helped me to overcome these barriers.

In the 5^th week of my smoke quitting process, my psychological disturbances reached a peak level with continuous depression, lack of concentration and tremendous stress at work. I was getting diverted from my purpose to quit smoking till this time. At family gathering and at the office I was only observing people smoking cigarettes. My depression was overruling my desire to quit the smoking habit. This psychological disturbance was a major barrier for me to overcome. There were times when I wished to have a real cigarette but I knew that I really don’t want that. The cravings were at a peak during 4^th and 5^th week of the cycle. It was all on my own to overcome these barriers to achieve my targeted goal.

To give up smoking has never been an easy task for me, smoking was almost a part of my life just like eating food, breathing etc. I never gave a thought to quit smoking from last 8years but certain health issues dwelling in my body forced me to do so. In the process to quit smoking many facilitators minor and major helped me to achieve my goal. From the studies of Jamal et al. (2015) I learned about various case studies where people died as a consequence of smoking even at early ages like 58, 54 even 40. Further, in certain reading by Kalkhoran & Glantz (2016), I found knowledge about a way out to plan my quit smoking process. I developed my 9weeks plan using the information from these studies.

The very important facilitator that helped me to achieve my target was ‘counselling’ with my General Physician. The counselling started sessions properly from 4^th week where GP provided me best possible information and resources that helped me in recovery. GP informed me about the use of pharmaceutical medicines and replacement therapy. The pharmaceutical medicines and alternatives provided by counsellor helped to overcome the initial cravings for nicotine. The replacement therapy involved dosage combinations of both alternatives (gums, patches) with medicine that was reduced with time to eliminate their use with time (Insel, Roth & Insel, 2012). My replacement therapy and counselling was a complete success.

Changes in eating habits

Well after successful counselling and modified lifestyle there was a noticeable control over my smoking habit. But, I was continuously under pressure of psychological disturbances harnessing my effort as well as creating demotivation and stress. I am an emotional person and needed emotional support in this situation. In a reading by Taylor et al. (2014), it is explained that psychological or cognitive behaviours can be very well controlled by emotional support from close once, friends or family. I went to my close friends and family members gathering support by diverting my mind from smoking. They all appreciated the change in me and motivated me further to have a healthy lifestyle by quitting smoke. Their motivational thoughts and stories really worked as therapy for me. I took off from my office for the complete 6^th week where I just relaxed and met people to divert my thoughts, relax and stabilise myself.

Till the end of 7^th week results were positive, my weight was under control and I was completely over my smoking thoughts as well as habit. The 8^th and 9^th week were meant to enjoy the feeling of success, gather confidence and appreciation. I started using quit smoking applications followed by getting indulged in quit smoking programs helping other to overcome this habit at the end of my cycle (Insel, Roth & Insel, 2012). This helped me to gain confidence and appreciation for my effort.

Any kind of behavioural change is completely a personal perspective depending on once own willpower to change that behaviour or not (Babb, 2017). Hence, it depends completely on the smoker to decide about quitting or keeping the habit. As an experience holder, I can personally help a person with my learning’s from the quitting process, encouraging and supporting, being optimistic with them and offering them my strategies to cope. Taylor et al. (2014) studied about the viewpoint of supporter helping people to quit smoking. As per study findings, supporters indicate that the hardest part of helping someone quitting smoke is to maintain positivity about behavioural change. Therefore, it is important to provide counselling while helping vulnerable people to maintain positivity about their behavioural change to quit the smoking habit.

I can definitely help a person to give up smoking but depending on my personal experience and limitations. Below described are some of the ways in which I can use my personal experience to control their disorder.

As I developed my reason, quit date and goals to quit smoking, I can encourage a smoker to develop their reason, quit date and goals in their quitting journey. I can help them out with improving their physical health, saving and investing money (saved from cigarettes control), gaining a sense of achievement and pride.

Quit smoking alternatives and medication

Getting into someone’s personal behaviour change process is not an easy process. In Biener & Hargraves (2014) studies it is mentioned to establish an agreement about once role while providing support to a person quitting the smoking habit. This means I and the other person need to decide my role as a supporter, friend or partner in their journey. This shall work better for both of us. According to Jamal et al. (2015) studies, it is beneficial for both the parties, supporter and vulnerable person to get in set dates of the contract while providing support.

I would provide help by discussing the obstacles a person feels while trying to quit their habit. I would try to understand their perceptions about the goals, worries, stress level etc. Even as a supporter I will try to make sure that vulnerable person is not pressurised or discouraged by my support providing process.

Supporting Ways

I will help in the number of ways described below, I have structured these strategies from studies provided by (Babb, 2017).

“Sparkplug”

This involves firing up, encouraging and boosting the enthusiasm of the person

“Coach”

I will work to teach them the benefits of changing their habit in every phase of their quitting process

“Booster”

Once the person has implemented the changes, I will work as a booster to increase their confidence.

“Bystander”

This is up to me to understand my limitation of involvement and take a step back once required in the recovery process.

“Resource provider”

I would provide the best possible resources to the vulnerable person that I have used in my quitting process. Some are online motivation websites, quit applications, quit calculator, books and helpline services.

“Counsellor”

Last but not the least, apart from encouraging the individual to get professional counsellor help, I would work as a passive counsellor helping that person to achieve their goal. I would work to remind them about their exercise, doctor’s visit, eating habits etc. Further, I would provide education about symptoms, science and technique behind the quitting process. I would listen to their views as much as possible and generate positive views wherever essential. I would also suggest them strategies and information to help them as much as possible.

Week 1	Week 2	Week 3	Week 4	Week 5	Week 6	Week 7
I modified my schedule, lifestyle changes and routine according to information obtained from my short-term goals. Further, weight gain was a consequence of quitting smoke.	I worked hard to implement change in eating and lifestyle (exercise, smart walk, medications) as much as possible. The use of medications and alternatives was very high this week.	I was deep into the practice of regular exercising and healthy eating. Further, implementing habit to eliminate the use of alternatives.	I got indulged in counselling with my GP to overcome the use of medication and alternatives. Further, I continued to exercise, medication and habit of good food in my diet. I got in to practice with these lifestyle changes.	I tried to divert my attention from smoking by meeting close once who provided me with help and motivation. However, the psychological disturbances (lack of concentration, and depression) were very high in this week.	I was motivated by close once and my GP leading to complete elimination of using alternatives and medication. I was able to attain a control over gaining weight by exercise and better eating habits. I was more confident, presentable, attentive and aware at my workplace. I found my family and friends happier with me now.	Lastly, the psychological disturbances were still present but were under control. By the weekend I was feeling assured about complete quit of my smoking habit.

References

Eysenck, H. J. (2012). Smoking, personality, and stress: Psychosocial factors in the prevention of cancer and coronary heart disease. Springer Science & Business Media.

Insel, P. M., Roth, W. T., & Insel, C. (2012). Connect core concepts in health. McGraw-Hill.

Personal journey experience

Agaku, I. T., King, B. A., & Dube, S. R. (2014). Current cigarette smoking among adults-United States, 2005-2012. Morbidity and Mortality Weekly Report, 63(2), 29-34.

Babb, S. (2017). Quitting smoking among adults—United States, 2000–2015. MMWR. Morbidity and mortality weekly report, 65.

Beard, E., West, R., Michie, S., & Brown, J. (2016). Association between electronic cigarette use and changes in quit attempts, success of quit attempts, use of smoking cessation pharmacotherapy, and use of stop smoking services in England: time series analysis of population trends. bmj, 354, i4645.

Biener, L., & Hargraves, J. L. (2014). A longitudinal study of electronic cigarette use among a population-based sample of adult smokers: association with smoking cessation and motivation to quit. Nicotine & Tobacco Research, 17(2), 127-133.

Carreira, H., Pereira, M., Azevedo, A., & Lunet, N. (2012). Trends in the prevalence of smoking in Portugal: a systematic review. BMC Public Health, 12(1), 958.

Carter, B. D., Abnet, C. C., Feskanich, D., Freedman, N. D., Hartge, P., Lewis, C. E., … & Jacobs, E. J. (2015). Smoking and mortality—beyond established causes. New England journal of medicine, 372(7), 631-640.

Chaiton, M., Diemert, L., Cohen, J. E., Bondy, S. J., Selby, P., Philipneri, A., & Schwartz, R. (2016). Estimating the number of quit attempts it takes to quit smoking successfully in a longitudinal cohort of smokers. BMJ open, 6(6), e011045.

Guydish, J., Passalacqua, E., Pagano, A., Martínez, C., Le, T., Chun, J., … & Delucchi, K. (2016). An international systematic review of smoking prevalence in addiction treatment. Addiction, 111(2), 220-230.

Jamal, A., Homa, D. M., O’Connor, E., Babb, S. D., Caraballo, R. S., Singh, T., … & King, B. A. (2015). Current cigarette smoking among adults—United States, 2005–2014. MMWR Morb Mortal Wkly Rep, 64(44), 1233-1240.

Kalkhoran, S., & Glantz, S. A. (2016). E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. The Lancet Respiratory Medicine, 4(2), 116-128.

Taylor, G., McNeill, A., Girling, A., Farley, A., Lindson-Hawley, N., & Aveyard, P. (2014). Change in mental health after smoking cessation: systematic review and meta-analysis. Bmj, 348, g1151.

Tian, J., Venn, A., Otahal, P., & Gall, S. (2015). The association between quitting smoking and weight gain: a systemic review and meta?analysis of prospective cohort studies. Obesity reviews, 16(10), 883-901.

Urquhart, C., Jasiura, F., Poole, N., Nathoo, T., & Greaves, L. (2012). Liberation!: Helping Women Quit Smoking: a Brief Tobacco Intervention Guide. British Columbia Centre of Excellence for Women’s Health.

Villanti, A. C., Bover Manderski, M. T., Gundersen, D. A., Steinberg, M. B., & Delnevo, C. D. (2016). Reasons to quit and barriers to quitting smoking in US young adults. Family practice, 33(2), 133-139.

Xu, X., Bishop, E. E., Kennedy, S. M., Simpson, S. A., & Pechacek, T. F. (2015). Annual healthcare spending attributable to cigarette smoking: an update. American journal of preventive medicine, 48(3), 326-333.