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SECTION XXIII: NICOTINE DEPENDENCE Therapists Overview

AVOIDING NICOTINE RELAPSE TRIGGERS

GOALS OF THIS EXERCISE


1. 2. 3. 4. Establish and maintain total abstinence from nicotine products while increasing knowledge of the addiction and the process of recovery. Increase awareness of development and maintenance factors for nicotine dependence. Develop personal reasons for working on a recovery plan for nicotine dependence. Identify known triggers or cues for nicotine relapse and develop strategies to maintain abstinence from nicotine.

ADDITIONAL PROBLEM FOR WHICH THIS EXERCISE MAY BE USEFUL


Relapse Proneness

SUGGESTIONS FOR PROCESSING THIS EXERCISE WITH THE CLIENT


The Avoiding Nicotine Relapse Triggers activity is designed to help the client plan for successful cessation of nicotine use. It is designed to be the clients creation. This exercise works well for individual therapy but can also be useful for groups. The three larger tasks outlined in the exercisegetting prepared, setting up supports, and identifying alternative coping methodscan be broken into smaller segments and assigned over several sessions.

EXERCISE XXIII.A

AVOIDING NICOTINE RELAPSE TRIGGERS

No one starts using nicotine because they want to get addicted. Some dont think about it at all. Most people who use nicotine become addicted very quickly, and many deny that they are addicted. While everyones experience is unique, there are both common physical factors (i.e., physical pleasure and cravings, biological processes) as well as social (i.e., what your peers see as normal) and psychological factors (i.e., relaxation, pleasure) that play important roles in maintaining the addiction. Giving up nicotine requires taking a realistic look at this addiction and why it is so hard to quit. You can gain useful information from attempts you may have already made to quit (what worked, what didnt?). This exercise will help you to plan the three basic components of a successful smoking/chewing cessation plan: (1) increasing your motivation, (2) finding and using supports, and (3) learning and using alternative coping skills. Preparation/Getting Ready 1. What signs of addiction do you see in your use of nicotine (e.g., increased use, multiple attempts to quit, tolerance, withdrawal, use despite negative consequences)?

2. What denial statements have you used to rationalize continuing to use (e.g., Life is too stressful now, Im not mentally prepared to quit, Ill probably fail if I try to quit now)?

EXERCISE XXIII.A

3. What are the top three reasons you want to give up nicotine, as of today?

4. What family, social, and emotional challenges will you face in your recovery plan?

5. Part of a successful recovery plan is identifying your doubts and fears about quitting, to prevent setting yourself up for defeat even before you start. What are your doubts and fears about quitting?

6. If youve quit before, what worked for you, and what led to your return to using nicotine?

7. Please set a start date to begin carrying out your plan. 8. How and when will you tell your family, friends, and coworkers about your plan?

EXERCISE XXIII.A

9. What triggers will you have to watch out for (e.g., certain people, places, situations, feelings, association with daily activities or habits, times of the day, events)?

10. Of these triggers, which can you avoid?

11. What is your plan to cope with the triggers you cant avoid?

12. Which of the following methods or sources of support will you use to deal with triggers and cues to smoke or chew nicotine? a. Self-help groups b. Acupuncture c. Medications d. Hypnosis e. Publications and reading material f. Smoking cessation clinics and program g. Online support h. Other: 13. How will you handle cravings and other withdrawal symptoms? (Remember, theyre temporary and will pass, and the longer you abstain, the more your withdrawal symptoms will lessen in both frequency and intensity.)

EXERCISE XXIII.A

14. What rewards will you give yourself for abstinence, and when?

Be sure to bring this handout with you to your future therapy sessions, and be prepared to discuss your thoughts and feelings about this exercise as you begin your recovery plan.

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