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In spite of the fact that my father was a heavy smoker, and modeled for me how smoking led to devastating health outcomes, I became a smoker in my adulthood. Even though I know that he died of a heart attack when he was 58, and that this was in large part due to his smoking habit, I decided in my 20s to try it out—I wanted to see what all the hubbub was about. While you'd think that my father's emphysema and bronchitis, which made him wheeze just from walking to a different room, would make me a fierce opponent of smoking, still I stupidly picked up one cigarette after another and lit it up.
I can vividly remember times when I was smoking and thinking to myself, "This is really dumb. [puff] I can't believe I'm doing this. [exhale] I don't even enjoy it. [cough]" In the winter, I'd have to leave parties and dinners to go outside in the freezing cold and take care of my habit. I'd be hugging myself tightly to shield myself from the cold, and bring my shivering hand up to my mouth for another shot of heat and smoke. "Boy," I'd be thinking. "It sure looks like they're having fun in there."
Why in the world did I do it? And why didn't I quit sooner than I did? Looking back on it now, I understand that there is a behavioral reason that the habit persisted, and that only a behavioral approach to quitting could ever work. I'd like to explain how a habit like smoking can work against you, and then describe the kinds of behavioral modifications that I eventually used to kick the habit for good.
Rewards and punishments: The backbone of everything we do
Once you're a pitiful smoker, habit in full bloom, your body has come to rely on the nicotine that you are ingesting at regular intervals. If you try to quit smoking all of a sudden, you'll find out that your habit is tied to very specific environmental cues that make your body anticipate the arrival of the nicotine. For me, these cues included alcohol, food, my wife, my back porch, watching TV, and driving in my car. In short, everything in my entire life!
Kidding aside, here's what was going on. Let's say I took a beer out of the refrigerator. I reach for the bottle opener, and my brain says to my body, "Red alert! Red alert! He's about to have a cigarette!" My body, knowing that the nicotine and smoke are about to do some crazy things like raise my heart rate and thicken my blood, prepares for the nicotine and smoke by lowering my heart rate and thinning my blood. Why? So that, when the substances hit my system, they don't take me nearly as far toward a heart attack as they would without these adjustments. This is what psychologists call a conditioned compensatory response.
Each time you are in the presence of one of your cues, the body's attempts to adjust to the poisons you're about to introduce aren't that noticeable—until you try to quit. Even if I cracked a beer and didn't light up, my body had learned to lower my heart rate and thin my blood. If I was no longer "fixing" the situation by smoking, my body's compensatory reaction left me feeling badly. This feeling was a punishment for not smoking. You catch that? I had messed myself up so much with my habit that my body was punishing me for not smoking! And then, to make matters worse, if I gave in and smoked, the bad feeling went away, and the positive feeling of the nicotine high filled my brain with a temporary delight. That positive feeling was a positive reinforcement, and the bad feeling going away was a negative reinforcement. I was being rewarded with the positive feeling, and also with the cessation of a negative feeling.
Before I was a smoker, these bodily reactions to cues didn't exist. But once I was hooked, the environmental cues that were the antecedents to my behavior punished me if I resisted, and then rewarded me twice over for being weak. No wonder breaking a habit is so hard!
In my next post, I'll discuss a behavioral plan that can help you counteract your habits, and get you on the road to a recovery. It all starts with identifying the nature of the rewards you are getting for your habit, and then finding different (and incompatible) rewards you will give yourself as you quit. I'll break this down into small steps, so you can achieve shorter and more frequent successes, and get the pleasure of receiving progressively bigger and more exciting rewards.
