Preventing Relapse in Smokers Who Quit

By Karon, Bertram P.; Widener, Anmarie J. | Ethical Human Psychology and Psychiatry, April 1, 2011 | Go to article overview

Preventing Relapse in Smokers Who Quit


Karon, Bertram P., Widener, Anmarie J., Ethical Human Psychology and Psychiatry


Most smokers who give up smoking relapse. There is a simple procedure that has been used successfully that prevents relapse. It has been used clinically for many years. When not smoking, we do not experience the feel, the taste, or the smell of the cigarette. When we next experience any one of these, we tend to reexperience a strong wish to smoke. Each day for 1 month, buy your usual supply of cigarettes. Whenever you want to smoke, light a cigarette and put it out immediately. You may take another one whenever you want, including right away. After a month you will be free of smoking, and you will not relapse. The procedure is simple and cheap and does not require a therapist. It has been used without medication.

Keywords: smoking; smoking cessation; memory; relapse; addiction

It is axiomatic that many, if not most, smokers who attempt to give up smoking relapse. It takes most smokers 8-11 tries, according to Cheryl Healton of the American Legacy Foundation, an antismoking group, as cited in the New York Times (Konrad, 2010). Despite this, in 1986, the American Cancer Society reported "over 90% of the estimated 37 million people who have stopped smoking in this country since the Surgeon General's first report linking smoking to cancer have done so unaided" (Chapman & MacKenzie, 2010, para. 1). Population studies have shown "unaided cessation" to be the most common method used by most successful ex-smokers (Chapman & MacKenzie). Yet, intervention studies have shown that those who try to quit without the use of medication or counseling have an abysmal 4%-6% success rate (Munsey, 2008). When medication and counseling are used (or used in combination), studies have shown only about one third successfully quit smoking after 2 years of treatment (Eisenberg et al., 2010; Ellerbeck et al., 2009). In those who successfully quit for a period of time, studies have shown that most of self-directed quitters (95%) will relapse within 1 year; furthermore, 60%-80% of those who enroll in a treatment program will relapse (Brandon, 2010). It could be, as noted in population studies, that "early failure" may be a sign of initial efforts that are not serious attempts (Chapman & MacKenzie).

There is a simple, inexpensive procedure for quitting smoking that prevents relapse. It has been used by one of us (Karon) for more than 40 years with patients, students, and others. We have not previously published this, because we practice psychoanalytic therapy or psychoanalysis, which does not usually treat patients for a single symptom but, rather, for all symptoms. Smoking has not been the most serious symptom for any of them, although it has been treated when raised by the patient. We have tended to write about symptoms which seemed life threatening, crippling, or of greater importance to the patient or therapist (Karon & VandenBos, 1981; Widener, 1998). However, smoking shortens life spans and can cause costly and serious diseases. Smoking cessation, if taken seriously, can increase health quality and decrease health care costs overall. In today's national efforts to curb health care costs while increasing health care and health quality, smoking cessation can be a key component of our nation's health reform. It is of increasing concern to individuals; indeed, even our current president, President Obama, during his election year and since, continues to try and quit smoking (Rosenbaum, 2008) not only for his own health needs but also to act as a role model for all of us.

This procedure is based on facts and theory about memory, best described by Tomkins in his book Affects, Imagery, and Consciousness, Volume 4 (1992). According to Tomkins' theory, if human beings experience something in a complex context and then do not experience it for a while, when we next experience it, we tend to reintegrate the whole experience in all its complexity. In the case of smoking, while we smoke, we feel the cigarette in our lips as well as our hands, we smell the smoke, we taste the smoke, and we react to the nicotine. …

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