When we say cold turkey is the preferable way to quit, who do we describe to be cold turkey quitters. The definition is often not as obvious as it sounds.
Quit Smoking Cold Turkey!
To many, cold turkey conjures up visions of torturous pain, suffering and general drudgery. In fact, it is easier to stop smoking using the cold turkey method than by using any other technique. Cold turkey induces less suffering and creates a shorter period of withdrawal. Most important, cold turkey is the approach by which the smoker has the best chance of success.
Smokers must recognize that they are drug addicts. Nicotine is a powerfully addictive drug. Once the smoker has smoked for a fairly long time, the body requires maintenance of a certain level of nicotine in the bloodstream. If this level is not maintained, the smoker will experience varying degrees of drug withdrawal. The lower the level, the greater the intensity. As long as any nicotine remains in the bloodstream the body will keep craving its full complement. Once the smoker quits, their nicotine level will drop to zero within three days, and they will have moved beyond peak withdrawal. Within 2 to 3 weeks, all symptoms of physical withdrawal will cease. Cravings for an occasional cigarette may continue, but this is due to past psychological conditioning and not to a physical dependence.
Cutting down on cigarettes or use of nicotine replacement strategies throws the smoker into a chronic state of drug withdrawal. As soon as the smoker fails to reach the minimum requirement of nicotine, the body starts demanding it. As long as there is any nicotine in the bloodstream, the body will demand its old requirement. Smoking just one or two a day or wearing a patch which is gradually reducing the amount of nicotine being delivered will result in the smoker not achieving the minimum required level, creating a chronic state of peak drug withdrawal.
This state will continue throughout the rest of the smoker’s life unless one of two steps is taken to rectify it. First, the smoker can stop delivering nicotine altogether. Nicotine will be metabolized or totally excreted from the body and the withdrawal will stop forever. Or, the smoker can return to the old level of consumptions accomplishing nothing.
Therefore, cold turkey is the method of choice. Once the smoker stops, withdrawal will end within two weeks. If you smoke, we can help you over this crucial period of time. Once it is past, you can rest assured that you will never need to smoke again. Then, to stay off you will simply need to remember to Never Take Another Puff!
© Joel Spitzer 1984
Is cold turkey the only way to quit?
I have seen it written that we have said that the ONLY way to quit smoking is to quit cold turkey. This is not a totally accurate statement. It is not that cold turkey is the only way to quit, it is just that cold turkey is the method which gives people the best chance of success. It is the method that all but a small percentage of long-term ex-smokers in the world used to successfully quit smoking.
There are people who have quit using alternative approaches. There are some who cut down gradually and actually succeeded at quitting. For every person who did it like this and succeeded, there are many many many many others who tried it and failed. The individual who used the method will think it is great because it worked for him or her, but since it works for so few people it will generally be recognized as a pretty ineffective technique by most people who do “real world” research into how to quit.
By “real world” research I mean by going to long-term ex-nicotine users who you know personally and finding out how they all got off nicotine. Again, you will very rarely find any who did it by gradual withdrawal. If you find a person like this who is now off years, you should never minimize the person’s success. He or she quit smoking, likely doing it in a way that made it much more difficult than it needed to be, but still he or she did pull off the quit. The only advice that I would encourage that you share with the person is that now to stay off he or she must understand the bottom line method of sustaining his or her quit. That message is staying cognizant of the addiction and that the only true guaranteed method to stay off now is knowing never to administer nicotine again.
The same principle here applies to people who use NRT products. There are people who have quit this way. Again, it is a small percentage of the long-term ex-users out there, but they do exist. An individual who pulled it off this way will also feel that it is a great method for quitting. But again, this method works for a small percentage of people who try it and if you look into real world long-term quits you will have a very hard time finding many people who actually successfully got off nicotine this way.
I feel it necessary to use that phrase, “got off nicotine,” as opposed to saying, “got off smoking.” There are some major experts coming out and advocating that people should be given nicotine supplements forever to stay off of smoking. Can this work? Of course it can. If you can give people enough nicotine via supplements it will satisfy their need for nicotine. After all, this is the primary reason they were smoking at the end — to feed a nicotine addiction. If the smoker can just get nicotine for the rest of his or her life via another route, he or she will avoid going through the three days of nicotine withdrawal.
The question needs to be, why should anyone have to pay what is likely to be tens of thousands of dollars to avoid a few days of withdrawal.? On top of this, these people will never be totally free of the moderate withdrawals that such usage is likely to keep going. These people will in fact tout the use of the product as a great aid, but when compared to what people who are totally nicotine free are experiencing, this victory over cigarettes is just a bit hollow.
There are a few people though whom you may encounter over your lifetime that did quit using NRT’s as intended, weaning down for week after week and eventually quitting. If the person is now off for years, he or she is pretty much in the same state as a person who had quit cold turkey. He or she is nicotine free, and he or she should be thrilled by that fact. In some ways I look at people like this with a bit of awe, for they in all likelihood stuck with a process that was pretty much a gradual and prolonged withdrawal and yet they succeeded.
Again, debating the merits of their method with them is pretty much a moot point. It worked for them and you are going to have a pretty hard time convincing them that it is an ineffective method. But you do have a message that you can share with them that they do need to know. That message is that even though they are off nicotine for years, they still need to recognize that they are not cured of nicotine addiction and never will be. No matter how they had stopped, they must still understand the bottom line message, that the only way to stay free now is staying totally committed to never administer nicotine again via any nicotine replacement source and to never administer nicotine again from the original source that likely started the whole process by knowing to Never Take Another Puff!
© Joel Spitzer 2003