Do Crave Episodes Really Peak Within Minutes?
Yes, generally, although we don't yet know why. After ending nicotine use, rarely does the challenge posed by a cue triggered crave episode last longer than the time that it took to smoke a cigarette.
While possible that multiple un-extinguished use cues may be may encountered within minutes of each other, decades of online support group discussions suggest that it isn't as common as we might think.
What is common is to see periods of conscious thought fixation being confused with a subconsciously triggered crave episode. It's easy to do.
A 2021 study exposed 64 smokers to a participant drinking water (a neutral stimulus), followed by watching them vape from a tank-type e-cigarette for up to 5 minutes. Thereafter, roughly half who watched were sensitive enough that they opted to smoke.[1]
But not being e-cigarette addicts themselves, did they smoke due to subconscious conditioning or because of conscious awareness of what was being inhaled? There's also the possibility that seeing exhaled vapor reminded them of cigarette smoke, which, for some, may have become a conditioned use cue.
Why is the distinction between conditioning and simple thoughts or thinking important?
Think about your favorite food. How long can you continue to stay focused and fixated upon it? Can you do so for 10, 20, or even 30 minutes? What about while trying to diet? The only limit upon the duration of conscious fixation is our ability to maintain concentration and focus.
It's one of many problems significantly infecting crave duration research. Most glaringly, the pharmaceutical industry is heavily invested in getting smokers to purchase nicotine gum. The shorter crave episodes, the less need for gum.
Unfortunately, many crave duration studies involve researchers who were directly or indirectly receiving money from those making and selling nicotine gum.
Researchers are studying smokers who continue smoking or who have not smoked since awaking,[2], or who were asked to not smoke for 3 days,[3] or smokers who were given replacement nicotine,[4, 5]. The common thread is that none are in recovery, that all fully expect to smoke again soon.
Nicotine use expectations effectively unchanged, operant conditioning still operating, and participants likely in the throes of early withdrawal, how could they not engage in extended fixation?
Obviously, seeing someone else smoke can be both a source of conscious thought fixation and an, as yet, unextinguished use cue. The primary distinction between conscious fixation and a subconsciously triggered crave episode is control.
While we have substantial direct control over the duration of fixation, and significant control over how the conscious mind responds when a subconscious cue is encountered, our subconscious controls the timing and duration of cue-triggered episodes.
The importance of the distinction is the recovery confidence flowing from knowing that we can control thoughts and thinking, while subconscious challenge is short lived.
How do you tell the difference? It's simple. Determine who's driving.
Once you've stopped using, the next time you find yourself thinking about inhaling nicotine, try replacing those thoughts with thoughts about your favorite person, place, or food. Visualize giving them a giant hug, being super relaxed at your special place, or this bite of your favorite food being the best ever. Can you feel your focus shifting?
But if cue triggered crave episodes peak and begin to subside within minutes, why do the minutes sometimes feel like hours?
Time Distortion
A 2003 study found that distortion of time perception is one of the most common nicotine dependency recovery symptoms.[6]
Smokers were asked to estimate the passing of 45 seconds both while still smoking nicotine and during a second session after which they had not smoked any nicotine for 24 hours. Their time estimates were also compared to a control group of non-smokers.
While at a loss to explain why, researchers found that time estimation accuracy was significantly impaired (300%) in smokers who had not smoked or used nicotine for 24 hours, as compared to estimates made while smoking.
The ability of smokers who had not smoked for 24 hours to estimate the passing of 45 seconds was also impaired when compared to estimates made by non-smokers. But timing estimates were found to be similar between non-smokers and smokers while smokers were allowed to continue smoking.
Keep a watch or clock handy
What the study didn't assess was the estimation of time during the occurrence of a crave episode.
Whether cessation time distortion is ultimately found to be physiological, psychological or some combination, knowing that it exists suggests the value of looking at a clock or watch during an episode, in order to bring honest perspective to time.
When a craving arrives, immediately look at your watch or a clock and note the time. The episode's false message - that the only way to make the craving end is to bring more nicotine into your body - will soon peak and then pass.
Not only will your recovery remain alive and well, you are highly likely to receive a reward, the silencing of a use-cue, and the return of yet another aspect of nicotine-free life.
It's important to note that for the 1.7% of adults diagnosed with panic disorder under diagnostic standards such as the American Psychiatric Association's DSM-IV manual, that DSM-IV criteria indicate that panic attacks may not peak for up to 10 minutes.[7]
Focus your panic attack coping skills training on handling nicotine cessation panic attacks. Already highly skilled, hopefully, you'll find this aspect of nicotine dependency recovery the least challenging of all.
We're each fully capable of handling a few minutes of anxiety. We all can. Accurately measuring the episode's duration will prevent time distortion from making it appear 300 percent longer than reality.
Don't let time distortion deprive you of your dream of again comfortably engaging life as "you."
References:
2. Heishman SJ et al, Prolonged Duration of Craving, Mood, and Autonomic Responses Elicited by Cues and Imagery in Smokers: Effects of Tobacco Deprivation and Sex, Experimental and Clinical Psychopharmacology, June 2010, Volume 18(3), Pages 245–256.
3. Heishman SJ et al, Imagery-induced Tobacco Craving: Duration and Lack of Assessment Reactivity Bias, Psychology of Addictive Behaviors Sept. 2004, Volume 18(3), Pages 284-288.
4. Niaura R et al, Comparative Efficacy of Rapid-Release Nicotine Gum Versus Nicotine Polacrilex Gum in Relieving Smoking Cue-Provoked Craving, Addiction, Nov. 2005, Volume 100(11), Pages 1720-1730
5. Shiffman S et al, Efficacy of Acute Administration of Nicotine Gum in Relief of Cue-Provoked Cigarette Craving, Clinical Trial Psychopharmacology, April 2003, Volume 166(4), Pages 343-50.
6. Klein LC, Smoking Abstinence Impairs Time Estimation Accuracy in Cigarette Smokers, Psychopharmacology Bulletin, May 2003, Volume 37(1), Pages 90-95.
7. American Psychiatric Association, Panic Disorder, Diagnostic and statistical manual of mental disorders, fourth edition, 1994.
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