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Discussion, comments and links related to Joel Spitzer's cold turkey quit smoking videos

The Terrible 3's

Video discussing why people “may” have problems at three day and three month marks.

The terrible threes

You will often hear the concept of the terrible three's in regards to quitting smoking. How things just go bad at three days, three weeks, three months, and three years. Except for the three day issue which has a real physiological basis, I do not put a lot of stock into the concept of the terrible threes, especially the 21-day or 3 year's mark. The three-day issue is a real phenomenon, although for some people it is a one-day or two-day issue and it may be eased up by the third day so that one is not even etched in stone. The three-month issue has a basis, but it is not physiologically based, but more so it is probably from seasonal variation.

As ex-smokers start pulling out their old wardrobes, start experiencing new weather conditions, start watching different sports seasons, start preparing for different holidays and events, these are all first time experiences without a cigarette. If a person quits in the heat of summer, there is no way they learn how to shovel snow, or scrape ice without a cigarette. Maybe driving in snow and ice always scared them. That scare would lead to increased smoking, intricately intertwining the two activities. The first time encountering the condition will be an automatic feeling of needing to smoke. On the

same token, if they quit in winter, they have no idea how to lay in the sun on a warm day. These are activities that also, by the nature of lasting twenty minutes or longer, would also become a smoking associated activity. While the winter-summer changes are dramatic contrasts, the three-month seasonal changes are still significant enough to elicit smoking thoughts.

You overcome these triggers the same way you overcome the original triggers-just don't give into them. The first time it will be a stronger thought, but after successfully overcoming the specific event, it will become easier and easier each successive time. Eventually, not smoking will become the habit for the specific event.

You need to be prepared for these periodic fluctuations in number of smoking thoughts. Not because of the terrible threes, just because you need to be prepared everyday that there might be moments where there is a desire for a cigarette. It is a matter of always keeping your guard up, and remembering that not smoking is important everyday. Still comes down to the premise of waking up everyday and saying to yourself, "I will not smoke today," and going to bed each night proud of the accomplishment. Do this and you will make it through all the "terrible threes" (and they might not be in any way terrible) having been able to successfully Never Take Another Puff!


The miserable threes

In response to the "miserable three's" we hear so much about. The three-day thing is a real understandable phenomenon. It is how long we basically have nicotine left in our bodies after smoking cessation. As long as we have any amount the brain is demanding the full compliment. The lower it gets, the more your brain and hence body complains. Once the three-day mark is passed, pure nicotine is either excreted or metabolized into other bi-products. Those bi-products are what can be tested for in a drug tested for nicotine for up to two weeks, but they do not have the power to maintain an active state of withdrawal. Some people seem to metabolize more efficiently than others, seeming to only have physical withdrawal effects for one or two day periods, but once overcoming the third day, most people's intense physical symptoms will diminish.

In clinic experience, the three-week mark never seemed to be a big issue. I still maintained contact heavily over the first month though, constantly reinforcing quitting concepts, and maybe, people left on their own devices didn't internally keep up that kind of ammunition strengthening. Another factor may be friends and families. During the first week, maybe even the first two, everyone pays a lot of attention to the smoker who is quitting. They are worried that this time may not take. They ask constantly how the person quitting is doing, offer support and encouragement, tell them how great they are and how proud they are of them. All this attention is either greatly appreciated or drives the person quitting nuts. Either way, it in a sense keeps their attention focused on the quit.

But after a couple of weeks, the novelty wares off, to the ex-smoker and the family member themselves. At some point, people stop asking. Sometimes this is interpreted to the ex-smoker that people stopped caring. This is not the case. The family and friends just start to take for granted that the person is over it. They get complacent. Understand something though, the family and friends probably still cares, whether they show it our not. If the person relapses, they may have a fit, but if he or she stays off, that's just the way things are.

This lack of attention to cessation often leads to the ex-smoker to feeling complacent too. Complacency is dangerous. That is when the thought is triggered by something, the ammunition has stopped being reinforced and the ex-smoker has lost access to their reasons for why they stopped and why they don't want to go back. I don't think three-weeks is a magic guide or absolute, like the three-day mark, but a variable due at least in part to this kind of mind set.

The three-month is another interesting time. If I had to venture a guess, I would say the thoughts are due to seasonal variation of activities, weather, clothing, etc. When you quit in the dead of winter, depending on where you live, you learn how to shovel snow, scrape ice, bundle up, watch football and hockey, in a sense, you learn to do winter activities without a cigarette. You learn this all by repetition, doing it once, then another time, then another, all without taking a cigarette. But when springtime rolls around, conditions may change. Maybe you do spring-cleaning. Last time you did spring cleaning, you were a smoker. Nothing you did in winter may have just the same flavor. How did you take breaks during spring-cleaning? You stopped for a cigarette. How did you reward yourself when finished? You smoked a cigarette. This is a new trigger. Then you start changing your wardrobe. Last time you wore that jacket, you were a smoker. You may even find cigarettes in pockets you paid no attention to when you quit. Sporting events change. Now you are watching baseball instead of football. Maybe even going to games. Every time you went to games before, you smoked. Win you watch your team win for the first time, you are supposed to smoke in celebration. After a couple of wins, you break the association. That doesn't yet prepare you to watch them lose though, that you will learn quickly too. (At least if you are from Chicago, the Cubs you know. Sorry I digressed). And what about getting ready for tax time, this too smoking had always been part of.

Well, let three more months pass and we have summer time activities. The beach, the pool, outdoor activities, barbecues, picnics, all things that are basically new to an ex-smoker who quit during snow. And then fall and its color changes, it's clothing, its basic change of flavor and nuances. All these changes are potential triggers.

While this may sound discouraging, that there are all these future changes awaiting the ex-smoker, consider this. Everything the smoker encountered the first three days was new. Everything! Getting out of bed, brushing teeth, using the bathroom, again, everything. And this is on top of drug withdrawal. The ex-smoker got through them all, breaking the day to day rituals and associations. That is why he or she is now an ex-smoker. That is why after weeks, he or she is not thinking about cigarettes every waking moment, but rather a couple of time a day.

At these seasonal times, new experiences trigger thoughts, but it doesn't have the physical withdrawal complicating it. It's still a battle, but now the all out war previously experienced. You all had the strength to win that war. You can beat these reactions too. Bring back your original ammunition, remembering why you quit. You were fighting for your freedom, your health, and eventually your life. Bring your reasons for quitting to the forefront of consciousness and when these thoughts are triggered, you will quickly squelch them. Next time the same circumstance will seem a little weaker, and after a few times, not trigger at all. Eventually days, weeks, at some point, even months will pass without a real problem. You will experience moments of thoughts, but at the same time be benefiting from thousands of hours of health and even greater serenity. If you want to permanently avoid making another year of constant new battles, remember…Never Take Another Puff!


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Reformatted 07/08/18 by John R. Polito