Reflecting on relapses

While some people can stop smoking once and for all at the first attempt, many smokers relapse. Sometimes they relapse several times before feeling confident that they have stopped for good. At one point Haseen had found it difficult to imagine himself not smoking, and Mariam said each attempt at quitting was harder because the habit of smoking was more familiar.

Ex-smokers have to contend with strong associations and old habits which meant they were prompted to smoke in particular company or circumstances. Alcohol was often mentioned as a particular prompt to start smoking again. There was always a danger of giving in to just ‘one cigarette’ on a night out, or on a casual basis, which could sometimes lead to their smoking as much as or more than before they quit.

Miles always had an association in his mind between smoking and drinking.

Age at interview 48

Gender Male

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I think, you know, threw the odd cigarette and oh just one then, go on. But certainly it was not, it was not going back. Because I knew as well that if I smoked, if I went back to it, the smell would catch up with me as well, so I knew may be the odd one was okay, but nothing too serious, but but again it goes towards peer pressure I suppose doesn’t it? Even at the age of 30, I was, you know, you were having a bit of peer pressure from friends I suppose, but it is difficult.

No, but anyway, it worked really well. I think it was only ever when really when it was alcohol involved. It was that association between nicotine and alcohol and I think that was my weakness. But generally I think I did get through it.

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Gareth said that when he met old friends and went for a drink he might end up smoking.

Age at interview 58

Gender Male

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So there are times when I think I should really just not do it. And, and of course there are times when I choose not to do it, but then it can easily re-start, particularly if I come into contact with friends of mine who I know roll their own cigarettes. Or if I’m meeting them socially or we go for a drink. Theres a good chance that I’ll just have one or two. But as a result of that I might even buy my own packet [laughs]. So I, you know, I’m not saying, I don’t avoid these social situations, because I have to deal with it. I really have to deal with my own, the decisions I make about my own life and my own health. So smoking I can’t really say I enjoy it. That’s not possible. it’s just the buzz you know, it’s the, I guess it’s the addiction, you know, but that can come and go. That, you know, I mean the addiction I think is always there. It’s always in the background and if you take a drag you want some more. But I do have the strength to say no and not smoke for long periods. But then I have a weakness when I start again. I don’t know I think it, well for example recently, because I restarted, I think it was last May I restarted, but you know, I’d been off the cigarettes for a number of years.

Last May I restarted. I think it was around Easter time. I think, you know, you become more and more aware of your behaviour and you think Oh my God that’s appalling and you see it when you observe other smokers and you know that you behave like that and you think oh and you know, you have. It actually interferes with what you’re doing because you have to stop to have a cigarette so if you’re doing a job of work, you stop to have a cigarette. You’re not working. You know, it’s all those sorts of things.

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A crisis or stressful period could also trip people up and prompt them to reach for a cigarette. Crises that people linked to starting smoking again included going through relationship break up or divorce or the death of someone close.

Sue had given up for a number of years before she enrolled at university as a mature student and started again because of the stress.

After a difficult day at work, Mariam’s colleague, who was upset, encouraged her to have a cigarette. She started smoking again.

Age at interview 43

Gender Female

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I wasn’t smoking and then woman at work. You know, she didn’t even have to force me or do anything, she was there saying, Come on, have a cigarette here. And I said, But I stopped smoking. I’m not smoking. Come on now. And she just like, we had a difficult day, we was talking about something and then she was like, really upset and she was smoking and I felt like I have to support her. Then I started smoking at the time. Have one cigarette. Have one cigarette. I said, I haven’t got cigarette. Well have mine. I was smoking with the cigarettes and then next day I was hating her. She did it to me like. I wanted to stop. That was really helpful for me. That was. Because I realised her name was [name], but you don’t want this.

I can take it out.

But I thought to myself there always will be [name] wherever I go. If I stop smoking there always will be [name]. Because I realised even when I was in Allen Carr’s clinic, it’s a human nature when you escape the trap, people who are there, they don’t want you to escape. They don’t do it on purpose but subconsciously they’re giving you a cigarette, they want you to stay trapped as they are. And then they will give you a cigarette. So there will always will be someone saying, Oh come on, have a cigarette. And you have to be strong enough to resist them, and it’s no point blaming here. So I am using it as an excuse. I have to do it. So I’m doing it to myself.

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When people looked back at the times they had tried to quit, and ended up smoking again, sometimes they realised that they hadn’t really been committed to giving up at the time, or that they still really enjoyed smoking. Some talked about not being in the right ‘head space’ or still enjoying smoking and not really wanting to stop but doing so for someone else. People often felt that ‘false starts’ happened because they had a vague feeling they should stop smoking, and hadn’t really wanted to or planned how they were going to give up.

Andy remembered kidding himself’ about wanting to give up smoking when he still enjoyed it.

Age at interview 31

Gender Male

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Everybody’s about to give up, and I was just the same, and I wish I, I knew I was kind of kidding myself, I knew, I knew I was kind of kidding myself to a degree, I knew I was just saying, I’m giving up for the sake of it, because everybody knows you should really. But then there were also times as well, when times when I actually restarted resmoking. I remember one time specifically actually. I made a conscious decision to start smoking again. It might have been, it probably was on a night out, but I went do you know what? To hell with it, I’m going to carry on smoking. I can afford to. I’ve got a bit of money at the moment and I want to. I’d given up for quite a long time at that point I think, and I thought, do you know what I’m going to start smoking again. I enjoy smoking. And I miss smoking. I’m going to go to the shop and get me some fags. And I enjoyed it, and I did, and I went back and I started smoking again. I mean the first couple of smokes were horrible and I led myself to doubt myself briefly while I was while I was, I was shall I be doing this, like, but having given up and started again so many times, I just knew that this’ll pass and I’ll be enjoying it within a, you know, with a couple of hours. And that was, and that for me I think is my philosophy on smoking. Is that I genuinely believe that if you really want to give up. If you have, for whatever reason, there are a thousand reasons to want to give up. I think if you’ve got a proper reason and you really genuinely want to give up, I think you will. I think it’s something I’ve always thought, in my, all of my experiences that every time I’ve tried to give up and failed, it’s because my heart wasn’t really in it. I didn’t really want to give up. I was just saying you know, I was paying lip service to the idea of giving up because it’s expensive, because it’s anti social, because it’s, you know, massively dangerous, you know, and will kill you. And by the time, you know, I actually sort of genuinely gave up, it’s because I just thought, do you know what I really want to do it this time. And, it didn’t make easier of course, but I think it just, having the determination to do it. And I think that’s why I failed so many times. And I think that’s why every time people fail to give up smoking. It’s not because they’re weak willed and it’s not because they’re doing the wrong thing or they’re doing anything wrong. I think it’s just because in their heart of hearts they don’t actually really want to give up. I know that was definitely case with me. And I think the moment that night out where I said to myself, do you know what I’m going to start smoking again. I think that for me was a key. That was when I realised that actually the reason I’d failed so many times is because I still enjoyed it. I still really enjoyed going out and having the cigarettes and I missed it, and I missed it loads and for me that was a yes, that was a bit of turning point in terms of, at least then later on, I knew full well that when I when I would give up, I thought all I need to do is actually want to, and want to give up and then crucially once I’d given up, want to stay off the fags as well and want to not go back to it.

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Jules thought that it wasn’t the method he tried that made the difference, but rather whether he wanted to smoke or not.

Age at interview 41

Gender Male

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I mean at the end of the day, the one thing, I’ve said this before, the one thing that everything will work if you want to give up smoking. If you don’t want to give up smoking it’s not going to work and don’t bother. If you want to give up smoking then, then search it out. Yes, hypnosis was one of my occasions. Allen Carr, was another of my occasions. The tablets was another of my occasions. the patches this time was an occasion. They all worked for a while. While I didn’t want to smoke. But as soon as I felt that I wanted or had a desire to smoke again then it stopped working.

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One of the strongest messages that people who had given up smoking wanted to pass on to others was that, no matter how many times you’ve tried, it is always worth trying again. Some people had friends and colleagues who were still smoking and who they suspected wanted to sabotage their quit attempt. Mariam remarked that it was human nature to subconsciously try to keep other people ‘in the trap’ with you.

Judith thinks that some people who still smoke can try to undermine your quit attempts in subtle and less subtle ways. “It’s important not to be discouraged if you relapse just try again!. [TEXT ONLY]

Age at interview 36

Gender Female

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And then you have the people who are still smokers, who generally, when they are still smokers they are either frustrated that you’ve managed it, because they’re wanting to manage it, and so generally they’re saying, You know, I hope it lasts, but you know, I know somebody, who, you know, was fine for six months and then all of a sudden they just started smoking again. So you know, you’ve got to, you know, don’t be surprised if you just start again. You’ve got the others who are, you know, think it’s funny to potentially offer you cigarettes, and you’ve got others who are genuinely wanting you to start again with the cigarettes as well. But it’s all through the fact that they can’t give up smoking, and you do Of the people who have given up smoking, you get the people who never wanted to give up smoking. Who still to this day say, I still get cravings every single day. You’ll get that for the rest of your life. And they’re not helpful people. They been forced into doing it and they will start again because it’s not been their decision.

Everyones journey is so different, but the one thing that you’ve got in common is if you want to do it, you will do it no matter what has gone before, and I think it’s dangerous to say that you’ve tried it before and you managed for six months and then you started again, and so not count the six months as being a non smoker, you have to forget about that previous time. You’re a non smoker from the time, the day that you stop, and you should take that, that achievement on board every single day. And yes, when, you know, you know, you might be aware when six months come up, but you’re not living with life exactly the same again. It’s a different time. It’s a different, it’s a different weather outside. It’s a different person whose in your house at that moment. Theres so many different things, that add to it, just be good to yourself with it, definitely.

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Falling off the wagon can be discouraging, but as Caroline points out, those who can work out why they smoke and why they want to give up may even find it easier to quit than they expect.

Caroline thought people should try to understand why they smoke; she found giving up easier than she had thought.

Age at interview 53

Gender Female

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Well my message definitely is to learn as much as you can about why you smoke, but not learn it in one great, big, long blob. You just need to kind of little bite sized bits, every now and then. First of all, about why you smoke and then what the benefits would be if you didn’t smoke, you know, so what damage you’re doing to your health through smoking. But the smaller, the better. So great big chunks of information to read, it puts you into information overload and as a smoker you actually switch off. You know that they’re right but you choose not to listen to it. So just small little bits is the best thing and to go for it. It’s easier [laughs]. It’s easier than you think. I think the hardest bit is thinking right I’m going to do it, and then once you’ve done it you suddenly think oh that actually wasn’t that bad.

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(Also see ‘Cannabis, alcohol and coffee‘, ‘Life events and their effect on people’s motivation to stop smoking‘, ‘The role of others in the decision to quit‘ and ‘Message to other smokers’).