Step 5 For Former Smokers Assist in Preventing Relapse

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Relapse prevention involves anticipating potential difficulties that may lead to resumption of smoking and addressing them in advance as much as possible. Issues to be dealt with may include:

1. Feeling a lack of support from family and friends

2. Negative mood or depression

3. Weight gain, expected or unexpected

4. Prolonged conditioned cravings or difficulty withdrawing from nicotine replacement therapy

5. Flagging motivation or feeling deprived

6. Keeping a lapse from evolving into a relapse

In regards to keeping a lapse from becoming a relapse, patients should be specifically told that if circumstances lead them to smoke one or two cigarets, they have not failed and can choose to go back being smoke-free. The worst situation is for them to smoke a single cigaret, decide they have failed, and resume smoking at their previous level. An effective analogy to use is as follows: "If circumstances lead you to say something you wish you hadn't said to a person, you don't need to go on saying it. The same thing applies if circumstances lead you to smoke one or two cigarets." Simultaneously with this message, however, patients should be explicitly told that this does not imply that they are being given permission to smoke one or two cigarets occasionally; their health does not benefit if they become occasional smokers, and their risk of complete relapse rises substantially.

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