Are you addicted?
Not everyone who is addicted to smoking experiences a withdrawal syndrome. Cravings to smoke can come during smoking and even after withdrawal, as defined here, is over. Withdrawal is just one part of smoking addiction, and there are many different patterns to addiction.
The object of this self-assessment isn't just about adding up the number of "yes" answers—it is about assessing whether smoking is making a problem in any of these areas. The object is to get you thinking seriously about whether you have lost control of, and developed a dependence on, tobacco smoking.

If your self-assessment shows you have lost control of your smoking behavior—that it no longer is like having a drink on Saturday night—then seriously consider setting your goal to be completely tobacco-free. Cutting down often amounts to no more than waiting to smoke. Do you want to break free of smoking addiction or just train yourself to wait for the next smoke?

1. Have you smoked every day for at least the past several weeks?

2. Do you experience any of the following withdrawal symptoms after you stop or reduce your amount of smoking ("withdrawal symptoms can begin within a few hours of cessation")?
  • Depressed mood
  • Insomnia
  • Irritability, frustration or anger
  • Anxiety
  • Difficulty concentrating
  • Restlessness
  • Decreased heart rate
  • Increased appetite or weight gain
3. Do you experience significant distress due to the symptoms in Question 2? Do you avoid social or work obligations, or leave in the middle of these obligations, due to significant distress or discomfort from not smoking?

If you answer "yes" to Question 1; "yes" to at least four of the symptoms in Question 2; and "yes" to Question 3, then you have a problem and may even meet the psychiatric definition for nicotine withdrawal. Knowing this can help you face mixed feelings about your smoking addiction. Perhaps it is as serious as you feared. It can also help build your commitment to change and to learning to breathe free.
4. In the past year, was there a day you didn't smoke at all—not even a puff?

If you answered "yes," think about how you did it and how you then went back to smoking. Try to learn from what worked and what didn't.

If you answered "no"—if you haven't had a day without smoking in the last year, or for many years—don't despair. The movie in your head about how impossible breaking free from smoking will be probably is greatly exaggerated. Usually, especially with proper use of medicines and a good behavioral plan, reality is much better than the scary movie in your head. Remember, it's possible to break free of smoking...some people just have to put in a higher level of effort than others. This may not seem fair, but some people have to work harder at this to feel normal afterward. The guidance provided by this program is designed to help make this journey as successful as possible with the least number of unnecessary detours. Think of the program as a guide who has been on this journey before and whose job it is to help you avoid the pitfalls and dead ends along the path to success.

5. Do you continue to smoke despite having a tobacco-caused medical problem like bronchitis or COPD (Chronic Obstructive Pulmonary Disease)?

If you answered "yes," consider that smokers are well aware of the medical problems associated with smoking. After all, they are listed on every pack they smoke. Even when told it is a matter of life and death, many continue to smoke after having a heart attack, lung surgery or oral cancer removed.

This behavior mystifies their loved ones and even leaves the smoker bewildered, yet this is a hallmark of addiction and distinguishes it from "bad habits," which also involve automatic behavior. The difference is that bad habits don't cause real and serious life consequences, however annoying they may be to those around us. Other consequences from smoking might include losing out on dating opportunities, upsetting relatives or frightening your young children.
6. Do you get less of an effect—of pleasure or satisfaction—from the same number of cigarettes each day?

7. Do you continue to smoke, even though you enjoy only 10–20 percent of the cigarettes you light up?

If you answered "yes," know that many people get sick of their addiction over time, especially after age 40. What was social and fun becomes rote habit with less pleasure than advertised. Keeping this in mind can motivate you to move forward with breathing free.

8. Do you still enjoy smoking most or all of the time?

If you answered "yes," consider the question of smoking addiction in a hardheaded way. Is this pleasure so great that it's worth the health risks? Even if you still enjoy smoking, would it also be nice to shed the burden of guilt and shame you carry from smoking? Remember, this is your body, and there is only one available for each customer. So even with all the new replacement parts available, you still can't protect your body from all the pollution in the cigarette smoke. Getting smoke-free is like taking out a new health insurance policy with no monthly payments!

9. Do you feel anxious and nervous, and has this continued every day for the past two weeks?

If you answered "yes," you may have more anxiety about getting through your breathe-free day—the day you go completely tobacco-free. In that case, you may need to pay extra attention to the next step—working on preparation, confidence-building and motivation.

10. Do you feel sad and blue, and has this continued every day for the past two weeks?

If you answered "yes," you may have more emotional discomfort after getting through your breathe-free day. In that case, you may need to pay extra attention to the following plans to get that extra confidence that you can succeed. You may also need to carefully review with your doctor nicotine withdrawal symptoms, using successful strategies and learning to live well without tobacco.
As a reminder, always consult your doctor for medical advice and treatment before starting any program.


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