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    Jennifer A. Kern, M.S., C.T.T.S.

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  • Quit smoking blog

  • Aug. 16, 2008

    Moving through ambivalence is a key step in quitting

    By Jennifer A. Kern, M.S., C.T.T.S.

36 comments posted

Any cartoon lovers out there? It may have been a while since you last watched them, but do you remember what sometimes happened when the main character was faced with a dilemma? All of a sudden there would be a "poof" over each shoulder — an angel would appear hovering on one side while a devil would be perched on the other, each arguing their case. The character would listen to the angel and agree, then listen to the devil and see his point as well — neither of which resolved the character's problem. That's a great visual depiction of something many tobacco users experience, called ambivalence.

Ambivalence is a state of internal conflict — different parts of the self are battling with each other about what they want and what is important. However, these things may not be compatible with each other; satisfying both what you desire and what you value cannot necessarily be accomplished from one single choice or action.

Ambivalence acts as a sort of immobilizer, keeping us frozen in a given state. We can see the pros and the cons of each choice, but cannot seem to take any action in one direction or the other. I think that most smokers live in this place for a long time, wrestling between what they enjoy about smoking and the intellectual knowledge regarding the consequences of continuing to use tobacco products.

When looking at any kind of lifestyle change, it is important to resolve the ambivalence that is an inevitable part of the journey. One way to start is by making a list of the good things as well as the not-so-good things of both smoking and of quitting. For example, a lot of people feel like smoking helps them relax, but they do not like the smell. To the same effect, they want to quit so they can feel better, but they are concerned about withdrawal.

Creating your own list like this can help you get in touch with where you are along the continuum of change. It'll help you identify how ready you are to start making new and different choices. Going through this process can bring to light any underlying issues you may need to address in order to move forward with stopping tobacco use.

Remember, it's normal to have ambivalence when you consider quitting smoking. Taking time to clearly identify how you feel about each course of action is one way you can work through ambivalence in order to resolve your dilemma and start moving forward in the direction you most want to go. What are some ways you've done this in other areas of your life?

36 comments posted

blog index
  • April 30, 2009 12:33 p.m.

    I don't see any blogs for the year 2009! Am I the only one still smoking? I am so unhappy with myself. I have tried so many times, and nothing. You are so right about the ambivalence phase.. I am stuck and can't get moving. Any advice out there?

    - Mary

  • December 15, 2008 5:15 p.m.

    As much as a gree with you mary, ambivilance is the only reason that people smoke, but you can overcome it anytime. My friend has been a smoker for more than 5 years and last year without warning, he woke and was smoke free. i remeber the previous evening we had smoke togather and he din't mention any plan of quitting. i can't be in his mind but i beleive you can take sides easily in your innner conflicts......

    - Eric N

  • December 2, 2008 7:34 p.m.

    I think that ambivalence thing hit it right on...I quit smoking for 4 months last year and then I went into a store that sells single cigarettes...that killed it right there. Now I smoke as much as before I quit. I also wish there was a rehab facility out there that can help. I really need to quit and am finding very hard to do so again.

    - Mary E

  • December 1, 2008 8:26 p.m.

    Smoked for 16 years then quit for 10 years then started again for 12 years.Now it has been 15 days without smoking and not even missing it. I sure hope Mary makes it (30Nov post).

    - Steve

  • November 30, 2008 8:32 p.m.

    I am about to attempt for probably the 10th time at least to quit. I want to succeed this time just as I wanted to succeed the first 9 times. But this time my health is at stake. I continuesly get pneoumonia and broncutis and can't seem to fight any illnesses. Much of this I am sure is due to 25 plus years of smoking. Please wish me luck and any suggestions would be appreciated Thanks, Mary

    - mary

  • November 26, 2008 7:01 a.m.

    one week tomorrow since I stopped smoking. Withdrawal effects not half as bad as I'd convinced myself they would be so that's a bonus. Yes that boring old ambivalent thing happens a lot but I'm very firm with my 'nicotine demon'. It's losing strength, dying, and it's desperate for me to give it a cigarette, but I'm a non-smoker now so 'no can do'. I believed for 40 years that old nicotine demon was my friend but it was my enemy all along - a very dangerous enemy that I have to kill before it kills me.

    - Alys

  • November 5, 2008 6:57 a.m.

    This has all been very interesting but as many have stated, we need a rehab available to us to help us save our lives. This is really a true life or death issue and we are begging for help. I wrote before that i'd had breast cancer and a femoral by pass on my legs from the blockage. No circulation gets through and you could experience amputation if not corrected. So 4 months after the by pass i am going in for another one due to not stopping the cigarettes and once again it has caused great pain while walking. Again, we have an addiction and need help. Real life saving help.Chantix made me suicidal. Beware!

    - Barbra K.

  • November 4, 2008 10:33 p.m.

    I am 72 years old and have smoked since I was 21. I have tried Chantix and everything on the market to quit. I have tried to quit several times and everytime I gain 10 pounds the first week which is not good for me either. My doctor keeps telling me that I need to quit, but for someone that does not smoke...it is easy to tell someone just to quit. I have just given up on quitting. To all of you that are younger and trying so hard to quit I wish you success. You really need to if at possible. May God Bless You All

    - Virginia

  • September 25, 2008 3:01 a.m.

    Hey Everyone! This is Heather again. I just want to say that it has now been 19 days without cigarettes!! Yeah! I feel like I am actually conquering it! It really is mind over matter. Word around is that it takes 21 days without cigarettes to actually BREAK the habit. I have made it 19 so far... I feel so good right now. I actually get up in the morning and can breath only Fresh morning air. Glad I could quit now, before I have a life threatening disease or stroke! It really isn't all that bad now that I have quit for a while. You get to a point where there is no turning back and if I do smoke again, I defeated the purpose and put myself through all that for nothing! Good luck to all of you. If you are thinking about quitting smoking, JUST DO IT!! Take care and God Bless! Pray to him and if you can't do it on your own, HE will help you!! :) Never quit quitting!!!

    - Heather

  • September 16, 2008 2:26 p.m.

    SMOKING VS STROKE OR HEART ATTACK.... I ODN;LT ANT TO GO IN A REST HOME AND HAVE SOME PEOPLE WHO DON'T CARE ABOUT ME TAKING CARE OF ME. i HOPE IT'S NOT TO LATE I AM 65 BEEN SMOKING 50 YEARS HAVE BEEN STOPPED FOR 5 WEEKS. GOOD LUCK TO YOU ALL YOU CAN DO IT YOU HAVE TO. BESIDES 6.00 A PACK THAT 180 A MONTH LOT OF MONEY TO KILL YOURSELF. GOD BLESS YOU AND PRAY TO GOD TO HELP YOU HE WILL I KNOW HE HELPED ME.. AS I CUT DOWN THE MORE I CUT DOWN THE SICKIER I GOT WHEN I WOULD SMOKE, FINALLY DOWN TO ONE AND I HAD TO LAY DOWN AFTER I SMOKED IT. WAS DIZZY AND SICK TO MY STOMACH. GOOD LUCK TO ALL OF YOU ITS MIND OVER WHAT EVER BUT YOU HAVE TO STOP.

    - No name given

  • September 16, 2008 2:14 p.m.

    IT WAS DIFFICULT I WOULD BUY A PACK OF CIGS SMOKE 2 AND THROW THE REST AWAY. FINALLY AFTER TWO WEEKS OF WASTING MONEY 6.00 A PACK SO THAT AS 6.00 FOR 2 SMOKES. I WENT TO THE DOCTOR AND MY CHOLESTROL WAS ALL SCREWED UP SO I STOPPED. ITS BEEN 3-4 WEEKS NOW AND I AM FINE. MY BODY AT TIMES FEELS WEIRD BUT I THINK ITS THE ADJUSTMENT. ALL I REALLY CAN SY IS THE FEAR OF HAVING A STROKE WAS THE THING I FEARED THE MOST. SO WE WILL SEE. I TRIED A CIG THE OTHER DAY AND GOT SICK FROM IT SO I KNOW I WON;T BE GOING BACK. IT WAS LIKE THE 1ST TIME I SMOKED. SO I ODN;T WNT TO GO THROUGH THAT AGAIN. I JUST WISH I FELT BETTER. I AM GOING TO THE DOCTOR NEXT WEEK SO WILL SEE IF THESE WEIRD FEELINGS I AM HAVING ARE FROM ME STOPPING OR SOMETHING NEW. IT'S ALWAYS SOMETHING WHEN YOU REACH MY AGE 65. SO TOTHOSE OF YOU WHO WANT TO STOP JUST IMAGINE YOU HAVING A STROKE OR HEART ATTACK AND HAVING TOBLAME IT ON SMOKING.

    - JIM

  • September 9, 2008 10:54 p.m.

    I want to quit so bad. Dr. gave me presc. for Chantix but it was too expensive. I can't get into the frame of mind to quit.

    - kelly

  • September 9, 2008 8:13 p.m.

    Hi All! I have been a smoker for over 10 years! I quit with both of my pregnancies and then over 3 years ago I quit over a 10.00 bet! But, I quit cold turkey for 3 years and then about 6 months ago started up again. For why? I am really not sure. So, just this past weekend, I have decided that it is my time to quit again. I had been thinking about the pros and cons for a few weeks now. Today is my 3rd day clean after quitting cold turkey and I can already tell the difference. I feel MUCH better. I kept telling myself that I like how it feels when I smoke and all my friends do it and it is a bad hand to mouth habit! But, I have two kids and that is really when it hit home.. when my 9 year old daughter begged me to quit and said "Mom, can you please quit smoking, you know that you could get cancer from that" and it is so hard to tell your child "yeah, I know" and then go outside and have a smoke! I figured if it wasn't totally for me and my health, I need to do it for my kids and family! There are lots of pros vs cons if you really think about it. I have just been keeping myself busy and my mind off it and have not had problems with wanting them. NEVER quit quitting!!! You can do ANYTHING you put your mind to!!! Good luck to you all!

    - Heather

  • September 9, 2008 6:19 p.m.

    I want to quit so much...for the most part..I hate the smell, hiding it from my social friends who do not smoke, telling my doctor I quit....it's too much trouble and I am getting sick from it...Have Chantrix..yesterday I moved to two pills a day...last time I tried it it started working then the nausea started. This time I am being sure to eat something when I take it and no nausea yet. When do I remember to not light up....it is such a terrible, addictive habit based around routine activities :( I lost the instructions :(

    - Jenna

  • September 9, 2008 3:05 p.m.

    What to do when the medicines offered does not help you quit smoking? I´ve been trying and trying and nothing seems o help. Have you heard about acupuncture without needles?Tell me more...

    - Dora

  • September 4, 2008 3:46 p.m.

    I have been a smoker since I was 15 and am now 39 and would love to quit. My mom has COPD, Heart failure and diabetes and smoked for many many years. I do not want to be like that. Any suggestions would help, I do think I am going to retry the nicotrol inhaler, worked well once for me.

    - Julie

  • September 3, 2008 1:59 p.m.

    I have never smoked, but my Dad died, from lung cancer when I was 16 and my Mom recently died, had COPD and had a very poor quality of life for the last 8 years. I teach a Freedom from Smoking class as part of my job. You do have to change your daily life style and habits. The one thing that I always stress is that you do not want to be one of the people who quit "cold turkey" the day that they are told that they have lung cancer. Nicotine addiction is the worst addiction there is, but you can do it. There is nothing "good" about smoking. You were born a nonsmoker, and smoking is a forgein thing to your body. The most successful people are committed and do not give up. Keep trying, you will find the way that works for you. My parents both smoked. They did quit the day the Dr. told my Dad he had to or he was going to die. He had emphysemia, and sat at the kitchen table every morning and coughed and choked. I always thought that he would choke to death at the kitchen table. He developed lung cancer a few years after the emphysema. If you can't quit for yourself, do it for your kids and your family. Get support from your family and friends. Get educated, there are 3 parts to quit smoking. The physical addiction, the mental aspect and the social aspect. Contact the American Lung Association, they will be happy to help. Contact your state health department. Do whatever it takes, just don't give up. Best wishes to all of you for trying. Most of all "KEEP

    - Cindy

  • August 29, 2008 7:56 a.m.

    Mary and other Bloggers, Many people are interested in finding a "smoking rehab". You may not have seen the comment I posted in response to a previous blog topic about residential treatment programs, but there are places where one can go to quit smoking in a protected environment. They offer the support and counseling you need to quit and maintain abstinence after you leave. These are three reputable programs we are aware of. There may be others. Mayo Clinic Nicotine Dependence Center in Rochester, MN http://www.mayoclinic.org/ndc-rst/residential.html St. Helena Hospital in St. Helena, California http://www.smokefreelife.com/ Hazelden in Center City, MN http://www.hazelden.org/web/public/tobaccorecovery.page An alternate, possibly more accessible form of support is Nicotine Anonymous. You can go to their website to arrange online or phone support or to locate meetings in your area. This is an international organization with resources available in several languages and in different countries throughout the world. See: www.nicotine-anonymous.org

    - Jennifer Kern, MayoClinic.com

  • August 27, 2008 6:11 a.m.

    This is the most inteligent article about quitting that I have ever read. She knows exactly what keeps smokers smoking. Most articles talk about replacing the cigarette with carrots or gum but never address the psychological battles of trying to quit. I also want to let people know that Chantix, the new stop smoking pill that is expensive but worth it because IT ACTUALLY WORKS! It helps to reduce what I call the brain battle. It also helps by making cigaretts taste like crap, so you dont want to smoke. Chantix costs about $60/mo for 1mg once a day, the reccommendation is 1mg twice a day, then it would be around $120/mo. I only use it once a day because I have never been a heavy smoker and my battles are during the morning hours through afternoon so I save money by only taking it once a day. I also agree with Mary Fraser's comment below! Having an addictive personality definately complicates the process. I have always thought they should come up with a nicoholics annonomus group/rehab program. I also agree with Debbies comments about growing up! I started when I was 15 and thought I was cool, well smoking is not so cool anymore!

    - Judy

  • August 27, 2008 4:57 a.m.

    I so agree that a residential rehab is needed for smokers who also have addictive personalities .I am one of those and at 40 got into trouble for 10 yrs with alcohol . Without rehab I couldn't have done it . I know I could quite smoking in a controled environment , unfortunately that will soon be the hospital . I have a small,1 1/8th non-small cell cancerous tumor in my upper rt lung . I'm putting the patch on the night before surgery and my daughter will be caring for me for 3 weeks post-op . 'Sgt' Marla will let me smoke over her dead body !!!Rehab would have been nicer . Mary

    - Mary Fraser

  • August 26, 2008 9:53 p.m.

    I smoked for 32 years (starting at the age of 15). I tried quitting hundreds of times, but just couldn't.... Finally at age 46 I told myself to "grow up"....and I did. I finally quit smoking....and this is how I did it....I QUIT BUYING CIGARETTES!!! That's right...I quit buying! It was alot easier to quit buying, then it was to quit smoking. Don't get me wrong, it was still very hard, hardest thing I had ever done... Sure, it's a game I played with myself, but who cares if it works for you and you quit smoking and stay smoke-free. That was four years ago! For all of you trying to quit, keep it up, eventually you will do it!! Find something that works for you..Grow Up...it feels good!

    - Debbie

  • August 26, 2008 8:24 p.m.

    I quit smoking - again. The last time for about two years - I did it cold turkey, no help. This time I am using Chantix - it blunts some of the craving, but there is still that emotional attachment- but it is better than going cold turkey. I think that one has to decide first that you can't control tobacco - and then that you have the power not to smoke. And, if you don't smoke eventually you will feel better about not smoking - it has been 9 days and I just trust that tomorrow, next week, next month things will be better - the last time I quit it took 12 weeks to get over the hump - wish I hadn't started again but I did - it helps to know that I quit once befor. I wish everyone who is trying the best of luck -for me, it will be such freedom not to have to smoke - not to worry about if I have enough cigs to get through the night and morning. John

    - jla

  • August 26, 2008 2:24 p.m.

    Chantix has an online support group. It can cause depression. If you get too depressed, get help, and get off the chantix. You should have recieved this info from the doctor who prescribed the Chantix. Try Chantix.com.

    - Rosie

  • August 23, 2008 8:15 a.m.

    I love this article! Back in June, I started doing this very thing. Started telling myself I was going to get healthy. August 2nd I woke up and told myself I was stronger than than cig. It had no control over me anymore. Now almost 3 weeks, everyday, every minute, I still tell myself I am stronger. NOT the little white stick.

    - Gayle, MI

  • August 21, 2008 11:10 a.m.

    My mother and my ex husband both quit smoking. My mother had been smoking for at least 50 yrs when she quit at the age of 69. The key for both of them was making up their minds to quit no matter what was going on around them. They made a choice to move out of the ambilivilance. No one helped them do it. They had to start on their own. now once they atarted their families were very supportive. We even had monthly celebrations for my Mom. My ex said he just started telling himself "I don't smoke" and that is what worked for him. My mother did use a patch that the doctor prescribed for her. I am sure it was very hard for each of them but they had made up their minds. Of course one thing that helped them both was they were not around many people socially that smoked. My mother wasn't working any more and I think my husband starting playing chess on his breaks at work and quit going to the smoking area. Also my brother who was still living with my mom at the time she quit stopped smoking around her and he eventually quit himself.

    - Red

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