Dear Alice,

I smoke. I don't like it at all but it's the only way I know to relieve stress. It makes me dizzy and nauseous. I tried quitting but I have reached a point in my life where I am overwhelmed by stress and cannot take out the time to exercise or sleep my stress away. I can feel the cigarettes altering my health. Please, aside from telling me to quit, can't you offer some kind of advice?

— Nico

Dear Nico,

People have different ways of coping with stress, and some turn to cigarettes. It sounds as though you already know that smoking may not be the best way for you to deal with stress. However, as you also pointed out, quitting may continue to be a challenge. Keep in mind though, quitting doesn’t necessarily mean a one-time event; it may be a gradual process that involves a lot of commitment through ups and downs. If you’re not ready to quit just yet, there are other ways to manage stress and begin thinking more about your smoking habits at the same time. Turning to others for support, whether they’re your friends, family, or health care professionals, can also help as you go through this rough patch.

First, a bit on how smoking impacts stress: Nicotine, the addictive substance in cigarettes, can be deceiving. It stimulates dopamine — a neurotransmitter associated with pleasure and reward in the brain — to be released. This stress-relief effect of nicotine allures smokers to keep coming back for more when they want a boost. Other pleasant effects may include euphoria, relaxation, sedation, and increased feelings of energy and sociability. However, nicotine can also actually change the way the brain experiences and regulates stress. Essentially, a person who smokes juggles two different stressors when they’re addicted to nicotine and experiencing stress. Nicotine can also work as a stressor in the body because it stimulates chemical messages other than dopamine to be released, which are then associated with some unpleasant effects which may include dizziness and nausea. Other more common side effects include light-headedness, increased heart pounding, and elevation of blood sugar level and blood pressure. Ultimately, the body is actually being stimulated, thereby amplifying stress even as you feel the stress-relieving effects of smoking. While this may be contributing to your physical symptoms, it's also a good idea to check in with a medical professional to make sure that they're not caused by something else.

As you start to tackle how to better cope with stress and to reconsider smoking, you can start with the next time you get an an urge to reach for a cigarette. At that time, it may help to think about what might be triggering that urge. Could it be that you’re hungry, tired, bored, or need some fresh air? Is it stress? By identifying what triggers your craving, you may be able to tease out the times when stress leads you to smoke and anticipate those cravings by planning for and engaging in alternative coping strategies. During stressful times, you may try avoiding circumstances you associate with smoking or try changing habits in those situations. For instance, if you really feel the need to step away from what you're doing, you can take a break, but try doing so sans cigarettes. Instead, try to sit still and just breathe for the time it would take to smoke a cigarette. Taking this breather may help satisfy a routine or help you to step away from whatever may be causing your stress.

Relatedly, it may also be worth it to dig a bit deeper and reflect on what’s behind your stress. Whether it’s associated with school, work, or a relationship (among other causes), identifying the root cause can help you tailor ways to manage and cope. As you figure out your triggers and sources of stress, you may want to focus on controlling the stressor itself or how you react to it. Switching up or adding to your stress management toolbox may also be in order. Although it may feel as though there’s not enough time to be active or to relax when you’re stressed, consider the amount of time that you spend smoking each day. Say you smoke three to five cigarettes per day — which might take an estimated 15 minutes. If you smoke more than that, it may be even longer. Short smoking breaks can really add up time-wise. If you repurposed the time spent, you could channel it into some other stress-relief activities, including physical activity, a catnap, or even just talking about what’s bugging you with a pal.

It's true that a busy lifestyle often leaves little time for getting active or extra zzzs. Have you considered why your life is so busy right now and why you have so much stress? Perhaps there are changes you’re able to make to relieve some of the stress. It’s also worth mentioning that when you’re under stress, working towards improving your time and stress management can seem overwhelming. But, it’s good to remember that even small and gradual changes can help and you don’t have to do it all at once or alone — consider calling on your family, friends, co-workers, or health care providers for insight and suggestions. Some schools and employers may also have stress and time management workshops and resources, so it may be worthwhile to see what may be available to you. Lastly, if in the future you do decide that you’re ready to quit again, check out Smoking withdrawal symptoms and how to quit in the Go Ask Alice! archives for more tobacco cessation information and support.

Good luck!

Alice!

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