Quitting nicotine and thebean

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One morning in 1992, I looked in the mirror. I
didn’t like what I saw. I saw a substance abuser. I couldn’t
survive without my drug, couldn’t get up in the morning without it,
couldn’t be productive, creative, or happy without it. Wherever I
went, I had to have a source of my drug nearby. If I didn’t, I’d
become anxious, frantic, impossible. Clearly, my need was out of
control. I knew it was time to quit coffee. But how?

My wife felt the same way I did. She, too, was a java junkie who
wanted to quit. We both loved the warm, rich taste of coffee, but
the caffeine made us nervous and irritable and gave both of us
insomnia. We decided to quit, cold turkey, and switched to
decaf.

It was a very bad idea. We’d heard that quitting caffeine could
cause a headache, but we had no inkling how severe and persistent
the headache would be. Our withdrawal headaches lasted for days. In
addition, we felt sluggish, constipated, befogged, miserable. We
couldn’t take it. We ran back to the bean.

Life without java’s jolt

Quitting caffeine didn’t exactly turn me into Buddha,
but it lengthened my fuse considerably. I had more patience,
especially with my kids.

Shortly after our abortive attempt to quit, the first major
study of caffeine withdrawal was published by The New England
Journal of Medicine. Johns Hopkins researchers studied sixty-two
healthy adults who drank an average of two-and-a-half cups of
brewed coffee per day–about what my wife and I consumed. The
participants completed a battery of physical and psychological
tests and were then placed on a caffeine-free diet (no coffee, tea,
coffee-flavored yogurt, caffeinated soft drinks, or chocolate;
Excedrin and other over-the-counter drugs containing caffeine were
also banned).

Some of the study participants were given caffeine pills in a
dosage of 235 mg, the equivalent of about two cups of brewed
coffee. The rest were given placebos. When retested after two days
and after four days, the group taking the caffeine pills showed no
changes in physical or mental function, but the poor suckers who
got placebos experienced the same withdrawal effects that had
plagued my wife and me: severe, persistent headache, fatigue,
constipation, anxiety, and depression.

I found the study reassuring. My wife and I were not wimps. We
were not latte losers. We were just addicts–two otherwise normal
people up against the withdrawal syndrome associated with an
addictive drug. We were like many people who decide to make a
positive change in their lives, but don’t know how to do it.

The researchers suggested that people interested in quitting
caffeine taper off gradually rather than stop abruptly to minimize
withdrawal syndrome. So my wife and I tried again.

We bought several pounds of regular coffee and an equal amount
of decaf. We mixed them in five combinations, starting with
straight-up real coffee, then one-fifth decaf, then two-fifths, and
so on. We drank each blend for a week to ten days. We also drank a
couple of cups a day of chamomile tea, which is calming, and took
white willow bark, which contains aspirin-like compounds, when we
felt a headache coming on.

The result: no withdrawal syndrome at all. Nada. No headache,
lethargy, constipation, or mental fog. It was amazing. In addition,
toward the end, as we drank very little caffeine and finally none,
two unexpected things happened. First, I woke up each morning
feeling surprisingly awake and alert. Once freed from the shackles
of caffeine, I didn’t need the cup of coffee I’d assumed I couldn’t
live without.

Second, friends began remarking on my “new mellowness.” I
confess I’ve always been a rather high-strung person. I assumed
that it was just my personality– quick-witted but short-tempered. I
was wrong. A good deal of my irritability was chemical. Decaf
didn’t exactly turn me into Buddha, but it lengthened my fuse
considerably. I had more patience, especially with my kids.

Since then, my wife and I have been committed decaf drinkers.
Once or twice, at a restaurant, I’ve been served regular by
accident. I was up all night. Now I always ask twice. A few times a
year, I have a cup of “real” coffee on purpose before I embark on a
long drive at night. But there’s a big difference between using a
drug therapeutically and being addicted to it. It’s been eight
years now, and I’m still glad I’m off caffeine.

Kicking nicotine

I once interviewed a former heroin addict about the challenges
he faced quitting the notorious narcotic. “It was rough,” he
sighed, “but nowhere near as hard as quitting cigarettes.”

There are more nicotine addicts than heroin addicts. According
to the U.S. Substance Abuse and Mental Health Services
Administration, about 540,000 Americans use heroin. But 48 million
Americans–about one in four–smoke. Smoking is the nation’s leading
cause of preventable death. Surveys also show that 74 percent of
smokers want to quit, and that 70 percent have tried, without
success.

As hard as quitting is, 1.2 million smokers (2.5 percent of the
total) quit for good each year, according to the U.S. Centers for
Disease Control and Prevention. How do successful quitters do
it?

Ex-smoker Tom Ferguson, M.D., has some sage advice: “To smokers,
I would say: ‘Don’t give up. Don’t whip yourself for being a
‘failure’ for all the times you’ve tried to quit but weren’t able
to. Keep trying.’ To friends of smokers, I would say: ‘Don’t nag.
Support the smokers you know to find their own way out.’ “

Back in the mid-1980s, Ferguson attended a medical meeting on
smoking cessation and was appalled to hear speaker after speaker
demonize smokers as bad people for not quitting. When he argued
that smokers needed support, he was met by blank stares. So he
spent several years researching nicotine addiction and quitting.
Ferguson then wrote The No-Nag, No-Guilt, Do-It-Your-Own-Way Guide
to Quitting Smoking (Ballantine, 1989).

Ferguson points out that not only is nicotine physically
addictive, but the act of smoking offers several unrecognized
benefits. It’s relaxing. It provides a break from daily
responsibilities. It helps the smoker deal with stressful
situations. It relieves pain. And it focuses the mind, improving
concentration.

So the challenge for aspiring quitters is not just to break
nicotine’s chemical grip, but to replace its benefits with equally
beneficial–but healthier–alternatives.

Ferguson suggests starting the process by adopting a healthier
lifestyle. This may seem like a contradiction in terms– becoming a
“healthier smoker.” But smokers who adopt other good health habits
do cut their risk of developing smoking-related diseases, even if
they continue to smoke.

A successful quitter’s advice

Here are author Ferguson’s tips for staying healthy while you
work up the determination to quit:

• Exercise. Start by walking for thirty minutes a day, and work
up to forty-five to sixty minutes at a brisk pace. Exercise
conditions the heart and blood vessels, which reduces the damage
smoking causes. It also provides stress relief, mood elevation, and
personal time.

• Eat more fruits and vegetables. Try to eat at least five
servings a day: a piece of fruit with breakfast, fruit snacks
during the day, a salad and vegetable with lunch and dinner, and
vegetable snacks (carrots, celery, cherry tomatoes, cucumber
slices). Fruits and vegetables contain antioxidant nutrients
(notably vitamins A, C, and E) that help prevent smoking-related
cancers and heart disease. They also make your diet lower in fat,
which helps control weight–and minimize post-quitting weight
gain.

• Manage stress. Exercise is one path to stress relief, but
there are many others: deep breathing, meditation, yoga, playing
music, spending time in nature, or in religious observance. Many
smokers feel that having a cigarette gives them some calm time to
themselves. You can enjoy those same islands of calm without
lighting up.

• Get support. Smoking is often a social activity. Smokers
frequently enjoy cigarettes with one another. Replacing the
fellowship of group smoking with other types of social support can
be an important step toward quitting.

Once you’ve become a healthier smoker, the next step is to cut
down. Addictions make people feel that they’re controlled by their
drug. Reducing the number of cigarettes proves that you’re not
helpless.

When you’re ready to quit for good, Ferguson suggests setting a
“quit date,” announcing it to your support network, and arranging
lots of dates, phone calls, and fun activities during the first
month, probably the toughest period.

Once you quit, you’re still not out of the woods. Many
ex-smokers say they felt powerfully tempted to start smoking again
for years after quitting. It’s important to become familiar with
the moments when you feel tempted to light up. If you give in,
that’s a shame, but again, it doesn’t mark you as a failure; it
only means that you need to analyze what made you relapse and how
you can avoid doing so in the future.

Herbs for quitters

Although herbs haven’t been tested in clinical trials as
smoking-cessation aids, natural health practitioners often turn to
them. Why? Because nicotine quells anxiety; habitual smokers know
they can light up and experience relief from this symptom. Quitters
often experience heightened anxiety. Herbal sedatives have a long
history of safe use; some have research that documents their
effectiveness in reducing anxiety, though not specifically in the
context of quitting smoking.

All of the following herbs are safe for healthy adults in the
amounts recommended. But if you’re pregnant or nursing or taking
any medication regularly, consult your physician before using
them.

St. John’s wort (Hypericum perforatum). The success of the
antidepressant bupropion (Zyban) in smoking cessation programs
strongly suggests that St. John’s wort may help smokers quit. Zyban
boosts two of the same brain chemicals that nicotine
elevates–dopamine and norepinephrine. It also made patients feel
better. St. John’s wort is involved in the same biochemical systems
in the brain, but exactly how it works is not fully understood. To
use this herb, buy a standardized extract and follow the package
directions. Be patient. It often takes a few weeks to feel
mood-elevating benefits. Do not take St. John’s wort in combination
with Zyban–or any other prescription pharmaceutical–without
consulting your doctor.

Lobelia (Lobelia inflata). When taken as an infusion or
tincture, this herb may help smokers quit. Lobelia contains a
compound, lobeline, that some research suggests binds to nicotine
receptors and helps reduce cravings for tobacco. Unfortunately,
lobelia has a nasty reputation that’s largely undeserved. In doses
much larger than recommended, it may cause vomiting and possibly
even death. The Food and Drug Administration has called lobelia
“poisonous.” But it’s usually safe when used cautiously in
recommended amounts. If you want to be extra cautious, consult a
qualified herbalist or doctor experienced with herbs before using
lobelia in your smoking cessation program.

To make a lobelia tea, steep 1/4 to 1/2 teaspoon of dried herb
per cup of boiling water for ten minutes. Drink up to 3 cups per
day. If you’d rather take a tincture, use 6 to 10 drops up to three
times per day. If you develop any stomach distress, stop using
lobelia.

Kava-kava (Piper methysticum) Many smokers light up to deal with
stress. Mild herbal tranquilizers can help calm smokers so they
feel less tempted to reach for a cigarette. Kava is the South
Pacific’s contribution to herbal medicine. In recent years, it has
become a top choice among tranquilizing herbs. For centuries,
Polynesians from New Guinea to Tahiti have used kava the way
Americans use beer–as a mildly intoxicating social beverage.

Starting about a decade ago, kava began attracting attention
among American herbalists because of European (mostly German)
studies showing that at doses lower than those used in the South
Pacific, the root produces little or no euphoria, but acts as a
tranquilizer. Many studies show that kava is an effective treatment
for stress and anxiety. At the Medical College of Virginia,
researchers gave either a placebo or kava (240 mg) to sixty adults
suffering from stress and anxiety problems. After four weeks, the
placebo group showed no significant change in anxiety symptoms, but
the kava group did–fewer interpersonal problems, fewer anxiety
symptoms, and less stress. Those taking kava experienced no side
effects.

If you can find powdered root, steep 1 to 2 teaspoons per cup of
boiling water for ten minutes. Drink up to 3 cups a day. Most
Americans use commercial capsules. Look for a standardized extract
containing 60 to 75 mg of kavalactones per capsule. The dose used
in most studies is 300 mg/day of a standardized extract in divided
doses (the equivalent of about 200 mg of kavalactones). Follow
package directions. Don’t mix kava and alcohol; don’t take kava or
other tranquilizing herbs if you take pharmaceutical tranquilizers
or sedatives.

Passionflower (Passiflora incarnata). For centuries, European
herbalists have used passionflower as a mild tranquilizer. Modern
science has confirmed this use. Passionflower contains
passiflorine, which is chemically similar to morphine, but not
addictive. Like kava, passionflower can help calm the anxieties
that spur aspiring ex-smokers to reach for cigarettes. The
Commission E approves the use of passionflower for nervousness and
restlessness. For a pleasant-tasting infusion, use 1 teaspoon of
dried leaves per cup of boiling water. Steep for ten to fifteen
minutes, then strain and drink up to 3 cups a day. If you’d rather
use a tincture, take 1/4 to 1 teaspoon up to three times a day. If
nicotine cravings interfere with your sleep, drink a cup of tea
just before bedtime. When using commercial preparations, follow
label directions.

Skullcap (Scutellaria lateriflora, Scutellaria baicalensis).
Skullcap is another mild tranquilizer that can help keep smokers
from lighting up. For centuries, Chinese physicians have used Asian
skullcap (S. baicalensis) as a tranquilizer and sedative and
treatment for convulsions. The Western herb (S. lateriflora) is not
as potent, but it, too, has some calming action. It’s an ingredient
in many over-the-counter sleep preparations in Europe. Steep 1 to 2
teaspoons of dried herb per cup of boiling water for ten to fifteen
minutes. Drink up to 3 cups a day. Skullcap tastes bitter; adding
honey, sugar, and lemon or mixing it with other herbs will improve
flavor. Or use 1 teaspoon of tincture up to three times a day.

Chamomile (Matricaria recutita). Among its many uses, chamomile
is a mild tranquilizer that soothes jangled nerves, so it’s a
likely herb to turn to for help in resisting the temptation of a
cigarette. Japanese researchers worked with chamomile oil vapors in
a study of animals under stress. In those exposed to the chamomile
vapor, stress hormone levels fell significantly. To make a tea,
steep 2 to 3 heaping teaspoons of flowers per cup of boiling water
for ten minutes. Drink up to 3 cups a day. If you prefer a
tincture, use 1/2 to 1 teaspoon up to three times a day.

Catnip (Nepeta cataria). In the 1960s, some people smoked catnip
thinking that it was a marijuana-like intoxicant. It isn’t. But
today, smokers can use catnip to help keep them away from tobacco.
German researchers report that the chemicals (nepetalactone
isomers) responsible for cats’ intoxication are similar to the
natural sedatives (valepotriates) in valerian. This finding
supports catnip’s traditional use as a mild tranquilizer and
sedative, and it tastes and smells much better than valerian. To
make a pleasant, minty tea, steep 2 teaspoons of dried herb per cup
of boiling water for ten minutes. Drink up to 3 cups a day. If you
prefer a tincture, take 1/2 to 1 teaspoon up to three times a
day.

Lemon balm (Melissa officinalis). Animal studies show that lemon
balm oil has tranquilizing properties. In Germany, lemon balm is
widely used as a tranquilizer and sedative. The German Commission E
approves lemon balm for the treatment of insomnia. To make tea,
steep 2 teaspoons of leaves per cup of water for ten minutes. Drink
up to 3 cups per day. To use lemon balm in a tincture, take 1/2 to
11/2 teaspoons up to three times per day.

Coffee and tea. It may seem odd to tout caffeine as a
smoking-cessation aid. But caffeine has some mood-elevating action
that may prove useful to aspiring ex-smokers. You can always quit
caffeine later if you want; it’s much easier than quitting smoking.
Sip for sip, regular coffee is the herb with the most caffeine.
However, many smokers strongly associate coffee and cigarettes, and
coffee may tempt them to light up. In that case, try tea or
caffeinated soft drinks.

While herbs can help ease the body’s chemical passage out of
tobacco addiction, taking them in tea form provides another
important benefit to aspiring quitters. Making and drinking tea
replaces the ritual of smoking. It gives your hands and lips
something to do instead of smoking.

When you quit smoking, your risk of smoking-related ailments
declines. Heart disease risk plummets rapidly. After three to five
years, ex-smokers face no greater risk of heart disease than people
who have never smoked. Lung cancer risk remains higher much longer,
but it, too, slowly declines.

But for most ex-smokers, the main benefits of quitting are the
ones you feel: enhanced vitality and greater self-confidence and
joie de vivre. You look in the mirror and see a winner, a victor
who has conquered a powerful chemical, a person who can do just
about anything. That’s a great feeling.

Smoking is the nation’s leading cause of preventable
death. Surveys show that 74 percent of smokers want to quit, and
that 70 percent have tried without success.


Michael Castleman is a widely published health and medical
writer based in San Francisco. His book, The New Healing Herbs, an
update of his million-selling book, The Healing Herbs, will be
published by Rodale Press this spring.

The reference list for this article is extensive. If you would
like a copy, please send a self-addressed, stamped envelope to
“Quitting,” Herbs for Health, 243 E. Fourth St., Loveland, Colorado
80537-5655, or e-mail us at HerbsforHealth@HCPress.com.

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