Most people, when they think about this addiction to smoking, they think of it as a physical problem with some element of habit. But I think people really don't get that for many smokers, making a good emotional adjustment after they quit is the hardest thing. If every time for 20 years you get upset you take a cigarette, that's going to become very much a part of your emotional repertoire, right? Once you can get [people] to think differently about that emotional belief system, it really helps them move beyond smoking and lose interest in it.
Why, in your experience, do people backslide?
Triggers, alcohol, and emotional discomfort or stress: I call these three the "Bermuda Triangle of relapse." It's like a place where people go and then fall off the radar. If you have one of those things, you might be able to figure out how to deal with it. If you have two going on together, you're really looking for trouble. If you have all three, they can really ambush you. So people really need to be aware of those things and figure out how they're going to handle them.
What are triggers?
Triggers are specific kinds of situations that make a person expect to go back to smoking or expect a cigarette. For example, being around other smokers. That's a really powerful trigger. There's something about the smoke that acts on you in a primitive way.
How can people best set themselves up for success?
I think there are four phases of quitting. One is a self-assessment. You have to understand something about your [smoking] pattern. Then, making some kind of a plan that works for you, so that you can build your confidence and prepare yourself. You don't necessarily just jump in and risk failure. It's like if you were going to run a marathon. You wouldn't just wake up one morning and say, "God! I'm going to go the whole way." Prepare yourself with some exercises to build your confidence, and [you'll] start to say, "Hey, wait a second, maybe I can really do this." If you don't believe you can do it, it turns out that you don't do well. The third part is the actual day you're going to stop. Plan that day, so you're going to facilitate your success. Don't go out drinking with a bunch of smokers. The fourth phase is preventing relapse, which is really more of a positive thing: Getting comfortable, finding more creative ways of handling situations where you would have automatically smoked. Let's say that somebody upsets you, and you automatically take [out] a cigarette. Maybe you have to engage more in handling that interpersonal situation in a positive way. People mainly think of the health benefits of quitting smoking, but there are actually tremendous psychological benefits.