It was June 1957 that the U.S. Surgeon General cleared the air: Smoking had conclusively been linked to lung cancer. The portion of Americans who smoke has fallen steadily – from more than 42 percent of American adults in 1965 to 16.8 percent in 2014 – and yet more than 15 percent of Americans still smoke, according to 2015 data from the Centers for Disease Control and Prevention. Now the CDC reports that cigarette smoking accounts for more than 480,000 deaths annually, of which more than 127,000 result from lung cancer. It's a safe bet that most smokers today know smoking is bad for their health, but quitting the habit can still be extraordinarily difficult.
One reason the habit is so hard to kick is because nicotine is addictive. This makes quitting particularly challenging for those who are heavy or daily smokers. But physical dependence isn’t the only reason smokers light up. Social connections, a break from the day, a means of coping with stress and other aspects of the smoking experience can all make it very difficult for some smokers to walk away entirely.
To solve the age-old problem of how to quit for good, some smokers are turning to technology for assistance. Bettina B. Hoeppner, assistant professor of psychiatry and a health psychology researcher at Harvard Medical School, says there are currently more than 200 different smoking cessation smartphone applications available online that offer a range of different approaches to help smokers kick the habit. Hoeppner says many of these commercially available apps don’t have the benefit of being grounded in science, which is why she’s developing a smoking cessation app called "Smiling Instead of Smoking," or SiS, that uses the principles of positive psychology and evidence-based techniques to support smokers as they quit. Positive psychology is a branch of psychology introduced in 1998 that focuses on improving a person's positive affect – the things we enjoy that make life worth living – rather than “using all of our time thinking about what doesn’t work, what’s maladapted and what’s abnormal,” Hoeppner says. Positive psychology focuses on “things that help us thrive, achieve flow, become better than ourselves and to be happier.”
Young man lighting a cigarette on the street,front view
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Using these principles, she says the SiS app helps smokers fill the void that quitting smoking leaves in their lives with positive experiences and activities. “It reminds you not to smoke and gives you motivation and tools to not smoke. It also engages you in positive psychology exercises, or happiness exercises. And the reason why it’s making you do those things alongside traditional smoking cessation activities [such as being purposeful in setting a quit date and preparing for it] is because there’s good research on the importance of positive affect in smoking cessation. So being able to maintain a high positive affect should help you build your confidence and ability to quit smoking, which we know is very important to smoking cessation.”
The app’s exercises are relatively simple and encourage users to focus on the good that’s happening in their day, such as noticing that someone held the door open, the sun is shining or you finished a project. Other exercises emphasize savoring positive experiences like snuggling with your children or enjoying your favorite food. Users are instructed to put these experiences and observations into the app, which records them, and in moments of stress or vulnerability to smoking, users can scroll back through and be reminded that there’s still a lot of positive stuff going on and they don’t have to pick up a cigarette to be able to cope with a stressor. Hoeppner says that because a user's smartphone is almost always at hand, it can be more immediately accessible in times of crisis than some other traditional means of smoking cessation, such as meeting with a therapist or a support group or reading a booklet.
Although the app is still in development and the initial sample size is small, Hoeppner says the results look promising and that the app will proceed to a larger scale trial to gather more data and feedback from users. In the meantime, anyone can download it and use it for free right now. The bottom line, Hoeppner says, is that “technology can be helpful.”
However, in some cases, technology can also trigger a smoker to pick up a cigarette. Christopher Graefe, a 43-year-old digital media producer from Jamaica Plain, Massachusetts, took up social smoking in college, and as a young professional, he found that the hectic pace of his career led him to seek refuge in a cigarette now and again. The habit escalated as the level of stress he experienced at work grew, and before he knew it, he was smoking nearly every day.
“It went on for 20 years. I’d stop for six months or a year, but then it just went too many years for too long that it just became normal in my 30s. It’s a stress response,” he says, and when he needed a break, he’d step outside, away from ringing phones and pinging computers and have a Zen-like smoke break. “To some degree, technology drove me to smoke. I love what I do, but I love it a little too much sometimes. We’re constantly on the go and pushing, and having that excuse to walk out of the office and have a cigarette and then come back with a clear head,” was a powerful way to hit pause. He says he was never a heavy smoker, having only about one cigarette per day, but even that was too much.
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What finally helped Graefe quit was deciding to get back into competitive swimming. Graefe had been a swimmer at the University of Pittsburgh, and he’d acquired the habit during the off season. Later on, when he began getting into triathlons and open water events, he recognized that he’d be able to perform better if he could eliminate smoking entirely. He says he did try an app to help him quit at one point. “It was just a counter that tracked the number of days you haven’t smoked. It reminded me of what my body was doing after all that time not smoking,” and he says seeing milestones pop up was helpful. But the more effective way of quitting for Graefe was being purposeful in setting a quit date and then focusing on the delayed gratification of potentially climbing atop the podium at an upcoming triathlon.
Graefe hasn’t had a cigarette in more than two and a half years, and his advice to other would-be quitters is “you have to change something fundamental in your life. Not necessarily your job, but how you respond to the stress of it. And for me, the beauty of the pool or the ocean is that technology can’t reach me there. Smoking was an escape, and I miss parts of it. I won’t lie,” he says. But focusing on the positive result he’s experienced after quitting has helped him hold firm to that quit date he remembers clear as a bell: May 19, 2015, one day before his 41st birthday.
Whether technology helps you get there or you find another means of quitting, becoming a former smoker is always a better option than having another cigarette.