Most people know that using tobacco is a dangerous habit for anyone, and especially for expecting mothers. The news of a baby on the way often motivates women to quit smoking, but staying off of nicotine is generally short lived. In this piece, Pamela McColl, doula and tobacco prevention activist, gives a glimpse into the severity of a tobacco addiction and discusses the mindset that successful “quitters” use to kick the bad habit – before, and after, pregnancy. Are you looking to quit smoking during pregnancy? Read on for inspiration.
Having managed to quit a variety of “off-limits” substances during four pregnancies, I knew the sweet feeling of success that comes with actually doing what you have committed to do instead of just talking or thinking about it. Unfortunately, on many occasions my success would prove fleeting, and I invariably found myself settling back into my pre-pregnancy ways. I found myself constantly worrying about the potential consequences of my choices – for myself, and for my child.
Yet today, I cannot imagine ever lighting up a cigarette, and it takes no effort on my part to be a non-smoker. How did I manage that? I found lasting success when I found the answer to a question that was posed to me by a friend who also wanted to quit.
How do you explain the fact that some people, but not all, are able to spontaneously quit and stay free of addictive substances, while others struggle? And why are these same people only able to quit at a specific time?
My friend confided that she wished she could remain pregnant all the time because it was only when she was expecting that she could keep herself from smoking. I agreed that this was indeed a rather drastic way to stay away from nicotine. My friend’s comment was made in jest, but her frustration was coming through loud and clear. It had an all too familiar ring to it. She and I agreed that the process quitting and relapsing was utterly exhausting.
When a woman enters a clinic and is told that she is pregnant, these few words drive her to quit addictive substances in a moment of time. How do we explain this? What does it tell us about addiction and the process of withdrawal? Some say that in this case the ability to spontaneously quit is due to the mother’s overriding concern for the wellbeing of the baby, or perhaps a clear understanding of the risks to her own health and the chances of having a complicated delivery if smoking continues.
Tobacco use during pregnancy is a cause of low birth weight in one in five babies. Low birth weight causes complications and poses serious health issues for baby.
However, this does not explain why some women who are in the same situation, with the same level of concern for their babies, do not find immediate success.
Quit smoking during pregnancy…and beyond
Spontaneous quitting is ignited by the instantaneous and remarkable power of the imagination making room for something new to take hold, offering something new to believe in, while sweeping away a string of old beliefs that no longer fit. The mysterious case of the spontaneous quitters does not tell us that addictions are not real, but rather that the experience of quitting smoking can be radically altered in a moment of time. This is very encouraging news to anyone wishing to quit tobacco before welcoming a child into their life.
The spontaneous quitter also provides evidence that in many cases the expectation of the withdrawal experience has been vastly over-stated. The experience of withdrawal varies between individuals. Some experience few, if any, side effects. This process is significantly affected by the psychological aspect of quitting and is directly related to the level of anticipation or fear the individual is expressing about quitting. The greater the fear, the greater the experience of distressing physical and psychological symptoms.
On average it takes 48 hours for nicotine to clear the physical body with withdrawal symptoms peaking on the second or third day; a single withdrawal episode lasting one to three minutes that occurs on average six times a day for just a couple of days. Individuals who are regular tobacco product users are very familiar with withdrawal, as this is the very essence of addiction. An addict lives in the experience of withdrawal.
We use our powers of imagination to review information. We take what we think will work and construct our worlds accordingly. Circumstances change and, with a little work, our beliefs adapt to fit new situations through the power of imagination and knowledge. Asking a continuing smoker what holds them to these products is essential for observing ones beliefs and testing the validity of perceived benefits of continuing. As long as an individual holds on to a belief that ongoing use provides them with a benefit, any attempts to end a relationship with nicotine will be hindered.
Over 90% of successful quitters achieved success with an unaided spontaneous quit attempt, or what is commonly referred to as “going cold turkey”. A single attempt at quitting the use of tobacco products by going cold turkey has been proven to have a success rate of just a little over 3%. On average it will take an individual between 5 and 11 serious single attempts before they successfully quit. Having a plan for quitting in place, along with a support system, are two of the pivotal tools to avoid repeated defeat.
An estimated 30% of women who regularly use tobacco before pregnant will quit during a pregnancy. This rate is higher than the quit rate for the general population, but it also establishes that the majority of women who smoke will continue to do so during a pregnancy. Of the women who do quit during pregnancy, many do not remain tobacco-free postpartum, with between 70% and 90% returning to tobacco products within the first year of giving birth. Over 80% of adults who smoke have stated that they would like to find a way to permanently quit and yet the vast majority continue to struggle in their pursuit to parent smoke-free. We need to find more effective ways to provide support for individuals who want to quit but continue to smoke in the face of mounting evidence of great health risks.
January 2014 marks the fiftieth anniversary of the 1964 Surgeon General’s Report that linked smoking tobacco products to the risk of developing cancer. Since that time the public health field and various levels of government have done a decent job alerting the public, including pregnant women, to the health risks of smoking. In spite of our shared common knowledge of the dangers of ongoing use 22.4 % of women of reproductive age in America are currently smokers.
The good news is that half of all Americans who have been regular long-term smokers have been able to succeed at quitting and move on to live smoke-free lives.
It is estimated that one in four deaths worldwide in the 21st century will be a direct result of the use of tobacco products. In order to repel the advances of the tobacco industry and save an estimated one billion lives this century from a tobacco related death, it will take a social cure, and the involvement of individuals, parents, educators, public health agencies, governments, and the movers and shakers of popular culture.
Escaping a dependency on tobacco products has everything to do with believing that it is possible to quit.
Armed with new information, it is absolutely possible to set oneself free from nicotine dependency in time to welcome a child into this world, and to come to a point when lighting up again is simply unimaginable. This one decision is the most important one a woman can make for the betterment of her own health and the health of her child. We all have a role in preventing the massive risk tobacco poses on not only our own health, but the health of our next generations.
Pamela McColl is a doula, tobacco prevention activist, author and publisher. In 2012, she published the first smoke-free edition of the famous poem “Twas The Night Before Christmas” to generate more discussion and awareness of the cultural influences that impact young children and their future use of tobacco products. The publication won seven book awards including four Benjamin Franklin Book Awards, a Moonbeam, a gold for Mom’s Choice Awards and a Global International Ebook Award. Working on Baby and Me Tobacco Free brought Pamela’s experience as a labor support doula and prenatal yoga to the discussion of tobacco cessation. Pamela continues to promote the need for greater prevention, education and assistance to those who find themselves wanting to stop the use of tobacco products.
Baby and Me Tobacco Free written by Laurie Adams and Pamela McColl Published by Grafton and Scratch 2013 Paperback ISBN 978-0-98812-164-5 and ebook 978-0-9881216-5-2 Available worldwide.