Happy New Year, But Be Careful What You Wish For

While most people look to January as a time to make positive change, often by cutting back on vices, I caution you to consider all possible outcomes of change. A common new year’s resolution is quitting smoking. This is an excellent recommendation for pain sufferers – studies have generally shown that smoking can have negative effects on pain onset, severity, and interference. However, for some people, vices like smoking serve as coping mechanisms, as means to relieve stress and avenues of distraction from pain. (There have even been studies showing that nicotine may reduce some types of brief and acute pain, in certain people; but note, the long-term effects of smoking outweigh such benefits.)

So, while cutting out smoking may improve your physical ability to cope with pain, for some people this behavior change may lessen their psychological/emotional ability to manage the anxiety and distress caused by pain. From another perspective, consider that cutting out smoking will improve your ability to exercise for longer periods (a positive coping skill for pain patients), but many smokers begin to eat and gain weight after quitting smoking, and increased weight inhibits exercise (and can worsen pain). And these are just a few possible scenarios…

Now, I’m not intending to dissuade you from making change, losing bad habits, and so on. However, if you get rid of a coping mechanism, you need to have another to put in its place. Behavior change, positive or negative, has consequences. Behavior is like a pyramid of soup cans or a stack of blocks (like Jenga). Remove a behavior from your repertoire (e.g., smoking) and, without a replacement behavior (or can or block) the whole stack can crumble. Take smoking out of your routine and you will likely see many benefits, but you may also have removed your main coping mechanism – and you may fall apart without a new means of coping. While pain can lead to anxiety, increased emotional distress can also worsen your pain.

So what can you do instead of smoking to reduce pain-related anxiety and life stress? Try deep breathing and meditation. Consider prescription medications (e.g., Xanax) in moderation. Explore the benefits of psychotherapy, spiritual counseling, or venting to peers as a means of relieving distress. Take up a new hobby to fill the idle time when you would “take a smoke break” to distract you from negative thoughts.

Happy holidays, and may you have a good start to the new year!

PS – I endorse the benefits of stopping smoking. This article is actually meant to aid you in your pursuit of removing nicotine from your life. It has been found that people have difficulty staying smoke-free if the costs outweigh the benefits. However, if you can foresee the negative effects of stopping smoking and plan for them, maintaining your positive behavior change is easier. Plan for the worst, hope for the best is my motto.

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