12 Steps and Nicotine Addiction

"I started to wake up in the middle of the night to have a cigarette," recalled Barry, a recovering alcoholic. "I could almost set my clock by it. About 2:30 every morning I'd need to wake up and have a cigarette before I'd go back to sleep. That scared me."

This was reason enough to get help for quitting smoking. For Barry, there were two more: His father died of lung cancer, and his brother had a heart attack. Both were heavy smokers.

Despite working successfully with alcoholism, Barry collided with nicotine addiction. Getting rid of that duality can be tough for recovering people partly because nicotine use has been so widely accepted. That's true even in Twelve Step groups such as Alcoholics Anonymous. Case in point: Bill W., co-founder of AA, was a smoker who died of emphysema.

The same Twelve Step principles that help people abstain from alcohol and other drugs can help them abstain from nicotine as well.

Admit Powerlessness

People addicted to nicotine show behaviors like those of other addicts: They continue to use the drug despite adverse consequences, and they fail to quit through sheer willpower.

Jeanne E., author of "Twelve Steps for Tobacco Users," a Hazelden Betty Ford Foundation pamphlet, recommends that smokers face their failure to manage nicotine use by asking key questions: How many times have I actually tried to quit or reduce smoking and failed? Have I ever avoided nonsmoking people or situations where I couldn't smoke? Have I avoided physical activities because I knew I'd get winded? Have I gone out at odd hours to buy tobacco?

Ask for People for Help

Smokers use an array of tactics to quit on their own, such as imposing an arbitrary limit on the number of cigarettes they smoke per day, buying low-tar products or brands they don't like, and tapering down to meet a projected quitting date.

People who successfully use the Twelve Steps admit that such tactics don't make it. The alternative is opening up to a source of help outside ourselves. The Steps refer to this as a Higher Power, and this term is open to whatever interpretation works for the individual. For some smokers, a Higher Power is God as conceived in their spiritual tradition. For others, the term refers to family members, friends, a smoking cessation program or a Nicotine Anonymous group.

Put Personal Relationships on a New Basis

The Twelve Steps call upon recovering people to take inventory, that is, to see the web of consequences that smoking creates in their lives. To perform this inventory, Jeanne E. recommends asking some further questions: How does smoking affect me, including my health, energy, finances and self-image? How does my smoking affect others? What specific incidents trigger my need to smoke? And what character defects, such as impatience, fuel my need to light up?

When smokers admit the answers to themselves, others and a Higher Power, they gain a powerful inducement to quit nicotine use. They can follow up by making appropriate amends to people they've harmed through their nicotine addiction.

Quit One Day at a Time

Central to the Twelve Step message is the slogan, "One day at a time." Breaking recovery into 24-hour segments makes quitting manageable.

Nicotine Anonymous, a Twelve Step support group for smokers, offers meetings and literature for people seeking to quit and those in recovery. To learn about an NA meeting closest to you or for more information, contact NA World Services at 1-415-750-0328 or http://www.nicotine-anonymous.org/.