“I’d really like to get my sister interested in working out with me,” one of your clients tells you. “I think hanging around the fitness center with people who care about their health would help convince her to quit smoking. I probably bug her too much, but what else can I do? I can’t stand watching her smoke herself into an early grave.”

Many nonsmokers feel frustrated when friends and family members continue to smoke, given everything that is known about the dangers of smoking. They beg, implore, nag, berate and even threaten friends and loved ones who smoke, hoping to convince them to kick the habit. Ex-smokers may be especially enthusiastic (and intolerant) thinking, “If I can quit, so can everyone else!”

Concern from friends and family members often contributes to smokers’ decisions to quit, and emotional support from family and friends can be critical in preventing relapses for recent ex-smokers. However, coercive and critical approaches are rarely successful. Such tactics make smokers feel shameful, guilty, inadequate and afraid. They also make smokers more likely to reach for a cigarette to soothe the emotional pain. Instead, try to understand why it is difficult for friends to quit, and encourage quitting in a way that is most likely to bring success, and not ruin a friendship.

A hard habit to break

The first step in encouraging a smoker to quit is to understand and acknowledge that smoking can be a hard habit to break. Smoking is a powerful psychological and physiological addiction. While some people have little difficulty kicking the habit, the majority of smokers who quit must cope with at least a short-term struggle. They miss the pleasure of lighting up, taking a cigarette break at work and smoking with friends. Remember that over time, the act of smoking has become associated with many pleasurable reinforcers.

In addition, nicotine is an extremely addictive drug. Some quitters experience intense discomfort and depression while going through withdrawal. Before passing judgment on a friend’s inability to quit, remember that each person is different, and that quitting might be very difficult for your friend. Imagine how you would feel giving up coffee, chocolate, exercise or something you really enjoy.

Inner strength and personal conviction

You cannot make another person quit smoking. You can only try to help the smoker find the inner strength and personal conviction required to quit.

Successful behavior change occurs when a person feels a sense of control and gains confidence. Forget about smoking for a minute, and think back to the last time you were criticized by a friend or family member. Maybe someone asked you to become neater, a better listener or more punctual. Maybe they pointed out a mistake you made or a weakness in your character. How did you feel? People often feel hurt and angry when criticized, especially if criticism is delivered in a judgmental or condescending way.

Now put yourself in your friend’s place while you give your lecture on the dangers of smoking. What effect are you creating with your words, tone, facial expression and body language? Instead of lectures and criticism, let your friend know you care, and you will be supportive in his or her effort to quit. Friendship and support help build and maintain the inner strength and personal conviction people require for successful behavior change.

A place for caring confrontation

While nagging your friends and family members about their smoking is counterproductive, an occasional caring confrontation can have positive results. At the right moment, tell family members or close friends that you love them and are worried about their smoking. Let them know you will be there to support them emotionally when they decide to quit. (Of course, let loved ones also know you will continue to care about them whether they quit or not.) Use this tactic sparingly, however, or it will lose its meaning and effectiveness.

Supporting quitters

Let’s say a close friend or family member has decided to quit. What can you do now to provide support during this critical period? Be understanding about the withdrawal effects your friend may be going through. If the ex-smoker is a family member, he or she may even be difficult to live with for a while. He or she may be irritable, upset, tired or depressed. Headaches, sleeping problems and difficulty concentrating are other symptoms of nicotine withdrawal. Help your ex-smoker see these as positive signs that the body is adjusting to a new chemical equilibrium. Be positive and sympathetic, and remind your friend that the symptoms are only temporary.

Of course, the extent of your support will vary depending on your relationship to the quitter. In general, ex-smokers report that praise and support from family and friends are helpful. Ask quitters how things are going. Let them know how glad you are they have quit. Most of all, express your confidence in the quitter’s ability to successfully remain an ex-smoker.

Take your ex-smoking friends or family members out for smoke-free recreation and fun to provide a distraction during the withdrawal period and to reinforce their good intentions. Also, encourage them to exercise. Regular physical activity will help them manage the stress of quitting, avoid weight gain and feel great about the positive steps they are taking to improve their health.

If the ex-smoker is a partner or very close friend, be aware of relapse prevention. Relapse is most likely when an exsmoker has been drinking, is feeling depressed or angry, has high levels of stress or is experiencing interpersonal conflict. Ex-smokers are also more likely to have “just one more” when they are in the presence of smoking triggers, such as being with other smokers or finding themselves at a gathering where there is social pressure to smoke. When possible, help your partner or friend avoid stressful situations during the withdrawal period. Ultimately, of course, while you can offer support, your friend or family member must be self-reliant.

What if, despite your best efforts, the ex-smoker resumes smoking? Practice compassion and forgiveness. The quitting process was still a valuable learning experience for both of you, making the next attempt more likely to succeed!



Barbara A. Brehm, Ed.D., is professor of exercise and sport studies at Smith College, Northampton, Mass.