Pulmonary Function Test Interpretation – The COPD perspective

This is a brief introduction to how you should interpret the values you got from a pulmonary function test at the doctors office. This article is focused on Chronic Obstructive Pulmunary Disease and look at
the values most important for this condition.
Did you know you can perform a pulmonary function test at home?

 

First of all, when you take a pulmonary function test, the person coaching you must be experienced and know how a correct test is performed and also be able to judge if the blow was satisfactory or not. Each session must give 3 different blows that meet the guidelines of the American Thorasic Society. Basically this means that the two best blows should not differ than more 5%. This shouldn’t be your concern and you must trust the professional coacher on this matter. The technique and quality of the test is essential to make a valid pulmonary function test interpretation.
To keep it simple we will look at only three parameters generated from a pulmonary function test, two of the values are measured and the third is calculated.

 

The values generated at the pulmonary function test are compared to a reference-guide. The reference-guide is based on sex, age, length and race. Your values are compared to the reference-guide and healthcare professionals often talk about how many percentage you have compared to the reference (the predicted value). If you are spot on the reference value you have  100%. The predicted value is calculated and based on statistics, so some people may have 90% or less naturally while others have 120% or more. It is important to remember that one value says nothing, we need the complete picture in order to know how to interpret the pulmonary function test.
  • First we take a look at the value called FEV1. FEV1 is short for Forced Exspiratory Volume during the first second of the blow. This value is commonly known as lung-function. FEV1 tells us about the elasticity of the lungs. The better elasticity the higher value. A person with severe COPD has a very poor elasticity while a young, healthy non-smoker have a great elasticity in the lungs. You could compare this with a ballon (great elasticity) and a plastic bag (no elasticity), this example shows the two extremes and most of us are somewhere in between.
  • The next value is FVC. FVC is short for Forced Volume Capacity. This is the total amount of air you exhale during the blow. To get this value correct you should blow no less than 6 seconds but preferably until you are out of air completely. This value is commonly known as lung-capacity.
  • The third value is not measured but calculated from the two parameters above and it is refered to as FEV1%FVC. This calculated value tells us how many percentage of the total volume(FVC) you exspire during the first second of the blow (FEV1). This value is not related to any references and should always be above 70%, meaning that from all the air you exhale during the test more than 70% should be exhaled during the first second of the test. If the value is below 70% it’s natural to suspect some sort of obstructive condition.

 

There are a few spirometers that are approved by the FDA and ATS for usage at home. This is  a good opportunity to keep check on your COPD and possibly even predict exacerbations. amazon.com sells a few versions here: Spirometers

 

We will be looking for links to different reference-guides and post them here. We use Reference values for spirometry of the European Coal and Steel Community. Different doctors prefer different references and you should now wich they use in order to make an pulmonary function test interpretation.

Quit Smoking Tips and Medications

If you’ve been a smoker for any length of time, you already know how difficult it can be to quit smoking. Once addicted, the habit becomes a part of your daily lifestyle and routine.

It’s not just the physical addiction to the nicotine that makes it seem nearly impossible to quit smoking.

There’s also a psychological need to have a smoke at certain times of the day.

For example, many smokers feel compelled to light up after a meal, while chatting on the phone, during rush hour traffic, or after completing a vigorous work-out. Their mind becomes accustomed to linking a specific activity or task to smoking. Even a certain time of day can bring on the urge.

While they may be able to cut back at other times of the day, they just can’t seem to quit smoking when it comes to that particular time or task.

By recognizing what activities trigger your smoking habit, you can learn to better deal with the problem and increase your chances of stopping smoking altogether. If you view certain tasks as unpleasant or stressful, it’s very possible your smoking serves as a relaxation technique for dealing with those situations.

Make a Commitment to Quit Smoking

In order to stop smoking, the first and most important step is to make a personal commitment to end your bad habit.

Although this may seem obvious, many smokers truly do not wish to quit smoking. While their spouse, children, or boss may constantly nag them to quit, stopping smoking is not one of their own top priorities. They may attempt to quit smoking on several occasions, but each attempt is usually short lived.

In Order to Quit Smoking, Examine Your Habits

Once you’ve made an honest commitment to stop smoking, next you need to review your personal situation.

Start by calculating the number of cigarettes you smoke per day. Do you smoke more during the week than on the weekend? If so, make a note of that and all your other smoking routines.

Create a Stop Smoking Checklist

Before making an attempt to quit smoking, you may wish to keep a record of your smoking for one week beforehand.

List each time of day you have a cigarette and tally your numbers at the end of each day. Look for certain patterns in your smoking. Do you smoke twice as much during the evening hours? Are you more likely to light up at social events than when at home alone?

Partner Up With a Friend to Quit Smoking

Some folks may be able to quit smoking cold turkey but they are in the minority. Pair up with a friend who is also trying to kick the habit or seek the encouragement of a former smoker.

While your spouse may offer kind words of support, it’s very difficult for a non-smoker to grasp the willpower and strength needed to successfully quit smoking.

Tips to Curb Your Nicotine Craving:

1. Rid your home and office of all smoking related items. If your ashtray, matches, lighter, etc. aren’t within reach, you’re less likely to give in to the urge.

2. One of the most popular quit smoking tips is to replace cigarettes with another habit. This suggestion works well but make sure you’re replacing your nicotine habit with a healthier alternative. Try exercising, reading a book, or munching on fresh fruit instead.

3. Make sure to get enough sleep while trying to stop smoking. Breaking any bad habit can be stressful. In order to increase your chances of success, your body needs to be well rested.

4. Accept setbacks. When attempting to quit smoking, most people have relapses. Don’t let a small slip crush your plan to stop smoking altogether. Simply pick yourself up, forgive yourself for slipping, and start over again.

5. Most smokers do not realize the relationship between caffeine and nicotine. Smokers are often able to handle a higher concentration of caffeine in the body than non-smokers. The nicotine breaks down the caffeine at a faster rate. When attempting to quit smoking, if you experience an increase in stress and anxiety try cutting back on caffeine consumption as well.

6. Set small goals when trying to quit smoking and focus on stopping smoking on a weekly or daily basis. Instead of saying, “I must stop smoking for good”, make it your goal to not smoke for the entire week. When you reach that milestone, set another goal. As your body becomes less dependent upon nicotine, stopping smoking will seem less overwhelming.

Prescription Medications To Help You Quit Smoking

Over the years, smokers have tried various prescriptions and over the counter remedies to cure their addition. From chewing gum, to patches, to popping pills, there seems to be an endless supply of stop smoking products available.

One could easily spend a fortune trying to quit smoking. It can also be very time-consuming to research products that have the best success rate and try to figure out which one will be the “magic bullet” for your habit.

In the past, most stop smoking aids contained nicotine. These products helped patients stop smoking by gradually decreasing the amount of nicotine released. They were designed to wean smokers gradually from their dependency instead of quitting smoking cold turkey and causing a shock to their system.

That was then, this is now.

New Quit Smoking Medications: Chantix and Zyban

Today there are effective and safe ways for patients to stop smoking. Medications like Chantix and Zyban help smokers break the habit without exposing them to more nicotine. And these stop smoking preparations help eliminate your nicotine craving without producing the withdrawal symptoms common to other types of stop smoking aids.

When starting treatment with Chantix or Zyban, patients are allowed to continue smoking for the first week. This allows the medication time to take effect. By the second week, trying to stop smoking is much easier.

Quit Smoking Without Extra Nicotine

Although Chantix and Zyban do not contain nicotine, they do release dopamine into the brain. It is the dopamine that greatly reduces unpleasant withdrawal symptoms.

Prescription Zyban also contains bupropion, a drug commonly used to treat depression. Bupropion is believed to be a key factor in helping smokers deal with their addiction without the unbearable side effects and withdrawal symptoms.

Helpful Quit Smoking Tips

Many have tried and very few have succeeded.  Quitting is one tedious act that most smokers cannot successfully achieve. Sheer determination is often not enough.  Cigarettes contain nicotine which makes it highly addictive. This is where the usual battle starts. Addiction may lead to severe issues such as heart problems and of course, cancer.  True enough, it is also considered as one of the most leading causes of death.  To help smokers achieve their goal, here are the quit smoking tips and a comprehensive explanation on how to follow them.

Knowing yourself and your degree of addiction is the very first step. Some smokers may be struggling for years while others are just on the ledge of addiction. Firstly, you must possess two basic qualities to successfully achieve this goal. It is important that you have both determination and mindset. Without this, it may be extremely difficult to maintain your goal or even begin it the first place. Then you can ponder on the reasons why you want to cease this dreadful habit. Thinking about spending a long life with loved ones and friends can be very motivating. It is also necessary to check and reflect on the how secondhand smoking can affect them. These are inevitable simple and easy tips.

After carefully analyzing yourself and your habit then you may now begin with planning. Monitoring how many sticks of cigarettes can also be of enormous help. Keep a journal so you can see the figures. Moreover, ask someone to check on your progress once in a while. Quitting all by you is a big challenge. However, having the support of your family and loved ones is sometimes the key to becoming a quitter. Realizing how important those people are in your life is one of the most effective quit smoking tips. Spend more time with them and less time with your cigarette buddy.

Useful Quitting Smoking Tips

Many have dabbled but very few have emerged victorious.  The idea of quitting the cigarettes seems to be one of the toughest goals to achieve especially if you have dwelled on the activity for years. The question is – how does one really start to stop smoking?  Reading several quitting smoking tips is a useful first step.  Doing your own research about these tips will keep your enlightened about the odd effects of nicotine in your system.

One of the most common ‘stop smoking tips’   is having an in-depth understanding about the risk poses on your heath. Learning more about diseases such as Emphysema, lung cancer, COPD, Thyroid problems, gum  and mouth infection and heart attacks will give you a clearer picture of how serious the repercussions of smoking are.  This will automatically register in your system especially for those who have just started smoking.

For those who have already begun their bottle with nicotine addiction, finding other activities is a good way to replace your old habits. Rediscovering your interests, meeting friends and spending more time with a non-smoking group will allow your body to get used to the system.  Simple strategies such as dining at a non-smoking restaurant or keeping yourself loaded and busy can likewise divert your attention.

On a more severe level, one of the most effective quitting smoking tips is finding professional help.  There are established therapies that can support your goal.  Some of the examples are Nicotine Replacement Therapy and the Water Therapy which is becoming more popular these days. Joining self-help group can also be of big benefit as well.  Several products are also made available in the market. However, it is always best to consult a professional before trying one. Note that fighting cigarette addiction also depends on your body and mind state. Stay nicotine free and have a better life!Â

Quit Smoking Tips Your State of Mind makes All the Difference

One the best quit smoking tips I can give you is how to think about quitting smoking. By far the most problematic symptoms of withdrawal come from the ways in which you are thinking about smoking and not smoking. It\’s not possible to have no attitude at all. What attitude you take is what makes all the difference to your process, how traumatic it is and how successful you will be.

When you first quit smoking, assuming you are not avoiding and repressing, you can expect your desire to smoke to be fairly constant for about two days. For some people it\’s continuous and for others it comes and goes in waves. The second day is often more intense than the first.

During this time, you may also be quite disorientated, so you end up feeling rather peculiar, to say the least. After these two days (variable from person to person) you will see the desire to smoke begin to diminish.

The people I have worked with who just experience their desire, and nothing else, are willing to accept it as a temporary phase and don\’t see it as a problem. It doesn\’t have to feel like hell.

Problems arise if, when they feel the desire for a smoke, people tell themselves they can no longer satisfy it. They deny choice, and they do that because they think that to acknowledge the freedom to smoke means they will smoke. The challenge is to fully acknowledge that the option of smoking exists – without actually doing it.

If you feel any of the following symptoms of deprivation after you stop smoking, then you have not yet changed the way you are thinking in this regard:

Desire to smoke doesn\’t diminish. Even a week after you quit smoking, you still feel an intense and persistent desire, perhaps for hours on end, because the one thing you think you \’can\’t\’ have is the one thing you want the most.

Stress. Take a look at this list of symptoms: loss of temper, loss of sense of humor, loss of concentration, difficulty making decisions, \’cotton wool\’ head, tiredness not relieved by sleep, insomnia, indigestion, overeating, depression, headaches, heart palpitations, chest pains, heartburn, trembling, leg cramps, twitching in limbs.

I copied this list from a book, but it wasn\’t a book about smoking, it was a book about stress. It\’s not a complete list. Stress will show up in different ways in different people – depending on your Achilles heel.

The most important thing to understand about stress is that the symptoms are often psychosomatic: physical problems with causes created by a state of mind. Extensive research on stress points to lack of choice as the principal cause. If you have a desire and you tell yourself you can\’t smoke, you are guaranteed to create symptoms of stress, especially:

Irritability: which may really be repressed rage.

Anxiety: like a caged wild animal you become restless, anxious and can even reach a state of panic. Symptoms of panic attacks are: palpitations, difficulty in breathing, dizziness, hot and cold flushes, sweating and trembling.

Tension: fighting the desire can create aches in neck, shoulders and stomach, nausea and difficulty relaxing.

Depression: which could be seen as a form of repressed anger. Some of the symptoms are: loss of energy, apathy, early-morning waking, inability to concentrate or make decisions.

The Best Quit Smoking Tip

There are so many methods out there designed to help you stop smoking that you may be overwhelmed in trying to decide which one would really work for you. One quit smoking tip you to think about is to ensure you are mentally prepared to stop smoking. If you feel you can quit cold turkey and have the willpower to do so then go for it but most people struggle. Many people that stop smoking by going cold turkey, start back smoking again. You will want to program your brain into despising everything there is that has to do with smoking and cigarettes.

When you smoke, you may not realize that your brain has certain chemicals in it that are being controlled by nicotine through addiction. In turn, you also become addicted to nicotine. Dopamine, beta-endorphins, acetylcholine, and norepinephrine are some of these chemicals that become affected by nicotine addiction.

When you stop smoking, these chemicals go through their own kind of withdrawal and that is why you get so irritable and edgy. An innocent puff here and there can lead to a full blown addiction that will take nearly an act of congress to stop. People who have never smoked could never understand the power of nicotine addiction.

The best quit smoking tip I can give you is to make yourself realize that while you are experiencing the withdrawal symptoms, you are going to have to stay mentally strong to keep yourself from giving in to temptation. Until you have been a few days without a cigarette, you are going to have all these horrible withdrawal symptoms.

Some people have tried hypnosis as a method to get their brains retrained into not thinking like a smoker. This may be an effective method, but at the same time a lot of it is still up to you and your conscious mind. You aren’t going to be able to handle the withdrawal symptoms without putting yourself into a frame of mind that is going to be ready for when those symptoms come along. You can quit smoking without the help of medicines and patches or gum, if you are strong enough and have the willpower to persevere.

There are nasal inhalers and sprays to help you stop smoking. You can also have low level laser treatment or acupuncture to help you in stopping smoking. Some people will go any lengths when they are trying to stop smoking. But, none of these are going to work until you get that mindset that you are going to stop smoking no matter what.

If you go and spend a lot of money on treatments then have a stressful day and smoke when you get home, it doesn’t matter how much you’ve spent, you will still have given in. What I am trying to say is that no matter what you spend or which method you use to quit unless you set your mind to it that you are going to quit and keep telling your brain that you are quitting, over and over you are likely to fail. Eventually, your brain will get the message and those chemicals will get a handle on being smoke free.

The aids and methods mentioned are simply there to help you quit, you still have to take the tough choices but with perseverance you can reach your end goal and start on the road to a new healthier lifestyle.

Do Methods For Quitting Smoking Help?

As an unwilling smoker who wants to quit smoking you commit a basic mistake. You are in search for methods to quit smoking. What you need is a method to quit smoking. If you contemplate more than one method, perhaps you are not going to follow any one of them with determination. And without determination, you will not be able to quit smoking.

Of these methods, now you have to decide which one is most suitable for you. There is nothing like easy method and the hard method. The first month of your decision is going to be tough. If you sail through this tough stormy sea, calm waters may greet you ahead.

Now, you have a well devised plan and you are brimming with motivation. In the beginning you need to take the assistance of quit-smoking aids. These may give you some psychological edge, but in reality it will not help. In the first month, you will count each day and perhaps each hour of the day.

You are stressed, beyond the limit?and yet, you need to tolerate. Diet-planning can wait, but in the meantime make a time table for physical exercises, and for breathing exercises. Have fixed hours of sleep. One good point about you, the smoker is that you don’t smoke, while asleep, except in dreams.

Advertise a lot in your family, with your friends, in your office, that you are no more a smoker. Earnestly solicit the support of your well-wishers and family members in your effort to quit smoking.

When the urge becomes difficult to resist, that is the time to resist! Take a book on horror- fiction, sit on the computer, take a bath, go to the kitchen and start cooking your favorite dish.

All the tobacco products need to be out of bound for you. Destroy the existing stock. Never think of gifting them to your still smoking friends. That which is not beneficial for your health, how can it help their cause?

With your solid determination in tact, no harm is there in your taking recourse to smoking aids. Zyban, which is a prescription medicine, reduces your craving for nicotine. You can also try some herbal equivalents of Zyban and they do not require prescription, and they will do you some good. You can also take recourse to laser treatment.

But keep your will power in tact. Nothing to beat it. Will power is like the constitutional guarantee to an individual. You await a glorious time, full of inner freedom, totally devoid of smoke coils.

Good for you, better for people around you and the best happening, all things considered!

10 Ways to Quit Smoking – Helpful Tips

A path in the write direction – Some helpful ways to quit smoking

With so much time and effort put into creating campaigns to help Americans quit smoking the progression has not resulted quite well.  Studies have found that 1 in 4 men and 1 in 5 women still smoke. Leading some to believe that helping Americans in ways to quit smoking are in need of a more aggressive approach.

Kicking the habit for good is what troubles and stands in the way of quitting.  Long term goals become short term results, ending smokers back to square one.  So why do millions still continue to smoke?  The obvious answer to that is the nicotine that all smokers are addicted to but it is the feeling in return that provides smokers the psychological comfort that comes with the many feelings of related stress.

With so many tools, programs and systems many have at their disposal considering quitting smoking is solely based on when you are ready.  Try consulting with an expert or your doctor.  But if you have started today, or at this moment these 10 ways to quit smoking will be a direction to the path of quitting smoking.

10 ways to quit smoking

1.)     Consider counseling:  Smoking is an addiction and any addiction is powerful many times over.  Counseling will provide support and can increase your will power.  You need to attend one on one counseling sessions, group meeting of experts and people that are like minded and that are there for the same reason.

2.)     Try deep breathing techniques:  Some find this one of the most powerful techniques.  Every time you feel the need to smoke try the following three times.

Take in the deepest amount of air you can, simply exhale and release the air very slowly.  Visualization is the key.  You must picture your body leaving its tension as its being released through your energy and body.  Follow through 3 times.

3.)     Start to exercise:  Get up and go to the gym.  Changing your routine can help you jump of the same routine you were in.  Consider jogging and/or walking.

4.)     Writing it down:  You want to take a page, split a line through it and write down good things about not smoking.  Sit for a few minutes and notice how you feel.  Write what you have accomplished.

5.)     Try to stay away from smokers or have anyone close to you stop smoking around you.  You want to be able to kick the habit and associating yourself in a smoking environment will only draw you back to square one.  This is vital.

6.)     Drinking plenty of water:  Flush your system of the nicotine.  Flushing out the toxins in your body and keeping yourself well hydrated will help fight cravings and also will make you feel better.

7.)     Eating smart:  Consider changing your eating habits.  Kick the saturated fats, processed foods, and junk.  You can find foods that actually do exist out there that are the exact same and taste just as good but healthier.  Look for them!

8.)     Sleep:  When quitting smoking your sleeping habits can be erratic, you might not pull a good night of sleep.  Try getting in 8 hours of sleep every night.  Do not eat 4-5 hours prior to bed time.  If needed in the day take some power naps to help keep you focused.

9.)     Smokers usually have certain times in a day that that they smoke.  It is a natural routine of smoking.  You want to try replacing those particular parts of the day with a piece of gum or hard candy.

10.) Re-direct thinking:  If you find yourself thinking of smoking or have cravings, it is your mind that is thinking of such things.  When this happens, you have to try picking a topic or something you need to do tomorrow, errands to run, just pick something and brainstorm it in your head, think about it, re-direct your thought into another branch of thoughts from your initial one.  Doing this occupies your mind.  Do not come full circle back to your thought of smoking.  This can take some control and time but it is not hard.  It is your mind. Control it and direct it.

Tried Everything? Quit Smoking Tips for the Desperate

If you’ve been looking around the internet for stop smoking tips, you’ve probably noticed that most of the advice out there seems intended for people who have never tried to quit before. Again and again, you see advice-writers running through the basics for beginners, but what about the rest of us?

When I finally quit, it was only after years of trying pretty much every method there is. And by the time I got to that point, I’d put so much time and energy into quitting that I’d made myself an expert. So I had no use for simple lists of quit smoking tips. I knew them all. That’s why I decided to get creative. Here are some of the new quit smoking tips I’ve come up with.

1. Use technology to broadcast your progress: You’ve probably heard the traditional stop smoking tip about telling your friends and loved ones you’re quitting, and relying upon the threat of public shame to keep you on the right track. With technology, you can elevate this strategy to another level.

Set up a blog with a name along the lines of, “[Your Name]’s Quitting Smoking Journal,” and send out a mass email to everyone you know. Give them the link to your blog, and ask everyone kindly to bookmark it and keep tabs on your progress. Then, write in your blog 3 or 4 times per day. Talk about your misgivings, your cravings, and how you’re dealing with them. No one likes to be seen as self-obsessed, but this is a good time to make an exception.

This way, you’ll get the whole threat of public shame thing, but you’ll also have a journal to help you work through your process.

2. Smoke something else: Okay, so this isn’t the most perfect quit smoking tip in the world, but it can work. Things like nicotine patches and gums have it backwards; they try to help you quit smoking by continuing to dose you with the very chemical you’re trying to stop needing. Basically, what these products do is keep you addicted, so that you’re primed to take up smoking again as soon as you have a moment of weakness. And let’s face it—smoking just feels better than chewing a gum or sticking a patch on your skin.

So, do it the other way around. Rather than cutting out the smoking and sticking with the nicotine, cut out the nicotine and stick with the smoking. This way, every time you have a craving to smoke, smoke! Sure, non-nicotine smoking products have many of the same negative health effects, but most aren’t nearly as addictive, so you can quit them once your nicotine cravings are gone.

3. Hypnosis: If you’ve always thought hypnosis was a little dubious, now’s the time to rethink your prejudice. With free stop smoking hypnosis that’s easy to do at home, you can change your deeply held attitudes about smoking and nicotine. Essentially, hypnosis is all about opening your subconscious mind to suggestion, and filling it with new, healthier patterns of thinking. It brings you to a heightened state of focus (not a trance, contrary to popular belief) and helps you reset the gears of your mind. Try it. It can’t hurt.

Quit Smoking Tips That Actually Work!

When you’re sifting through pages on the Net looking for some tips which are going to help you stave off your smoking cravings, you come across a lot of nonsense. I’ve sifted through all the nonsense and come up with a few powerful quit smoking tips which you can easily implement which will actually help. Have a look and see if these work for you.

Quit Smoking Tip #1: Cut Back on Cigarettes Gradually

If you’re going through say a pack of cigarettes daily, don’t make big leaps like cutting your smoking in half. Set a plan in motion to cut back GRADUALLY. Try cutting out 1 cigarette a day every 3-4 days. Load up all the cigarettes you will be smoking for the day in *1* pack and have that be your sole source of cigarettes for that day. As time goes by, you will be removing 1 cigarette from this pack at a time, if in the process of utilizing this technique you feel any discomfort, distract yourself by chewing some gum or drinking some coffee.

Quit Smoking Tip #2: Tell your Friends and Family of your Quit Smoking Plan

The more people you tell about how you’re embarking on a journey to quit smoking the better. What will take place is the principle of accountability. When we feel accountable to someone to follow through with a plan of action, we are more likely to do it. The more you speak with enthusiasm and intent to those around you about your plans the more you will feel COMPELLED to follow through. When you take pride in your word being your bond and then follow through with this exercise, the accountability and responsibility factor will take affect on your psyche each time you feel the urge to cheat on your plan.

Quit Smoking Tip #3: Take it Day by Day and assess progress weekly

If you focus on quitting smoking for good, you will only overwhelm yourself. You must learn to small chunk things, try and improve little by little and set your main focus on seeing weekly progress. Every week, re-asses what you’ve done for the past 7 days. Have you cut back on the cigarettes you smoke each day? If you’re using the above method of cutting out 1 cigarette every 3-4 days, you should be assessing whether or not you are smoking 2 less cigarettes a week.

If for any reason you did not follow through or see any progress, don’t loose hope. The fact that you have a system in place and are taking affirmative action is proof enough you are moving in the right direction, it is a process. You may re-assess your plan and make for a more gradual cutback if you failed to see progress in the last week, just as long as the overall trend each week is a decrease in smoking activity.

These tips are extremely powerful, if implemented! It is not enough to read these and get a slight positive high over what you could potentially do. Take action starting NOW! Get out a pen and paper right now, yes now, and take 10 minutes to write down your own personal cutting back plan. Once you are finished, explain this plan to at least one other person, then set it in motion by getting out a cigarette pack and placing your daily allowance of cigarettes for the following day. Pack that away in your pocket and make that your ONLY source of cigarettes for the day. Get writing, there is no tomorrow, all there is, is the eternal NOW, get up and make this a reality!


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