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Web Site Story
Pick of the Week! 3/16/98

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Working backward to quit smoking .

By Scott Farmer

“Smoking has a higher failure rate than heroin”. “I was able to quit drinking but I can’t quit smoking!”

I have heard these statements time and time again from addiction specialist and my patients and clients. I had to ask myself “how could this be”. Smoking is less intoxicating, less destructive in terms of ability to get things done and remain responsible. People don’t kill to get cigarettes; they don’t crash cars because of central nervous system failure. So what makes quitting cigarettes so much more challenging?

I though of this and many ideas crossed my mind. Cigarettes are more socially accepted (not by much though); they are allowed in more places (not by much though); so maybe the fact that because more opportunities exist then more association with smoking is created, triggering more unconscious desires. I don’t doubt that at some level this is true; however, I can’t help but think that the therapeutic approach toward other drugs and alcohol may be more comprehensive.

It is a pretty common fact that greater than 50 percent of smokers have some level of depression. And Dr. Shipley found in his research that starting smoking in earlier years creates a higher likelihood of an anxiety disorder. Yet when we look at common treatments for smoking, psychology isn’t really the foundation of smoking cessation, especially when compared to treatment programs for other drugs. Now I am not basing my hypothesis on having a master’s in exercise physiology. I am basing it on 9 years of working in smoking cessation and my own struggles with depression and anxiety and the research I have done to try and help myself.

I want to start with an idea I call “following the links of the chain backwards”. Instead of just looking at smoking, I want to look backwards. When I asked my smoking friends why they smoke the number one reason they give me is emotion. Emotion could come in the form of boredom, anger, frustration, anxiety and even happiness. (The cigarette used to celebrate finishing a task)

Now in the numerous books written by psychiatrist and psychologist one common theme keeps jumping out at me. Thinking creates emotion and emotion drives behavior. Smoking is a behavior and I just mentioned that emotion was the number one reason why people smoke; then it makes sense that a thought, whether unconscious or conscious, provoked an emotion. A thought is based on our experiences and knowledge possessed. More or less a thought is an interpretation of what is being heard, seen or sensed and if we work to change our interpretation (eastern philosophy refers to this as the automatic wiring of our brain) we can than change emotion and finally behavior, a behavior like smoking.

When it comes to success of any goal Dr. Maxell Maltz has proven through research that all living animals have an innate success mechanism. He illustrates this by using a baby squirrel. A baby squirrel is born in the fall and already knows to collect acorns for the winter, even though the squirrel has never seen a snowflake. He believes humans have this skill too but many times conscious thought inhibits us from trusting that wonderful tool we are all blessed to have. Dr. Maltz also lists 7 personality success types and 7 failure types.


1. Sense of direction – A bicycle maintains its equilibrium only as long as it is going forward toward something.

2. Understanding - Most of the time the other person’s reaction or position is not taken in order to make us suffer, nor to be hardheaded, nor malicious, but because he “understands” and interprets the situation differently than us.

3. Courage – Nothing in the world is guaranteed. Often the difference between a successful man and a failure is not ones better abilities or ideas, but the courage that one has to bet on his ideas, to take a calculated risk – and to act.

4. Charity – Successful personalities have some interest in and regard for other people. They have a respect for others’ problems and needs. They respect the dignity of human personality and deal with other people as if they were human beings, rather than as pawns in their own game. They recognize that every person is a child of God and is a unique individuality, which deserves some dignity and respect.

5. Esteem – “ Of all the traps and pitfalls in life, self-disesteem is the deadliest, and the hardest to over come; for it is a pit designed and dug by our own hands, summed up in the phrase, “It’s no use – I can’t do it. “ For real self-esteem is not derived from the great things you’ve done, the things you own, the mark you’ve made – but an appreciation of yourself for what you are – a child of God. When you come to this realization, however, you must necessarily conclude that other people are to be appreciated for the same reason.”

6. Self Confidence – “ Practice improves skill and success… not because “repetition” has any value in itself. If it did we would “learn” our errors instead of our “hits.” A person learning to pitch horseshoes, for example, will miss the stake many more times than he will hit it. If mere repetition were the answer to improved skill, his practice should make him more expert at missing since that is what he has practiced most. However, although his misses may outnumber hits ten to one, through practice his misses gradually diminish and his hits come more and more frequently. This is because the computer in his brain remembers and reinforces his successful attempts, and forgets the misses.

7. Self Acceptance – Self-acceptance means accepting and coming to terms with ourselves now, just as we are, with all our faults, weaknesses, short comings, errors, as well as our assets and strengths. Self-acceptance is easier, however, if we realize that these negatives belong to us – they are not us. You may have made a mistake but this does not mean that you are a mistake.


1. Frustration – Chronic frustration usually means that the goals we have set for ourselves are unrealistic, or the image we have of ourselves is inadequate, or both. 2. Aggressiveness – The failure-type personality does not direct his aggressiveness toward the accomplishment of a worthwhile goal. Instead it is used in such selfdestructive channels as ulcers, high-blood pressure, worry, excessive smoking, compulsive overwork, or it may be turned upon other persons in the form of irritability, rudeness, gossip, nagging, fault-finding.

3. Insecurity – The feeling of insecurity is based upon a concept or belief of inner inadequacy. If you feel that you do not “measure up” to what is required, you feel insecure. A great deal of insecurity is not due to the fact that our inner resources are actually inadequate, but due to the fact that we use a false measuring stick. We compare our actual abilities to an imagined “ideal, perfect, or absolute self. Thinking or yourself in terms of absolutes induces insecurity. 

4. Loneliness – The person who is alienated from his real self has cut himself off from the basic and fundamental “contact” with life. The lonely person often sets up a vicious cycle. Because of his feeling of alienation from self, human contacts are not very satisfying, and he becomes a social recluse. In doing so, he cuts himself off from one of the pathways to finding himself, which is to lose oneself in social activities with other people.

5. Uncertainty – Uncertainty is a “way” of avoiding mistakes, and responsibility. It is based upon the fallacious premise that if no decision is made, nothing can go wrong. Being “wrong” holds untold horrors to the person who tries to conceive of himself as perfect. If he were ever wrong his picture of a perfect, all-powerful self would crumble. Therefore, decision-making becomes a life or death matter. 6. Resentment – Resentment is an attempt to make our own failure palatable by explaining it in terms of unfair treatment, injustice. But, as a salve for failure, resentment is a cure that is worse than the disease.

7. Emptiness – It is impossible to psychologically accept something that you feel does not belong to you – or is not consistent with your self. The person who holds an unworthy and undeserving self-image may hold his negative tendencies in check long enough to achieve a genuine success – then be unable to accept it psychologically and enjoy it. He may even feel guilty about it- as if he had stolen it. His negative self-image may even spur such a person on to achievement by the well-known principle of over-compensation.

As I copy the brilliant writings of these great doctors of the mind, I can’t help but see longitudinal application that their research covers. Looking at their ideas gives us the tools to follow our chain backwards to our human roots. By increasing our knowledge of what it means to be a human, we are given the power to make changes. But I can tell you from my own experience with depression, change takes time and persistence. Over years of thinking a certain way, feeling a certain way and acting a certain way, we have burned a neurological path so deep than only a rare few can get themselves out without any help. For most people it is imperative to change the very things that keep the pathways burned. One of the difficulties that we all run into is our culture. With Western or Westernized culture we have seen some rather unfortunate statistics. Depression up over 60% since WWII, heart disease, obesity, diabetes and cancer all at epidemic levels. In Dr. Kaufman’s book titled “Shame: The Power of Caring” he describes three cultural impacts that effect the psychological health of our nation.

1. Success ethic – which enjoins us to compete for success and to achieve by external standards of performance. The mythic figure of the self-made man or woman is a dominant image of the literature of our nation. We are stimulated to seek our advantage over others through competition. We are taught to view achievement as the measure of our intrinsic worth or adequacy. We are further taught to strive after success and to measure it directly through our accomplishments. Hence, external performance becomes the measure of selfesteem. Striving for success can breed anxiety in the form of fear of failure because success is never entirely within our control. When success by any external standard becomes the measure of self-validation, then competition is inevitably fostered, generating hostility and fear. Failure to attain these goals produces loss of self-esteem and feeling of inferiority.

2. Independent and self-sufficient – Deeply imbedded in our cultural consciousness are images of the pioneer, cowboy and more recently, the detective. These archetypal figures mirror how to stand proudly alone, never needing anything, never depending on anyone. Needing becomes not a source of strength, but a clear sign of inadequacy. To need is to be inadequate, shameful. Crying and touching are expressions of personality which are heavily shamed in this culture: we are shamed for being human.

3. Popular and conform – In a culture which esteems popularity and conformity, individuality is neither recognized nor valued, Being different from other becomes shameful. To avoid shame, one must avoid being different, or seen as different. The awareness of difference itself translates into feeling lesser, deficient.

Both Dr. Maltz and Dr. Kaufman describe a copy defense strategy. Strategies which Dr. David Burns calls the ten distorted thoughts of humans. By identifying these distortions in our thoughts, we can begin to challenge them and create new healthier neuro pathways. This will allow us to change behavior and begin to heal.

1. All or nothing thinking – You see things in black-or-white categories. If a situation falls short of perfect, you see it as a total failure.

2. Overgeneralization – You see a single negative event, such as a romantic rejection or a career reversal, as a never-ending pattern of defeat by using words such as “always” or “never” when you think about it.

3. Mental Filter – You pick out a single negative detail and dwell on it exclusively, so that your vision of all reality becomes darkened, like the drop of ink that discolors a beaker of water.

4. Discounting the positive – You reject positive experiences by insisting they “don’t count.” If you do a good job, you may tell yourself that it wasn’t good enough or that anyone could have done as well.

5. Jumping to conclusions – You interpret things negatively when there are no facts to support your conclusion. Mind Reading: Without checking it out, you arbitrarily conclude that someone is reacting negatively to you. Fortune Telling: You predict that things will turn out badly.

6. Magnification – You exaggerate the importance of your problems and shortcomings, or you minimize the importance or your desirable qualities.

7. Emotional reasoning – You assume that your negative emotions necessarily reflect the way things really are: “ I feel terrified about going on air-planes. It must be very dangerous to fly.

8. Should statements – You tell yourself that things should be the way you hoped or expected them to be. After playing a difficult piece on the piano, a gifted pianist told herself, “ I shouldn’t have made so many mistakes.” This made her feel so disgusted that she quit practicing for several days. “Must”, “oughts” and “have tos” are similar offenders. “Should statements” that are directed against yourself lead to guilt and frustration.

9. Labeling – Labeling is an extreme form of all-or-nothing thinking. Instead of saying “ I made a mistake,’ you attach a negative label to yourself: “ I’m a loser.”

10. Personalization – Personalization occurs when you hold your-self personally responsible for an event that isn’t entirely under your control. Quitting smoking is tough. Finding a successful way to quit can be challenging because one size doesn’t fit all. The truth is, even in the medical field success in helping people quit is not real impressive. There are many unexplained phenomenons with smoking. Like why did most (> 90%)of the thousands of patients I worked with in the hospital have no nicotine withdrawal? The truth is that no one has found a cure for smoking addiction. I think that thinking, feeling and behaving (which smoking is) has no lines of distinction and is dependent on each other. If a person wants to change a behavior like smoking, taking a look at his or her perception of life may be a valuable step. Changing certain components of one’s self can help lower stress and other emotional disturbances. This can make the need for nicotine obsolete.

Scott M Farmer MS. CSCS., CES
Minnesota Health Fitness and Sports ™
President and Owner
Exercise Physiologist and Strength Coach
Certified Cardiac Therapist
State Certified Smoking Cessation Counselor
Waiora Consultant and Broker
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Scott Farmer MS, CSCS, CES (Coordinator)
Bachelor Degree in Exercise Physiology. University of Iowa, Iowa City, IA 1990
Master Degree in Exercise Physiology with an emphasis cardiac rehab and counseling. Old Dominion University, Norfolk VA 1992
Certified Clinical Exercise Specialist. American College of Sports Medicine 1994 to present
Certified Strength and Conditioning Specialist. National Strength and Conditioning Association 2001 to present
Board member of Minnesota Association of Cardiovascular and Pulmonary Rehabilitation (MNACVPR) 1994 to 2004
President of MNACVPR 1996
Cardiac Therapist/Clinical Cardiology 1992 to 2005
Owner of Minnesota Health, Fitness and Sports org. 2002
Smoking Cessation counselor 1995 to present
Minnesota state smoking cessation counselor 2003 to present


Scott holds a master's degree in exercise physiology. He is certified as a Strength and Conditioning Specialist through the National Strength and Conditioning Association and as a Clinical Exercise Specialist through the American College of Sports Medicine. Scott has also studied hockey specific training under Peter Twist, an eleven-year veteran strength conditioning coach for the Vancouver Canucks. Athletically, Scott has played and trained in sports for over 30 years; having played High School, College, Semi-Pro and Amateur baseball. He has coached athletes from the little league level up to high school and is a certified hockey coach with USA Hockey TM

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