My dad quit smoking cold turkey when he was 49 years old. He'd smoked for at least 30 years and probably longer. He'd tried to quit, but few quit-tobacco aids were available back in the 1970s. The need for a triple heart bypass in 1976 accomplished what his enviable willpower couldn't. He never smoked again even though he wanted to.

Dad was among many smokers who didn't understand that quitting smoking is a process and it takes time. Smoking is a lifestyle, as much a part of a smoker's daily routine as eating. There are aids now to help with the nicotine addiction. But anyone trying to quit tobacco also has to deal with the psychological addiction - lighting up to calm down, smoking with friends, puffing away with the morning coffee, celebrating with a cigarette.

Exercise is one often overlooked answer to breaking habits that permeate our lives. Smokers trying to quit can also help themselves by pausing to figure out the real message behind their urge to smoke.

Norman Edelman, M.D. and chief medical officer of the American Lung Association, says exercise helps people deal with their craving for a cigarette. Edelman cites studies that show withdrawal symptoms and cravings for cigarettes decrease during exercise and for nearly an hour after exercise.

In one study, 10 smokers stayed off nicotine for 15 hours. Five of them then exercised for 15 minutes and five of them didn't exercise. All 10 were then given MRI (Magnetic Resonance Imaging) scans while they looked at pictures, some of which featured cigarettes.

The brain scans showed different activity for the two groups. The smokers who didn't exercise had high activity in the brain areas associated with rewards. The smokers who exercised showed no increased activity in the same brain area and reported low cravings for cigarettes.

Researchers theorized that exercise improved the mood or caused a shift in blood flow away from brain areas that link pleasure with images of cigarettes.

Other benefits of exercise include limiting weight gain, distracting smokers from thoughts of smoking, relieving stress and building energy. A moderate amount, at least 30 minutes each day, is all that's needed.

Linda Harder, coordinator of the Panhandle Health District's (PHD) Smoking Cessation program, suggests people who are trying to quit smoking take advantage of free exercise opportunities such as walking in a mall.

PHD's free Fit and Fall Proof classes are offered in all five northern counties and are for people of all physical abilities. For a list of classes, visit www.phd1.idaho.gov and click on Classes Scheduled on the QuickLinks menu.

Smoking becomes such a large part of a smoker's life that lighting up a cigarette often replaces natural responses to feelings. Angry? Smoke a cigarette to calm down. Tired? Smoking must be the answer to staying awake.

Harder and other smoking cessation experts recommend smokers pause before lighting up and think about why they're grabbing a cigarette. Ninety percent of smoking cravings are linked to hunger, anger, loneliness or fatigue.

Harder recommends people trying to quit use the HALT method. H is for hunger; A is for anger; L is for loneliness; and T is for tired. When people trying to quit tobacco reach for a cigarette, they should think, "HALT," and analyze which of those categories is behind the urge to smoke.

When hunger hits, smoking isn't the answer. Eating is the appropriate response. If weight gain is a concern, people should drink water before eating and keep healthy snacks, such as fruit and vegetables, close at hand.

Anger is tough. Ideally, a person should deal with the situation that is causing the anger. Talking to friends or writing in a journal is a better way to vent than reaching for a cigarette.

Former smokers feeling lonely are most likely bored. Smoking has been a constant companion and activity. Exercise is a good distraction. So are hobbies.

The smoking urge tied to fatigue is hard to overcome because the appropriate response to fatigue is rest and most people don't want to slow down. People trying to quit smoking need to allow themselves to relax or rest when they recognize fatigue behind the urge to smoke. Resting will help protect health and healthier people are more likely to quit tobacco successfully.

For information on quitting tobacco, visit www.phd1.idaho.gov.

Cynthia Taggart is the public information officer for the Panhandle Health District. She can be reached at [email protected].