Part 1 of 2
I have had a number of patients come to my office wanting to quit smoking cold turkey. No medications, no slow taper, just white-knuckling it until they've conquered their cravings. Doesn't sound easy, and certainly not fun. But can this method work?
Remember the movie Chocolat (2000)? The plot goes something like this: A single mother and her young daughter move to a small town in France and open up a chocolate shop during Lent. She quickly wins over the townspeople with her delicious treats, except for the curmudgeony mayor, who disdains her, her kindness and her sweets. All through Lent he brags about his control over his village -- how he's been able to keep undesirable people (and passions) out of town. Late in the movie, when his self-restraint has failed him, he breaks into the chocolate shop and gorges himself by eating vast quantities of chocolate in the window display. Eventually he passes out from his overindulgence.
Sound familiar? Ever tried to restrain yourself from some behavior, only to end your fast totally defeated and overindulging? Two interesting points here. First, this is a well-known phenomenon called the "abstinence violation effect." Basically, the theory states that our self-control is like water building up behind a New Orleans levee -- eventually, the levee will burst. If you are trying to resist smoking, eventually the urge becomes too strong to resist. And when that levee bursts, you end up smoking a bunch of cigarettes. Afterward, you tell yourself, "Screw it, I've failed. I might as well keep smoking," which just feeds the process.
More importantly, this highlights an idea that has gained some traction in self-control research recently called "ego depletion." The work of Dr. Roy Baumeister has supported the idea that self-control is a non-renewable resource. Just like a car that has only so much gas in the tank to keep driving, we may have only so much reserve of self-control for any one day.  In a recent study by Dr. Baumeister and colleagues, when they followed people and how they dealt with desire for different things throughout the day, "resistance became less effective for high levels of resource depletion."
Interestingly, "higher levels of resource depletion predicted more behavioral enactment -- but only for the desires that people actively attempted to resist." In other words, people only went nuts with the behaviors from which they were trying to restrain themselves. Unlike the mayor in Chocolat, a smoker who has quit cold turkey and whose "willpower gas tank" has gone empty doesn't binge on chocolate; rather, he smokes a ton of cigarettes. And the more folks in this study tried to restrain themselves, the more nuts they went when they lost their self-control.
What can we learn from this? If you're gung ho on quitting cold turkey, make sure you've got plenty of gas in the tank (and can keep filling it up). Common signs of an empty tank are summed up in the acronym HALT (Hungry Angry Lonely Tired). Also, if going cold turkey has failed you before, or if it sounds particularly painful, try other methods. We've talked about substitution strategies in previous blogs, and we will talk about other emerging treatments such as mindfulness training in future posts.
And in my next post, we'll explore paradoxical ways of gaining self-control. Stay tuned, and don't beat yourself up too much if you end up passed out in the chocolate shop. Most of us just don't have that kind of self-control.
For more by Dr. Judson Brewer, click here.
For more on emotional intelligence, click here.
1. Hofmann, W., K.D. Vohs, and R.F. Baumeister, What People Desire, Feel Conflicted About, and Try to Resist in Everyday Life. Psychol Sci, 2012.