An Introduction to Smoking Cessation – Stages Four and Five: Action and Maintenance

Hello, there! My name is Krystle Eckhart, PsyD, HSP. I’m Think Whole Person Healthcare’s Integrated Behavioral Health Specialist. I’m excited to share with you the final article in my series about smoking cessation. Before we get into specifics on stages four and five, let’s first talk about all five stages of smoking cessation.

With smoking cessation, like most behavior changes, you will likely find yourself going through these stages:

  • Precontemplation: “I’m not ready to quit smoking yet.”
  • Contemplation: “I know that I should quit but I’m not sure how to do it.”
  • Preparation: “I have cut down the number of cigarettes I smoke per day.”
  • Action: “I am ready to quit smoking now.”
  • Maintenance: “I have quit smoking.”


In this article, we’re talking about Stages Four and Five: Action and Maintenance. If you missed my previous articles about the other three stages of smoking cessation, make sure you go back and read them before you continue! (Intro, Stages One & Two, Stage Three).


Stages Four and Five: Action and Maintenance

When you reach your “stop smoking” date, be prepared for feelings of withdrawal in the first days. Not all people will go through the same withdrawal symptoms or the same intensity of symptoms. For many people, the most intense symptoms will lessen 3-4 days after quitting. Most physical withdrawal symptoms should be gone within 7-10 days. It is important to know what to expect and to develop a plan for ways to cope with these symptoms.

Common symptoms include:

  • Intense cravings
  • Mood swings, irritability
  • Anxiety, tension, restlessness
  • Difficulty concentrating
  • Trouble sleeping
  • Coughing/dry mouth
  • Headaches, dizziness
  • GI upset (constipation, nausea)
  • Increased appetite
  • Feeling down/sad

Strategies for coping with withdrawal:

  • Nicotine Replacement Therapies (NRT) (e.g., lozenges, gums, patches, Chantix, Wellbutrin, etc.)
  • Visualize surfing the urge waves
  • Delay
  • Distractions
  • Deep breathing/progressive muscle relaxation/5 senses grounding and meditation techniques
  • Drink water!
  • Connect with support person
  • Re-engage in leisure activities or try new hobbies
  • Take walks
  • Physical activity (e.g., weight lifting, stretching, yoga, dance, etc.)
  • Reduce alcohol and/or caffeine
  • Engage in healthy sleep hygiene
  • Take warm baths/shower
  • Eat low-sugar hard candy (to prevent throat dryness)
  • Eat foods higher in fiber (e.g., whole-grains, fruits and vegetables)
  • Brush teeth after eating
  • Smile at yourself in the mirror
  • Find humor
  • Express yourself creatively (e.g., journal, draw, play musical instrument, sing, etc.)
  • Have compassion for yourself if you slip up. Learn from the slip up rather than criticizing yourself. Review motivation list and reach out to support network and/or primary care team for additional resources and support.


That’s it! This completes my quick overview of the five stages to smoking cessation. If you missed my previous articles about the other three stages of smoking cessation, make sure you go back and read them! (Intro, Stages One & Two, Stage Three).


Please share this article with your loved ones to spread awareness for smoking cessation and Lung Cancer Awareness Month. If you need more assistance and information about smoking cessation, please speak with your Think Whole Person Healthcare primary doctor, or become a patient at Think Whole Person Healthcare today. That way, your Think primary doctor can determine if I’m the right fit for you, or they can refer you to other resources you can use to help you quit smoking. Get out there, exercise, explore, and use those powerful lungs of yours…because Life is for Living!