Lesson 6: Stimulus Control and Cues

Remember, some physical activity is better than none! Try to avoid situations that tempt you to be inactive.  Plan ahead to anticipate your usual “couch potato” times and substitute doing something more active.

• Avoid triggers to be inactive
  • To prevent becoming so tired you don’t feel like being active, try to exercise first thing in the morning.  Also, make sure you get the recommended 7 or more hours of sleep per night, so you are well-rested.  
  • Store the television remote control in a place that’s inconvenient to reach, so you won’t be able to turn on the television easily, without effort 
  • Leave your smartphone by the door when you come home, so you won’t be tempted to use it for games and social media 
  • Remove the cushions from the couch so it won’t be so comfortable to sit there and watch tv
• Alter triggers to be inactive
  • If you feel too tired to be active, try to go to bed 30-60 minutes earlier and wake up 30 minutes earlier to get some activity in. 
  • Ask a friend, coworker, or family member to call you to remind you to be active  
  • Set up a regular “activity date” with a friend or family member. 
  • Try exercising at different times of the day to see what works best for your body.  
  • Lay out your clothes for your workout the day before or put your workout clothes on first thing in the morning.  
  • Keep your gym shoes by your front door to remind yourself to be active.  
  • Schedule your exercise sessions on your calendar and treat them like any other appointment. 
  • Set an alarm on your phone for when you want to get up and move more.
• Substitute new behaviors as an alternative to being inactive
  • Get up and walk in place or do bodyweight exercises while watching TV or during commercial breaks or for 5-10 minutes between episodes of streaming TV shows  
  • If you can, limit piling things at the bottom of the stairs. Climb the stairs each time something needs to be taken upstairs.

Take a 5-minute walk every hour, if you are sitting for long periods of time. Get an exercise accountability buddy or an “accountabuddy.”

• Avoid triggers to overeat an unhealthful diet
  • Try to avoid shopping when you’re hungry or stressed. Instead, …. 
  • Make a shopping list ahead of time. Stick to the list! Avoid sections in the store that have high-calorie, non-nutritious foods that are tempting to you, if possible. 
  • Pack the same healthy lunch or breakfast each day.  
  • Don’t stock foods that create temptation for you. If ice cream is too tempting, then don’t keep it in your house. 
  • If you can, create some distance between you and places that have a bunch of unhealthy food options. For example, if a bakery is on the corner of your street or in your neighborhood, can you enter your neighborhood another way or drive down and circle the block to get to your home? If you pass fast food on your way home, maybe take a new route!
• Alter triggers to eat foods with too many calories and too few nutrients
  • Determine the probable cause of food cravings. Were you hungry when the craving occurred? Was it associated with any emotion? Instead of eating, try stress management skills.
  • When it’s appropriate, be the first to order when you eat out at a restaurant.  That way you won’t be influenced by other people’s orders.
• Substitute healthier high-fiber, low-calorie options
  • Bring low-fat/low-calorie foods to share when you go to a dinner party. 
  • If someone offers you unhealthy food, suggest something they can do to help you
    • Example: “No, thanks. But I’d love a glass of ice water.”
      
  • Leave fruit out on the counter as an easy snack to grab 
  • Ask grocery store managers to order low-fat/calorie foods if you can’t find what you want. Only use food coupons for low-fat/calorie foods. 

Knowing what your smoking cues are will help you to avoid what you can and cope with what you can’t avoid. High-risk situations make you vulnerable to smoking a cigarette. To prevent that risk from becoming a reality, it is important to find ways to manage the cues that tempt you to smoke. So, the first step is to identify your cues and then determine ways to manage them so the temptation or urge to smoke doesn’t turn into actual smoking behavior. It is important to anticipate when tough situations are likely to occur and have a plan for how you will not smoke in those situations. Three strategies can help you not smoke in high-risk situations:

• Avoid trigger situations
  • If you can, distance yourself from the situations, people, or places that remind you of smoking.
  • Try to avoid places where individuals gather to smoke. If drinking alcohol or coffee reminds you of smoking, try to temporarily avoid social situations with alcohol and leave the table after dinner instead of lingering over coffee.
• Alter trigger situations
  • Distract yourself from thinking about smoking by getting involved in an activity that requires concentration, like a recreational sport, in-person book club, or a walking group, and is not compatible with holding a cigarette.
  • If your friends are other individuals who smoke, let them know that seeing them may trigger you to return to an unhealthy habit. Explain why you’ll need to stay away for a while, and, when you resume contact, ask them to join you in being smoke-free when you’re together.
  • Talk to your oncologist about smoking cessation medications. If you decide to use an over-the-counter nicotine replacement product, such as nicotine lozenges or nicotine gums, plan to use them when you would typically have a cigarette. For example, if you often have a cigarette right after a meal, plan to use the lozenge or gum as soon as you are finished eating. Using nicotine replacement can also be a helpful substitute strategy.
• Substitute something in place of cigarettes
  • Try chewing carrots, pickles, apples, celery, or sugarless gum.
  • Keeping your mouth busy interferes with the ability to smoke a cigarette. Replace the old cue with a new cue that helps you lead a healthier life!
  • Relaxation techniques like deep breathing rather than a cigarette in stressful situations
  • Changing your thoughts — “I’m doing great — I can do without this cigarette,” “One cigarette can hurt,” or “This feeling is a signal — I need to use a coping technique now.”  Be prepared to challenge “permission-giving thoughts” with counter thoughts.