When you've had one

I hope you won't need this chapter, but plenty of people do, and it's better read in advance.

Suppose it's the third week. It's been going well. Then there's a bad day, or a good night out, and a cigarette is in your hand and then it's smoked. The thought that follows is nearly always the same. You've blown it. Three weeks are wasted, you're a smoker again, so you may as well buy a pack.

That thought does more damage than the cigarette. One cigarette is a small dose of nicotine that your body will clear by tomorrow. Buying a pack on the strength of it means twenty more, and that's how a slip becomes a return to smoking. The NHS puts it kindly. It says relapse happens to lots of people and that the most important thing is to try again. I'd add that you don't need to try again from scratch, because you aren't back at the start.

Think about what three weeks bought you. Your brain has done most of its adjusting to life without nicotine. You've had twenty first coffees without a cigarette and the pairing is half worn out. You know what day three feels like and that it ends. One cigarette doesn't erase that, unless you decide it has.

So here's what I'd do, in order.

Stop at the one. Put it out, even half smoked. If you bought a pack, throw it away, and don't keep the rest for emergencies. It feels wasteful, but it costs far less than smoking the rest would.

Notice what it was like. This is useful information you can only get this way. From the mechanism, I'd expect the lapse cigarette to be a disappointment. After three weeks away it's likely to taste harsh and make you light-headed, and it won't fix whatever was wrong. Then, an hour or so later, I'd expect a pull towards another, stronger than anything you'd felt for a week. That's the mechanism of this whole book happening in front of you. The cigarette set up a need and then offered to relieve it. If that's how it goes for you, you've just confirmed the central claim with your own body.

Work out what happened, without putting yourself on trial. Where were you, who with, what had you been drinking, how were you feeling? The study in chapter 8 found the same few ingredients again and again, which were low mood, cigarettes within reach, other smokers and a place where smoking was allowed. Find which of those applied and change the plan. It may need a new when-then line, or a different arrangement for Friday nights, or a call to your adviser to adjust the product or the dose.

Carry on the same day. Waiting for Monday or the first of the month only gives the habit time to settle back in. You stopped three weeks ago and had one cigarette on a Thursday. That's the accurate account of what happened, and it's much easier to live with than "I failed".

I'd also let go of counting days as a streak. A streak makes one cigarette catastrophic, because it resets you to zero, and someone at zero has nothing to lose. It's more useful to count how many of the last thirty days were smoke-free. If the answer is twenty-nine, it's obvious you should keep going.

If you do slide back into regular smoking, which happens to a great many people on the way to stopping for good, the same attitude applies on a longer scale. You've learned where your plan was thin. The belief you took apart in the earlier chapters doesn't put itself back together just because you've smoked. When you're ready, set another day, and get more help than you had last time. That doesn't mean less of your own effort.

Some things are reasons to talk to a professional. Trying harder isn't the answer to any of them.

• Your mood stays low or anxious for more than a few weeks after stopping, or gets worse instead of better.
• You have a mental health condition and notice your symptoms changing, in either direction, after you stop. Medicine doses may need adjusting.
• You get side effects from a stop smoking medicine that worry you.
• You've made several serious attempts with help and none has held. A specialist adviser can offer combinations and approaches that a pharmacy visit won't.
• You have thoughts of harming yourself. That needs urgent help the same day, from your GP, NHS 111 or an emergency department, whatever else is going on.