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Healthy Hot Topics!

Based on the ACHA-NCHA II survey conducted at SUNY Geneseo in the spring of 2018, 46.8% of Geneseo students noted that stress had affected their individual academic performance; in addition, 35.7% endorsed anxiety as a factor and 29.4% mentioned sleep difficulties.*

College Students & Stress

If you think your stress may be causing anxiety, panic, depression, or other related problems, check out the Counseling Services page on Common Mental Health Issues.

Stress or Overstress?

Stress is a normal part of everyday life. Too much stress, however, begins to interfere with your functioning. Stress levels tend to build over time, and chronic high levels of stress can lead to a condition called overstress. When not managed well, overstress can result in physical illness as well as anxiety and depression. 

Depression poster

Ways to Manage Stress

  • Engage in arts and crafts or other hobbies.
  • Listen to music, sing, or go dancing.
  • Practice yoga and/or meditation.
  • Try a basic breathing strategy: sitting in a comfortable position, count "one" to yourself as you exhale. The next time you exhale, count "two," and so on up to "five." Then begin a new cycle, never counting higher than "five" and counting only when you exhale. Try to do for 10 minutes.  Or, try diaphragmatic (deep) breathing--review this handout, Just BREATHE!
  • Use an app for that!  We have researched free apps that can assist with meditation, breathing, anxiety management, and other forms of de-stress such as coloring!

Utilize Health & Counseling Resources

Get More Information

  • Mindfulness/Meditation Resources:
  • College Students and Stress--Ulifeline.com offers additional information on recognizing warning signs and proactive stress management.
  • Audio Relaxation Exercises--If you are one of those people who say, "I just can't relax," click on this link now!  Hobart and William Smith Colleges offer two audio relaxation exercises; you can use them directly from their web site or download as MP3 files put on your iPod and use any time you need them.  Ithaca College offers MP3 files as well, including ones designed for both reducing stress and improving sleep.
  • Progressive Muscle Relaxation--More relaxation!  Learn how to fully relax with this 10-minute YouTube video.
College Students & Sleep

How's Your Sleep?

College students are at a high risk for not getting an adequate amount of sleep. Varying class times, demanding work schedules, and busy social lives often mean that sleep is a low priority. However, problems with insomnia and ongoing sleep deprivation have many negative repercussions:  it can contribute to memory problems and difficulty in logical reasoning, it can interrupt physiological processes related to hormone function and blood pressure, and it is associated with decreases in both efficiency and ability to concentrate.

Although getting 8 hours of sleep per night is still the general guideline, individual needs can vary from as little as 5 to as many of 10 hours of sleep necessary to feel rested and refreshed. Sleep debt can be a real problem, because it accumulates over time--i.e., a couple of "all nighters" in a week will make a serious impact. Catching extra sleep on weekends can feel like it helps to repay some of this debt, but irregular amounts of sleep can actually serve to interfere with your sleep cycle and to result in increased difficulties falling asleep, also known as insomnia.

So, what to do? Continue reading for ideas on getting a restful night's sleep.

Girl laying on a bed in the dorms

Make the most of the sleep that you DO get

  1. Modify alcohol consumption. Although alcohol can help you to fall asleep, it disrupts the sleep cycle and will leave you feeling less rested the next day.  For more assistance in this area, visit College Students & Alcohol/Other Drugs and/or our AOD pages.
  2. Decrease smoking. Large levels of nicotine in the blood result in increased agitation and decreased restful sleep. If you need help managing your smoking, visit our Hot Topics! Stopping Smoking page.
  3. Exercise regularly. Regular exercise produces a higher percentage of deep sleep as well as fewer awakenings during the night. However, don't exercise just before bedtime. For more information, visit our Hot Topics! page on Eating Well & Exercising in College.
  4. Take a look at your diet.  Make sure that you are consuming adequate amounts of B-complex vitamins, as several of the B vitamins can enhance restful sleep as well as reduce fatigue. If you are not eating a well-balanced diet, consider taking a supplement.
  5. Reduce caffeine intake.  In particular, don’t consume caffeine within 4 hours of bedtime--for most people, caffeine contributes to insomnia and disrupts sleep.
  6. Set realistic daily goals. Setting goals helps to minimize the possibility that you will stay awake thinking about what you have not accomplished that day. Perfectionists and worriers tend to have more trouble sleeping. If you need help reducing anxiety, visit our Hot Topics! page on College Students & Stress or attend one of our Healthy Bodies, Healthy Minds programs through GOLD.
  7. Establish a regular sleep schedule. Although this can be difficult for college students, as much as possible, it is important to try to go to bed and wake up at approximately the same time each day--failing to do so is like putting yourself through jet lag on a regular basis!
  8. Practice diaphragmatic (deep) breathing.  When practiced before bed, not only will deep breathing help you to feel more relaxed and to facilitate sleep, but also you are likely to obtain more restful sleep.  For specific instructions for doing this effectively, read our article on Just BREATHE!
  9. Sleeping Well in the Digital Age - This resource provides insights into the correlation between light and the brain and how it negatively impacts sleep patterns.

If you have tried all of the above and are still feeling tired all of the time, you might benefit from reading The Exhaustion Cure, a Whole Living article offering solutions to some of life's most common energy drains.

Combating Insomnia

While it is normal for college students to have occasional difficulties falling asleep, regular insomnia can cause serious problems. Symptoms of insomnia include difficulties falling asleep, waking up often during the night and having trouble going back to sleep, waking up too early in the morning, and unrefreshing sleep. Acute or short-term insomnia may not require treatment. But if your insomnia makes it hard to function during the day because you are sleepy and tired, you may want to consider making an appointment with a professional in either Health or Counseling Services.

For some basic strategies to help combat insomnia, review this handout on Getting a Good Night's Sleep. The article includes links to other web sites for more information on healthy sleep. For further information, Yoga Journal magazine has also written an excellent article titled Sweet Slumber--check it out for additional tips on learning how to relax, engaging in breathing to help you feel calm, and even practicing a few basic yoga poses to facilitate sleep.  If you need more help with relaxation, try this link for Audio Relaxation Exercises on our College Students & Stress page or try one of the various free apps available, including a guided meditation for sleep and a white noise machine.  And, if all else fails, you can always try counting sheep!

Get More Information

College Students & Relationships

Maintaining Healthy Relationships

Relationships aren’t always easy to maintain…college opens the door for all kinds of new relationship challenges such as roommate issues, casual dating, serious dating, friendships, and sex. You may also be confronted by interpersonal issues when you play on an intramural team, become involved in a student organization, or decide to join Greek life. These various relationships can provide a great deal of comfort and support during your college years, but they can also be a source of confusion and stress at times. How do you keep the lines of communication open so that you can maintain strong, honest, and respectful relationships? Review the qualities of healthy relationships below:
 

Communication--both people in the relationship need to feel free to express positive and negative feelings, complaints, and affection

Active Listening Skills Handout
  • check out misunderstandings
  • do not make assumptions about the other person's feelings or motives
  • do not assume that the other person knows how YOU feel, talk directly with the other person about your needs
Expectations--both people need to be on the same page about what they want from the relationship

Basic Communication Skills Handout
  • agree on how much time together and how you will spend that time
  • be aware of the other person's needs and interests
Conflict--in all relationships, there are times when communication breaks down; healthy relationships are able to clear up conflicts and to emerge stronger as a result

Managing Conflict, Dealing with Confrontation, & Diffusing Anger Handout
  • negotiate a time to talk about difficult topics
  • use "I" statements to express your own feelings; avoid "you" statements
  • don't overgeneralize; avoid using the terms "always" and "never"
  • use respectful language and avoid name-calling
  • listen without interruption
  • focus on one problem at a time
  • brainstorm a range of possible solutions
  • be willing to compromise
  • show appreciation for the other person's contributions
  • admit when you are wrong
Boundaries--both people need to be clear about what is okay/not okay in the relationship

Limit-Setting Skills Handout

 

  • clearly state any limits which you have for the relationship
  • say no when you are asked to do something that makes you uncomfortable
  • don't take responsibility for the other person's destructive behavior (e.g., alcohol abuse, eating disorder, suicidal gestures)
  • set limits with the other person's behavior as needed using the steps described below

Five steps to limit setting:

  1. Choose to set limits. You will tolerate a difficult relationship situation just as long as you choose to tolerate it. To change the situation, you need to be the one to choose to set boundaries in place.
  2. Identify the source of your feelings. It often takes some real soul-searching on your part to figure out the source of your anger or resentment.
  3. Decide when, where, and how to set the limits. Think about the entire situation. Consider your time, emotions, and means. Remember that setting limits is about getting your needs met.
  4. Express the limits clearly. For example, you say to your friend, "I will loan you my car once per week for two hours."
  5. Stick to your limits. You are not responsible for making the other person obey the limits. You are only responsible for following the limits yourself and for reinforcing them.

Print the handout above for more information on limit-setting.

Do you think that you might be in a relationship that is NOT healthy for you? 

Take a look at the handout "Are You in an Unhealthy Relationship?", review signs of verbal and emotional abuse in the guidelines for "Recognizing an Abusive Relationship", or visit web resources on Physical/Emotional Abuse.  Finally, find additional information on our Stalking and Dating Violence page.

Get More Information

  • The Friends and Friendships Web--This site is designed to assist with making and maintaining friendships; it covers topics such as building a friendship from casual friends and setting limits in friendships.
  • Healthy Romantic Relationships in College--This online brochure is specific to romantic relationships and contains information on building a healthy relationship, resolving conflict, and coping with outside pressures on the relationship.
  • Sexual Assault - Focus on Education (S.A.F.E.)--This section of our web site offers information, education, referrals, and resources for all types of sexual violence on the SUNY Geneseo campus.

Return to Hot Topics!

Healthy Eating/Exercising/Weight Management

Nutrition and Healthy Eating on Campus

You would like to eat better and get more exercise, but lots of things keep getting in the way: classes, studying, parties, your budget (or lack of!), fatigue, significant others, and sleep. With careful planning, you CAN find a way to eat well on campus and to add some exercise to your daily routine. Check out some of the awesome links below!

A great starting point for helpful nutrition information is the Mayo Clinic's Nutrition & Healthy Eating resource, which includes an expert blog. Also be sure to take this quiz on How's Your Diet? to get a better sense of exactly what you are eating and where you can make changes. Finally, check out how you can customize the USDA nutrition guidelines with the MyPlate Plan.

Several helpful web sites have information specific to eating well while at college, such as College Eating and Fitness 101, which offers dining hall tips and alternative food choices  Get more general nutrition information via the additional links below.

Exercising on Campus: Basic Fitness Needs

Be sure to visit our Exercise is Medicine page for more information!

Aerobic Exercise

  • Includes any type of exercise which gets the heart pumping and uses up additional oxygen (i.e., you breath faster and heavier).
  • Recent research has shown that even 5 minutes of running per day has health benefits--try jogging up and down stairs in your residence hall during a study break!
  • Interested in walking for fitness? Check out this guide on Walking and Steps from MyFitnessPal.

Strength Training

  • Strength (resistance) training can include both body weight exercises and exercises using other forms of resistance, including dumbbells, free weights, kettlebells, resistance bands, and machines.
  • Join Geneseo's Workout Center for access to equipment as well as Personal Trainers who can help you develop a program tailored to your needs.

Flexibility Training

  • Stretching should be done after your muscles have heated up.
  • Flexibility can include activities such as stretching, martial arts, ballet, yoga, and Pilates - try yoga stretches while you watch TV

Staying Active

You can participate in fitness activities on campus through Intramural Sports, the Workout Center, and recreational activities such as skating and swimming.  Try this list on the Top 5 Ways to Include Fitness in College Life (scroll down to the bottom of the page). Using exercise DVDs is another easy, inexpensive way to get started on a fitness program; check out VideoFitness.com to determine whether working out with videos is right for you.

If you already participate in regular fitness activities, test your current fitness levels via a few quick, easy tests which you can perform yourself at home.  Think you are already active?  Take this quiz on How Much Do You Sit?

Managing Your Weight

If you want to start an exercise program as a means to lose weight, take this Fit or Not? quiz to determine whether you are currently at a healthy weight. This personalized assessment tool also calculates your body mass index and helps you design a safe plan for using exercise to lose weight. In addition, the Mayo Clinic's Weight Loss Center offers strategies for successful weight loss as well as information on adding pounds for those who are underweight.  Also be sure to review resources for Health at Every Size (HAES).

Finally, take a look at this excellent brochure, College Eating & Fitness 101--it offers great eating and exercise hints, tips on dining room dilemmas, a dorm room food guide, and more!

College Students & Sexual Health

Get the Facts

"I’m in love." "You’re sexy." "Get your annual pap smear." "Do you have a condom?" "What’s an STI?" "The big O." "I need ECP ASAP!"

It’s important to take care of your sexual health just as you would any other part of you. If you are sexually active (or thinking about it)…be informed! Find out how much you really know about contraception, sexually transmitted infections (STIs), intimacy, orgasm, healthy relationships, HIV, yeast infections, abstinence, gynecological exams, masturbation...

Start by visiting the General Sexual Health Information area of our web site. These pages contain information on contraceptive options, sexually transmitted infections (STIs), men's health, and more. The Reproductive Health Center, a service provided through Livingston County, offers basic  sexual health services to both men and women on the Geneseo campus.

Get More Information

  • Sexual Assault - Focus on Education (S.A.F.E.)--This section of our web site offers information, education, referrals, and resources for all types of sexual violence on the SUNY Geneseo campus

  • Go Ask Alice--Another excellent question and answer site from Columbia University's Health Promotion Program; addresses topics such as sexual health, relationships, and sexuality.

  • Planned Parenthood--Follow the links on this page for a list of Planned Parenthood's Health Centers or for information about specific topics such as birth control, pregnancy, emergency contraception, abortion, sexually transmitted infections, and women's health.

  • The Center for Young Women's Health--This page offers specialized information about the sexual health needs of women, including a review of contraception options, guidelines for lesbian sexual health, and details about sexually transmitted diseases and infections.

  • Transgender Sexual Health Guide--The Apicha Community Health Center provides information on practicing safe sex, talking with a partner, and more.

For more information on rape/sexual assault, visit the Counseling Services page on Common Mental Health Issues.

Alcohol and Other Drugs

Get the Facts

Now that you are in college, you’ve got the freedom to make your own decisions about your life. That includes how much (if ever) and how often you drink, smoke or take drugs. But before you start partying every night, take a look at some of the links below and make sure you know all the facts about alcohol, tobacco, and other drugs. Are you good to go?

Here are some hints for maintaining a moderate blood alcohol concentration (adapted from How Alcohol Affects Us):

  • Educate yourself. The contents of a 12 oz. beer, 5 oz. glass of wine, or shot of liquor each contain virtually identical amounts of pure alcohol. When it comes to alcohol, a drink is a drink is a drink and are they all the same to a breathalyzer. For more, visit Standard Drinks.
  • Know your limit. Most people find that they can consume one drink per hour without any ill effects. Also, experiment with this FUN and informative "Drink Wheel."
  • Eat food while you drink. Food, especially high protein food such as meat and cheese will help slow the absorption of alcohol into your body.
  • Sip your drink. If you gulp a drink, you also lose the pleasure of savoring its flavors and aromas.
  • Accept a drink only when you really want one. If someone tries to force a drink on you, ask for a non-alcoholic beverage instead. If that doesn't work, "lose" your drink by setting it down somewhere and leaving it.
  • Skip a drink now and then. Having a non-alcoholic drink between alcoholic ones will help keep your blood alcohol content level down, as does spacing out your alcoholic drinks
  • Limit consumption of alcohol beverages to one drink (as defined above) per hour, a general guideline which works well for most.
  • Keep active; don't just sit around and drink. If you stay active you tend to drink less and to be more aware of any effects alcohol may be having on you.
  • Beware of unfamiliar drinks. Some mixed drinks can be deceiving as the alcohol content is not detectable. Therefore, it is difficult to space them properly.
  • Use alcohol carefully in connection with pharmaceuticals. Ask your physician or pharmacist about any precautions or prohibitions and follow any advice received.
  • Avoid "chugging" contests or other drinking games.

Where can you learn more?

Take a free BASICS screening for personalized information about your alcohol or marijuana usage patterns; your results are  completely confidential. You can also obtain individual BAL (blood alcohol level) information given your gender and weight using this Blood Alcohol Chart.

Thinking about making changes to your own use patterns?  Talk it over with our Alcohol & Other Drug Program (AOD) Counselor, Sarah Covell. Make an appointment with Sarah by calling 585-245-5716 (on Thursdays you can visit with Sophie!).

Don't drink alcohol but still want great refreshment? Check out webtender.com awesome selection of non-alcoholic mixed drinks.

Quitting Smoking

How to Quit | Quitting Tips | Online Quitting Resources | More Information

How to Quit

We know that you already know all the reasons why you should quit smoking, but do you have any idea how to go about doing it? There is no right or wrong way for quitting smoking, but there are four main steps which will increase your chances of success:

  1. Making the decision to quit
  2. Setting a quit date and choosing a quit plan
  3. Dealing with withdrawal
  4. Staying quit (maintenance)

Making the Decision to Quit

The decision to quit smoking is one that only you can make. The Stages of Change Model identifies the stages that a person goes through in making a change in behavior. Here are the stages as they apply to quitting smoking:

Pre-contemplation: This stage includes smokers who are not thinking seriously about quitting right now. If this is you, check out WebMD's answers to the question Why Quit?

Contemplation: In this stage, the smoker is actively thinking about quitting but is not quite ready to make a serious attempt. This person may say, "Yes, I'm ready to quit, but the stress of school is too much/I don't want to gain weight/I'm not sure if I can do it."

Preparation: Smokers in the preparation stage seriously intend to quit in the next month and often have tried to quit in the past 12 months. They usually have a plan. Action This is the first 6 months when the smoker is actively quitting.

Maintenance: This is the period of 6 months to 5 years after quitting when the ex-smoker is aware of the danger of relapse and take steps to avoid it.

Setting a Quit Date and Choosing a Quit Plan

Here are some strategies to try as you prepare yourself to quit:

  1. Keep a smoking diary.
  2. Learn from your smoking habits:
  3. Cut out the cigarettes that you do not feel a strong need to smoke (e.g., eliminate your two "least needed" cigarettes each day).
  4. Take fewer puffs each time you smoke--one way to do this is to smoke only half of each cigarette.
  5. When you feel like smoking, try chewing gum.
  6. If you have tried to quit in the past, review what happened and LEARN from your past attempt(s).
  7. Find a "Stop Smoking Buddy" who can help.
  8. Set a quit date.

Selecting a quit date is a very important step! Choose a specific day within the next month as your Quit Day--picking a date too far in the future allows you time to rationalize and change your mind, but do give yourself enough time to prepare and come up with a plan. Once you decide on a date, circle it in your planner and make a strong, personal commitment to quit on that day.

Your next step is to choose a quit plan. There is no right way to quit smoking, but there are two main approaches: cold turkey or gradual withdrawal.

Cold Turkey: Going cold turkey means stopping abruptly and totally. To quit cold turkey, you can either smoke as usual until your quit day and then stop all at once or you can smoke fewer cigarettes for a week or two before your quit day.

Gradual Withdrawal: Gradual withdrawal involves cutting down on the number of cigarettes smoked each day. For example, you might cut out cigarettes smoked after meals, or you might decide to smoke only at certain times of the day. You can also taper down by cutting out 1-2 cigarettes per day until your quit day.

Dealing with Withdrawal

Withdrawal from nicotine has two parts, the physical and the psychological. The physical symptoms, while annoying, are not life threatening. Nicotine replacement can help reduce many of these physical symptoms. But most smokers find that the bigger challenge is the psychological part of quitting.

If you have been smoking for any length of time, smoking has become linked with nearly everything you do--waking up in the morning, eating, reading, watching TV, drinking coffee, etc.--and thus it will take time to "unlink" smoking from these activities. One way to overcome these urges or cravings is to identify rationalizations as they come up. A rationalization is a mistaken belief that seems to make sense at the time but is not based on facts. If you have tried to quit before, you will probably recognize many of these common rationalizations.

  • How bad is smoking, really? Uncle Harry smoked all his life and he lived to be over 90. Air pollution is probably just as bad. (Do you really think so? Go back to Why Quit? for more information about the negative effects of smoking.)
  • You've got to die of something. (So why not go out into traffic and play chicken?)
  • I'll just have one to get through this rough spot. (Does a smoker ever stop with just one?)
  • Today is not a good day; I'll quit tomorrow. (We've heard that one before.)
  • It's my only vice. (Does that make it okay?)
  • Life is no fun without smoking. (Oh, come on!)

You probably can add more to the list. As you go through the first few days without smoking, write down any rationalizations as they come up and recognize them for what they are: messages that can trap you into going back to smoking. Use the Quitting Tips section below to help you keep your commitment to quitting.

Staying Quit

You can use the same methods to stay quit as you did to help you through withdrawal. Think ahead to those times when you may be tempted to smoke, and plan on how you will use alternatives and activities to cope with these situations. More dangerous, perhaps, are the unexpected strong desires to smoke that occur, sometimes months (or even years) after you've quit. To get through these without relapse, try the following:

  • Utilize the Quitting Tips below.
  • Remind yourself that there is no such thing as just one cigarette or even just one puff.
  • Ride out the desire to smoke; it will go away!

What if you do smoke? Don't despair--one cigarette is not a relapse! The difference between a slip and a relapse is within your control. You can use the slip as an excuse to go back to smoking, OR, you can look at what went wrong and renew your commitment to staying off smoking for good.

 

Quitting Tips 

Below are some tips to help you stick with your commitment to quit smoking.

  • Get rid of all your cigarettes as well as your ashtrays and lighters.
  • Put up a "NO SMOKING" sign in your room or suite.
  • Enroll in a smoking cessation program such as the one offered by the Livingston County Department of Health (call 243-7524 for more information).
  • Stop by Health Services to pick up a "Quit Kit" from the Health & Counseling Self-Care Center or make an appointment to speak with a provider about whether nicotine replacement or other prescription medications (such as Zyban) might help.
  • Utilize Online Quitting Resources.
  • Let your friends, family, professors and others know that you are quitting and ask for their help.
  • Call your "Stop Smoking Buddy" when you have the urge to smoke.
  • Reduce the urge to smoke by...
  • Trying the 4 D's:
  • take DEEP breaths
  • DRINK plenty of water
  • DO something else
  • DELAY until the urge passes
  • Keeping yourself busy
  • Exercising regularly
  • Chewing sugarless gum
  • Nibbling on low-calorie items such as apples and sugarless candy
  • Avoid smoke-filled settings and situations in which you are more likely to smoke (e.g., drinking with friends).
  • Increase your time in places where you can't smoke (e.g., campus buildings such as the library, restaurants, etc.).
  • Make some new, nonsmoking friends.
  • Are you also struggling with anxiety, depression, or other mental health issues?  Read more about Tobacco Use and Mental Health.
  • Make a list of activities to do instead of smoking, including what you will do when you are stressed. For more information about stress management, visit our College Students & Stress page.
  • Do something new! Try an intramural sport, join a student activities group, or take up a favorite hobby from when you were a kid.
  • Remind yourself of the reasons Why Quit?
  • Each week, deposit the money you would have spent on cigarettes in a special "bank." Use your special "bank" money to buy yourself a special treat for each week or month you go without smoking.
  • Plan a big celebration your six-month anniversary of being a nonsmoker--you deserve it!

More than two-thirds of all college graduates who have ever smoked have now quit--you can too! Say to yourself: I can be a NON-SMOKER.

Online Quitting Resources

  • A panel of Geneseo students chose the following web sites as the best quitting resources for college students:
  • NYS Smoker's Quitline Also has a toll-free number, 1-888-609-6292.
  • Quit Smoking Journals.com Huge grassroots site providing support from others in all stages of quitting.    
  • Quit Now Offers expert advice, motivational emails, free postcards and other downloads, and a "Quit Wizard."
  • WhyQuit.com Joining Freedom from Tobacco provides additional resources, including an online support group.
  • The Great American Smokeout Resources for quitting on the day of the annual Great American Smokeout, held on the third Thursday of November each year.    

Get More Information

How to Quit

We know that you already know all the reasons why you should quit smoking, but do you have any idea how to go about doing it? There is no right or wrong way for quitting smoking, but there are four main steps which will increase your chances of success:

  1. Making the decision to quit
  2. Setting a quit date and choosing a quit plan
  3. Dealing with withdrawal
  4. Staying quit (maintenance)

Making the Decision to Quit

The decision to quit smoking is one that only you can make. The Stages of Change Model identifies the stages that a person goes through in making a change in behavior. Here are the stages as they apply to quitting smoking:

Pre-contemplation

This stage includes smokers who are not thinking seriously about quitting right now. If this is you, check out WebMD's answers to the question Why Quit?

Contemplation

In this stage, the smoker is actively thinking about quitting but is not quite ready to make a serious attempt. This person may say, "Yes, I'm ready to quit, but the stress of school is too much/I don't want to gain weight/I'm not sure if I can do it."

Preparation

Smokers in the preparation stage seriously intend to quit in the next month and often have tried to quit in the past 12 months. They usually have a plan.
Action This is the first 6 months when the smoker is actively quitting.

Maintenance

This is the period of 6 months to 5 years after quitting when the ex-smoker is aware of the danger of relapse and take steps to avoid it.

No smoking sign

 

 

*Item ratings were based on the past 12 months.