Today, a little over one year after completing Hazelden's Your Next Step tobacco recovery program, Kim says that cigarettes--and that old level of fear--have vanished from her life.

As an AA member, Kim worked the Twelve Steps. But she smoked for years without considering it an addiction on par with alcohol and other drug dependence.

Kim cycled through a number of strategies to quit smoking on her own: Cutting back. Going cold turkey. Using nicotine gum and lozenges. She even had a six-month period of freedom from tobacco--followed by a relapse that lasted nearly a decade.

"I think I realized my addiction when I started waking up every single morning wishing I hadn't smoked the day before, then going straight down to my smokes and lighting up another one, like I had no choice," Kim says.

Desperate to quit, she signed up for Your Next Step. There, in a seven-day respite from her life as a teacher and mother, she stopped using nicotine.

About Your Next Step
Hazelden has offered Your Next Step since 1990 as an intensive tobacco recovery program in which clients stay on campus. Based on the Twelve Steps, Your Next Step includes individual counseling, motivational lectures, and group discussions led by counselors who are recovering tobacco users themselves. The program also offers massage, acupuncture, yoga, and information on nutrition and fitness as tools for living tobacco-free.

Success rates for this multidisciplinary approach compare favorably with other programs that treat nicotine dependence. One year after completing Your Next Step, 38 percent of graduates are still tobacco-free.

Kim values Your Next Step's emphasis on the addictive power of nicotine. This aspect of the program is grounded in Steps One, Two, and Three of AA--admitting powerlessness over the drug and relying on a Higher Power for daily help in remaining abstinent.

"I just think that people really underestimate the drug and how much we can depend on it on many levels," she says. "Time and time again you'll have people passionately argue that nicotine is not the same as alcohol. And yet if I don't treat nicotine addiction the same way I would treat another addiction, my experience has been that I'll never be successful in any long-term recovery."

Living nicotine-free
Asked to describe how her life has changed after returning home from Your Next Step, Kim speaks first about children.

"I have five kids, and now I am so much more attentive to their needs," Kim says. "I can really sit down, spend time with them, and be physically close and affectionate, especially with my toddler.

"I'm also a teacher, so my image in the community is very important for role modeling," Kim adds. "If they see me with a cigarette in my hand, the message is that smoking is cool. That's always been very difficult for me."

In addition, nicotine recovery has removed a painful contradiction in her self-image: "I've always felt it's sort of silly to act like you care so much about your health when you're trying to get better by recovering from alcoholism--and then killing yourself at the same time with cigarettes. I try not to judge others who smoke, because I know they're addicted. But for me, I feel so much better about myself. And that in turn makes it easier to be sober. It's like coming full circle."

A matter-of-fact approach to relapse
Kim admits that she smoked on two occasions since graduating from Your Next Step--incidents that involved a total of three cigarettes. She dealt with this fact by applying something that she learned in Your Next Step.

"My attitude is to not sit in shame, but to be open and honest with others about the moment of weakness," Kim says. "I watched how the people at Your Next Step dealt with a woman in our group who slipped while there. There was no shaming. There was just, ‘What are you going to do about it?'"

Kim's experience underscores what addiction researchers report: Relapse is one feature of addiction as a chronic disease. And, relapse does not have to be seen as an end state. Rather, when skillfully managed, it is part of the way that recovery unfolds for people on the way to long-term sobriety.

Barry McMillen, supervisor of Nicotine Dependency Treatment Services at Hazelden, agrees with Kim's no-shame, no-blame attitude. However, he stays away from the word slip.

"A slip is an accident, but smoking a cigarette is a very focused decision and behavior," says McMillen. "Slip is a nice way of trying to wiggle out of responsibility for it. You've got to call it what it is--a relapse."

Your Next Step includes a lecture about how relapse happens and what to do about it. "It's the same basic procedure for any person in recovery from any substance," McMillen says. "If you used, call your sponsor. Call another recovering person. Get back into your program. Don't let the guilt and shame drive you back further into use."

Gaining support at home
When she attended Your Next Step, Kim was the only participant with a spouse who smoked. Earlier this year, her husband made a commitment to change that situation by enrolling in Your Next Step himself.

"We both feel strongly that this is a rare and highly successful option for us," says Kim. "Other programs and medications have failed us and so many of our friends. Your Next Step seems to work just as well as AA works for millions of others with alcohol and chemical addictions."

Hazelden offers a range of services to promote nicotine recovery, including an array of voluntary options to quit for people who enter treatment at Hazelden for alcohol and other drug addiction. For the remainder of 2005, Your Next Step programs will be held Sept. 18-25, Oct. 30-Nov. 6, and Dec. 4-11. In addition, Your Next Step will be offered for the first time as an outpatient program Oct. 3-27 (see accompanying article).

For more information about these programs and a schedule of events for 2006, call 1-877-685-1414 or send an email to info@hazelden.org.

--By Doug Toft

Published in The Voice - Summer 2005