Saturday, March 19, 2022

The Importance of Routine

woman face with rows of clocks

Imagine if you have the freedom to wake up to a completely unstructured day, free from all constraints of time. To do whatever you want whenever you want all day long. This may sound like a dream; but try it for a few days and you will soon feel listless, dissatisfied and directionless. The feeling that life is passing you by and you have no control over it will overwhelm you, and you will long for the comfort of routine. 

Such is the power of routine and structure in our lives! It anchors us to our lives, gives it meaning and purpose. It is, undeniably, one of the most important aspects of our physical and mental well-being. As exciting as an unplanned day may appear, it can be very harmful for mental health and can exacerbate feelings of anxiety and distress.

Our lives involve constant interactions with our social and physical environment – at home, at work, in the neighbourhood and in the wider world around us. We have little or no control over most of these aspects of our lives and we know not when the unexpected may happen; therefore, it gives us a great sense of stability to have some things under our control. 

In a changing world, it is reassuring to realise that some things will be constant - the alarm that wakes us at a particular time, the morning cup of coffee, our daily walk, meals at particular times, getting dressed and reporting for work. This morning routine calms and prepares us for the day ahead and helps us cope during a crisis. 

The sense of normalcy that routine brings reduces stress and anxiety, which benefits us both physically and mentally, regulates the biological clock and enables better sleep; setting in a cycle of wellness and regularity.

Without structure, there is little motivation. Having a definite structure to the day also improves productivity and our sense of self-efficacy. By completing the routine tasks and chores which must be done, we get a sense of achievement, free ourselves of the nagging worry that incomplete tasks and procrastination inevitably bring and lets us focus on the more challenging tasks of the day.

How to start a routine

  • Keep it simple. 
  • Start with a sleep schedule. Go to bed and get up at the same time every day. The very act of getting up and changing into fresh clothes can set us to feel refreshed and motivated. 
  • Build in the essentials – the things that must be done. This includes daily activities – such as meals, exercise, bath; and weekly chores such as buying groceries, laundry, house cleaning etc. 
  • Do daily activities at the same time every day. Choose a time that works for you. If you are rushed in the mornings, schedule your exercise and bath for the evening.
  • Always include some activities you enjoy – gardening, reading before bedtime, talking to friends or watching your favourite serial. 
  • Remember not to keep your schedule too rigid. Allow for flexibility when the situation demands.
  • Don’t be disheartened if you falter. According to one study, it took a minimum of 66 days to form a single new habit! 
  • Reward yourself when you stick to a schedule.

  2. The Importance of Keeping a Routine During Stressful Times (


Saturday, June 4, 2011

Quit Smoking for World No Tobacco Day (31-May)

Fagerstrom test for nicotine dependence
Fagerstrom Test for Nicotine Dependence

Quitting tobacco is the most important thing you can do to protect your health


Quitting by willpower only

40% of smokers try to quit each year. The success rate of those who quit on their own is about 5% and with self-help books it is about 10%. Most smokers make 5-10 attempts to quit. Unsuccessful attempts to quit are a sign of nicotine dependence.
85% of current daily smokers are nicotine dependent

Signs of nicotine dependence

  1. Tolerance - Increasing the number of cigarettes smoked per day (Most smokers escalate to a pack)
  2. Withdrawal - Mood changes, irritation, anxiety, insomnia, restlessness when unable to smoke
  3. Loss of control - Most smokers do not intend to continue, but 5 years later 70% do
  4. Increased time spent using the drug - Leaving office/ work-site to smoke
  5. Continued use despite harm - cough, hypertension, heart disease
  6. Giving up important activities - air travel

Are you nicotine dependent?

Take the Fagerstrom Test
You can quantify the extent of your dependence by adding your points scored for each question.
  • 7-10 points - high level of addiction
  • 4-6 points - medium level of addiction
  • 0-3 points - low level of addiction

Why does nicotine produce a severe dependence?

  • Nicotine has direct effects on concentration and mood
  • Nicotine reaches brain in seconds → a rapid effect
  • Allows user to titrate the dose by varying puff frequency and depth
  • The habit is Intense (>200 puffs/day x 20 years)
  • There are many environmental cues (eg, others smoking/ ads)
  • Never impairs the user via intoxication

How do I quit?

Make a START

Set a quit date-today! Choose a birthday, wedding anniversary, New Year’s Day
Tell family, friends and co-workers – Enlist their support
Anticipate challenges- Withdrawal symptoms and craving will occur. Tell yourself that you can face the challenges ahead. Behavioural techniques will help you through this phase.
Remove cigarettes and all related products-lighters, matches, ashtrays from your home and workplace
Talk to your doctor – Medication, Behaviour therapy and Nicotine Replacement Therapy are the mainstay of treatment. Your doctor will help you decide what suits you.

After quitting

The habit is still latent after you have quit tobacco smoking. Some vigilance is required to stay quit. However, the longer you stay quit the easier it becomes. Some of the things you could do to reduce the chances of a relapse are as below

Watch out for the triggers

  • Habit situations (things you used to do while smoking)
  • Stress / -ve moods
  • +ve moods/ celebrations
  • Alcohol
  • Use coping skills to beat the urge and handle craving

Avoid smoking at all costs

  • If you do slip
  • Can I have just one cigarette?
  • You must do everything you can to avoid that first cigarette

9 out of 10 people who have that one cigarette after quitting return to regular smoking.

Enjoy the rewards of quitting!

  • Within 20 minutes Heart rate slows towards normal
  • 8 hours Carbon monoxide levels drop to normal
  • 2 weeks-3months Heart attack risk lessens, lung function improves
  • 1-9mths Coughing and breathlessness reduce
  • 1 year - Heart disease risk ½ of chronic smokers
  • 5-15 years - Stroke risk = non-smokers
  • 10 years - Risk of death due to lung cancer same as that of non-smoker
  • 15 years - Coronary heart disease risk same as that of non-smoker


  1. Agency for Healthcare Research and Quality
  2. Centers for Disease Control and Prevention
  3. Heatherton T, Kozlowski L, Frecker R, Fagerström K: The Fagerström test for nicotine dependence: A revision of the Fagerström tolerance questionnaire. British J Adict 1991, 86:1119-27.