How to Quit Smoking (or other habits) with ACT: A Singer's Guide to Letting Urges Pass
03/07/2026
Why fighting cravings backfires, and how the acceptance approach helps you quit smoking (and anything that pulls you away from your voice and your values).
I trained in Acceptance and Commitment Training, which grew out of Acceptance and Commitment Therapy (ACT), to help the singers I work with handle performance anxiety. Along the way I found something I did not expect: the same approach gave me a way to actually help singers stop smoking, not only support them through it. This post is about how to quit smoking with ACT, written for singers and drawn from using it in my own practice.
It reaches further than smoking. The same approach works for anything that pulls you away from what matters to you and costs your voice, your breath, your health, your singing, or your performance life. You could use it to stop drinking, to put the phone down when scrolling has eaten your evening, or to step away from any habit that keeps taking you off course. I use smoking as the worked example here, partly because it is where my own story with this began. The logic underneath does not change with the habit. ACT is not really about cigarettes. It is about your relationship with an urge, and the direction you want your life and your voice to go.
A note on scope: I share this as a coach trained in Acceptance and Commitment Training, for educational purposes. It is not medical advice, and for nicotine dependence the approach combines well with support from your doctor.
For a long time, when a singer I worked with wanted to stop smoking, there was a limit to what I could offer. I could support them, and I could teach them what smoking does to the voice and the breath. That was important, but it was never the same as helping them actually stop.
The shift came through my own training and supervision with Dr Dave Juncos PsyD, clinical psychologist, music performance researcher & performance coach, who trained me in ACT and with whom I still take supervision. In one session I asked him how I could support a client who wanted to quit smoking. He pointed me to the work of Dr Jonathan Bricker, a behavioural psychologist at Fred Hutchinson Cancer Center who has spent years researching ACT for smoking cessation and has tested it in a series of randomised trials. Reading his work and putting it into practice changed what I was able to give the singers I work with, and that effectiveness is the reason I am writing this.
Why knowing the damage is rarely enough
Teaching a singer what smoking does to the voice rarely makes them stop. That is not because they do not care. It is because of how the habit is built.
A cigarette delivers fast relief. Tension in the chest eases, performance nerves settle, frustration lifts, tiredness lifts a little. That relief arrives within seconds, and the speed is what makes smoking so effective. In behavioural terms it is a negative reinforcer: the behaviour is rewarded by taking away something unpleasant. The damage to the voice, by contrast, is slower and more abstract, and in the moment a craving hits, immediate relief tends to win over a distant consequence, even a consequence a singer can hear in their own voice. This is why information on its own is a weak lever, and why ACT works on the relief cycle instead.
Why fighting a craving makes it stronger
Try this for thirty seconds. Close your eyes and do everything you can not to think about smoking. Not the taste, not the feel, not any image of a cigarette.
For a few seconds it works. Then the thought pushes back, and the harder you push against it, the louder it gets. This is the paradox at the centre of the ACT approach. Avoiding a craving, or distracting yourself from it, tends to produce more cravings and more smoking, which is the opposite of what you wanted. Fighting the urge feeds it.
Step one: the ABCs of your smoking
Before changing anything, ACT asks you to understand your own smoking. Bricker calls this learning the ABCs, a functional behavioural analysis that is a standard part of behaviour therapy. For about a week, on paper or in an app, you track three things: the triggers, the smoking itself, and what follows.
A is for antecedent, the trigger.
- Attention easily points outward, so the situational triggers are easiest to spot. For a singer they often cluster around the work: the cigarette after a rehearsal or a gig, the one with coffee or a drink, the one before walking on stage or into an audition, the social smoke outside the venue with other performers, the drive to a performance.
Then you look inward, which might be less familiar:
- The emotional triggers might be performance nerves, social anxiety, the flat feeling after a show, tiredness, or frustration with how a session went, and they can be positive too, like the high after a performance that went well.
- The physical triggers are body sensations, often a tightness in the chest, the throat, or the hands. For a singer those are the very places you depend on, and on top of that there is the physical pull of nicotine itself.
B is for behaviour.
Note when in the day you smoke.
C is for consequence.
- The immediate consequences are the engine of the habit. The tension eases, the nerves drop, the tiredness lifts, you feel a little more alert. That fast relief is what keeps the behaviour going.
- The slower consequences are the ones that affect the voice, and as a singer you may already know them. Smoking irritates and inflames your vocal folds, which shows up as hoarseness and a rougher, less reliable sound. Over time it can cause swelling of your folds known as Reinke’s oedema, which lowers and thickens your voice and sometimes needs surgery. It dries the lining of your vocal tract, raises mucus and coughing, and as lung function declines it limits your breath management and stamina, the foundation of singing. For a singer, some of these effects are felt sooner than the long-horizon risks such as cancer and heart and lung disease, and that can make them more present than they are for other smokers. Even so, Bricker’s point holds:
Knowing the cost, even hearing it in your own voice, rarely outweighs the relief of the next cigarette in the moment it is wanted.
That is the cycle the rest of this approach is built to interrupt.
The withdrawal-relief trap
You might notice something in that list. The sensations in the chest, throat, and hands appear twice, as a trigger and as something a cigarette relieves. That is not a contradiction. It is the withdrawal-relief cycle at the heart of nicotine addiction.
As the nicotine in your blood drops, withdrawal creates discomfort, the tight chest, the restless hands.
That discomfort is the trigger → you smoke → nicotine relieves the discomfort → the behaviour is reinforced → the nicotine metabolises → withdrawal returns → the next trigger arrives.
This can repeat many times a day. ACT works by teaching you to stay with those withdrawal sensations without smoking, which gives the body time to recalibrate as physical dependence fades over the following weeks.
The urge monster: drop the rope
If fighting does not work, what does? Bricker uses a metaphor he calls the urge monster. Picture a craving as a monster on the other end of a rope, with you in a tug of war against it. You pull, it pulls back harder, and the more you struggle, the bigger it grows.
The instinct is to pull harder or to hold the line. The move that works is the counterintuitive one: drop the rope. Don’t try to win the tug of war. Let go of it. This frees you to put your time and attention somewhere that matters to you (your values), rather than spending it fighting cravings by smoking. Before a performance, that can mean letting the urge be there and walking on anyway, instead of stepping out for the cigarette that used to feel necessary. More on values later in this post.
What to measure: urges passed, not cigarettes counted
ACT measures progress in a way that might surprise you. Everyone counts cigarettes. Bricker counts something else: the number of times each day you let an urge come and go without acting on it.
Cigarette reduction is important and worth tracking. Going from ten a day to six is real progress. In the first weeks, though, the measure that predicts success is not how many cigarettes you smoked. It is whether you are practising the skills, and whether your daily count of urges allowed to pass is climbing. Across a series of randomised trials, this is the mechanism Bricker’s team found doing the most work: allowing cravings, emotions, and thoughts to come and go on their own, without acting on them.
The skills: letting an urge pass
The skill of letting an urge pass is trained through simple acceptance exercises. Bricker builds his programme around a few core ones, and the point of each is the same: to help you notice a craving, an emotion, or a thought, and let it move through without acting on it. Add one at a time, roughly one a week, so each becomes familiar before the next.
Acceptance Exercise 1: Stop and Breathe
As a singer, you obviously know a lot of breathing exercises. Here, the aim is to settle and notice rather than to manage a sung phrase.
The breathing exercise in this video is not Bricker’s, and I first shared it for something else. It works well for many purposes, this one included.
Using your own Hobermann Sphere is most effective due to the 3D-effect, but watching and following the video is great too.
Click here if you want to watch this video on Instagram and save the reel.
Feel free to replace it by any breathing exercise that feels comfortable for you and helps you breathe in a mindful way.
Here are the important details, no matter which breathing exercise you choose:
- Take slow, deep breaths in through your nose (if possible and comfortable).
- Breathe out on a long Fffff/ Ssssss / Shhhh. Make sure that the outbreath is longer than the inbreath.
- Hold for a few seconds before every breath in and before every breath out.
- Notice the coolness of the air coming in and steady flow going out.
- Notice your chest or your stomach rising. Either is fine.
- If you get distracted, return to the breath and carry on.
- Practise three times a day ànd use when urges pop up.
Acceptance Exercise 2: Leaves on a Stream
This one comes from the wider ACT tradition, set out in the early ACT manuals and made well known by Russ Harris in ACT Made Simple. It trains a skill called cognitive defusion, which means stepping back from a thought or an urge so it has less hold on you.
- Sit comfortably, eyes closed or resting on a fixed point.
- Picture a gently flowing stream with leaves drifting on the surface.
- As each thought, feeling, or urge to smoke arises, place it on a leaf and let it float past. Pleasant, painful, or neutral, every one goes on a leaf.
- Do not speed the stream up or push the leaves away. Let it flow at its own pace.
- If the stream stops, keep watching. The thoughts will start again.
- If a leaf sticks, let it stay until it is ready to move. If a thought returns, watch it float by again.
- If you get caught up in a feeling such as impatience or frustration, name it, place that on a leaf too, and carry on.
If you find visualisation hard, or it does not sit well with you, an eyes-open version such as noticing and naming your thoughts works just as well. The point is to watch the urge come and go, not to picture a perfect stream.
Acceptance Exercise 3: Five Senses
A grounding exercise that brings you into the present moment through your senses, which is exactly where you can let an urge be there and pass rather than be pulled along by it. Two versions work well:
- The first is open noticing. Take a slow breath, then notice and say out loud what you can see, what you can hear, what you can feel, what you can smell, and what you can taste. One or two things for each, with attention to the detail, without judging any of it.
- The second is a count: notice and say five things you can see, four you can feel, three you can hear, two you can smell, and one you can taste.
When a craving arrives, the senses pull you out of autopilot and back into the room, where the urge has far less grip.
BREAKS: a way to remember it
Bricker gives a one-word acronym to hold the whole approach: BREAKS. It is a play on taking a smoke break, turned into something you do instead of smoking.
- B – Break
Stop and pause. - R – Read
Read what is inside. Notice what is happening in your body, a place we do not usually look. - E – Expand and exhale
Do the breathing exercise. - A – Allow
Allow everything to be as it is and accept it. You do not have to change anything. Let the craving come and go. - K – Know
Know your values, know what matters to you: your voice, your singing, the people you sing for. - S – Step
Take a step in the direction of your values.
What you are quitting toward
The S in BREAKS is committed action, and it points to the second half of the model of ACT. Acceptance and Commitment Therapy is named for two things, not one.
- The acceptance skills clear the obstacle
- The commitment is what you do with the space that opens up, guided by your values.
Acceptance is not the goal in itself. You sit with a craving in service of something, and that something is what makes the willingness last. An urge you tolerate for no reason is white-knuckling. An urge you let pass so you can keep singing the way you want to is a different thing.
This also sets the direction of the whole effort. Quitting to avoid illness points away from something, and as this post has shown, a distant fear is a weak driver in the moment a craving hits. Values point the other way. You are not only giving smoking up, you are moving toward a life and a voice you care about, and that toward is present, chosen, and yours.
Values are directions rather than destinations: not “land this one audition” but “keep growing as a singer for as long as I sing.”
I take the singers I work with through a specific process to help them figure out their values. Here are some values that might resonate with you:
- The longevity of your instrument. Your voice is the one instrument you cannot replace. Stopping protects your vocal folds and your breath so your voice is still there, and still free, in ten and twenty years.
- Your artistry. A reliable voice with its full range and stamina is what lets you do whatever the music asks of you. Caring for your instrument keeps all of it available.
- Connection with the people you sing for. Singing is communication. Breath and a free voice let you reach an audience and stay present with them, which is often the reason you sing at all.
- Being someone others can count on. A voice that does not let you down is part of how you show up for the people you sing and work with.
- Freedom on stage and off. Performing from a grounded, present nervous system rather than one you manage with nicotine, and not being run by a craving in the first place.
Naming the value is the K in BREAKS: know what matters to you. The S is acting on it in a committed way, a step in that direction, however small.
- Before your quit date, that step is the tracking and the exercises: noticing an urge and letting it pass on purpose.
- After your quit date, next to the tracking and the exercises, you add a chosen action in place of the cigarette, something that serves the value: a walk to clear your head, a message to someone you trust, spending the money on a voice class with your favorite teacher instead of cigarettes, nebulising before a show instead of smoking.
The step is not a distraction from the craving. It is the thing the craving was getting in the way of.
Before and after the quit date
The approach usually runs over six to eight weekly sessions and consists of two phases.
- For the first two to three weeks, you keep smoking at your usual rate while you do the functional analysis, learn how the relief cycle works, and build the acceptance skills thourgh the exercises. Smoking as normal in this phase takes the pressure off and lets you practise in real situations, including the ones around singing.
- The quit date tends to fall around week three or four. After it, you use the same skills, and the urges are stronger now, so the practice is more important. This is where changes to your environment and support from other people matter alongside your acceptance and commitment skills.
The one thing to remember
If you take one idea from this, let it be the one that changed my own practice:
Quitting is not winning a fight against your cravings. It is learning to let a craving come, rise, and pass, while you get on with what matters to you, your voice included.
Every part of the approach, the tracking, the breathing, the leaves on the stream, the urge monster, the BREAKS acronym, points back to that single skill.
You are not trying to make the urge disappear. You are learning that you can have it, and let it pass, without lighting a cigarette. For the singers I work with, that has been the difference between coping and quitting.
Dr. Tracy Smith Bessette - Singer, Voice Instructor, Early Music Coach & Course Lecturer
Amy Bebbington - Director of Training bij Association of British Choral Directors
Esther De Bièvre - Recovery therapist
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Frequently Asked Questions About Using ACT to Quit Smoking
What is ACT?
ACT stands for Acceptance and Commitment Therapy. Outside clinical settings the same approach is delivered as Acceptance and Commitment Training, which is how I work with singers. For smoking, it focuses on accepting cravings and acting on what you value, rather than fighting or avoiding the urge to smoke.
I am a singer. Is this different from ordinary quit-smoking advice?
The method is the same evidence-based ACT approach. What changes is the lens. We map the triggers that come with performing, look honestly at what smoking does to the voice and the breath, and work on it alongside the performance-anxiety and breath work you may already be doing as a singer.
Does knowing what smoking does to my voice help me quit?
It matters, but on its own it is rarely enough. Immediate relief tends to outweigh a slower consequence, even one you can hear in your own voice. That is why ACT works on the relief cycle rather than relying on information.
What is the main skill?
Letting urges pass. You allow a craving, emotion, or thought to come and go without smoking. Bricker found this to be the central mechanism of change in his trials.
Should I count cigarettes or something else?
Both have a place, but in the first weeks the more useful measure is how many times a day you let an urge pass without smoking. That number climbing is a stronger sign of progress than cigarette reduction on its own.
Is there evidence behind it?
Yes, from a series of randomised trials in the general population, where an ACT-based approach outperformed an avoidance-based one. There is no trial specific to singers; what I offer is that tested method applied through a singer’s lens.
RESOURCES:
- ACT for Musicians: A Guide for Using Acceptance and Commitment Training to Enhance Performance, Overcome Performance Anxiety, and Improve Well-Being, book by David G Juncos and Elvire de Paiva e Pona (2022)
- Mechanisms of Smartphone Apps for Cigarette Smoking Cessation: Results of a Serial Mediation Model From the iCanQuit Randomized Trial, Bricker JB, Levin M, Lappalainen R, Mull K, Sullivan B, Santiago-Torres M (2021)
- Efficacy of Smartphone Applications for Smoking Cessation: A Randomized Clinical Trial, Bricker JB, Watson NL, Mull KE, Sullivan BM, Heffner JL (2020)
- Dr Jonathan Bricker’s research group, Fred Hutchinson Cancer Center
CURRENT STUDIES:
- 2025-2030
Providing nicotine replacement therapy to enhance the efficacy of a smoking cessation smartphone app for Hispanic adults
Source of support: NIH/NCI
Grant type: R01CA298383
Role: Principal Investigator
Goal: To test the efficacy for providing nicotine replacement therapy to augment the efficacy of the iCanQuit smartphone app tailored to Hispanic adults. - 2024-2029
Project 1: Navigation and artificial intelligence technology for Indigenous virtual education on smoking cessation
Source of support: NIH/NIMHD
Grant type: U19MD020533
Role: Project Principal Investigator
Goal: To test the efficacy a large language model chatbot for commercial cigarette smoking cessation tailored to American Indians and Alaska Natives. - 2023-2028
Digital smoking cessation intervention for nationally-recruited American Indians and Alaska Natives: A full-scale randomized controlled trial
Source of support: NIH/NCI
Grant type: R01CA284687-01A1
Role: Principal Investigator
Goal: To test the efficacy for commercial cigarette smoking cessation of a smartphone app tailored to American Indians and Alaska Natives. - 2021-2026
Comparative Effectiveness of Mobile Health Smoking Cessation Approaches Among Underserved Patients in Primary Care
Source of support: Patient-Centered Outcomes Research Institute (PCORI)
Grant type: Dissemination and Implementation Research Grant
Role: Site Principal Investigator (PI: Jesse Dallery, PhD)
Goal: To test the efficacy for cigarette smoking cessation of the iCanQuit smartphone app combined with contingency management among underserved patients in primary care. - 2020-2026
Telephone Delivered Acceptance and Commitment Therapy for Weight Loss
Source of support: NIH/NIDDK
Grant type: R01 DK 124114
Role: Principal Investigator
Goal: To test the efficacy of Acceptance and Commitment Therapy telehealth coaching for weight loss. - 2020-2026
Quit2Heal: Rigorous Randomized Trial of a Smartphone Application to Help Cancer Patients Stop Smoking
Source of support: NIH/NIDDK
Grant Type: R01 CA 253975
Role: Principal Investigator
Goal: To test the efficacy for cigarette smoking cessation of a smartphone app for cancer patients. - 2020-2026
Full Scale Randomized Trial of an Innovative Conversational Agent for Smoking Cessation
Source of Support: NIH/NCI
Grant Type: R01 CA 247156
Role: Principal Investigator
Goal: To test the efficacy of an AI-based conversational chatbot for cigarette smoking cessation.
- 2025-2030
As always, feel free to send me your thoughts, questions, and feedback in the comments below this blog, via the contact form or in the singsing! online community 
Cordially,
Sarah