I'm with suzi on this. Those seem more like stipulations that should come from a medical doctor than a mental health therapist. But I'm new to this and still looking forward to getting the recommendation to proceed with HRT from my therapist. It puzzles me a little that you'd have to start over after once getting the recommendation. Did a lot of time lapse after you discontinued HRT?
That said, it's really in your best interest to kick the nicotine addiction. Two cans per day seems like a lot to me so the addiction is probably very strong. Stopping the Xanax may also be adding to the anxiety. And that anxiety will be there even if you use other forms of nicotine as a substitute. I have heard nicotine addiction is harder to kick than cocaine addiction.
I had to quit smoking just a few years ago. It was a matter of life or death according to my doctor. Cigarettes were my primary source of nicotine, but I had used snuff and chew. It was hard! It took a few weeks for the frequent cravings to become more occasional, and even still, I will still get the urge now and then.
Here's what worked for me. I set a date to stop and then steeled myself daily (sometimes several times per day) through meditation using the consequences (do I choose life or death?) as motivation. In preparation, I got rid of all the ashtrays, butts, etc. I armed myself with some of the nicotine gum and when the day came, I quit. For me, there were certain situations that triggered the craving. I worked to either avoid or modify those situations. For a few days, when the craving seemed overwhelming, I used a piece of gum. I didn't use the gum very often. I used my incremental success as motivation and meditated on that, "I've done it for one day, so I know I can do it for two, etc." It took a couple of weeks for the intense cravings to subside.
The last thing, I stared to leave out, but it did work for me. After quitting, I left one cigarette on the nightstand. If I was at home and the craving was strong, I'd go in the room, look at it and mentally reject it. I'd tell myself that I wasn't using those anymore. It gave me resolve, but I can see where it might be too great a temptation for another.
Best of luck with it.
-AshleyP