SilkQuit

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Why is quitting smoking so difficult?

You have probably quit smoking (or using tobacco in another form) before, and you have probably gone back to the habit. Whether your "smobriety" (to use a term from the addiction recovery program Nicotine Anonymous) lasted an hour or a year, you no doubt learned a basic truth: breaking away from tobacco products can be, at best, unpleasant, and at worst, a living hell. And the memory of that unpleasant experience may have left you with a fear of trying again.

Understanding the source of your physical and emotion reactions can help get you through those difficult early days. Quitting smoking will be one of the hardest things that you will ever do. This is because smoking is actually a three-fold problem: you have developed psychological, social, and physical needs for the drug nicotine.

As a smoker, all your emotions were medicated with a nicotine packed cigarette: you relaxed with nicotine; you laughed with nicotine, wept with nicotine, digested with nicotine. You used smoking to pass the time, ready yourself for a crisis, calm yourself after one, even (ironically) to catch your breath during a difficult task. You began your day by dosing with nicotine, your drug of choice (perhaps one among others), and ended it the same way. No wonder that, suddenly deprived of all that, your mind and body go wonky for a little while.

Nicotine attaches itself to you physically. From the American Heart Association:

Nicotine Addiction

When a person smokes a cigarette, the body responds immediately to the chemical nicotine in the smoke. Nicotine causes a short-term increase in blood pressure, heart rate, and the flow of blood from the heart. It also causes the arteries to narrow. Carbon monoxide reduces the amount of oxygen the blood can carry. This, combined with the effects produced by nicotine, creates an imbalance in the demand for oxygen by the cells and the amount of oxygen the blood is able to supply. Smoking further increases the amount of fatty acids, glucose, and various hormones in the blood. There are several ways that cigarette smoking may increase the risk of developing hardening of the arteries and heart attacks. First, carbon monoxide may damage the inner walls of the arteries that encourages the buildup of fat on these walls. Over time, this causes the vessels to narrow and harden.

Nicotine may also contribute to this process. Smoking also causes several changes in the blood. They include increased adhesiveness and clustering of platelets in the blood, shortened platelet survival, decreased clotting time, and increased thickness of the blood. These effects can lead to a heart attack.

The 1988 Surgeon General's Report, 'Nicotine Addiction,' concluded that:

  • Cigarettes and other forms of tobacco are addicting.
  • Nicotine is the drug that causes addiction.
  • Pharmacologic and behavioral characteristics that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.

For additional information on this subject, contact your local American Heart Association office or call 1-800-242-8721.

The social attraction of smoking is perhaps the most insidious prong of the nicotine addiction. Until recently, even after the dangers of smoking were well known, smoking was widely seen as essentially harmless; though this opinion is now held by fewer people (and I'll wager that most of them are still smoking), it has not disappeared. We still often hear smoking defended with the argument that the sale, purchase, promotion and use of tobacco products are legal activities nearly everywhere in the world.

While true, this statement obscures the question of the safety of smoking and fails to raise other explanations for its legitimate status, such as the financial contribution which the tobacco industry makes to the world economy.

And, greater public awareness of the harm that smoking does has not greatly altered its image as sexy, cool, adult, fashionable. Books such as Christopher Buckley's Thank You For Smoking and movies like Reality Bites (where the sole non-smoker is Ben Stiller's dorky outsider character) override those public service announcements and notices on the sides of cigarette packages in the minds of the tobacco industry's most important consumers: adolescents and teens. (Incidentally, we have it from a very reliable source that the people who make a certain brand of popular cigarettes featuring a certain dromedary on the package paid for the actors in Reality Bites to smoke their cigarettes. And for more proof of this common industry practice, here's an interesting letter

(from one of America's top action stars.) Give it a minute's thought: do you really like smoking, or do you just like your smoker image and the props associated with it (the cigarette, the nifty smoke rings, the ash; the holes in your clothing, yellow stains on your teeth, nasty taste on your breath)?

The minute you quit smoking your life changes drastically. Your identity as a smoker is gone; the crutch which helped you handle situations is kicked out from under you; your body and mind begin to play quite clever tricks on you to get their drug. All these changes can be nearly overwhelming, but the important thing to remember is that things will get better as you learn new and better ways to live your life. And everyone can learn; a few hundred of us at AS3 alone will testify to that!

(Paraphrased from 'The Cigarette Papers' by Dr. Stanton Glantz)

According to researchers, nicotine stimulates the Hypothalmus to produce the same chemicals it does in stressful situations: corticosteroids. This makes one feel less anxious, and yet possibly more focused. Add nicotine to a stressful stiatuion, and you get more than a regular dose.

Over time (and number of cigarettes), the hypothalmus adjusts. Now, "without" a cigarette, you're getting less than average corticosteroids, but smoking brings you back up to a normal level, maybe not even surpassing what a non-smoker gets, but compared to a lowered baseline it feels good.

After quitting, over time the hypothalmus adjusts back. The research doesn't say how fast. (AS3 may be able to add some estimates to that).