Smoking a tough addiction to quit

Thursday is the Great American Smokeout, a day recognized by the American Cancer Society as a chance to reinforce how vitally important it is for those who smoke to quit, set a date to quit, or at least contemplate quitting. No one can argue that quitting smoking is hard. There are those who work in the addictions field who say that nicotine can be more addictive than heroin, making it harder for some people to stop smoking cigarettes than it is to quit using heroin. That speaks volumes about how difficult it truly is to quit smoking. Nicotine is only one of about 4,000 chemicals found in cigarette, pipe and cigar smoke, but it is the major one responsible for the addictive quality of smoking. The cigarette itself is probably the fastest and most efficient way to deliver a drug to the brain besides intravenous injection. The brain receives the highest level of nicotine within 10 seconds of the first inhalation but the effect only lasts a few minutes, which causes the smoker to continue inhaling in order to maintain the drug’s pleasurable effects and prevent withdrawal. That’s why the more one smokes, the more one smokes.

 An addiction is defined as compulsive drug-seeking and use, even in the face of negative health consequences. It is well documented that most smokers know it is harmful and many would like to quit, but the addiction is very strong. Nicotine stimulates a part of the brain that is responsible for pleasurable feelings, just like other drugs that are abused. No wonder so many smokers find it so hard to quit. It feels good! The immediate effects of nicotine withdrawal, on the other hand, feel terrible. Irritability, craving, trouble thinking and paying attention, sleep disturbances, and increased appetite can begin within a few hours of the last cigarette — potentially sending a wanna-be-ex-smoker right back to the habit. These symptoms can be strong for a few days before they begin to decrease in the following days, weeks and months. The negative health effects of smoking are staggering. Cigarette smoking kills more U.S. citizens a year than alcohol, cocaine, heroin, homicide, suicide, car accidents, fire and AIDS combined. It’s not just lung cancer, either. “Smoking harms every organ in the body, causing many diseases and compromising smokers’ health in general,” according to a research report by the National Institute on Drug Abuse. Here’s a short list: Cancers of the mouth, pharynx, larynx, esophagus, stomach, pancreas, cervix, kidney, ureter and bladder. The list also includes chronic bronchitis, emphysema, heart disease, stroke, heart attack, blood vessel disease, and aneurysm (ballooning and possible bursting of a blood vessel). Not so short, is it? Dunhill cigarettes.

 Having said all that, it is possible for anyone to quit, no matter how much or for how long one has been smoking. There are multiple kinds of nicotine replacement therapy (NRT) in the form of patches, gum, lozenges and inhalers. If a smoker who has tried quitting using one of these products has not been successful in the past, another form of NRT might work. Several oral medications are available that have been proven to help a smoker become a non-smoker. These meds are available by prescription only, so a phone call or visit to one’s health care provider is required and it would make their day. Research is showing that NRT or medication combined with behavior modification learned either in a class setting or one-on-one, is the most successful recipe to quit smoking. The NRT or medication takes care of the physical craving for nicotine. Behavior education/modification helps one recognize situations where there is a high-risk for relapse and fosters development of coping strategies, stress management techniques and increases social support. The New York State Smoker’s Quitline is a useful resource for those who want to quit or are even thinking about quitting. It’s free, staffed by trained personnel, and some people are eligible for free NRT. Chewing tobacco is not a safe alternative to smoking. E-cigarettes are not yet tested by the FDA so no one really knows what the vapor contains besides nicotine. It is hard to deem something like that safe until testing has been carried out.