Written by Dimitrios Vrachatis, Specialist Cardiologist, PhD, National and Kapodistrian University of Athens.
Why is it difficult to stop smoking?
Smoking is the leading reversible cause of death and disease in the modern world. It is estimated to kill more than 480,000 people in the United States each year. For every person who dies because of smoking, at least 30 live with a serious smoking-related illness, such as hypertension, dyslipidaemia, coronary artery disease, heart failure, lung disease or various cancers, and associated symptoms such as breathlessness or chest pain.
Why does smoking cause addiction?
Physical dependence on smoking is caused by a substance called nicotine. Nicotine is the main addictive component of tobacco that makes quitting so difficult. Cigarettes are designed to deliver nicotine quickly to the brain. There, nicotine triggers the release of chemicals that make us feel good. As it repeatedly stimulates particular areas, the brain becomes accustomed to its presence. Over time, nicotine changes the way the brain works, making us feel that we need it simply to feel well.
What happens when I stop smoking? Will I experience withdrawal?
When we stop smoking, the brain becomes irritable. We may feel anxious or uncomfortable, struggle to concentrate or sleep, have strong urges to smoke or simply feel generally unsettled.
These symptoms are called withdrawal. They improve a few weeks after quitting, usually around three, as the brain adjusts to the absence of nicotine. Some stop-smoking medicines contain nicotine, providing a safe way to adjust gradually to no longer receiving it through smoking.
What role does psychological dependence play?
A smoker’s day is full of habits associated with smoking. During an attempt to quit, getting through everyday life without a cigarette can be difficult.
Many smokers associate cigarettes with a short break at work, a cup of coffee, the end of a meal, conversations with friends or telephone calls. These associations are called triggers.
Emotions can also trigger the urge to smoke: feeling stressed or low, but also happy or relaxed. During the attempt to quit, or even after successfully stopping, one of these feelings can bring back the desire for a cigarette.
Will life without cigarettes be boring and stressful?
Do not give up before giving yourself the freedom to try. People who stop smoking find ways to live without cigarettes and to manage anxiety or depression without smoking.
The good news is that millions have stopped permanently, and most report feeling better very soon after quitting.
What do I need to do to stop smoking for good?
There are two challenges: helping the brain no longer need nicotine, and removing cigarettes from everyday routines. Tackling both at once can be difficult, but:
- Stop-smoking medicines can help with the first challenge by reducing cravings and withdrawal symptoms such as irritability and difficulty concentrating or sleeping.
- This allows you to focus on the second challenge: getting through activities previously associated with smoking, without a cigarette. Many simple steps can make this easier. Prepare for the difficulties of quitting so that you can manage them effectively.