Why is it so tough to quit smoking cigarettes? Over the years during my career as a medical writer I’ve had occasion to write about alcoholism and drug addiction and to visit rehabilitation centres. Talking with recovered and recovering alcoholics and addicts, I heard again and again that it was easier to give up the booze or heroin than it was to quit smoking.
Yet for many years non-smokers scoffed at those of us who told of horrible problems with withdrawal, and the irritability that inevitably occurred. I’ve known non-smokers who have bought cigarettes for friends or relatives to end the mutual suffering, rather than putting up with and encouraging those trying to quit. All of us smokers who tried to stop and failed were branded as having no willpower.
It wasn’t until 1988 that Surgeon General C. Everett Koop, MD, declared cigarette smoking to be an addiction, as much so as addiction to heroin or cocaine or any other drug. The addicting substance, he said, based on much research, was nicotine. Occurring naturally in tobacco leaves, nicotine is found nowhere else. It has amazing effects on the brain and nervous system.
Used in low dosages, nicotine can produce a feeling of alertness. Light up a cigarette to get started in the morning, puff away to keep going late at night. At higher doses, the drug can having a calming effect. And we control those doses by drawing more or less smoke into our lungs. Within seven seconds, that nicotine has entered the bloodstream and hit the brain. That’s faster than a drug can act when injected into a vein!
Here we have a perfectly legal drug that’s used with no social objections for the most part. Smokers give themselves a “fix” again and again throughout the day. This is a drug that increases the alpha waves of the brain associated with relaxation and triggers the release of beta-endorphins, the body’s natural tranquillisers.
Try to switch to low-nicotine cigarettes and you’re just going to smoke more of them and to suck deeper. Pick up a Carlton and there’s no satisfaction unless you block those tiny holes in the filter. Right?
But if it’s just a matter of addiction to nicotine, why do we enjoy those cigarettes so much? Why are they so good with a cup of coffee, after a meal, and especially after a period of deprivation such as during a movie or church service? In fact, the three most enjoyable things in life are a drink before and a cigarette after. Right?
Well, that’s actually wrong. What you feel as pleasure is actually the elimination of pain. After a period of deprivation, even a short period such as 15 to 20 minutes, you enter withdrawal. Receptor sites in your brain begin to scream for a nicotine “fix”. You provide it by lighting up, and the withdrawal is gone in seven seconds flat. You’re at peace. For a while.
Even when your body begins to feel the adverse reactions from sucking in all the tars and crud from the burning tobacco, your throat is sore, you cough in the morning or throughout the day, you still crave the nicotine. You might have a cold or the flu, and smoking makes you feel worse, but you still need that fix on a regular basis to keep your brain’s receptors from giving you grief.
As with heroin, a little goes a long way at the start. But then you need more and more, until you settle into your own daily maintenance dose. That might mean a pack, a pack and a half, two packs, or more. When the nicotine level goes too low in the brain, you’re painfully aware of it.
Imagine having a lover whose idea of giving you pleasure is relieving you of the pain that he or she inflicts! Hard to believe, and hard to come to grips with, isn’t it? But that’s the reality of the pleasure of smoking.
Of course, there’s far more to it than the nicotine addiction. The withdrawal from nicotine lasts only about two weeks, and with the aid of nicotine gum or drug patches, even that agony can be lessened significantly. So why doesn’t everyone quit? And why do so many go back to the habit? Now we enter the realm of psychological addiction.
Smokers have allowed cigarettes to become inextricably entwined in each and every aspect of life. Virtually anything and everything is a cue to light up. For some smokers, life is unimaginable without cigarettes. One man told me that he really believed he’d rather die. He came close to dying, but eventually he did quit. Now he wonders how he could have thought that way.
I was just about as bad. At work I couldn’t leave the office without my pack of cigarettes, even to go to the men’s room, because I might run into someone who’d start a conversation. Can’t talk without smoking, of course, because that would mean the jitters. The phone rings, light a cigarette. Coffee, drinks, meals, snacks, all meant a cigarette or two. Start the car, light a cigarette. Read a book, light a cigarette. Forty times a day.
I couldn’t buy a shirt that didn’t have a pocket. 1 planned my holidays in terms of how many cartons to pack. I kept a “stash” in the office, in the car and at home. The idea of running out was unthinkable.
I had learned through many years of experience to associate all my waking experiences with cigarettes. It took a long time to learn to live without those cigarettes. As I’ll discuss a bit later, you learn to do that one cigarette at a time, one day at a time. But I did it, anyone can do it, and you can do it, too.
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Cardio & Blood/ Cholesterol
