Why is it so hard to quit?

Smokers are not weak willed nor are they simply making a bad lifestyle choice. They are victims of a powerful drug addiction.

why-hard-to-quit.jpgThe vast majority of smokers in Australia want to quit, and most make repeated attempts to do so. About 40% try to stop smoking at least once each year. (1)

However, long-term quitting is an elusive goal for many smokers. Only 1 in 25 smokers who tries to quit ‘cold turkey’ is successful. (2) Even among those who do quit, there is a steady drop off over time. After 12 months, about one third of all quitters will relapse at some time. (3)

Most smokers keep failing to quit because they are addicted to nicotine. Within several hours of quitting, smokers experience powerful urges to smoke and nicotine withdrawal symptoms, such as irritability, restlessness and disturbed sleep. Nicotine has been rated by drug addicts as the most difficult drug of all to give up.  (4)

About eight out of 10 smokers are addicted to nicotine. Click here to find out if you are addicted to nicotine. 

 

Adolescents

Eighty per cent of adult smokers start smoking before 18 years of age, usually for all the wrong reasons. Adolescents are very sensitive to nicotine and quickly become addicted. Ten per cent of teenage smokers start to become addicted within two days of inhaling from a cigarette for the first time.

 

Genetics

We now know that some people are more prone to becoming addicted to nicotine than others. 50-60% of the chance of becoming addicted is determined by your genes. To find out more about the genetics of smoking click here.

For example smokers who metabolise (break down) nicotine more quickly are generally more addicted. These patients smoke more cigarettes and find it harder to quit. 

 

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Reward pathway

Like other drugs of abuse, such as cocaine and heroin, nicotine acts on the reward pathway in the brain. Nicotine gets to the brain in 10-20 seconds and attaches to the receptors on the brain cells, like a key in a lock. This releases dopamine which can produce a feeling of pleasure. As you smoke more, the brain makes more nicotine receptors and you become more and more needy of nicotine.

Nicotine from a cigarette gets to the brain in 10-20 seconds, however, within a few hours of the last cigarette, the dopamine levels fall and cravings and withdrawal symptoms develop. As a result, you need another cigarette to feel normal again, and the cycle continues.

video_icon-small.jpgClick here to see a video on how nicotine acts in the brain.

 

Other reasons why people smoke

Over the years, smoking becomes part of your daily life. You learn to associate smoking with certain activities such as drinking a cup of coffee or the smell of smoke. Exposure to the trigger creates a strong urge to smoke (a conditioned or learned response). Quitting means changing your routines, avoiding certain places or trigger situations.

Also, nicotine can make smokers feel more alert, temporarily relieve anxiety or depression, reduce hunger and may help to control of body weight. Some people smoke partly for these effects.

Some people feel that smoking gives them comfort and company and is their 'best friend' and experience a powerful sense of loss or grief when they quit. Click here to find out more.

 

Quitting

Doctors now see smoking as a chronic (long-lasting) medical illness. Most smokers try and fail to quit repeatedly and this is a normal part of the process of quitting. Don’t be too hard on yourself if have an unsuccessful quit attempt. Very few smokers quit easily on their first attempt.

The only real failure is to stop trying. Each time you try to quit, you learn something and it is easier next time.

Although some smokers can quit without help, many need assistance. However, for most people motivation to quit is just not enough and it is necessary to get professional advice and support along with using stop-smoking medication.

The best time to quit is now. For every year you keep smoking your life expectancy is shortened by 3 months on average. Smokers live 10-12 years less than non-smokers and the earlier you quit the sooner the healing can begin.

 

The benefits of quitting

Quitting is the most important thing you will ever do for your health. Your health will improve immediately and you will live longer.

Fairly soon, you will breathe better, have more energy, feel more relaxed and your cough will improve. Your skin will improve and you will no longer smell like an ashtray.

Three years after quitting your risk of having a heart attack is reduced by about 50%. The risk of lung cancer is reduced by half after 10 years.

The sooner you stop the better. If you quit at 60 years you gain 3 years of life. If you quit at 40 years, you gain 9 years.

You will also save a lot of money. Click here to find out how much. 

 

pdf_icon_30px.jpgClick here to download a more detailed published peer-reviewed version of this article

 


 

References

(1) Borland R. How much unsuccessful quitting activity is going on among adult smokers. Addiction 2011

(2) Hughes JR. Shape of the relapse curve and long-term abstinence among untreated smokers. Addiction 2004

(3) Etter JF. NRT for long-term smoking cessation - meta-analysis. Tobacco Control 2006

(4) Blumberg HH. British opiate users: people approaching London drug treatments centres. Int J Addiction 1974

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Last Modified: 19-04-2017