November 22, 2022
Every new year marks the time when many smokers try to quit, with only a small percentage of them succeeding. While new “alternatives” to cigarettes have hit the market, their safety and efficacy are still in question. Understanding why this habit is so addictive and having a realistic plan are the keys to success in making 2023 your year to quit.
More than a bad habit
If quitting smoking was as simple as changing a habit, more people would be successful. The fact is, cigarette smoking is highly addictive, both physiologically and psychologically.
“It has to do with how the nicotine is absorbed,” says John Egan, M.D., a Board-Certified Interventional Pulmonologist. He points out when a drug is ingested orally, it is subject to what is called “first pass metabolism,” in which the stomach, intestines and liver each play a role in reducing the drug’s concentration. Smoking bypasses that process.
“The lungs are an amazing interface for drugs because they are designed to absorb oxygen directly into the bloodstream with almost no resistance,” Dr. Egan says. “Smoking cigarettes propels nicotine directly into the bloodstream and brain, making it far more potent.”
The psychological component of nicotine addiction is equally strong, says Shalu Gugnani, M.D., Addictionologist and Medical Director of Addiction Medicine at Linden Oaks Behavioral Health, a partner with Northwest Community Healthcare (NCH).
“Nicotine stimulates neurons that excite many parts of the brain, including the ones responsible for pleasure and reward,” explains Dr. Gugnani. “Smoking also causes arousal during periods of fatigue and relaxation during periods of anxiety with resultant improved mood.”
Identify and address triggers
Once you’ve decided to quit, your success will depend on whether you have strategies in place to help you along. Dr. Gugnani recommends setting a quit date and journaling to increase awareness about patterns and triggers. According to smokefree.gov, triggers typically fall into four categories:
Emotional triggers: People often smoke when they are emotional. When someone is experiencing an emotional trigger, they are remembering a time when smoking made them feel better or less stressed.
Pattern triggers: These are activities a person associates with smoking. It can be as simple as talking on the phone, watching TV or drinking coffee.
Social triggers: These are situations and scenarios where other people smoke, such as going to a bar or party or having friends who smoke. Even seeing another person smoke can be a social trigger.
Withdrawal triggers: These symptoms peak between 24 to 48 hours from the last cigarette use and can include irritability, restlessness, difficulty concentrating and craving.
Use what Dr. Gugnani refers to as the “3 A’s” to deal with triggers:
Avoid: Avoid the triggering situation. For example, if social triggers are an issue, consider taking a hiatus from those social situations where smoking is prevalent or habitual.
Alter: Consider altering the situation so that it is not as much of a trigger. For example, if drinking coffee is a trigger, drink tea instead.
Alternative: Find an alternative to smoking such as chewing gum, having a piece of chocolate or finding an activity that keeps your hands busy like crocheting.
In some cases, group and individual therapy, state-funded quit lines and medication can help with smoking cessation.
What about e-cigarettes and vaping?
NRT, or nicotine replacement therapy, and vaping can be used as a bridge in a sequential manner to quit smoking. However, neither should be considered a replacement because they still contain nicotine.
Vaping has swelled in popularity and is being promoted as a “safe” way to smoke, especially to young adults. But the jury is still out on whether it’s safe, says Dr. Egan. “At the end of the day, our lungs were designed to inhale one thing — air. Not heated chemicals and not nicotine,” he stresses. “Any amount of nicotine is not good for developing brains and can seriously impact other systems in the body, including the central nervous system, the heart and the vascular system.”
You can do it!
This can be your year to quit smoking. Start by finding helpful information at smokefree.gov.
NCH offers services and support that can help you quit. NCH’s Tobacco Cessation support group helps smokers on their journey to quit. The group discusses addiction and withdrawal, benefits of quitting, smoking cessation medication, craving management and how to deal with triggers for smoking.
Tobacco Cessation support group is held:
One-on-one counseling is also available at NCH. For more information on Tobacco Cessation support group and counseling, contact HealthConnection at 847-618-7992.