How to quit smoking – Part 1
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It’s easy to quit smoking. I’ve done it hundreds of times – Mark Twain.He was the Supreme Commander of the Allied Forces during the Second World War who became President of the United States. His memoirs have earned millions of dollars. He was a man of iron will, but for nearly four decades there was one thing he could not do; he could not stop his habit of smoking several packets of cigarettes each day.
But then one day he decided that was it. He gave up smoking and never touched a cigarette again. His name was Dwight Eisenhower, nicknamed Ike. But few of us are like Ike, and for many smokers it is an addiction that, however much they try to, they cannot quit. Though ‘cold turkey’ may not be for you, there are more gentle but effective ways to stop smoking.
But first, if you are a smoker, you may ask, “Why should I stop smoking?”
In the 1950s, nobody suspected that smoking was a problem. Many, especially men, smoked. It was glamorous to smoke. Some may remember the magazine advertisements of the handsome Marlboro man in a Stetson sitting on his horse gazing into the sunset. This advertising campaign by Leo Burnett, which only ended in 1999, was one of the most successful of all time.
Though for many years tobacco companies have tried to hide the truth, research has concluded that smoking causes lung and other cancers, emphysema, chronic bronchitis and contributes to hardening of arteries, heart attacks, high blood pressure, and strokes. Many of the Marlboro men in the advertisements died of these complications.
Cigarette smoking damages every organ that has been studied. Even living in the close vicinity of a smoker increases the risk of lung and heart problems in non-smokers. Smoking is the leading cause of preventable death in the world and about 8 million people die prematurely each year because of tobacco smoking. There is no safe level for smoking. Even if you smoke one cigarette a day, it significantly increases your risk of dying from heart disease. In fact, your risk is half that of a person who smokes 20 cigarettes a day.
Cigarette smoking is costly. A not so well-off smoker will spend a significant proportion of his disposable income on cigarettes. It is costly for governments too. Even though it is claimed that taxes collected from tobacco companies help the economy, the overall cost in health and lost productivity because of premature death and disability far surpasses the taxes collected. If you are a smoker, you have more than sufficient reasons to quit now. But why is it so difficult for a smoker to stop smoking?
The reason is nicotine. This addictive substance was named for Jean Nicot, a French ambassador to Portugal, who sent tobacco seeds to Paris in 1550. Nicotine is one of the most addictive substances known. The addictive potential of nicotine is higher than even heroin or cocaine and yet it is legal to smoke tobacco, but not heroin or cocaine.
An addictive substance is a substance that, in small quantities, causes significant alterations in brain function – short and long term. In the short-term, nicotine decreases appetite, increases heart rate and blood pressure. It may improve memory and alertness, but these effects are brief. The long-term effects are the criteria for diagnosis of dependence. The most important are tolerance and withdrawal effects.
Tolerance is the need to consume more and more of the substance to get the same effect and the rate of development of tolerance is different for different substances.
Withdrawal effects are what you get when you stop using the substance. That too is different for different substances. For smokers, the withdrawal effects are restlessness, difficulty in concentration or sleeping, irritability, anxiety, increase in appetite and weight gain. The most important is craving, an almost irresistible desire to have another smoke.
Most persons smoke when they are young due to peer pressure. The immediate effects are not pleasurable but the happy circumstances of the act of smoking drive persons to continue. After a while, they are addicted and continue to smoke not because it is pleasurable but to keep at bay the unpleasant effects of withdrawal.
Even though tolerance and withdrawal effects are the most important features of dependence or addiction, there are other features. These are preoccupation with smoking, rationalising smoking, continuing to smoke even when there are good reasons not to, prioritising smoking over family, friends, jobs (sneaking out for a smoke during working hours), ethics or money, continuing to smoke even if there is obvious harm (for example after a heart attack or stroke) and most important, restarting after having stopped smoking for a time.
Nicotine is not the only harmful substance in tobacco smoke. It contains over 7,000 chemical substances, 69 of which are known carcinogens. Tar, the thick resinous compound formed when tobacco is burnt is deposited in the lungs changing them from a healthy pink to black and contributing to increasing the risk of cancer. It also damages the thread-like wavy bodies that line the windpipe and that, by their sweeping action drive dust particles out of the body. Cigarette smokers lose all their cilia within a short time of starting to smoke. These cells never regenerate even after stopping smoking.
Withdrawal occurs only when the nicotine level drops in the blood. A smoker will breakdown half the nicotine in his or her body after two hours and will therefore feel the withdrawal effects after three to four hours. If you have a cigarette every 90 minutes or so, you will only feel withdrawal effects in the morning or middle of the night if you wake up. Other than smoking to avoid unpleasant withdrawal effects, there are other reasons for a smoker to light up.
There are social factors too that drive the habit. It is important to understand these factors when trying to stop smoking. When people do things in the same way repeatedly, they have developed a ritual. All of us have rituals. For example, when we go to a place of worship, we will follow a certain order of behaviour. After some time this behaviour becomes automatic and every time we are in that situation, our behaviour will follow the same steps. Humans feel comfortable and secure when they follow a ritual, even if what they are doing has no profound meaning or reason. If you are a smoker, rituals will help you structure the day. Some smokers will have a cigarette with their morning cup of tea or coffee, and others with the morning newspaper. Or they may have a smoke after finishing work.
Smoking a cigarette also helps relieve stress and anxiety in those addicted to smoking, even though nicotine has no inherent relaxing properties. The reason is that smoking has become associated in their minds with these situations, leading to the automatic reaching for a cigarette. The technical word for this is conditioning. It is a powerful reason for a smoker to continue to smoke.
We have now discussed the reasons a smoker should stop the habit and the difficulties they face. Next month I will tell you about a scientifically validated method smokers can follow to quit their habit.
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