Smoking Cessation: The Science of Quitting

We started off the year with a blizzard here in Connecticut……we’re never short of fun surprises in this state when it comes to weather!

As you may know from previous posts, I DO NOT believe you need to make resolutions on January 1st. You can make changes ANY TIME you are motivated! January 4th, August 18th, whenever! But to make changes in behavior, it helps to know what drives your behavior.

In this regard, I’d like to talk a little about SMOKING and why people become addicted to cigarettes.

On New Year’s day while watching the Honeymooners marathon, I saw some pretty depressing commercials about smoking in which actual patients allowed themselves to be filmed dying from end-stage smoking-related illness. It made me think about why so many people smoke in spite of the super well-known health dangers and social taboos connected with smoking!

It’s because your brain chemistry is altered by smoking, and your brain then compels you to keep smoking.

This is a true chemical addition, so the same tenets hold as for addiction to alcohol and drugs. This can even happen with food: Dr. Kelly Brownell at Yale did research showing that the same area of the brain lights up when a “carb craver” eats sweets as when an opiate addict uses drugs!

The main problem is that nicotine, along with other chemicals in cigarettes, cause release and delayed metabolism of the neurotransmitter DOPAMINE. Dopamine stimulates the pleasure centers in the brain. Once your brain senses a pleasure, it drives you to want it again. It says: “This is good, I want more!”

This same reward mechanism can have survival value: for example, it’s tied with sex and thereby assures we’ll procreate as a species!

Your brain starts to associate the pleasure of smoking with “people, places and things,” which become additional triggers.  For some people, the feel, smell, and sight of a cigarette and the usual rituals of obtaining, handling, lighting, and smoking the cigarette are all associated with the pleasurable effects of smoking.

Memory and habit have their own neural pathways that are reinforcers of the addiction problem. Places and times can have traditions of smoking built into them, like after sex, after meals, or driving home from a stressful day at work. These particular rituals, times, and places associated with the pleasurable effects of smoking can cause cravings and make withdrawal worse.

The brain further compels you with the negative force of withdrawal: Nicotine enters the blood in 10 seconds or so. After you finish a cigarette, within a short time you start to experience nicotine withdrawal. Your brain says: “This is really bad! This is hurting me! I want more nicotine!” and then compels you to smoke again.

On the conscious level, negative emotions can then kick in: You can beat yourself up for failing to quit.  It becomes hard to believe that you can be an ex-smoker. So, once you understand how the chemical addiction works, you can learn to outwit your brain and you can stop beating yourself up.

Remember: Most people have to try 4 or more times to quit.

Here is an awesome web site that breaks down quitting into manageable steps based on the science of addiction:

Please pass it on to any friends who smoke!

Be good to yourself in the New Year!

Dr. Nolfo