Is There One Best Approach or Method to Quit Smoking? (continued)

by Ken Derow

As I postulated earlier in this posting, this website also reinforces that there are two types of addiction. They are physical addiction and psychological addiction. The website goes on to state “when most people decide to stop smoking, they will choose some sort of stop smoking aid to help them. The problem with this is that each one of these aids only handles one of the two addictions. While they work fine on one type of addiction, most will end up smoking again because the other type of addiction took over and motivated them to smoke again.” This is exactly the opinion that I have, and that I share with the views expressed on this site.

In his book, “The Psychological Addiction to Smoking,” George Davis says, “I don't deny that there is a psychological component to smoking addiction. However, I have always been of the opinion that its importance is relatively minor when compared to the physical addiction to nicotine. Depending on source, you will see more or less emphasis placed on the importance of psychological dependency on smoking behavior. Some experts take an extreme view playing down the physical addiction. Some say that the physical addiction only lasts two days and if you relapse after this period it is down to psychological aspects of the addiction. I think this sort of advice is counter productive as it instills in the mind of the smoker that quitting should be a relatively easy process. After all, if you can last two days without cigarettes you only have to deal with your psychological dependency on tobacco; the fight against the physical addiction has been won. You can be assured that physical dependency does not go away after two days. Physical addiction to nicotine will be around for a while. We are all different and I suppose this also applies to nicotine addiction. Not everyone is addicted to the same degree. The reasons for individual differences in response to nicotine addiction are complex, although differences in our genetic make up have an important influence. Individuals will vary in how long they remain physically addicted to nicotine. Taking an average however, six months is not an unreasonable estimate. Although it may take longer than this for you to be entirely comfortable with your new found non-smoker status.”

Psychological addiction is linked to smoking behaviors that are associated with particular activities, often activities that are pleasurable in themselves. As I have referenced in other articles, these associations include such psychosocial cues as smoking: with a cup of coffee or an alcoholic drink; after sexual relations; when talking on the telephone; in the bathroom; in the car, and many others. In his book the author says that “the association between these separate activities becomes habitual. Smokers become conditioned.” These cues “will trigger an urge to smoke irrespective of whether there is a physical need to smoke to maintain nicotine levels.”

The author also states, as I firmly believe myself, that “it is important that the smoker, wishing to become a non-smoker, tackles this component of their smoking addiction.” He says, in “my considered opinion, psychological and behavioral aspects of tobacco addiction are a lot easier to deal with than the physical aspects of nicotine addiction. Changing your behavior and avoiding situations which act as cues for your smoking habit will no doubt play a part in your overall strategy to remain smoke free.”

On the website, “ehealth.com, it states that “a smoking addiction means a person has formed an uncontrollable dependence on cigarettes to the point where stopping smoking would cause severe emotional, mental, or physical reactions. Everyone knows that smoking is harmful and addictive, but few people realize just how risky and addictive it is. Chances are that about one in three smokers who do not stop will eventually die because of their smoking.”

Many sources cite the observation that most successful quitters have tried to stop multiple times before they are successful, but, this website indicates that only about “one third will have successfully quit by the time they are 60.” In fact, only about 4% to 5% percent of smokers successfully quit each year.
Because of the physical and psychologically addictive nature of smoking, it is so very difficult to quit successfully, yet, people do quit everyday with a wide variety of methods and various approaches. Quitting smoking is very difficult, but, it is still possible.

How does physical addiction work? The “ehealth.com site says that “nicotine is the drug in tobacco that causes addiction. It is absorbed and enters the bloodstream, through the lungs when smoke is inhaled, and through the lining of the mouth when tobacco is chewed or used as oral snuff or for non-inhaled pipe and cigar smoking.”

Nicotine is a psychoactive drug that stimulates the brain. In the very short-run smoking seems to have a calming effect, however, nicotine is a strong stimulant, so the nicotine itself does not calm and soothe the body, the affect is a mental attribution only. The website goes on to say that “although its (smoking) subjective effects are less dramatic and obvious than those of some other addictive drugs, smoking doses of nicotine causes activation of "pleasure centers" in the brain which may explain the pleasure, and addictiveness of smoking.”

Clearly, it is difficult to give up smoking, and without assistance most smokers fail despite trying many times. Even after initially stopping, most relapse within 2 to 3 months. The smoking addiction develops easily, and while many may start smoking for the psychosocial reasons mentioned previously, the addictive effects of nicotine soon take over.

The website goes on to say that “nicotine induces structural as well as functional changes in the brain of smokers. When nicotine is suddenly withdrawn, physiological functions in the brain and other parts of the body are disturbed. This is known as withdrawal syndrome. It takes time for the body to readjust to functioning normally without nicotine.”

The addictive quality of smoking habituation may develop very quickly as it does for some smokers, or more slowly over time. Addiction will develop if the drug has pharmacological and psychological effects the smoker finds to be rewarding.

As ehealth.com puts it, smoking habituation is basically a learning process:

“Learning when, where, and how to take the drug to get the most rewarding effects. The taste, smell, visual stimuli, handling, and other movements that are closely associated with the rewarding pharmacological effects gradually become rewarding themselves. This is known as conditioning.

The situations and activities associated with smoking, together with the smoker's mood and psychological state at the time, also become linked with its rewards and with the relief of withdrawal. They come to serve as signals or triggers for the urge or craving for nicotine's effects (for example, after meals, with coffee or alcohol, when meeting people, working, talking on the phone, and when anxious, angry, celebrating, or having a well-earned break, and so on).

Triggers that bring on the urge to smoke are numerous because smoking can take place in so many situations.”

There are many other sources that cite the dual physical and psychological dependencies created by the smoking habit. All of this evidence supports and reinforces the premise that the approach a smoker takes to quit, must address both of these vital concerns, unfortunately, there is no similar agreement on what specific method is best for most smokers who wish to quit.

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