Anyone who has tried to quit smoking will tell you how difficult it is. It’s tempting to smoke a cigarette over beer with friends or escape from work to have a “smoko”, as Australians call it.
Research studies suggest that 60-75% of people relapse in the first six months after trying to quit smoking.
Living without cigarettes can be a psychological struggle. Social events, depression or simple daily habits can have you craving for one.
But the .
The risks of stroke and coronary heart diseases, as well as overall health, improve significantly within weeks or even months of quitting smoking.
Smoking is one of the biggest killers, with around 14% of deaths worldwide attributed to , according to World Health Organization data in 2019. Most of these deaths can be attributed to the rising rates of smoking in low- and middle income countries. And more recent studies show that to be an ongoing trend.
“Smoking is a massive global health burden. There will be a billion deaths globally in this century from smoking-related illnesses if we don’t bring smoking rates down,” said Hazel Cheeseman, deputy chief executive of Action on Smoking and Health (ASH), a UK-based public heath charity.
What makes cigarettes addictive?
When you smoke a cigarette the burning tobacco releases , which enters the blood via the lungs.
Nicotine is pumped into the brain where it triggers receptors called nicotinic receptors.
Activating these receptors triggers the release of chemicals in the brain — neurotransmitters — such as dopamine.
The release of dopamine doesn’t necessarily cause addiction. But when it acts in a specific part of the brain — where our so-called reward system lies — it can cause addiction. That part of the brain is called the mesocorticolimbic circuit.
And this is how the addiction works: When nicotine triggers dopamine release in the reward system, it induces a rewarding feeling, like a mini rush. This feeling is reinforced with each cigarette, leading to a craving for cigarettes.
This is why, if we are to quit smoking, it’s important to remove the link between smoking and feeling rewarded. It’s tough. It’s tough. You will need every bit of help to get it right. It is still possible.
Interventions to stop smoking
There are two main methods to break the : willpower and self-discipline.
You can also use therapies to fulfil the nicotine cravings, but without the health problems associated with active smoking.
For therapies, there are three types. There are three types of nicotine replacement therapy. These include patches, gums, and inhalators, which slowly release nicotine to stop the desire to smoke. Nicotine itself isn’t harmful, but the smoke you inhale from cigarettes is.
Medications such as bupropion and varenicline are also available.
Varenicline promotes dopamine release in the reward pathway, mimicking the reward of smoking and reducing withdrawal symptoms from stopping smoking.
Bupropion works in a similar way but via a different neurotransmitter system known as GABA, the main neurotransmitter that dampens brain activity.
“Although medications are a more expensive treatment, they’re enormously cost effective when you look at the impact of smoking on health and on health systems,” said Cheeseman.
E-cigarettes — good or bad?
Electronic cigarettes have a strange reputation when it comes to giving up smoking. Do they have any safety?
“There is good evidence that e-cigarettes can help you stop smoking. But they are a non-medically licensed product, so they’re not administered as medication,” said Cheeseman.
She stated that e-cigarettes were safe for the short and medium term or at least less harmful than traditional cigarettes. But she added that “.”
Another concern is that e-cigarettes may create new addictions or act as a gateway to smoking tobacco. Some evidence suggests that vaping teens are more likely in the future to start smoking tobacco.
Try everything to quit smoking, all at once
Which method works best to help you quit smoking?
The consensus among scientists is that you should use multiple methods simultaneously.
A 2020 meta-analysis of more than 700 clinical studies found that combining several methods has the best results for helping people achieve sustained abstinence from cigarettes.
While individual treatments were better than placebos — or doing nothing at all — the results are only seen when they’re combined.
“Behavioral support is the most effective method to quit smoking. It helps to create strategies for dealing with cravings and the psychological aspect of them. [combined with] Medication can help with physical withdrawal symptoms,” says Cheeseman.
Everyone’s pathway to quitting smoking is different — some can go cold turkey and quit on a whim, others need years of complimentary therapies. It might take a while to find your best method. It’s a question of how badly you want to stop smoking.
Edited by: Zulfikar Abbany
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