The Addictive Power of Nicotine
Do you find yourself reaching for a smoke? Every wondered why? Read on and find the real reasons.
I am a smoker and have been so since I was 30 years old. I have made repeated attempts to quit over the years and, like an addict, have always returned to the source of my addiction. I have tried most things, over the years, to quit smoking and have on a few occasions, succeeded for a few weeks and then relapsed. There are many reasons for this, partly to do with psychology and partly to do with neurology and some due to genetics so in a final attempt to quit, I have decided to write an article which explains why nicotine is so addictive and to explain the different methods which can be used to quit and posit a combination of methods which actually works.
What is addiction?
First, let's talk about what addiction actually is and how this affects the body. We all have an idea of what it is, but let's get this straight. According to the Cambridge Dictionary, addiction is:
an inability to stop doing or using something, especially something harmful
In my case, that's not really telling me anything I don't know and it's not particularly helpful in the context of this article. I want to dig a little deeper and I know from previous reading that addiction is more easily understood when broken down into two parts: biological and psychological, so let's take a look at these.
Biological Affects
Nicotine
When you smoke, you inhale a complex set of chemicals. If you've seen cigarette packaging in Europe or Australia, you'll have seen messaging like "tobacco smoke contains over 70 substances known to cause cancer" (from the UK Government tobacco packaging guidance). The two I'm going to focus on here are nicotine and carbon monoxide.
Nicotine, when inhaled, is absorbed into the lungs and enters the bloodstream. Once in the bloodstream, it is able to cross the blood-brain barrier by mimicking the neurotransmitter acetylcholine and binds to specific receptors within the brain. Once there, these receptors release a series of neurotransmitters, including dopamine which signals pleasure to the rest of the brain and is responsible for the addictive effects of nicotine.
The stimulation of dopamine in the brain is quite significant: you may not feel it so much, but try going without sugar for a day, then eating something very sweet: that pleasure response you feel is dopamine being released into your brain.
Carbon Monoxide
The second chemical to look at is carbon monoxide (CO) which is a by-product of the burning process and, whilst not directly part of the addiction process has an interesting affect on the brain. Specifically, when inhaled, CO binds to haemoglobin (the red blood cells) in your blood and prevents oxygen from binding to those cells and reduces your body's ability to move oxygen to where it's needed.
The body's natural response to this is to increase the flow of blood, leading to an increase in bloody pressure. One of the side-effects of this process is that, for a short period, your brain will be receiving oxygen and its response to this is to become overstimulated whilst it tries to work out why it's being suffocated.
This is why, whilst smoking, you might get a flash inspiration: oxygen deprivation.
Psychological Effects
So now that we have a rough idea of how smoking affects the brain, let's talk about your mind, specifically in terms of the habit-forming nature of smoking. Users develop routines around their tobacco consumption and often those routines will dictate the pattern of their day. Some have a cigarette in the morning "which sets them up for the day", some after meals and so on and over time these habits become such a normal part of the daily routine that they're performed almost automatically.
The issue here is how ingrained these behaviours become: the longer a person smokes, the more used to their routine they'll be and the harder it becomes to break these patterns. Have you ever noticed how strong your feeling of frustration is when you just miss the bus or the train on your way to work?
Stopping Smoking
I'm deliberately not going to talk about the harms of smoking, or spend much time writing about the benefits of quitting. Your own experience in these areas will vary considerably, depending on how long you've been a smoker and the lifestyle you live. Instead, I'd like to write about the various methods you can use to stop smoking, how they work and how they impact you along with suggesting a step-by-step approach that I'm going to try.
Preparation
Before stopping smoking, it's really important to make some mental preparation. How easy the process is will vary depending on how long a person has smoked and how much but important point is to commit to the process and make sure you're ready for the route you choose to take.
Preparing your Mind
One of the key things I've discovered in my many attempts is that I have often switched to auto-pilot when I'm smoking: I don't tend to think about it, I just step outside and light up. This not thinking step is the first to tackle and may be the most important, because it's key to being able to change your habits and notice when you have triggers and your responses to them.
Some people will call this "mindfulness" (a buzz-word that's been thrown around a lot) which essentially means being aware of your thoughts. Mindfulness practices is a great tool, but for stopping smoking, you don't really need to go on an 8-week course to get the minimum you need to be aware of your triggers and habits.
In essence, to prepare your mind, you need to find yourself 5-10 minutes per day (twice a day if you can) where you're going to be undisturbed. Sit quietly, close your eyes and feel the movement of your body as you breathe. After a while, you'll notice how busy your mind is: thoughts popping up, odd sensations, fidgeting and so on. The trick with this is just to notice that these things are happening (i.e. "oh, I have to buy some milk") and then acknowledge these thoughts or sensations (I say to myself "hello shopping", for example) as they pass across the stage of your mind.
This is basic mindfulness and this bit is important because once you stop smoking, you'll be more aware of the sensations you feel when you have a craving and also the situations which trigger you to want to smoke. Some people may find they need to avoid being in the presence of smokers, or you may find that you need to take a regular break at work when you'd normally have a cigarette (going to the bathroom is the easiest alternative - and there you can sneakily do a 5 minute meditation!)
You're also going to need to plan some things to do with your hands if you're a heavy smoker: get a stress ball or a slinky - something to squeeze or play with if you find yourself itching to have a cigarette in your hand. Try not to chew things or hold something in your hand that feels anything like a cigarette as this won't break psychological habits.
One of the most important parts of this exercise is so that you can become aware of the changes that happen in your body when you stop. From my own experience, I notice the changes in my mouth first: my teeth start to feel less grubby, my sense of taste comes back and after a couple of weeks I find I can feel the blood moving around my body!
Nicotine Replacement Therapy
In the UK, the general medical advice is that quitting smoking is best done through NRT - essentially nicotine patches, lozenges or inhalators. These provide an alternative supply of nicotine which is generally considered as non-harmful. The result of using NRT is that the nicotine receptors in your brain are constantly stimulated whilst you're awake (when using 16-hour patches) or all the time (with 24-hour patches). This makes these receptors effectively wear out and stop responding to nicotine meaning that once they're burned out, your nicotine addiction stops.
Using patches is a good way to start your journey, even if you only use them for a little while. I have found that, when I don't have any cigarettes in the house and I wear a patch, the craving goes away: that's their purpose. It's really important to have planned smoking alternatives, though so that you have something to give you a little break.
One final note on patches is to pay attention to how you feel shortly after you put on your first patch: if you start to feel unpleasant after about half an hour, step down the dosage in your patch. When you have the right dosage, you should barely notice any change to how you feel - I discovered this by mistake a while ago myself. I would suggest starting with the lowest dose and working upwards.
Vaping
Put simply, vaping is still smoking, albeit with a lower level of the risk of harm because you're no longer putting something in your mouth that's on fire and breathing in the smoke. People who vape will still have a similar response to nicotine as smokers although one advantage of vaping is that the level of nicotine can be lowered to provide a gradual tapering off. I have heard, though, that people continue to vape even without nicotine which, I think, is continuing the "smoking" habit. I've tried vaping, but found it difficult to adjust so I've kept my distance.
Urge Surfing
One of the more modern approaches used when stopping smoking can also be one of the most difficult - and also most rewarding, which takes a form of "mindfulness" (that buzz word again) specifically related to smoking, so that when you get a craving, you're aware of it and "surf" it, hence the term "urge surfing".
To facilitate this, a team at a big American university built the Craving to Quit programme, which teaches you the basics of becoming aware of your cravings and to avoid reacting to them, in theory lessoning the effects of withdrawal.
Allen Carr's Easy Way to Stop Smoking
Apparently more effective than NRT, Allen Carr (not the comedian, as I'd thought) developed a book (or app, or course) where he uses some clever psychology to enable you to quit. I can't say too much about this, but it's definitely worth spending £10 (less than a packet of 20 cigarettes) to read and try.
Which Approach to Take?
Everyone is different, as is their smoking habit so your approach to stopping smoking should be tailored to you. You may find that what works for someone else doesn't work for you, so don't be afraid of failure. Every time to attempt to quit, try to refrain from smoking for a longer period of time, even if it's only an hour longer, or a day.
Top Tips
As with all things, how you do this and how you prepare is down to personal choice. However, I have a few important tips on how to go about this.
Notice your Habit
Before you even start the process of stopping, notice how frequently and in what situations you smoke including the number and the context - and also what triggers you to smoke in the first place. Write this down. By doing this, you'll find it easier to map out your current habit and also create a plan for "what to do when X happens" which will really help going forwards.
Do the Meditation
Definitely make the time to just sit quietly and do daily meditation. Practicing this before you stop means you'll have an understanding of how you can calm yourself if you're feeling stressed at work, or at home as this is one of the most common triggers of smoking.
Set Your Own Quit Date
Don't let anyone else influence you. This is your choice, so you must own it.
Don't Taper Down
This might sound crazy, but I have found that all tapering does is delay my quit date and make me stress out because I've reduced my level of nicotine intake. When you stop, stop.
Clear your House
The day before your stop date, completely clear your house of anything smoking-related, so that you don't see any of your normal cues. Also try changing some furniture around, or your at-home behaviours like where you sit: by making these changes, you're indicating to your subconscious that you have changed habits.
Clean your House
Finally, once you've stopped smoking for a while, make sure you do a full clean of your house: everything from the floor, to clothes, to the outside area you smoked (or the walls and basically every surface if you smoked inside). You'll really start to appreciate the smell of fresh air again - and don't use air fresheners to mask the smell - actually clean it. The work will be quite satisfying!
Good luck!