Smoking Cessation: Introduction

The Center for Disease Control and Prevention (CDC) considers smoking to be the leading preventable cause of death. Smoking is directly responsible for cardiovascular disease, chronic respiratory diseases and cancer and quitting smoking reduces the risk and/or progression of all three diseases. Quality of life and life satisfaction are reduced in smokers, however their quality of life improves with smoking cessation.

Quitting smoking is remarkably hard to do with only 6% of smokers able to do so. Multiple strategies have been attempted but one of the best only increased the quit rate to ~16%. Unfortunately, only half continued not to smoke at one year in that study. 

Why is it so difficult to quit smoking? 

Nicotine addiction.

Nicotine produces a strong addiction that is harder to quit than alcohol or heroin. Of adult smokers, 90% started before age 18 and nearly everyone began by age 26. Reasonable estimates suggest nicotine levels produced by smoking 5 cigarettes a day is associated with long term nicotine addiction.  Suggests an obvious answer to why cigarette manufacturers added extra nicotine to tobacco as reported in 1984 by ABC.

Tobacco smoke is one of the most efficient mechanisms of getting nicotine into a person. Nicotine reaches the smoker’s brain within 2 minutes after the first puff. However, the rapid decrease in nicotine over the first 30 minutes causes the nicotine addicted smoker to begin experiencing withdrawal symptoms. Symptoms of nicotine withdrawal include anxiety, depression, irritability, restlessness, difficulty concentrating and sleep disturbances. 

Given how easy it is to buy cigarettes, its easy to see how smokers have difficulty quitting when these nicotine withdrawal symptoms are easily and quickly countered by the first puff off a cigarette.