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Why is it hard to quit smoking?

Dr. Douglas E. Severance, MD
Family Practitioner

Nicotine in cigarettes is extremely addictive. In this video, addiction specialist Douglas Severance, MD, shares how an addiction to nicotine may be harder to break than a chemical dependency to opioids.

Dr. Frank T. Leone, MD
Pulmonary Disease Specialist

Most smokers would like to quit smoking, and millions of people have been able to do so.

Quitting smoking can be difficult and often requires an organized approach to get the job done. Smoking is about learned behaviors, but it’s also about the biological effects of nicotine on the brain … addiction. Smoking inserts itself into your life because of the ways in which nicotine affects the instinct parts of your brain. To quit successfully, it’s important to think about both the motivations to stop, as well as the obstacles to stopping. Many smokers have a hard time quitting because they don’t address the obstacles in advance, and find themselves without an effective plan when the instinct to smoke pops into their head.

Smoking is so addictive that of those smokers who try to quit, less than 5 percent are successful at any one time. Behavioral associations with smoking such as pairing it with eating or socializing or even with just waking up are the greatest barrier to quitting. The nicotine in cigarettes creates an additional chemical dependence, making smoking cessation both a physical and mental challenge.

Cigarettes deliver the "free-base" form of nicotine to the brain. Just like crack cocaine is more addictive than plain cocaine, free-base nicotine is much more powerful than plain nicotine. That's why even the idea of giving up cigarettes can be so depressing. The good news is that, unlike many other drugs, nicotine addiction can be treated fairly easily and effectively. All you need to do is ask for help.

Nicotine is probably the most addictng substance known to mankind even more than cocaine. Once you get hooked on it it is very difficult to stop. That's why various nicotine based products are usefull .They give you a low dose of nicotine without exposure to all the harmful chemicals in tobacco smoke  and let you gradually withdraw from the addiction.

Dr. Leigh Vinocur, MD
Emergency Medicine Specialist

The main active ingredient in cigarettes and other forms of tobacco is nicotine, which is an addictive drug causing both physical and psychological dependence. Because of this, the Food and Drug Administration now regulates cigarettes as a drug. A Surgeon General’s report found that tobacco addiction has similar characteristics as addiction to heroin and cocaine.

Nicotine’s addiction is believed to work by stimulating reward pathways in the brain to release dopamine, a chemical signaling pleasure, commonly released when eating or during sex. It is also believed that nicotine releases endorphins, which are proteins that can lead to feelings of euphoria. At night, when you don’t smoke, those pathways shut down and you wake up craving a cigarette; studies find those addicted usually smoke within 10 minutes of waking up.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.