Some start as teenagers and others later in life; many stop and some start again, but most continue until death separates them…from their cigarettes.

With today’s article, we close out our trilogy on smoking and its damage. We do so by describing the reasons that lead people to smoke and, above all, by trying to explain the reasons that prevent these people from quitting.

Many studies suggest that teenagers start smoking in order to “feel big”, to imitate, to integrate into a specific group and to be more “cool”. Then, with advancing age, the reasons change and adults often indicate by their behavior (e.g. it makes them more relaxed, brings them closer to some characters in movies, even to de-stress); the reasons that lead them to start. In adults, the reasons that prevent one from quitting are found in psychological and physical dependence, in the stimulus that comes from it or in the relaxation that comes out of it, in habit, because it’s morphed into both an “inalienable right and a pleasure”.

If it’s interesting to understand why a person starts smoking, it’s even more interesting to understand why smokers can’t quit and how they literally become a drug addict.

Various studies have demonstrated that there are many components that prevent a person from quitting smoking.

Nicotine addiction

Nicotine is the main substance that causes smoking addiction. Nicotine is able to bind to receptors in the nervous system and stimulate the production of substances called neurotransmitters that cause sensations of well-being to the smoker, usually a feeling of relaxation.

In addition, with smoking a cigarette, our body releases another important molecule, dopamine, which induces the sensation of pleasure and finally adrenaline that increases blood sugar levels, heart rate, blood pressure and elevates breathing. These effects vary from person-to-person and the context in which you smoke, which is why some smokers report that a cigarette either relaxes or excites them.

Once the effect of smoking subsides, abstinence (brought on by the lack of these sensations) arises and consequently the need to continue smoking; therefore creating a strong addiction.

Other causes of cigarette addiction

Unfortunately, nicotine is not the only cause of cigarette addiction. There are other substances whose function is to improve the release and absorption of nicotine, but which are themselves addictive. I cite as an example the aromas that are added to (i.e. infused into) tobacco. These, such as menthol, are intended to change the taste of the cigarette and facilitate a deeper inhalation — and therefore the intake of a greater amount of nicotine that results in a strengthening of the addiction; a gimmick that cigarette manufacturers know and use very well.

Genetics: As described above, nicotine binds to a specific receptor. Some studies have demonstrated that one or more mutations in the nicotine receptor, particularly in the alpha 5 sub-unit (specifically, the Gamma-aminobutyric-acid A receptor, alpha 5 sub-unit), lead to a significantly higher consumption of nicotine than those who don’t have the normal alpha 5 sub-unit. Knowledge of the mutations and how they interact with the nicotine molecule may be useful in developing drugs to help smokers quit.

Psychology: despite all the research that can shed light on how nicotine and other substances contained in cigarettes cause smoking addiction, the main component that prevents a person from quitting smoking is PSYCHOLOGICAL. In fact, numerous studies have shown that the smoker must first interrupt a habit, which manifests itself in a change of behavior, and it’s well known that the human being doesn’t easily accept change by always looking for the least difficult way. Smokers in general underestimate the potential harm that comes from smoking. The main motivation lies in the fact that the damage occurs slowly and over many years, and therefore does not induce immediate action; rather, simply to procrastinate in the hope that smoking-related diseases “simply” won’t occur. This behavior is quite irrational when you think of all the anti-smoking awareness campaigns that have been put in place over the past several decades, and the disturbing images placed on cigarette packs that are in front of smokers’ eyes every day. However, maybe by now smokers are so used to these images that they’ve become slowly desensitized.

How to stop smoking

In Italy, there are about 400 Anti-Smoking Centers, and for the treatment of smoking that aim to help those who seriously want to quit smoking. It’s important to point out that it is essential that the smoker wants to quit so that any therapy can have an effect; otherwise, the person will begin smoking again.

There are also pharmacological treatments that can be prescribed by a doctor or a specialist. These treatments include antidepressants that can help to overcome the “moment of detachment” from the cigarette, and drugs that act on the brain in a nicotine-like way, and in so doing, they reduce the desire to smoke.

Among non-pharmacological treatments, auricular acupuncture (Acudetox) and medical hypnosis are both worth mentioning — which have a respective success rate of 20% and 60%.

What about E-cigarettes?

A very popular method for quitting smoking is the electronic cigarette. The main message that companies that market electronic cigarettes convey to potential customers is that they’re a healthy alternative to the traditional cigarette. In fact, there’s a lack of combustion of the many carcinogenic products that we mentioned in a previous article, and also the effects of second-hand smoke.

However, some studies have demonstrated that the vaporization process of electronic cigarettes would favor the formation of formaldehyde — a substance 5-to-15 times more carcinogenic than tobacco.

As usual, financial interests are intertwined with health interests and too often prevail, so the real damage that an e-cigarette can cause is not really yet known.

“Anti-smoking” technology and the latest generation of apps

Finally, in the Era of Apps, “there’s an app for even that.” Indeed, there are now dozens of them. They all work more or less in the same way: they monitor the financial advantages (i.e. the money saved) and the health of the user.

These apps encourage users with rewards; they make both short-term and long-term predictions of the possible benefits. They seem to provide valuable support for those who don’t have enough willpower to commit themselves, but for an application to be truly effective, there’s always a willingness to change a habit rooted in uninformed (or even misinformed) behavior.

Finally, an interesting video from the Veronesi Foundation (in Italian), for many years engaged in the treatment of smoking patients and lung damage caused by smoking.

This post is also available in: Italiano

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