How to Quit Smoking: Know Your Enemy
“If you know the enemy and know yourself, you need not fear the result of a hundred battles. If you know yourself but not the enemy, for every victory gained you will also suffer a defeat. If you know neither the enemy nor yourself, you will succumb in every battle.” – Sun Tzu, The Art of War
Cigarettes are a formidable opponent, but they can be conquered.
In order to stop smoking, you must know what you are up against.
This means understanding the physical and psychological aspects of smoking addiction.
Once you understand why cigarettes have a hold on you, you can begin to release yourself from its grip.
WHY you become addicted
Smoking addiction has physical and psychological components.
Physical addiction
Nicotine, one of the main ingredients in tobacco, is one of the most widely used recreational drugs in existence. It is also one of the most addictive, and (as you already realize) is known to be significantly detrimental to health.
The addictive nature of nicotine includes psychoactive effects, drug-reinforced behavior, compulsive use, relapse after abstinence, physical dependence, and tolerance.
Nicotine is somewhat paradoxically considered to be both a stimulant and a relaxant, due to the different effects that it can have on the brain and on nicotine levels in the blood. Users of nicotine may experience either alertness or relaxation, depending on how the drug is taken. Short, concentrated inhalations will create a stimulant effect, while longer and calmer inhalations can help a person to feel relaxed.
Cigarettes are a very efficient and cleverly engineered nicotine delivery system. A smoker can get nicotine to the brain very quickly with every inhalation. A typical smoker will take 10 puffs over a 5-minute period. For a person who smokes about one-and-a-half packs (30 cigarettes) each day, this equals 300 daily nicotine hits to the brain.
Within 10 seconds of entering your body, the nicotine reaches your brain, causing it to release adrenaline. This creates a buzz of pleasure and energy.
But that buzz fades quickly and makes the user crave that feeling again.
The smoker lights up the next cigarette, and the cycle of addiction continues.
Because the body is able to build up a high tolerance to nicotine, the user needs to smoke more and more in order to get those pleasurable effects and prevent withdrawal symptoms.
Just how addictive are cigarettes?
When I said that cigarettes are a cleverly engineered nicotine delivery system, I wasn’t kidding.
They are designed to be that way.
Here’s the ugly truth: the tobacco industry has been engaged in a conspiracy to defraud you for over 50 years. This fact was first exposed by industry insiders in the 1990s.
Jeffrey Wigand is perhaps the most well-known Big Tobacco whistleblower. He was the head of research and development for Brown & Williamson Tobacco Corp., which was the country’s third-largest tobacco company at the time. In 1996, he revealed that cigarette companies were intentionally trying to get us hooked on nicotine, despite tobacco executives’ public statements to the contrary. Wigand also said that his former colleagues knew all along that their tobacco products contained additives that increased the danger of developing diseases.
Philip Morris – now the largest tobacco company in the US – also has a history of deception.
In 1979, Dr. Victor J. DeNoble, an experimental psychologist, was hired to run a behavioral pharmacology laboratory for Philip Morris. He was told the company wanted to replace nicotine with an analog that would significantly reduce health risks for smokers.
Philip Morris built the Behavioral Research Laboratory, a sophisticated super-secret facility for DeNoble and his partner, Dr. Paul C. Mele, to use for their research.
During the first two years of the lab’s existence, the scientists were not allowed to discuss their research – even within the company.
But by 1983, DeNoble and Mele’s studies began to generate unwanted evidence regarding just how addictive cigarettes actually are. Their research was halted by Philip Morris, and their efforts to publish their work were blocked by the company.
Philip Morris officials abruptly shut down the lab in 1984, and both scientists were fired on the afternoon of April 5, 1984. They were told to halt their studies, turn off all their instruments, kill all the laboratory rats, and turn in their security badges.
It took nearly a decade for the results of DeNoble and Mele’s studies to become widely known.
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In 1994, Food and Drug Administration (FDA) commissioner Dr. David Kessler wanted to know if nicotine was a drug that should be regulated by the agency. He also wanted to know what the tobacco companies knew about nicotine.
Kessler and a team of FDA investigators worked undercover with informants with code names like Deep Cough, Veritas, and Research. The informants revealed that tobacco companies had deliberately manipulated nicotine levels in cigarettes to keep smokers coming back for more.
In 1994, Rep. Henry Waxman began conducting hearings on the tobacco industry. On April 14 of that year, Waxman put seven big tobacco executives under oath.
Each and every one of them denied that nicotine is addictive.
In subsequent hearings, Waxman proved that they were lying: he revealed documents that showed tobacco companies had buried internal research showing nicotine was addictive. They knew cigarettes caused cancer, heart disease, and other serious diseases.
Waxman also exposed documents that described the following secret research activities of Philip Morris from January 1969 to November 1980:
- Philip Morris conducted an extensive, but secret, research program into nicotine pharmacology for over a decade.
- Philip Morris scientists and executives have known for decades that cigarettes have powerful and addictive pharmacological effects.
- Philip Morris conducted secret research that focused on the pharmacological effects of cigarettes on children and college students.
DeNoble testified at the hearings. He explained that he and Mele had identified a psychoactive and possibly addictive substance in tobacco other than nicotine. That substance is called acetaldehyde, which is a natural product of burning sugars and other materials in the tobacco leaf.
They found evidence that acetaldehyde is just as addictive as nicotine, and that combining it with nicotine far exceeds the addictive power of either in isolation.
One important measure of a drug’s addictive potential is whether a laboratory animal will work hard pressing a lever to get the drug. Nicotine will get a rat to press a bar steadily, more than 100 times an hour.
DeNoble found that the animals would do the same for acetaldehyde, though not for water or saccharin or other favored substances.
But when the rats were given a chance to have both nicotine and acetaldehyde together, the rats tripled their bar-pressing to more than 500 times a hour.
Philip Morris executives were very supportive of DeNoble’s research on nicotine and acetaldehyde, but not because they wanted to reduce or eliminate the substance in their products.
They wanted to know if there was an optimal ratio that was the most reinforcing in rats – that is, which ratio had the most addictive effects.
DeNoble was told that the acetaldehyde work was very sensitive and that Philip Morris did not want it to be misinterpreted if it got out, so they wanted to move it out of Philip Morris’s Richmond labs. They talked about firing DeNoble and Mele and having them continue their work from outside of the company.
He was also told “that the lab was generating information that the company did not want generated inside the company, that it was information that would not be favorable to the company in litigation.”
The researchers made another striking discovery: an artificial version of nicotine that seemed to have few of the toxic effects on the heart that the natural substance in cigarettes has.
Remember, DeNoble was hired under the guise of Philip Morris wanting to formulate a cigarette that was less harmful to health.
But all evidence points to the true intent of the tobacco giant – to develop an even more addictive product.
When the court asked DeNoble if he believed Philip Morris was committed to making and selling a product that reduced or eliminated the adverse cardiovascular effects of nicotine, he said,
Absolutely not. I say that because I saw the company choose not to continue research or go further to support research that was making progress toward something they could implement or use to make the product safer.
Do you want to give your hard-earned money – and possibly your LIFE – to such a corrupt industry?
As you can see, tobacco companies have been going to great lengths to keep you uniformed and addicted. They have extensively manipulated cigarette chemistry with the sole purpose of keeping you hooked.
Speaking of the chemistry of cigarettes, this infographic from Compound Interest provides a summary of a few of the hazardous compounds in cigarette smoke and their effects.
The industry has billions of reasons to keep you addicted.
During 2014, nearly 264 billion cigarettes were sold in the United States. Three companies – Philip Morris USA, Reynolds American Inc., and Lorillard -accounted for about 85% of U.S. cigarette sales.
Total profits for the 6 largest tobacco companies (worldwide) combined was $35.1 billion in 2010.
The average cost to consumers of a pack of 20 non-generic cigarettes is $6.28, including federal, state, and local excise taxes (as of November 2014).
Now, back to the science of addiction.
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The pleasure provided by nicotine is complicated, as neuroscientist Marc Lewis, author of Memoirs of an Addicted Brain: A Neuroscientist Examines his Former Life on Drugs and The Biology of Desire: Why Addiction Is Not a Disease, explains:
Nicotine molecules find their way to receptors (little harbors) on several types of brain cells. The first type processes acetylcholine, one of the brain’s main neurochemicals. Acetylcholine makes us more alert and focused, it powers consciousness itself – so nicotine enhances our sense of being alive, if only slightly. The second type of brain cell colonized by nicotine processes dopamine, the neurochemical that causes us to feel attraction and anticipation. Dopamine is a well-known culprit in all kinds of addictions. It’s been linked with pleasure conventionally, but its main function is to promote desire and goal pursuit rather than pleasure per se. In fact, nicotine receptors are scattered all over the brain, and they turn up the tap on other neurochemicals, in charge of every brain state from arousal to relaxation.
He goes on to explain why quitting is so difficult:
As with other addictive drugs, the comforts of nicotine are outweighed by the discomforts attendant on quitting. All those receptors in all those regions grow accustomed to their nicotine diet after several months. They adjust to that diet, so they are relatively starved when it’s suddenly withdrawn. The positives rebound into proportional negatives – and we feel that backlash in our bodies as they receive distress signals from our brains. Just as nicotine makes us feel good in subtle and complex ways, nicotine withdrawal makes us miserable in subtle and complex ways.
Gene Heyman, an American addiction researcher, explored epidemiological data on the average time to quit several drugs, and here are his surprising findings:
With the onset of dependence as the start date, half of those ever addicted to cocaine had quit using this drug at clinically significant levels by year four, and the half-life for marijuana dependence was six years. In contrast, alcohol and cigarette dependence had much longer half-lives. For alcohol, the 50% remission mark was not reached until year 16, and for cigarettes, it took on average 30 years for dependent smokers to quit.
Physical addiction is potent, but the good news is that it is short-lived.
It is relatively easy to overcome.
But Lewis reminds us that psychological addiction is physical too:
Psychological states depend on brain states, and the brain is obviously a physical entity. Second, the psychological state of craving is the lynch pin of relapse. As any addict will tell you, persistent craving is like an acid that eats through resolve and good sense. So how does craving work, and what sort of brain mechanisms support it? Craving is just intense, focused desire, and the neural engines of desire have been fine-tuned over hundreds of millions of years of evolution. We need desire in order to survive.
Cravings become an established habit “through repeated cycles of desire, acquisition and loss. You want it, you get it, then it’s gone,” Lewis says:
Each time that cycle of wanting, getting and losing is repeated, a network of connections is reinforced in your brain. Acute focus, fuelled by desire, grows connections (synapses) among the brain cells devoted to the thing you can’t help wanting. With each repetition, that synaptic cluster is enriched: millions of new synapses fill in the gaps, and the synaptic networks underlying other goals dissipate with disuse. Then, when a reminder or “cue” pops up, that now-familiar synaptic configuration is activated like a cluster of Christmas lights. That’s when you can’t think of much else or wish for much else until you get it. That’s craving.
Some experts believe that addiction is a “brain disease,” but Lewis expresses his disagreement eloquently:
I see addiction as the outcome of a brain doing what it’s supposed to do: seek pleasure and relief in a world that isn’t cooperating. Other researchers also recognize that addiction grows best in a vacuum, in environments devoid of other, more wholesome rewards, such as prosperity, community, close interpersonal relationships and self-esteem. Desire can get stuck in a lot of places: in loving and caring for your kids or your pet, gourmet cooking, stamp-collecting, you name it. Or it can get stuck on drugs, including nicotine, when that empty feeling comes around again.
The brain changes that underlie addiction indicate a deep and entrenched history of learning, not a disease. So, to fight addiction, we have to address the feelings and the conditions that send people searching for short-lived rewards with long-term consequences.
Nicotine is usually out of your body 72 hours after you quit smoking. Nicotine withdrawal symptoms usually reach their peak 2 to 3 days after you quit, and are typically gone within a few weeks.
This leads us to the what is the trickier part of the quitting equation for many: psychological addiction.
We will discuss that in Part 3.
Related Reading
How to Quit Smoking: Are Irrational Beliefs Getting in Your Way? (part 1 of a 4-part series)