Why Is It So Hard to Quit Smoking?

Did you know that tobacco smoking is responsible for the deaths of approximately five million people each year, according to the World Health Organization?

Despite educating people about the very serious health effects of smoking, approximately 22% of adults in the United States are smokers.

Surveys have found that even though 80% of smokers would like to quit smoking, less than five percent are able to quit on their own due to the highly addictive properties of nicotine.

Why it is Difficult to Quit Smoking

So if smoking is so bad for you, why is it so hard to quit? Stopping smoking is difficult for several reasons:

    Nicotine is Highly Addictive
    Nicotine stimulates pleasure centers in the brain and is highly addictive. When nicotine is discontinued, the smoker will experience physical withdrawal symptoms, making the person want to start smoking again to stop the withdrawal symptoms. Each person experiences withdrawal from nicotine addiction a little differently.

    Typical nicotine withdrawal symptoms include (but are not limited to):

    • Flu-like aches and discomfort
    • Cravings for a smoke
    • Irritability
    • Sleep problems
    • Fatigue
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    • Difficulty concentrating
    • Headache
    • Cough, chest tightness
    • Sore throat
    • Sore tongue, gums

    Rewarding Psychological Aspects of Smoking
    The behavioral and social aspects of cigarette use are highly rewarding for the smoker. Smoking behavior becomes closely linked with daily activities and "cues" such as after a meal, when socializing with friends, when consuming alcohol, to "take a break", when under stress (to relax), when relaxing (to relax further), etc.

    The psychosocial-behavioral aspects of smoking can be just as challenging to overcome as the physical dependence.

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    Genetic Predisposition
    As science advances, the effects of genetics have been found to influence a number of health issues that were thought to be the domain of behavior only (e.g. alcoholism, etc.).

    Studies have established a substantial genetic contribution to smoking behavior (See the article for Ho et al. 2007 for a review).

    It has also been found that genetics differentially influence the multiple aspects of smoking, such as the urge to start smoking, continuing on to become a "smoker", etc. This may explain why some people cannot stand smoking at all, some can smoke occasionally with a "take it or leave it" attitude, and others will become regular smokers.

These factors explain why, even using behavioral approaches and anti-smoking medicine, the relapse rate for smoking is quite high.

Quitting Smoking in the Long Run

After quitting smoking, the first few weeks are usually the hardest. It usually takes at least eight to twelve weeks for an individual to start feeling more comfortable without smoking.

The bottom line: Stopping smoking over the long term (e.g. becoming a true "non-smoker") is challenging but clearly worth the effort.

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