According to a 2018 Canadian Community Health Survey, almost 11% of Canadians smoke cigarettes each day. Another 5% identify as occasional smokers, and a little over 21% used to smoke every day but have since given it up. Of everyone who has smoked at least one whole cigarette during their lifetime (roughly half of the Canadian population aged 12 and older), roughly three quarters have, at some point, been daily or occasional smokers (the remainder are “experimental” smokers who tried it once only) .
In spite of concerted efforts by governments around the world to reduce smoking, about one fifth of the world’s population engaged in regular cigarette smoking in 2016, including more than 24 million children aged 13-15.
In spite of these numbers, which indicate that most people who try smoking end up as regular or semi-regular smokers, the use of cigarettes is generally regarded as a bad habit rather than a nicotine addiction. According to several studies, though, six or seven out of ten smokers want to quit in the next six months, and it may take the average smoker as many as thirty attempts before they are able to quit successfully .
These figures do not factor in the troubling rise in the use of electronic cigarettes (e-cigarettes), or “vaping”, which is increasingly prevalent especially among young adults: about 31% of Canadians aged 20-24 years claim to have tried electronic cigarettes in 2015 .
Cigarette use is the leading cause of preventable death in adults in both Canada and the United States. The danger comes from multiple sources: according to the American Lung Association, traditional cigarettes contain about 600 ingredients, at least 69 of which are known carcinogens. When cigarettes are burned, they produce over 7,000 chemicals, posing significant risk not only to the smoker, but to those who are in close proximity .
Classed as a stimulant, nicotine is a nitrogen-containing chemical that is produced naturally by tobacco plants, and synthetically in laboratories. Not only is nicotine highly addictive, it exposes people to other ingredients in cigarettes that are dangerous.
The appeal of nicotine is that it improves memory and creates a heightened sense of alertness, while simultaneously making the user feel relaxed. Like most addictive substances, it creates a surge of dopamine – the feel-good chemical in the brain – leading to a sense of contentment.
However, nicotine also comes with a host of harmful side effects that can affect almost all of the body’s systems. These include the following:
In addition, smoking during pregnancy can result in risks to the child, such as obesity, diabetes, high blood pressure, developmental delays, and behavioural challenges.
The fact that it takes most smokers several attempts to break their addiction is testament to the belief held by many that nicotine is at least as difficult to give up as heroin. While there is no physical danger to stopping “cold turkey”, this can result in some uncomfortable withdrawal symptoms, including:
Although nicotine itself does not carry any known cancer risks, at least 69 of the chemicals in cigarettes do. These chemicals include benzene, chromium, cadmium, acetaldehyde, ethylene oxide, and many more .
According to the Canadian Cancer Society, 72% of lung cancer cases in Canada are a result of smoking, with smokers 20 times more likely to develop lung cancer than non-smokers.
The risk does not end there: smokers are at increased risk of developing the following cancers :
Many people who have been smoking for a long time believe that since the damage done is permanent, there is no point to them stopping. However, people of any age, who have been smoking for any length of time, can experience health benefits, some of which start almost immediately after the last cigarette was smoked.
The following is a timeline, starting from the quit date, of how and when giving up smoking can impact a person’s health :
There is no way to get around the fact that quitting smoking is extremely difficult. According to the Ontario Tobacco Research Unit, most smokers who attempt to stop start smoking again about a week later.
The good news is that the longer you can stick it out, the more your chances of success improve. Someone who has been smoke-free for two years has a 92% likelihood of staying that way . The cessation aids that are effective vary widely from person to person, and are discussed below.
While some people revert to smoking as a result of stress or an inability to abstain in the presence of friends and family members who smoke, the number one cause of relapse is the nicotine withdrawal symptoms.
Nicotine replacement therapy (NRT) has been devised as a way to reduce these withdrawal symptoms and improve the chances of the person trying to stop smoking. It works by enabling the former smoker to ingest nicotine in a less harmful format while eliminating exposure to the harmful chemicals in cigarettes.
NRT comes in several forms, including gum, nicotine patches (transdermal nicotine systems), nasal sprays, lozenges and inhalers.
You can improve your chances of success with nicotine replacement therapy by following these tips:
NRT should not be used without the advice of a doctor in the following circumstances:
Like most addictions, smoking is often rooted in context. People smoke their first cigarette for all kinds of reasons, such as peer pressure, a desire to “fit in”, and as a response to a stressful situation. Through individual counseling, you can be guided through the process of exploring the issues that made you start or continue smoking. With the help of a therapist, or through the stories of people who have been through experiences similar to yours, you can learn some tools and coping strategies to use at times when you would regularly smoke. This method can be highly successful when used with lozenges, nasal spray, nicotine gum, or other aids that are designed to help with symptoms of nicotine withdrawal.
An extended-release form of the antidepressant bupropion (Zyban) has been approved by the FDA as a smoking cessation aid. It works by increasing the levels of some of your brain chemicals, thereby reducing cravings and nicotine withdrawal symptoms. Since bupropion takes several days to take effect, it is most effective if you start your prescription about a week prior to your planned quit date.
Another prescription alternative is varenicline (Chantix). This medication controls withdrawal symptoms by blocking the nicotine receptors in your brain. Like bupropion, it should be started about a week before you smoke your last cigarette.
In some cases, people can stop smoking without the use of any smoking cessation aids. You have a greater probability of succeeding if you have a quit plan that lays out how you are going to quit. Some tips that may help ensure success include the following:
Everyone is different – former smokers will tell you that the experience with smoking cessation varies widely from person to person. Some people can go it alone, while others may need Zyban, nicotine gum, or nicotine patches. If you are wanting to quit smoking, it is important that you don’t do so impulsively, by following the method that worked for your brother, your co-worker, or your neighbour. Different things work for different people, and you will be more likely to succeed if, before your planned quit date, you take some time to think about what is most likely to work for you and how you can best control the craving.
And if you do revert to smoking, don’t be down on yourself. That simply means that the method you tried was not quite right. Revisit your plan, see what tweaks you can make, and try again! Within days, you will start to feel like a healthier version of yourself.
Photo credit: Rosewoman. This picture has a Creative Commons attribution license.— Addiction Problem, Cigarettes, Nicotine, Quitting Smoking