Why so many people don’t succeed when they try to quit smoking: Overcoming the physiological addiction

In part one of this series we talked about attacking an addiction or a habit from all of the sides, not just one of them. If you haven’t read that, go back and read it now. In this article we’re going to focus on the physiological addiction, or in the case of smoking, nicotine.

Nicotine is a chemical that effects our nervous system, triggering a number of interaction which in the end can make us feel calmer, happier, and overall better. However the more we consume, the more dependent we get on this chemical. Our body knows to expect it, and we even create more receptors waiting to be filled with nicotine, increasing this feeling of craving. When we don’t supply our body with that nicotine dose that it’s expecting, we start entering a state called withdrawal. This withdrawal is physiological, and can include sweating, stomach pains/constipation, headaches, sore throat and many other things. However it’s important to keep up with it, because if you manage to get off nicotine for a few years, you can lower your risk of almost all of the diseases that are associated with smoking. And by the way, that’s a very long list.

3 ways to help yourself overcome the physiological addiction of nicotine:

  1. Nicotine alternatives – easy enough, right? The idea is to continue to give your body the nicotine that you are craving, in decreasing doses so that you become less dependant on the chemical.
    • Nicotine patches are an example of this. One of the main advantages of the patch is that it works for a relatively long time, up to 24 hours in most cases.
    • Gum is another example, though it is shorter acting. Chewing a lot of gum can also has it’s disadvantages including dental health,  social norms, manners etc.
    • There are also candies that are short acting, though both gum and candies might be a good solution to handle immediate crises when you think that you are going to fall back to the bad habits.
    • Inhalers are available which provide nicotine without the dangerous aspects of a cigarette. The downside with inhalers is that the activity is very similar to smoking, so the behavioural aspect of the addiction is not overcome, and sometimes strengthened.

2. Bupropion (Zyban, Wellbutrin) – This is a drug which acts as a dopamine re-uptake inhibitor. What does that mean exactly? Dopamine is a neurotransmitter, or a message in a bottle used to pass messages between cells of our nervous system. It is one of the chemicals which creates those positive feelings that come along with cigarettes, as mentioned before. Bupropion increased the availability in that space between cells, so that more of the dopamine particles can be received by the receiving end, having an increased effect. It is a good drug, one that requires prescription in most places. It also is used as an antidepressant, and often in PTSD so it reduces the effects of withdrawal. Buproprion may cause seizures, so anyone with epilepsy should not take it. It also encourages weight loss in some people, which is the opposite of what happens to most people who quit smoking. 

3. Varenicline (Champix) – This is a drug developed specifically for smoking cessation. It works by connecting to the nicotine receptors and partially activating them, though they are bound in an irreversible way. It causes an effect that when you smoke, your nicotine receptors are not available so you won’t get all of the advantages. Champix also reduces the side effects of quitting. It needs to be taken for at least 3 months in order to be effective. Once you start the medication, the smoking cessation should start only 2-3 weeks after, so the recommendation is to take if for a few weeks before you actually stop smoking. There is a side effect of nausea which is common, and usually goes away by itself after a month at most. It can also cause you to have weird dreams, and anxiety at night. Many people also have reported to feel head aches, palpitations, and anxiety, but these are effects of withdrawal, and not from the medication. There is a rumour that Champix causes suicide, however a large trial in 2016 disproved this rumour, and deemed that the medication is safe even for psychiatric patients. One of the great advantages of this medication is that it does not interact with other medication, so if you are on a number of other meds (and if you smoke you probably are, or will be) it can be taken safely. 

These are the 3 ways that you can attack your smoking addiction from the physiological aspect. Remember, you still have to create other strategies to attack the emotion and behavioural aspect, though these are topics that we will cover in other articles. Good luck!

Are you ready now to move on to the behavioural addiction?

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