No matter how cold it gets this winter, people will stand outside bars and other buildings, hand in one pocket, cigarette in the other, smoking. Nonsmokers will pass by and think, “Why the hell do they do this?”
Because smoking is addictive.
David Bohl, executive director of Kiva Recovery, a substance-abuse treatment and recovery center located in Vernon Hills, said that addiction was once seen as a moral failing but research has come to show that it’s a disease that influences the brain’s reward and pleasure centers.
‘I have often chosen cigarettes over … clothing or paying a bill’
Gold Coast resident Margaux Meder said she uses smoking as a crutch during times of anxiety and high stress.
The 37-year-old smoking addict said she was 16 years old when she started and she did it to fit in with some of the more popular girls in her grade. She’s been smoking ever since. Meder quit cold turkey during her pregnancy but went right back to it once her baby was born, and today she smokes a pack a day.
“I missed it terribly, and I didn’t think to myself during the pregnancy, ‘Oh good! I’ve quit.’ All I was looking forward to was when I’d be able to go back and start smoking again,” Meder said.
Meder said that smoking cigarettes has had a huge financial impact on her life along with causing her health problems. She said she spends about $15 a day on cigarettes—amounting to roughly $450 a month.
“I could afford to live in a nicer place or pay other important medical bills if I didn’t smoke,” Meder said. “The financial impact affects me daily. I have often chosen cigarettes over healthy food, clothing or paying a bill.”
What makes smoking/nicotine so addictive?
A smoking or tobacco addiction is an addiction to nicotine, which is the highly addictive chemical found in cigarettes. Upon inhalation, the nicotine is absorbed into the bloodstream and within seconds begins affecting the entire body. According to the Centers for Disease Control and Prevention, smoking is the leading preventable cause of death in the United States and kills more than 480,000 people a year.
According to the CDC, nicotine can be as addictive as heroin, cocaine and alcohol. Research suggests that more people in the U.S. are addicted to nicotine than to any other drug.
“The nicotine locks onto receptors in the brain, and the person feels more alert and more aware, which feels nice. Dopamine is stimulated in the brain and causes it to feel pleasure and rewarded,” Bohl said. “Chasing those intense feelings of pleasure happens as the addiction kicks in. That rush of nicotine is gone after 40 minutes, and so that person needs to smoke again. After a while, the brain circuitry changes, the brain rewires itself, and they need nicotine to feel normal.”
“There is this misconception that nicotine is what’s doing the damage to the body. But in these tobacco products, it’s the additives that are doing the damage,” said Carol Southard, a registered nurse and tobacco treatment specialist at the Osher Center for Integrative Medicine for the Northwestern Medical Group. “People are afraid of nicotine, but they should really be afraid of what’s being added.”
Tobacco smoke contains a mix of more than 7,000 chemicals, 70 of which are proven to cause cancer, according to the CDC.
Cancer, other negative health impacts of smoking
Southard outlined some of the short-term and long-term effects smoking has on the body.
“Short term, smoking impairs the respiratory system immediately. The heart enlarges, the pulse increases and the blood pressure increases. Plaque forms outside the heart due to all the other chemicals that are being inhaled,” Southard said.
“Thirty percent of cancer deaths are caused from smoking cigarettes. It impairs the heart, lungs and truthfully every other organ in the body,” Southard added.
Why is it so hard to quit?
David Cohen, a licensed clinical social worker and certified alcohol and drug counselor in Chicago, said that it’s the withdrawal symptoms that keep people from quitting.
“Like all chemical addictions, one primary reason for continuing is the pain that one goes through when ceasing their drug of choice,” Cohen said. “They experience withdrawal symptoms like mood swings, depressed respiration, high levels of anxiety and sleep disturbances. To avoid withdrawal, a person continues to use.”
“While this is true, another driver for continued use is the enjoyment and pleasure one derives from the substance,” Cohen added.
Cohen’s parents were both lifelong smokers, and both ended up suffering from smoking-related health problems. Cohen said that although he’d seen his parents endure the consequences of a smoking addiction, he still chose to smoke cigarettes. But why?
“I think we live in a culture where we want what we want when we want it. We take what feels good over what’s healthy,” Cohen said.
While Cohen has since quit smoking cigarettes, he said he still uses e-cigarettes.
Meder said her goal is to quit, and she hopes to join a support group that will hopefully help her be done with cigarettes for good.
The Great American Smokeout
The American Cancer Society’s Great American Smokeout, a day to encourage smokers to give up smoking, is Thursday, Nov. 19 and happens every year on the third Thursday of November.
While quitting is hard, it’s important to know that it’s never too late to take that first step, Southard said.
“No matter how much someone has smoked or at what age they are trying to quit, every single organ in the body improves by quitting smoking,” she said. “Damage can start to be reversed almost immediately after quitting.”
According to Brian Hitsman, assistant professor in preventive medicine and psychiatry and behaviors sciences at Northwestern University Feinberg School of Medicine, nicotine dependence is chronic and the problem with treatments for the addiction are that they’re usually delivered in short-term increments.
“We give short-term treatment for tobacco dependence, but we need to treat it like it’s a chronic dependence—because it is,” Hitsman said. “Most people who are treated for only 12 weeks will usually go back to smoking. When we talk about how addictive tobacco is, for many, it is a lifelong addiction, and we need to care for it like other lifelong chronic health problems.”
“Studies that adopt that way of approaching dependence achieve better smoking cessation results,” Hitsman added.
Social smokers
So what about those people who only smoke around their friends? They’re not a daily smoker or a weekly smoker. They’re what we call a “social smoker.” Are they susceptible to a smoking addiction?
After talking with experts, it’s clear that there hasn’t been much research done on social smoking, so it’s hard to say anything for sure.
Hitsman said that nondaily smokers (people who smoke weekly and still have some of the same aspects of addiction as a daily smoker) make up about 40 percent of smokers, and around 15 percent of nondaily smokers are social smokers.
“We don’t know to what extent social smoking will lead to the kind of dependence we see in daily smokers,” Hitsman explained. “Some social smokers can maintain that low-rate social smoking for quite a while, but the likelihood of an addiction developing in the longer-term is still unclear.”
“We know that social smoking is certainly not healthy, but we need to better understand whether it would cause an addiction later on,” Hitsman added.
Southard said that the risks of a social smoker becoming addicted to cigarettes are related to dose, but that there is no safe level of smoking.
“We know that when tobacco and alcohol are combined, they have a synergistic effect on a person and enhance the effect of each other,” Southard explained. “If you give yourself permission to smoke, even if … it’s just in a social setting, you’ll be able to give yourself permission to smoke in the future. So [social smoking] could definitely be a gateway to a smoking addiction.”
Quitting
There are a lot of different options a person can choose when deciding to quit his or her addiction. Many experts suggest treatment that includes a combination of counseling and medication.
“Smoking is the most powerful addiction in humankind and can be harder to battle then heroin, cocaine or alcohol. The self-quit rate is around 2-4 percent, but no smoker should feel like a failure,” Southard said. “Not only can you ask for help, you should. Getting professional intervention increases your chances of quitting and staying quit.”
The U.S. Food and Drug Administration has approved seven medications to safely and effectively help people quit smoking, and they include three over-the-counter medications (nicotine gum, patches and lozenges) and four prescription medications (Nicotrol nicotine inhalers and nasal sprays, Zyban and Chantix).
Counseling comes in many forms, and smokers looking to quit can choose from in-person counseling from a doctor or health-care provider, telephone quitlines, support groups or enlisting the help and support of family, friends and co-workers.
Other options to quit smoking include smartphone apps, quitting cold turkey or e-cigarettes. Researchers have learned that a person needs to keep trying because it may take several attempts to quit their addiction once and for all.
“If a person gains the support and resources they need, they double or triple their chances of quitting for good,” Bohl said. “Who wouldn’t want to do that?”
Fast Facts
According to the CDC:
>> On average, smokers die 10 years earlier than non-smokers.
>> In 2013, 17.8 percent of all adults (42.1 million people) were cigarette smokers.
>> Smoking causes more deaths each year than HIV, illegal drug use, alcohol use, motor vehicle injuries and firearm-related injuries combined.
>> There are 12 cancer types known to be caused by smoking.
>> If you quit smoking, risks for cancers of the mouth, throat, esophagus, and bladder drop by half within five years.
>> The total economic cost smoking has on the U.S. is more than $300 billion a year in direct medical care and lost productivity due to premature death and exposure to secondhand smoke.
>> Smokers CAN quit: Today there are more former smokers than current smokers.
