Every year, research organisations survey smokers about their attitudes towards smoking. The results for 2022 seem encouraging: one in five Russians plans to quit soon. But according to UN figures, only 4–7% of people who decide to quit succeed on their own. That does not mean everyone else is weak-willed: quitting smoking really is difficult. We explore why.
How nicotine dependence develops
Giving up smoking is not like learning to stop leaving socks around or biting your nails. There is an important physical component. The nicotine in cigarettes stimulates the dopamine system, which is involved in anticipating pleasure and rewards. External stimuli such as smells, sounds and tastes normally trigger dopamine release. If you enjoyed a hamburger once, smelling one will make you want another. Cigarette dependence works similarly: your brain sends signals telling you to take a puff right now if you want to feel better.
Why people start smoking
The reasons people start smoking are psychological rather than physical, and they are hard to classify. Many begin as teenagers to fit in or to rebel against their parents. Adults often want to relieve stress or distract themselves from problems. Some start out of curiosity.
For a long time, secondhand smoke was also thought to cause dependence, but this is not the case. Addiction specialists have debunked that myth. Regular exposure to secondhand smoke can harm the body, particularly in children, but it does not create the habit.
When does someone become hooked?
How many cigarettes does it take to become hooked on nicotine? Ten or fifteen, or just one? Dependence does not develop instantly, of course. There are three stages of becoming dependent on smoking.
Stage one: occasional smoking.
Nobody enjoys their first cigarette. Quite the opposite: it causes nausea and dizziness. But the body adjusts quickly, and soon the smell and taste stop being unpleasant. Dopamine continues to be released, however, and the urge to smoke becomes more frequent. At first, a person smokes only in certain situations, such as when stressed. Soon, more situations trigger that urge. The first stage lasts from one to five years.
Stage two: withdrawal symptoms develop.
If a person becomes irritable and nervous when they cannot smoke, they have reached the second stage. They want to smoke more often, and cigarette breaks become part of their daily routine. This stage can progress very quickly, within a few months.
Stage three: accepting the habit.
The body is now so dependent on nicotine that going without it causes genuine withdrawal. Smoking feels like an essential part of life. The smoker needs at least a certain number of cigarettes each day to relieve withdrawal, and that number keeps growing: many smoke a pack a day. At this stage, breaking the habit without help is very difficult.
Is there a way out?
Even if withdrawal feels like a steamroller running you over every time you miss a cigarette, there is a way out. There are many ways to quit, from nicotine gum to medicines that replace the effects of cigarettes.
The key to success is reducing withdrawal symptoms and breaking psychological dependence. That means combining several methods of quitting. Nicotine patches, for example, help reduce the urge to reach for a cigarette. Antidepressants prolong the dopamine effect, reducing the need to keep stimulating its release.
Better still, see a psychiatrist before quitting: they can suggest the most suitable methods and prescribe antidepressants.
A few words about motivation
No method of quitting will work without sustained motivation. Everyone has their own reason: wanting to stay youthful, fear of lung cancer or concern for loved ones' health. Any motivation is useful if it keeps you applying patches and staying away from cigarettes each day.
Quitting smoking is hard, but not impossible. Twenty million people manage it every year. The culture of giving up cigarettes is constantly evolving, with new approaches and solutions emerging. Perhaps scientists will soon develop a new method that makes overcoming nicotine dependence much easier.
