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Why is it so hard to stop smoking?
Smoking cigarettes can cause many fatal and non-fatal diseases and is the world's leading preventable cause of death. Cigarette smoking is so difficult to quit due to the nicotine in cigarettes. Nicotine is found naturally in tobacco and is as addictive as heroin and cocaine. When a smoker inhales it carries the nicotine down into the lungs where it enters the bloodstream and is carried all through the body causing the body to respond in many ways.
Nicotine is a stimulant, similar to caffeine, which causes the brain to become more active and creates a “buzz” mostly due to the stimulation of the adrenal glands (in the brain) which releases adrenaline. This adrenaline rush energizes the body and causes a number of responses, an instant release of glucose, increased blood pressure, respiration, and heart rate. Nicotine releases the neurotransmitter dopamine which causes you to feel pleasure.
Over time the body builds a tolerance to nicotine and requires people who use it to use more and more of it to obtain the “buzz”. This is why, over time, people who smoke need to increase the amount they smoke so they can continue to obtain that buzz. When people who have built their tolerance to nicotine attempt to quit they get symptoms of withdrawal including dizziness, headaches, irritability, and insomnia. When you quit smoking your body releases less dopamine as well which can cause feelings of anxiety and depression.
Benefits of Quitting Smoking
Most tobacco contains thousands of chemicals, many of these are extremely damaging and contribute to serious health issues, some can even cause cancer. Stopping smoking will greatly benefit your health and not only that but the health of your family, and will save you a lot of money in the long run. Stopping smoking includes these great benefits:
- Reducing your risk of the following diseases- Cardiovascular disease (coronary heart disease, stroke, etc), lung disease (Chronic obstructive pulmonary disease, COPD), cancer( lung, head/neck, esophageal, pancreatic, and bladder), peptic ulcer disease, osteoporosis, type 2 diabetes, sexual problems (erectile dysfunction), gum disease, some infections.
- Reducing your family and friends' risk of disease- exposure to second-hand smoke can have serious risks to many diseases including lung cancer, coronary heart disease, and stroke. Children exposed to second-hand smoke have an increased risk of sudden infant death syndrome, asthma, ear infections, and developing cardiovascular disease or cancer later in life.
- General benefits-food will taste better, you will have extra money, you will be able to be more active, your home, care, clothes, and breath will smell better, and you will have fewer signs of aging.
How to prepare for quitting smoking
It is important to prepare yourself for quitting smoking in order to be successful. The first step is just being ready to quit smoking, next you need to fully understand your smoking habits, understanding your smoking patterns can help you be more successful when you are ready to quit. The first thing you should do once you have made the decision to quit is to set a quit date. Try and set your quit date during a low-stress time in your life. It is important to set a quit date so you have time to mentally and emotionally prepare for quitting. Some people choose to slowly reduce the amount they are smoking up to their quit date, while others quit “cold turkey” on their quit date, choose the way that works best for you.
Once you have set your quit date there are things you can and should do to help you prepare for the coming days. First, talk to your doctor about ways to help you quit smoking. Maybe this is your first time quitting or maybe you have tried before, think about what has happened in your past attempts at quitting and think about what worked and what didn’t work and try and learn from your past experience. Let your family and friends know your plans for quitting so they can be there to support you through this. Make a list of all the reasons you want to quit smoking so you can refer back to it when you need a boost. Prepare yourself for nicotine withdrawal symptoms and think of ways you will handle them, they will be worse in the first few days but it will get easier with time. Think about things that would typically trigger smoking and attempt scheduling your quit date when it is easy to avoid these situations. If you are able, plan to start an exercise program before your quit date, this will help develop healthy habits and help to distract you from smoking. Lastly, plan to reward yourself for quitting, maybe you reward yourself for every day you don’t smoke, or maybe you save all the money you would have spent on cigarettes and buy something really special.
It is a difficult decision to make, but if you have a plan and are prepared for this lifestyle change you will be extremely successful in quitting smoking.
Where to get treatment to help stop smoking
Medication can help you stop smoking and help to reduce cravings for smoking. Talk to a healthcare provider about what medication will work best for you. Seeking this help using an online doctor is convenient and it will save you time. You simply set up an appointment with a healthcare professional, have a consultation where you will be asked questions about your medical and smoking history, and discuss the best treatment option for you. These companies can send a prescription to your pharmacy or sometimes they can even ship the medication directly to your home. There are many online doctor companies that provide this service and you can find them listed below.
- Lemonaid Health
- Zero (quit with zero)
- Rory (does not directly offer treatment, but will direct you to its sister company Zero)
- Roman (does not directly offer treatment, but will direct you to its sister company Zero)
Types of treatment and possible side effects of stopping smoking
Taking medicine can increase your chances of quitting and quitting for good. There are many medications available to help you stop smoking, some that require a prescription, and some that do not. Those who are trying to quit could benefit from using a single medication, some people may see a greater benefit in using a combination of medicines. Talk to a health care professional to see what will work best for you. Effective medications approved by the U.S. Food and Drug administration include nicotine gum, patches, lozenges, spray or inhaler, and varenicline and bupropion. We will discuss these medications in greater detail below.
- Nicotine gum (Nicorette)-Nicorette is available without a prescription and comes in many flavors. It comes in a 2mg or 4 mg dose, the 2 mg dose works best for those who smoke 25 cigarettes a day or less and the 4 mg dose works best for those who smoke more than 25 cigarettes a day. This gum needs to be chewed differently than regular chewing gum, as the nicotine needs to be absorbed into your cheek or gums. If the gum is chewed to quickly you will end up swallowing the nicotine causing an upset stomach. For Nicorette to be effective you will need to chew the gum just enough to feel the nicotine being released (tingling sensation) and then hold the gum inside your cheek until the feeling goes away, then repeat the cycle until no longer effective. You can use up to 24 pieces in one day. The gum does not completely prevent symptoms of withdrawal but reduces them. Side effects typically include mouth irritation and jaw soreness.
- Nicotine patches (Habitrol, Nicoderm CQ, Nicotrol, ProStep)-Nicotine patches work to deliver nicotine to the blood through your skin. The patches come in many different doses, the highest dose being 21 mg/patch. The patch will reduce symptoms of withdrawal but will not prevent them completely. It is typically recommended that you use the patch for 8-12 weeks and slowly work to decrease the dose of your patches over time. Some side effects of wearing the patch at night may include insomnia or vivid dreams. Some nicotine patches require a prescription and others do not.
- Nicotine lozenge (Commit)-Nicotine lozenges work to release the nicotine as the lozenge slowly dissolves in your mouth. It works similarly to the gum in that the nicotine needs to be absorbed by the mouth and not swallowed. The lozenges come in a 2 mg and 4 mg dose and you do not need a prescription to buy these. Side effects typically include mouth irritation and jaw soreness.
- Nicotine inhaler (Nicotrol)-A nicotine inhaler is a device that you use similarly to a cigarette, it is made up of a mouthpiece and a cartridge that contains nicotine. The nicotine is released when you inhale through the device and the nicotine is absorbed by your mouth and throat. Because the nicotine does not reach your lungs the nicotine is absorbed more slowly. It is common to experience irritation of your mouth or throat, sneezing or coughing, when using this, especially in the beginning. You will need a prescription to purchase this in the U.S.
- Nicotine nasal spray (Nicotrol NS)-The nasal spray works by delivering nicotine in a liquid solution into your nose and is absorbed quickly into your bloodstream. You may experience a burning sensation in your nose or sneezing but this will lessen with more use. This is available with a prescription in the U.S.
- Varenicline (Chantix)-Chantix is a prescription medication that works by attaching to nicotine sites in the brain and blocking nicotine. Chantix will still release the “feel good” hormone dopamine but less than would be released with nicotine. It is recommended you start taking Chantix a week before your quit date and take it for at least 12 weeks. If after 12 weeks you have quit smoking your doctor may recommend that you continue taking Chantix for 12 more weeks to help reduce the risk of relapse. Side effects of Chantix can include nausea, abnormal dreams, and may have an association with risk of heart attack and stroke.
- Bupropion SR (Zyban, Wellbutrin SR)-Bupropion is an antidepressant and can be taken to help you quit smoking. It works to reduce the desire to smoke. It is a pill at your start taking 7-10 days prior to your quit date. Typically people take Bupropion for 2-6 months, your doctor will let you know how long is right for you. This medication should not be taken if you have a history of seizures or if you are taking an MAO inhibitor (Marplan, Nardil, or Selegiline). You may experience some side effects which include dry mouth, insomnia, appetite changes, agitation, or headaches. Notify your doctor if you have any unusual physical or emotional reactions while using Bupropion.
How to prevent relapse after you stop smoking
The best way to prevent yourself from relapse is to be mentally prepared for the feelings, situations, withdrawal symptoms, and activities that make you want to smoke. It is important to learn what your smoking triggers are and to plan how you will respond in those situations. Most relapses happen in the first three months, if you do slip up, know that you aren’t a failure and that it's important to get back on track and not fall into a total relapse. It is important to learn from these setbacks and figure out what you can do to prevent these from happening in the future. It may help to find healthy coping skills such as exercise to help prevent mood swings and depression. Many people smoke to increase their pleasure and elevate their mood, so it is important to find other ways to make yourself feel better while you are in the process of quitting. If you find there is an ongoing issue that continues to cause setbacks you may want to enlist the help of a counselor. There are many counseling options including individual counseling, telephone counseling, or support groups. Having somebody else to help hold you accountable can go a long way to increase your chances of quitting.
Stopping smoking will likely be a difficult journey, but with the right preparation, you can be very successful. There are many healthcare professionals available right now to help you take the first step in your decision to stop smoking. Check out our list of the top online doctors who are there to help make this journey to quitting easier for you.