As far as bad habits go, smoking has to be one of the biggest ones out there. There are no positive effects of smoking to speak of; it drains your wallet and it’s bad for your health. Smoking a pack a day can set you back as much as $3000 or more every year, which is money that would have been much better suited to work for you at the markets, accruing interest rates via index funds and stock equity.
I was a smoker on and off for the past 12 years. I managed to quit a couple of times, but it often took me only a couple of weeks or months before I fell back into the habit. It took a long time for me to realize what it was that was causing me to relapse. It wasn’t until I started studying the neurochemistry of smoking and talking to people who had managed to successfully quit that I began to piece things together. Barring all of the obvious health-related concerns as regards lung and heart function, let’s take a look at the brain and the actual chemistry of the habit.
Nicotine acts on nicotinic cholinergic receptors, triggering the release of neurotransmitters that produce psychoactive effects that are rewarding.
With repeated exposure, tolerance develops to many of the effects of nicotine, reducing its primary reinforcing effects and inducing physical dependencies in the form of abstinence. With repeated exposure to nicotine, neuroadaptation (tolerance) to some of the effects of nicotine develops, which leads to the number of binding sites on the nicotinic cholinergic receptors in the brain to increase.
The negative affect that typifies the response to nicotine withdrawal probably results in part from a cascade of events involving increased levels of extra hypothalamic corticotrophin-releasing factor (CRF) and increased binding of CRF to corticotropin-releasing factor 1 (CRF1) receptors in the brain, thereby activating the CRF–CRF1 receptor system, which mediates responses to stress. This is why so many smokers find it to be an effective stress relief, and why people who quit often find themselves irritable and frustrated over the next few days.
If a smoker were to cease all forms of tobacco use, the worst parts of the neurochemistry of smoking will have been flushed out in three days, but it takes about three to months for the billions of nicotinic receptors in their brains to return to normal levels. Even a single hit of nicotine from tobacco can cause these receptors to quickly up-regulate again, which is why someone trying to quit can find themselves right back were they started after the addiction tells them, “you can have just one”. It’s never just one.
Interestingly, nicotine replacement therapy does not have the speed or power to sustain the billions of up-regulated receptors. Research shows that people on cessation medication are losing these receptors at the same rate as if they quit cold turkey, which is why doctors and counselors recommend medications in tobacco treatment – they help manage withdrawal while allowing the addiction to continue dying away uninterrupted. The only thing that can cause these billions of nicotine receptors to return is tobacco use.
The medication and other treatment options are so successful, in fact, that we need only look at the statistics to see how they differ. Even though far more people report being able to quit cold turkey, the actual statistics are closer to 5% of all people quitting cold turkey being smoke-free one year later. Cold turkey is the most frequently tried way of quitting, however, so there’s a massive built-in selection bias that makes this method seem most successful. Simply because so many people try it, odds are that the person you meet who successfully quit smoking used this method.
If you compare this to the method that involves counseling and treatment medication, however, you’re going to be seeing success rates closer to one third of all smokers being smoke-free a year later. Especially if you get a prescription for Varenicline (Chantix in the USA and Champix in Canada, Europe and other countries), you can find enormous relief from the habit, as it simply makes smoking far less pleasurable. Instead of containing nicotine and supplanting the habit, it displays full agonism on the α7 nicotinic acetylcholine receptors. In contrast, nicotine gum or patches only supply a steady stream of nicotine into the body and lessen the craving for smoking that might otherwise appear.
I’m quitting smoking again now. I’ve quit cold turkey many times in the past, and have almost always fallen back into the habit again within a year and a half. This time, I’m going to go for the patch for a month or so. If that doesn’t work, I’m aiming for a prescription of Varenicline so that I’m completely smoke-free by August first. It’s going to be such a relief.