Willpower to Quit Smoking

Even in the face of withdrawal symptoms that can challenge the strongest of wills, millions of Americans have conquered their smoking “habit,” step by step. According to the U.S. government’s Agency for Health Care Policy and Research (AHCPR), for every one of the 46 million American smokers, there is an ex-smoker who has successfully quit smoking.

True, it’s not easy. The nicotine in cigarettes can command both a physical and mental hold that can be tough to overcome. For some, nicotine is as addictive as heroin or cocaine and after quitting; there’s no question about it, sometimes you are going to think, “I’ve got to have one.”

For many smokers who want to quit smoking, willpower alone isn’t enough to beat the yearning. For them, smoking cessation products, which the Food and Drug Administration has approved, may reduce the cravings and other withdrawal symptoms.

Many people have used OTC nicotine replacement products such as the patch or gum to help them quit. While these products can ease the symptoms resulting from the physical addiction to nicotine, group or individual counseling and encouragement from family and friends are critical to help address the psychological effects of smoking.

“You really have to be committed to quitting smoking,” says Celia Jaffe Winchell, M.D., a psychiatrist and FDA’s medical team leader for addiction drug products, “and when you’ve made the decision to quit smoking, commit to using whatever it takes to quit.”

Smoking – The Killer Addiction

Imagine: Two jumbo jets crash every day and not a single person walks away alive. That, then-Surgeon General C. Everett Coop told Americans in 1989, is the number of people who die each day from smoking.

Cigarettes alone kill more than 400,000 Americans each year–more than AIDS, alcohol, car accidents, murders, suicides, illegal drugs, and fires combined. And smoking can harm not just the smoker, according to the Environmental Protection Agency and other experts, but also family members and others who breathe “secondhand smoke.”

Given that cigarettes are known killers, why do so many Americans continue to smoke?

Seventy percent of adult smokers want to quit smoking completely, according to a survey by the national Centers for Disease Control and Prevention. But the nicotine in cigarettes is an addictive drug that makes quitting difficult, as confirmed by the 1988 Surgeon General’s report on smoking and health.

“There is little doubt,” wrote smoking researcher M.A.H. Russell in 1974, “that if it were not for the nicotine in tobacco smoke, people would be little more inclined to smoke than they are to blow bubbles or light sparklers.
As with other addictive drugs, people can experience withdrawal when they get less nicotine than they are used to. Symptoms can include irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, and craving for tobacco.

One reason cigarettes in particular are so addictive, Winchell says, is that a person gets a “very rapid and effective dose” of nicotine by inhaling the smoke. Within seconds of inhaling a cigarette, nicotine enters the lungs and then travels directly to the brain.

Tobacco use “is not just some bad habit, but a powerful addiction that warrants appropriate medical treatment,” says Michael Fiore, M.D., director of the Center for Tobacco Research and Intervention at the University of Wisconsin Medical School.

As a rule, Fiore says, people who smoke more than 10 cigarettes a day and want to quit should use an FDA-approved smoking cessation product.

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