Smoking is a highly addictive, life-threatening condition which can lead to a large number of physical and mental health issues, including cancer, cardiovascular diseases, and depression. In an effort to truly quit cigarettes and other tobacco-related products, smokers consider and try many different products and treatment options. How effective is counseling when it comes to smoking, and how does it compare to other options available on the market?
Smoking addiction (aka nicotine dependence) is defined as the compulsion to inhale nicotine via tobacco smoke. Neural pathways, a genetic predisposition and social pressure have all been found to contribute to this addiction.
On a neurological level, nicotine creates a pleasant feeling by binding to the nicotinic cholinergic receptors in the brain. Since one develops a tolerance to nicotine over time, inhaling nicotine through cigarettes, cigars or other tobacco products causes them to increase the amount of smoking you need to maintain that same feeling they had when they first started. Once they refrain from smoking, they become irritable and tense, until they feel the need to smoke just to return to a baseline level of calmness.
On a genetic level, a predisposition has been found among certain individuals toward nicotine dependence. This means that they are more likely than the general population to become smoking addicts to what is already a very addictive substance.
Finally, social pressure has also been implicated in smoking addiction. Working in tandem with the neural pathways and genes implicated in its highly addictive nature, wishing to become part of a group, especially during adolescence, is what draws many individuals to their first cigarette. Eventually, this social habit becomes a personal one as they begin smoking regardless of their current social situation.
Smokers make up 13.7% of the adult population, with men smoking at a higher rate than women (15.6% vs. 12.0%, respectively). 45 million Americans smoke tobacco.
One-third of those who smoke tobacco become daily users, and only 7% are able to successfully quit.
Smoking is a serious risk factor for a number of physical health issues. These include cancer, cardiovascular illnesses, diabetes, lung disorders, and other significant health problems.
8 million individuals die from nicotine addiction-related causes annually.
As mentioned earlier, a major, non-physical side effect of smoking is that your emotional equilibrium, or well-being, becomes dependent on a steady supply of nicotine.
And while this unpleasant result of nicotine addiction is harmful enough, smoking withdrawal has been shown to cause even more significant mental health and emotional issues, making smoking cessation that much harder to achieve. Sadness and moodiness are among the more common adverse emotions that appear early on due to nicotine withdrawal.
Symptoms of anxiety and depression, two significant mental health disorders, have also been shown to appear as a result of nicotine withdrawal. They include low mood or difficulty concentrating (relating to depression) and a sense of constant or near-constant tenseness (relating to anxiety). These symptoms usually pass within the first few weeks, making the cessation process more tolerable.
At its core, smoking cessation counseling emphasizes encouragement and one’s own agency. By initiating conversations about this subject, promoting cessation and highlighting the smoker’s potential to kick their undesirable habit, many health professionals are aiding their patients in their journey toward nicotine recovery.
As part of this form of support, physicians and other health professionals are being taught to use the five A’s—ask, advise, assess, assist, and arrange—in an effort to promote cessation.
During every appointment, patients should be asked about tobacco use. This can help raise awareness to the issue and open the door to an honest conversation on how smoking is influencing their lives. Such questions should be repeated in all future sessions.
If they confirm they have been smoking, they should be advised to quit by listing the detrimental effects that smoking can have on their lives, presently and in the future. The benefits of smoking cessation, both to their physical and mental health, should also be stressed. These include easier breathing and improved heart rate, a better mood, increased taste and smell, saving money that would be spent on cigarettes, and of course, protecting against the many illnesses that smoking can bring about.
Assessing the patient’s status of addiction—how often they smoke, in what social contexts, whether they can identify any triggers to their smoking habit, etc.—this helps paint a clearer picture of their current situation.
Though many smokers are eager to quit smoking, many find it daunting to contend with nicotine withdrawal and could greatly benefit from receiving assistance. Healthcare providers should therefore have a firm grasp of the withdrawal process, the patient’s available treatment options, and the contact details of nearby smoking cessation treatment centers on hand. Among these options are nicotine replacement products such as patches and lozenges, as well as two FDA-approved medications: Chantix and Zyban. It is especially recommended that any patients considering these and any other types of medications consult with their doctor before beginning treatment.
Helping patients arrange their own smoking cessation treatment is also an important part of cessation counseling. While patients should be told that it is their body and lives that are affected by their smoking, supporting them by making the necessary connection to a professional able to prescribe the appropriate medication, or to a treatment facility that offers smoking cessation care, helps them feel they are not alone in their battle. Hopefully, with enough support and a growing belief in their own self-reliance, they will be able to see through their own process on the road to recovery.