If you or someone you know has ever tried to quit smoking, you know it can be extremely challenging. That is because nicotine, the chemical in tobacco, is addictive.
The Mayo Clinic explains the addiction as a cycle: Nicotine produces pleasing effects in your brain, but those effects are temporary, so you smoke another cigarette. The more you smoke, the more nicotine you need to get those pleasing effects, and when you try to stop, you feel unpleasant mental and physical effects. This is nicotine withdrawal.
To be more technical, nicotine binds with the brain’s nicotinic cholinergic receptors, releasing a mood-elevating neurotransmitter called acetylcholine.
Due to its highly addictive nature, nicotine causes one-third of people who smoke even once to become regular tobacco users. Most people who try to quit smoking relapse, with only 7.5% managing to quit.
Read on to learn about the benefits of quitting cigarettes, the stages of smoking cessation, and treatments for smoking addiction.
The Benefits of Smoking Cessation
According to Medical News Today, the health benefits of smoking cessation are both immediate and long term: After as little as 20 minutes, your heart rate slows and returns to normal. Blood pressure decreases and circulation may improve. Within 12 hours, your body starts to cleanse itself of excess carbon monoxide from cigarettes, returning to normal levels and increasing oxygen levels in the body.
After one day of quitting smoking, your risk of heart attack starts to decrease, as blood pressure decreases, and oxygen levels reach healthier levels. After two days, the nerve endings that were damaged from smoking – the ones responsible for sense of smell and taste – begin to heal.
After three days, nicotine levels in the body are depleted. Unfortunately, this can cause nicotine withdrawal with symptoms such as moodiness, irritability, headaches, and cravings.
Fast forward a month after quitting and most people see improved lung function along with less coughing and shortness of breath. As the months go by, circulation continues to improve.
A year after quitting, your risk for heart disease decreases by half, with the risk continuing to decrease as time goes by. Five years later, arteries and blood vessels begin to widen, lowering the risk of stroke. The health benefits continue the longer you stay a nonsmoker.
The Five Stages of Smoking Cessation
There are typically five stages of smoking cessation, starting with pre-contemplation. In this stage, people are not yet considering quitting. If asked about smoking, they may defend their behavior. They also may feel discouraged by prior attempts to quit or feel they are too addicted to stop.
The second stage is contemplation. This is when a smoker starts to think about quitting at some point in the future. They are thinking more about the impact of smoking on their health and begin to view smoking as a problem.
Eventually, the smoker may get to the third stage: preparation. In this stage, a smoker has decided to quit. They see the negative impact of smoking and are considering a plan to reduce this behavior. They may try to smoke fewer cigarettes and admit that it is a problem that needs to be solved.
The fourth stage is action or quitting. A smoker may use a reward system to stay motivated and seek support from friends and family. This stage generally lasts up to six months, and is the period when people need the most help.
The last stage is maintenance. This means that the person has the tools and techniques needed to stay a nonsmoker. They have learned new ways to manage stress, boredom, and social pressures that previously may have triggered a desire for a cigarette.
Best Treatment Options to Quit Smoking
There is no one size-fits-all approach to quit smoking. Some people may be able to stop completely without additional resources, going “cold turkey.” However, many people need treatment in the form of medication, nicotine replacement therapy, or Deep Transcranial Magnetic Stimulation (Deep TMS™).
Medication for Smoking Cessation:
Numerous studies have found varenicline (sold under the brand name Chantix®), one of two FDA-approved smoking cessation medications, to be the most effective treatment. By binding to the brain’s nicotinergic receptors, varenicline both facilitates a reduction in the severity of nicotine withdrawal symptoms (such as craving and moodiness) and prevents nicotine from releasing the pleasure-inducing acetylcholine upon smoking.
This form of medication helps ease the withdrawal process while detaching the act of smoking from the enjoyable context that had caused the addiction in the first place. Side effects of this medication can include nausea, difficulty sleeping, vivid dreams, constipation, diarrhea, dry mouth, and headaches.
The other FDA-approved medication, bupropion (sold under the brand name Zyban® or Wellbutrin), also manages to reduce nicotine withdrawal symptoms. It is also used as an antidepressant, particularly when treating major depressive disorder (MDD). Unlike varenicline, though, the exact process by which bupropion works to facilitate smoking cessation is yet unclear. And while both have been found to help sustain long-term smoking cessation efficacy, bupropion is considered less effective than varenicline in its ability to do so. Bupropion side effects include dry mouth and insomnia.
Nicotine Replacement Therapy (NRT)
NRT is often available in the form of nicotine patches. These patches have been shown to quickly cut down withdrawal severity, halving smokers’ relapse rates. While nicotine patches can take up to 12 hours to reach the peak of their efficacy, other forms of nicotine replacement products, such as gum, lozenges, inhalers, and nasal spray have been shown to provide relief within 20-30 minutes. On the other hand, the effects of patches can last for a longer period of time, with 24-hour patches currently available. NRTs are also FDA-approved as a safe and effective smoking addiction treatment and are mostly recommended during the first 4-12 weeks of the cessation process. NRT therapy side effects can include jaw pain, heartburn, nausea, nasal and throat irritation, coughing, and sneezing.
Deep TMS for Smoking Cessation
Deep Transcranial Magnetic Stimulation (Deep TMS) has become an increasingly popular option. The FDA-cleared treatment utilizes electromagnetic fields to stimulate the neural activity of brain structures associated with smoking addiction, specifically the bilateral insula and prefrontal cortex.
This noninvasive treatment option has been shown to significantly reduce the severity of the cessation process, without causing any systemic side effects.
A double-blind, sham-controlled, multicenter randomized controlled trial of 262 patients found Deep TMS to be an effective treatment, significantly improving the continuous quit rate, reducing craving and the average number of cigarettes smoked per week. Participants in the study were highly addicted to smoking, with a history of smoking an average of over 26 years and multiple failed attempts to quit.
Deep TMS does not require a significant recovery period, and the 18-minute treatment can easily be integrated into each patient’s day-to-day schedule.