Quitting Smoking

Some commercial for a popular non-smoking aid says that it takes several times to quit smoking. I suppose each time is practice. Maybe each time trains your brain to not expect its hit of nicotine. It took several tries for me to quit smoking, too. So maybe the commercial has a point.

When you smoke a cigarette (or use any other form of tobacco, but I'm going to focus on cigarettes) a pleasure center is activated in your brain. Dopamine, a chemical associated with feeling pleasure, is stimulated by the nicotine. The sensation of pleasure is prolonged after only a brief encounter with nicotine due to a complex interaction of chemicals in the brain that continue to stimulate production of dopamine. This provides a powerful incentive to continue smoking.

Eventually, though, as anyone who has smoked knows, the pleasure wears off and leaves those poor pleasure centers gasping for more. This is withdrawal, and leads to feeling cranky, deprived, and occasionally shaky. A smoker can legally give their brain thousands of hits a day of nicotine to activate the pleasure center. No wonder we continue to smoke. Even after smoking has been banned in several cities, banned in most workplaces, and looked on as definitely second-class almost everywhere, we continue to huddle in stairwells, braving freezing cold and hot humidity to suck down another cigarette. Quitting smoking is not as simple as mustering willpower.

There are quite a few products on the market to assist a smoker in weaning from his or her cigarettes. Nicorette Stop Smoking Gum was one of the first. The premise is that by breaking the association of smoking to nicotine a person could wean away from smoking. The gum contains nicotine and is meant to be secreted between your cheek and gum and only chewed when a craving hits. I am sure this was very helpful to lots of people, but when I tried it, the nicotine just made me crave a cigarette more. I had better luck short term with Wrigley's.

In addition to nicotine gums, there are other ways to get a hit of nicotine without the tell-tale cigarette smoke. There is a lozenge, a patch, nasal spray, and an inhaler all designed to give the smoker nicotine without the smoke.

Then Zyban (bupropion) showed up. Buproprion is an antidepressant that was found to have an interesting side effect: smokers showed less of an incentive to smoke, perhaps because the bupropion decreased the need for constant stimulation of the brain's pleasure center; or activated the brain's pleasure center in some complex way itself, reducing the need for nicotine to do so. Zyban was a lot of smokers' answer to quitting smoking. Since it is one of the few "quit smoking" aids that does not contain nicotine, I gave that one a try.

And it worked. For the first time in many years, I did not feel chained to a pack of cigarettes. I actually still smoked one cigarette a day about four days a week, but I felt like I was in control of smoking. When I left the house with no cigarettes, I didn't immediately start panicking and scheming how to carve out enough time or money to stop for another pack of cigarettes. I even went out for a night of drinking and only had one cigarette the entire time….without feeling the tight jaw and general bitchiness I usually associated with my attempts to quit smoking.

There was one downside to this exciting way to quit smoking. No one had ever told me that occasionally when you quit smoking, your body reacts by developing asthma-like symptoms. I had days when I truly thought I was going to do because I couldn't't draw another breath. I had two ER visits that ended with me feeling embarrassed because the doctor told me I needed to relax and quit freaking out and I'd feel better. Some incentive to quit smoking! I thought. When I'd bum one of my favorite cigarettes from a coworker, my symptoms would ease. After a couple of weeks of this misery, I quit the Zyban, bought my own pack of cigarettes, and went on my merry way. Quitting smoking was no longer on my agenda.

I did notice that I could go longer without a cigarette. And I wasn't as anxious when I was stuck in one of the increasing no-smoking zones. So perhaps the Zyban had worked to help regulate those pleasure centers in my brain that were activated by nicotine even though I had not completely quit smoking. I never got back up to a pack a day again .

It took several other attempts to completely quit smoking. In one of those attempts, I took the 7 or 8 cigarettes I smoked in a day and put them in a Ziploc bag instead of the cigarette pack so I would know when I had reached my limit. I smoked one fewer cigarette each couple of days until I was down to two cigarettes a day. For a long time, that was as close as I got to quitting smoking. When I would get stressed or have a fight with my boyfriend or a bad day at work, I'd sometimes smoke a few more cigarettes than my allotted two, but I was always able to go back to the controlled amount.

And then I got married. And pregnant. And despite all those horrible warnings about smoking while pregnant, I still did. Two cigarettes a day…less if I could do it. Quitting smoking is really not as easy as it sounds for some people. It took having that child, and quitting smoking, and then starting smoking again, and then getting pregnant again for me to finally stop smoking. I am happy to report that I don't even miss smoking. And when I smoke a friend's cigarette, it does not set up the clang of yearning that it used to. So now I can say I finally quit smoking!

Why is it easier for some people to quit smoking? My husband is a social smoker. He can smoke for a week, and then not again for months. Actually, he hasn't smoked in several years, but back when I was struggling with quitting smoking, his ability to take it or leave it really irritated me. Some people have a lower need for dopamine. Or it could be that their body metabolizes nicotine slower, so they don't develop that dance of pleasure and craving for tobacco. Some research has indicated that a so-called "risk-taking" gene means that a person more apt to take risks is more apt to become addicted to nicotine. Some recent studies are looking at ways to block the effect, and therefore the pleasure of nicotine to help people quit smoking.

Whatever the reason, if you smoke and feel like you could never give it up, keep trying. In quitting smoking like a lot of other things, practice makes perfect!