It won’t come as a surprise when I tell you that smoking is unhealthy. Even so, many people still smoke regularly. Even those who consider themselves to be non-smokers, occasionally smoke when out with friends for a drink.
Why do so many people still smoke? Why not simply quit? Because it’s not easy. In this article we discuss why smoking is addictive and what it does to your health and give you some tips on how to quit.
Apart from the tobacco, the filter, and the paper they are wrapped in, cigarettes contain many additives such as flavouring agents and other chemical compounds—more than 600 ingredients on average.
The chemicals in cigarettes come from multiple stages of manufacturing. Some chemicals, like nicotine, are found naturally in the tobacco plant, some come from the soil or fertiliser, and others are added when the leaves are processed. When a cigarette is burned new chemicals form, creating up to 4000 chemicals in the smoke.
Tobacco is made from the leaves of the tobacco plant, which contain nicotine. Nicotine is addictive. Consuming nicotine leads, indirectly, to the release of dopamine in the brain. Dopamine is the “feel-good” neurotransmitter, our internal reward-system. It makes us want to do more of whatever gives us a dopamine hit, including common activities such as eating, having sex, or smoking. The more dopamine you get from a certain activity, the more you will want to do it, making some activities or substances particularly addictive. Smoking is one of these.
Beyond that, people often use smoking to relieve stress. Sometimes we start smoking because we want to fit in. Many are social smokers who like to have a cigarette at parties with a drink. Smoking also serves as a psychological tool—it can start a conversation or allow for much needed silence.
Many of the ingredients cigarettes contain are harmful. Let’s take a closer look at the three of these.
Nicotine is an alkaloid (a nitrogenous organic compound that has strong biological effects on humans and animals). A number of plants synthesise nicotine—primarily to discourage pests—including vegetables such as potatoes, tomatoes, and eggplant, and some herbs and weeds such as deadly nightshade and milkweed. The tobacco plant produces it in relatively high concentrations—20 000 to 40 000 parts per million.
Nicotine can act as a sedative or a stimulant, depending on how much is ingested and on each individual’s level of responsiveness. Side effects of nicotine ingestion include decreased appetite, increased heart rate, increased blood pressure, and disrupted sleep, as well as the heightened mood and improved memory and concentration that give smokers that kick of alertness.
Regular doses of nicotine lead to changes in the brain, which in turn cause withdrawal symptoms once the doses have stopped.
Tar is the common name for the chemical substance formed by burning tobacco. This ingredient contains most of the cancer-causing and harmful substances present in cigarette smoke.
When inhaling smoke, the tar temporarily paralyzes the cilia—tiny hair-like structures that line the trachea. The cilia keep the lungs clean of pollutants and mucus. Because smoking stuns them, the tar makes its way deep into the lungs. An accumulation of tar damage can cause a number of lung diseases such as chronic obstructive pulmonary disease (HOPS), emphysema, chronic bronchitis, and lung cancer.
Carbon monoxide (CO) is a colourless, odourless, toxic gas that is produced when fuels containing carbon fail to burn completely. It is present in indoor and outdoor air in varying amounts from gas stoves, wood-burning stoves, furnaces, car exhaust fumes, and cigarette smoke.
CO passes through your lungs into your bloodstream. There it attaches itself to the haemoglobin molecule that usually carries oxygen through the body, creating carboxyhaemoglobin. Oxygen can’t travel on a haemoglobin molecule that already has CO attached to it. This process decreases the blood’s capacity for carrying oxygen, while causing extra strain on vital organs such as the heart and lungs.
Everyone has some degree of carboxyhaemoglobin in their bloodstream, but the environmental exposure is normally less than 1%. The percentage of carboxyhaemoglobin in smokers is much higher, sometimes up to 20%.
If the blood cells do not carry enough oxygen, the heart is forced to work harder to distribute enough oxygen to the body. This makes CO a major contributor to heart disease and heart attacks.
There are many ‘smokeless tobacco’ products on the market, such as chewing tobacco, snuff, snus, dip, that are either inhaled, held in the mouth, or chewed, as well as ‘dissolvable tobacco’ products that deliver nicotine in the form of strips or lozenges.
Some people claim that these products are less harmful than smoking, however there is no proof to back this up. Prolonged use of smokeless tobacco contributes to many of the same health conditions, including cancer, heart disease, oral and oropharyngeal cancer, as well as other forms of malign tumours.
The electronic cigarette (e-cigarette, vapor cigarette, or vape) is like a cigarette in name and gestures only. Unlike cigarettes, it does not contain tobacco, does not burn, and does not create smoke. The inhaled vapor comes from heating a liquid composed mainly of propylene glycol, glycerol, flavours and, most often, nicotine.
There is a widespread opinion that electronic cigarettes are not as harmful as conventional cigarettes. Some believe that e-cigarettes can help smokers quit. However, vaping is suspected of causing lung damage. In 2019 there was an outbreak of pulmonary disease among young people that has been traced back to vaping. The American Center for Disease Control has begun using the term EVALI for e-cigarette or vaping-product-use-associated lung injury.
When a non-smoker breathes in smoke from somebody else’s cigarette they become a ’passive’ smoker breathing in ’second-hand smoke’ (SHS). The health risks surrounding SHS are the main reason for the smoking bans adopted by most countries in the late 1990s and early 2000s. Smoking is no longer allowed in restaurants, cafes, and other public spaces.
SHS causes many of the same health problems as ’active’ smoking, including cardiovascular diseases, lung cancer, and respiratory diseases. The risks increase with proximity. Public awareness of the danger of SHS is now widespread, but the degree of risk is still uncertain.
One thing is certain, both active and passive smoking are bad for your health.
Smoking while pregnant can cause harm to both parent and child. Smoking reduces the chance of getting pregnant and increases the risk of infertility.
Complications caused by smoking during pregnancy include:
Smokers are not oblivious of the health risks that accompany smoking but knowing about the risks doesn’t help them quit. No matter when you started smoking or how long you’ve been doing it, quitting is a major task.
Smoking is not just an addiction, it’s also a psychological habit that requires willpower to break. Because of nicotine’s dopamine stimulating properties, smoking can be a way to relieve boredom, anxiety, and even depression. Quitting means finding a different way to cope with these unpleasant emotions.
Smoking often becomes a daily ritual. Having a cigarette can feel like an integral part of your morning coffee break, or just what you do after sex. If some of your close friends or colleagues are smokers as well, quitting will be that much more difficult. They may see you not smoking as a judgment of them continuing to smoke, and you’ll have to find something to replace the effortless interaction of having a smoke together.
Create a plan that suits your needs. Some people benefit from a ‘buddy system’, some prefer to rely on apps designed to help smokers quit, while others choose to ease their way out of nicotine addiction with the help of nicotine patches or similar products.
There is no one right way to stop smoking, but these are some tips that could be useful in the first few weeks:
What else you can do? Try physical activity as an alternative way of relieving stress and tell people about your plan to stop smoking, they can help keep you on track.
Just like with any other addiction, quitting smoking involves living through the symptoms of withdrawal. The most common withdrawal symptoms are:
You may also experience increased appetite, headaches, insomnia, tremors, decreased heart rate, increased coughing, fatigue, constipation or upset stomach and depression.
The degree to which people experience withdrawal differs, however it is best to be prepared. Take comfort in knowing that no matter how bad it gets; the symptoms are temporary and will ease after a few weeks. Be kind to yourself in the meantime.
People are social creatures. We tend to gravitate towards what others around us are doing. If those around us smoke, we are more likely to pick up the habit even if it comes with significant risk. Although the public perception of smoking has shifted, kicking a habit you engage in socially is challenging. Creating habits that serve your health and well-being will be much better for you in the long run.
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