Understanding why tobacco is such a powerful foe will help you escape its grasp. Have you ever heard that cigarette smoking is as addictive as heroin? It's true. In a landmark report issued back in 1988, Surgeon General C. Everett Koop warned that "cigarettes and other forms of tobacco are addicting in the same sense as are drugs such as heroin and cocaine."
Like those illegal substances, Dr. Koop noted, tobacco is an addictive drug because it:
- Controls the user's behavior
- Leads to compulsive use despite the harm it inflicts
- Produces effects, such as feeling alert, that reinforce its use
- Requires increasing doses
- Causes withdrawal if stopped, which often leads to relapse
Fortunately, the science of quitting has also become stronger in recent years. Health professionals now have clear evidence that certain methods, and combinations of methods, really work. They make it easier than ever to help people quit–and stay quit.
The addictive substance in tobacco is nicotine, a chemical found in a group of flowering plants called nightshade. There are tiny amounts of nicotine in useful nightshade plants such as tomatoes and potatoes, and much larger amounts in tobacco. Nicotine is so toxic it can be used as an insecticide, but this is one bug killer that your body can become dependent on. As the American Heart Association notes, "Nicotine addiction has historically been one of the hardest addictions to break."
The nicotine in cigarettes enters the bloodstream through the lungs and then goes on to the brain and other organs. It produces those pleasant feelings that get you hooked, such as reduced tension and increased focus, but it also does everything from interfering with your hormones to narrowing your arteries and raising your blood pressure.
You might wonder why some smoking-cessation aids contain nicotine. How can this be safe? One part of the answer is that these products don't contain the hundreds of other harmful chemicals ("tar") found in cigarettes and tobacco smoke, such as arsenic, carbon monoxide and formaldehyde. Also, smoking cessation products are used for only a short time to wean you off your addiction, so you're not exposed to as much nicotine as you would be if you smoked.
Your doctor may suggest one or more of these ways to fight nicotine addiction:
- Nicotine replacement therapy (NRT). This includes a nasal spray and an inhaler available by prescription, as well as over-the-counter patches, gum and lozenges. These products provide small doses of nicotine, which eases physical withdrawal and cravings.
- Non-nicotine medications. The U.S. Food and Drug Administration has approved two non-nicotine prescription medications to aid in smoking cessation. One, a nicotine receptor blocker approved in 2006, is designed specifically to help people quit smoking. The other is an antidepressant that reduces symptoms of nicotine withdrawal.
- Off-label medications. Some doctors prescribe other drugs "off label" to help in smoking cessation, such as antidepressants, blood pressure drugs or a type of injected drug known as anticholinergics.
Reviewed by: Timothy Yarboro, MD