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  • Debi Stafford

Nicotine Addiction

Quitting smoking is perhaps one of the hardest things many of my patients have ever tried. I see the look on my patient's faces when I ask them if they have ever thought about quitting smoking. It's a combination of a glazed-over "here we go with the nagging" coupled with a slight look of terror that reads as if they feel permanently enslaved to tobacco.

Cigarettes, vape, and E-cigs are one of the biggest unnecessary strains on the human body. Nicotine and the dangerous chemicals in these inhaled products are blamed on everything from lung cancer to erectile dysfunction. Tobacco is not required for the human body, and yet throughout history, wars and taxes have been waged over access to tobacco.

But did you know nicotine also does some good? Nicotine has been found to lessen some types of epilepsy Nicotine has also been found to offer some benefit to the brain function of people with schizophrenia. We have nicotinic acetylcholine receptors in the brain that nicotine can plug into, and that alone can potentially predict the risk for addiction to nicotine. I once read over 95% of people with schizophrenia smoke, and when they try to quit, their mental health oftentimes suffers.

Am I saying yay nicotine addiction? By no means! But I am saying quitting smoking and stopping all the nicotine marketing devices can be far more challenging than a non-smoker may realize. Acknowledging this fact is step one in trying to beat the addiction. It's hard. Really, REALLY hard!

But quitting is still possible. My favorite quit smoking method is the step-down approach. When I have a patient who smokes and they tell me they are ready to quit smoking, they likely are not yet in a good position to lay down smoking for good. The more we smoke per day, the harder it's going to be. If someone is smoking 1-2 packs per day, stopping cold turkey can be misery and not long-sustained. In general, I have found when my patients are smoking less than 5 cigarettes per day, they are far more likely to permanently quit.

So what is this step-down approach? First, get honest with how much you smoke per day. If you aren't sure, start counting. So, let's say you smoke 1 PPD. That's 20 cigarettes. Take your 1 new pack and take 1 cigarette out of it each morning. Put that one cigarette in a ziplock bag. Smoke your 19 cigarettes for the day, but do not smoke beyond 19. Do that each day for 1 week. On week 2, take 2 cigarettes out of the pack and into a ziplock bag. Do not smoke more than 18 cigarettes for the day. Week 3 takes 3 cigarettes per day out, and so on and so forth. Do you see how before long you are literally eliminating packs of cigarettes from your body!?!?!?

When you are less than half of your normal smoking consumption, change up your habits. Don't light up in the car anymore. Stop smoking inside your house. Wait for a few minutes after you finish eating before you light up. Go sit outside with a straw in hand and puff on that for 5 minutes before lighting up. If the urge passes, let it!

If you ever reach a week where you feel you simply cannot reduce cigarettes any further, don't. Stay there for a week or two. Look at how far you've come. But don't backtrack. Stay the course. After a month or so, start back. And if you cannot go lower, hold for a bit. Let your body adjust to the reduction of nicotine. Do not turn to dip, E-cig, or another crutch. The goal is to get you off nicotine, not transfer your addiction.

Eventually, you will be down to 5 cigarettes per day or less. Once you get to less than 5, formulate your quit date. That is the day you will NOT smoke. Ever. Again.

If you need Chantix or another medication, come see me. I am glad to assist. And it could be that you have smoked so long to unknowingly deal with stress, anxiety, or depression, that you may need new approaches with herbs, supplements, cognitive therapy, and/or medications to address those issues. It's okay. Our clinics can help.

Please share this blog with loved ones who cannot seem to stop smoking. I know in healthcare it's many times an all-or-nothing approach. It's time healthcare gets real and helps people instead of shaming people.

PS. I used to smoke. I smoked 1 1/2 packs per day for over 10 years. I quit smoking in 1999. I know how hard it is to quit. But I'm so glad I did.

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