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Nicotine Dependence - Why Is It SOOOO Hard to Quit?

Years ago, a former client called me on the phone and said, "Helena, Guess what?". "What?", I said. "I quit smoking!", he said. I responded, "NO S#%*!". Truly. We cheered and laughed, my reaction unexpected and pure, excitement and joy for him, a tremendous step in his dedicated journey to wellness. We had traveled down the path of recovery together for 7 years, he having steadily addressed the primary elephant of opioid addiction, while supporting his recovery with equally, if not more daunting, changes to his personal and professional life; wow, he made so many amazing changes! Smoking was a topic we addressed routinely and one which brought up equal feelings of overwhelm, awareness of the health implications, wanting to be around for his daughter, and doubt about his ability and desire to achieve cessation. At some point, something shifted for him and both his confidence and readiness moved towards recovery and away from doubt.

His struggle to feel ready to pursue cessation while at the same time desperately wanting to quit (and, not) reflects the puzzle of addiction; while we can visually see how a particular substance and/or behavior negatively impacts us now and in the future, the power of the addiction convinces us to continue. Herein lies a frustration with recovery; it can take a while to get from where you are to where you want to be and sometimes, where we want to be is not in recovery, yet.

It is and isn't surprising that nicotine addiction is often forgotten about, overlooked, and thought of as easy to quit, "Just put down the (cigarette/cigar/vape/chew...)." News flash, it's not easy! In fact, it can be the most difficult of substance addictions to quit.

So, why is it so hard to quit nicotine? To understand this, you have to first give credit to the power of the physical addiction and how this not only changes brain chemistry (I mean, seriously, your brain changes!), but also how it sets the stage for your brain to become much more easily introduced and enamored with other addictions.

Consider this, when we are born, our brain is wired to release a set amount of Dopamine (this is the BIG deal neurotransmitter in recovery stuff) in response to various stimuli, e.g., to aid us in various endeavors such as planning, focusing, remembering, motivation, reward and reinforcement. Our brain goes about it's daily business and when dopamine is called for, it gets released in a normal pre-planned amount. Well, when nicotine is introduced, your Dopamine gets the steroid HULK treatment and nearly bursts out of its clothes with the amount that gets released! It feels like a flood of positivity, release, relaxation, calm and focus. Hence, makes it easy to understand why physically it's reeeaallly easy to get hooked on nicotine (note, other substances do this too!).

What is positive also has a negative friend. On the other end of this over-abundance dopamine reward loop is the crash - the withdrawal symptoms (headaches, stomach aches, difficulty sleeping, sadness, anxiety, irritability, restlessness, difficulty concentrating, etc...) and cravings - and the stimulation of negative physical effects (physical dependence on nicotine, impotence and fertility difficulties, increased heart rate, increased blood pressure, etc..). However, when you are receiving a flood of reward from nicotine and you know you can get rid of the negative friends by using nicotine again, it makes sense why the use continues, no?

This brings us to the power of the associated cues of nicotine addiction, and these are many. Firstly, it's likely been your closest and most reliable friend since you were ___ years old. It can be pretty difficult to end that relationship. Secondly, recognize it's there in most, if not all, moments of your daily life (whether you are thinking about it or using it), e.g., after a meal, when you wake up first thing or middle of the night, taking a break during work, driving, talking on the phone, spending time with certain friends, coping with stress, after sex, etc... All of these environmental, emotional, and social factors spindle you relationship with nicotine into an intertwined web, making the idea and process of quitting feeling quite perplexing.

It's likely at this point after finishing the last paragraph and having some moments of awareness, you are either craving nicotine or using it. Your brain has just demonstrated the power of nicotine dependence!

Rest assured, you can work on recovery and reach abstinence! Note, quitting is part of the recovery process, but a whole lotta other stuff goes into supporting a life without nicotine. This is why my client who I mentioned at the start of this post took a bit of time to reach his readiness , confidence, and ability to quit.

With support, guidance, coaching and sometimes nicotine replacement medications, you can quit and nurture a healthier life.

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