Why Is It So Hard to Quit Smoking?

Smoking is so extremely addictive that many people fail at their first attempt to quit. Learn more about why this is true.

By Dennis Thompson, Jr.

Medically reviewed by Cynthia Haines, MD

The American Cancer Society says about 70 percent of smokers want to quit and about 40 percent make an attempt to stop smoking each year. However, only 4 to 7 percent actually accomplish this goal without assistance.

Why is it so hard to quit smoking?

The short answer is nicotine. The long answer is more complex. First, nicotine is physically addictive and, second, nicotine addiction also causes psychological changes in smokers because they connect its pleasurable feelings to many different aspects of their lives. Cigarette smoking becomes interwoven with their lives, so that when they try to quit smoking, they not only have to beat back an addiction to smoking, they also have to deal with dozens of triggers that can prompt a desire to smoke.

Nicotine is a drug that naturally occurs in tobacco. When you puff on a cigarette, you inhale nicotine in the smoke and it then spreads through your body. Nicotine interferes with communication between nerve cells. The result is a relaxing, pleasant feeling that makes you want to smoke more.

As you continue to smoke, your body adapts and becomes tolerant to nicotine. You have to smoke more cigarettes in order to achieve the same pleasant feeling. Because your body metabolizes nicotine quickly, the level of nicotine in your blood drops within a couple of hours and you find yourself needing to smoke repeatedly throughout the day to refresh the drug’s effect. At some point, enough nicotine may accumulate in your system that you may need only a certain number of cigarettes each day to keep the level stable.

The Power of Nicotine

You can become physically dependent on nicotine after just a few weeks of regular smoking. When you try to quit smoking, your body goes into nicotine withdrawal. Your system reacts to the absence of nicotine with symptoms including:

• Irritability and impatience
• Hostility
• Anxiety
• Depression
• Headaches
• Fatigue
• Trouble sleeping
• Restlessness
• Difficulty concentrating
• Increase in appetite
• Decreased heart rate

Beating the Nicotine Addiction

If physical addiction were the only problem, it might be easier to quit smoking and more people would succeed. But smokers have to deal with the psychological addiction to smoking as well as the physical dependence of nicotine addiction. Even people who use cessation aids to take the edge off the symptoms of physical addiction have trouble feeling “normal” without cigarettes and smoking rituals. This feeling is exacerbated by psychological triggers that build up over time as people use the pleasant feelings prompted by nicotine and their smoking habit to either cope with unpleasant things or enhance their enjoyment of activities.

Activities that trigger the desire to smoke can include:

• Talking on the phone or even just hearing the phone ring
• Finishing a meal
• Drinking a cup of coffee or an alcoholic drink
• Driving
• Seeing someone else light up a cigarette
• Watching television or relaxing around the house

You also might find the desire to smoke triggered by negative emotional states that you previously coped with through nicotine use, including:

• Sadness or disappointment
• Anger, frustration, or resentment
• Anxiety or stress
• Depression
• Embarrassment
• Guilt
• Fright or fear
• Boredom or loneliness

Nicotine is addictive, but it can be beaten. You can take comfort in the fact that most people try many times before finally kicking the habit.

from http://www.everydayhealth.com/smoking-cessation/understanding/index.aspx