Most smokers say they are serious about giving up smoking and that they want to quit, but they don’t. Many have already tried and failed. As we have discussed in early posts on this site, the symptoms of actual nicotine withdrawal are typically mild and painless, so this alone cannot account for the difficulty that smokers face when giving up smoking, and the high failure rate.

We also know that the habits linked to smoking behavior can be changed like any other habits - again without pain or trauma. It seems there is a gap in information and understanding. This blind spot particularly relates to the psychological aspect of dependency - the role of the mind. So here I want to explain some of the psychology of giving up smoking - why it seems so hard to most people, what happens in the brain, and so on.

Justifying Smoking

What do smokers say?:

• It helps me concentrate, or relax.
• I get pleasure.
• I’ll put on weight if I stop.

Smokers often include one or more of these in what they will ‘lose’, or give up, and the fear of that perceived loss adds to the hurdle of quitting smoking. Even when a person has made a firm decision to give up smoking, sometimes outdated beliefs such as these linger and unconsciously affect their behavior. So it is better to address each of these common smoking ‘justifiers’ which are related to giving up smoking, even if they don’t seem to apply in your case.

Other benefits are claimed. For instance, some claim that smoking relieves boredom. But - think about it - any honest smoker could think of 101 useful, or at least harmless, things they could do to relieve boredom (ask your spouse or partner, or boss at work). So although we shall find that the above fears of loss are illusions anyway, what you learn about them will also apply to the boredom illusion and many other less common pretexts people use for not giving up smoking.

The ones quoted above are merely representative. Most important, the methods you will learn about changing beliefs like these apply universally, so your particular situation will be fully catered for. We will also consider the psychological and practical aspects of giving up smoking.

In future posts that follow over the next few days we will deal in more detail with the above common difficulties that smokers say they contend with, as these describe specific mental programs which you need to change.

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So, in order to find some ways to quit smoking that will work for you, you need to understand all your habits that involve smoking. The easiest way to do that is to write down everything that results in you smoking a cigarette.

The habits associated with smoking can be many, and include any habitual behavior or situation linked with the practice of smoking. For example:

• what you do with your hands
• what you do after a meal
• what you do before a staff meeting
• what you do when receiving a telephone call from a particular person
• a time of the day, such as first thing in the morning and last thing before bed
• a place, such as a pub, restaurant, car or waiting room
• any familiar, innocuous aspect of a person’s life.

All sorts of stimuli like these can trigger habitual smoking behavior – so you need to understand them all when looking for effective ways to quit smoking. To be forewarned is to be forearmed, so start to consider these sorts of associations in your own life, and be ready to write them down.

The best ways to quit smoking are centered around changing or replacing your smoking habits with non smoking habits. Smoking-related habits have to be treated differently to the physical addiction to nicotine. Each habit has to be replaced with another habit that provides the same benefits or fulfils the same function or ‘intention’ in a better way.

This replacement habit can be any legal activity that does not reinforce the smoking habit. At one level it may mean sucking sugar-free wine gums, drinking fruit juice, twiddling a pencil or breathing deeply or simply occupying your mind with something else more interesting. At another level it may mean missing out a regular pub stopover with smoking friends, at least for a few weeks. In every case it will mean:

• identification of the associated habit
• and preparation for the period following your last puff.

That should have already started as you read with an open mind and reflect on the reasons why you might have become dependent on cigarettes.

Finding successful ways to quit smoking requires you to understand your habits. Habits are an integral part of the way we live and we don’t like a vacuum, or sudden changes. Hence the need to replace them with different activities - new habits that preferably bring their own pleasure and benefits as well as replacing unhelpful habits.

For example, social smoking time might be replaced by time with your children, enjoying a hobby, or studying for a qualification to help your job prospects.

Smoking-related habits may be numerous and of very different types, but fortunately the methods for changing them and supporting ways to quit smoking are fairly standard. So you can eliminate them one by one, which makes changing the most ingrained habit feasible.

You can start with the easy ones, and gain practice and confidence as you carry on. You can then use these new found ways to quit smoking and your habit-changing skill in many other ways.

For many people giving up smoking opens a doorway to many other possibilities in their life. Smoking is rarely the only habit a person can well do without, so there can be real bonuses in addition to all the benefits of giving up the smoking habit. For instance, you will benefit by an increase in confidence as you start to take control of your behavior and live the life you want to live.

So, to find effective ways to quit smoking, first make a list of everything you do that results in your smoking a cigarette, then look for ways to change those habits and replace them with other more beneficial actions. I’m not saying it will be easy, but the more you understand how your habits affect the many different ways to quit smoking, the sooner you wind a way to quit smoking that works for you.

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Nicotine, the active and addictive ingredient of tobacco, is a mild central nervous system stimulant and a stronger cardiovascular system stimulant. It constricts blood vessels, increasing the blood pressure and stimulating the heart, and raises the blood fat levels.

In its liquid form nicotine is a powerful poison - the injection of even one drop would be deadly. It is the nicotine, not the smoke that causes people to continue to smoke cigarettes, but it is the cigarette smoke that causes many of the problems.

Cigarette smoke is a combination of lethal gases - carbon monoxide, hydrogen cyanide, and nitrogen and sulphur oxides, to name a few - and tars, and contains an estimated 4,000 chemicals. Some of these chemical agents are introduced by current tobacco manufacturing processes, such as to make the taste sweeter and more palatable to young people, and to increase the addictive properties.

Although tobacco has been smoked for centuries, only recently has it moved from the naturally grown and dried process. It appears that in the last century the negative effects of smoking have increased, partially due to the added risk produced by the chemical treatment and unnatural processing of tobacco.

Dangers in modern tobacco products include pesticides used during growth and chemicals added to the tobacco to make it burn better or taste different.

Chemicals added to the leaves and papers to enhance burning are among the major causes of fire deaths, as cigarettes continue to burn after they have been put down. The forced burning also makes people smoke more of each cigarette in order to complete it.

Sugar curing and rapid flue drying are also associated with increased toxicity of cigarettes. Kerosene heat drying contaminates the tobacco with another toxic hydrocarbon.

Other toxic contaminants in cigarettes include cadmium (which affects the kidneys, arteries, and blood pressure), lead, arsenic, cyanide and nickel. Dioxin, the most toxic pesticide chemical known to date, has been found in cigarettes. Acetonitrile, another pesticide, is also found in tobacco.

The nitrogen gases from cigarettes generate carcinogenic nitrosamines in the body tissues. The tars in smoke contain polynuclear aromatic hydrocarbons (PAH), carcinogenic materials that bind with cellular DNA to cause damage.

Radioactive materials, such as polonium, are also found in cigarette smoke. Some authorities believe that cigarettes are our greatest source of radiation. A smoker of one-and-a-half packs per day may be exposed to radiation equal to 300 chest x-rays a year. Radiation is a strong aging factor.

Acetaldehyde, a chemical released during smoking, causes aging, especially of the skin, as it affects the cross-linking bonds that hold our tissues together.

Source: Elson M. Haas MD (excerpt from Staying Healthy with Nutrition, Celestial Arts)

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Although nicotine addiction is ostensibly a physical condition, it is important psychologically who you ‘blame’, especially when feeling irritable in the days after you quit smoking. If you place the blame on anything or anybody other than the drug, you will turn to a cigarette like an old friend at the first weak moment to gain the relief you perceive - however misguidedly - it provides.

On the other hand, if you place the blame squarely on the cigarette you will not be inclined to turn to it when your defenses are down. It is now rightly the villain - the enemy. Hence the need to come to the point at which you are not ‘giving up’ anything whatsoever of benefit or value - just the many harmful effects of smoking.

This requires a whole change of attitude and beliefs about yourself and the smoking habit. Fortunately this change can happen imperceptibly and effortlessly. You can also do special exercises to ensure the old program based around your nicotine addiction is fully replaced.

In a previous post I compared nicotine addiction with physical hunger. The body gets all sorts of signals that it wants food, even before we really need it. For example when we see a tempting, color photo of a favorite dessert in a restaurant, or on a busy morning we notice the time and realize it is almost lunchtime.

True hunger pain doesn’t come for a long time. Even the headaches we get when fasting are more likely due to withdrawal from coffee and junk food additives rather than lack of food.

In practice most westerners overeat anyway, and dieting can actually prevent disease and extend life. The analogy with nicotine withdrawal is useful in several ways:

• Neither case involves serious physical pain.
• Both are affected by habits - we do them without thinking.
• In neither case are we robbed of our free will to act as we wish. We choose to eat and we choose to smoke.

We need food but certainly not harmful drugs to survive. Even when hunger involves pain it is a welcome survival warning, as it prevents us from not eating and eventually dying. In other words, food is life-enhancing rather than life-shortening, which is the case with nicotine. The longer we go without eating, the harder it gets, whereas the longer we go without smoking the easier it gets, as the beneficial life functions quickly start to replace the harmful effects of the nicotine poison.

Breaking habits

Because nicotine addiction is inextricably linked to the habits we associate with smoking behavior - habits we also need to break - the true nicotine withdrawal symptoms are misunderstood and usually grossly overstated. Giving up smoking is certainly a problem, but any problem becomes easier when you can break it down into smaller, achievable parts. Treated in this way, you can keep nicotine addiction in proportion. Thousands of one-time smokers look back on kicking their habit as a brief, painless non-event that was not worth the fuss.

The method for treating nicotine addiction is simple: don’t smoke for three days. More importantly, don’t stop until you understand the effect of smoking habits and how you treat these.

Psychological addiction and not just nicotine addiction, and the habits surrounding it, is by far the most important aspect of giving up.

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I also recommend that you check the statistics of the stop smoking program that you may have in mind, to find out how many people actually stop smoking using that program, and more importantly, how long they stay stopped for. The main reason being that most stop smoking programs focus on replacing the nicotine you get from smoking cigarettes, with an alternative method. Nicotine isn’t really the problem – you’re smoking habits and desires are.

Whenever a thought crosses your mind that leads to the lighting of a cigarette, you have experienced your desire to smoke. Sometimes it feels like an urge, a craving or a compulsion. Sometimes you just think to yourself that you fancy a cigarette, or that smoking would help you in some way. So you light one. As a smoker, you are continuously feeding and satisfying that desire by smoking cigarette after cigarette after cigarette – so any stop smoking program has to address these habits, rather than simply offering a nicotine replacement option.

A Part of Your Life

The desire to smoke may be associated with virtually any situation or circumstance in your life. This is a feature of all addictions: the conditioned response that the scientist Ivan Pavlov first demonstrated with his dogs. Pavlov rang a bell every time he fed the dogs, and after a while the dogs would salivate whenever they heard the bell, thinking food was on the way.

Just like Pavlov’s dogs, some smokers actually salivate for a cigarette on hearing the telephone ring. You train yourself, over and over, to expect a cigarette (a nicotine buzz), especially on certain cues.

I’m sure you would have no difficulty in identifying all kinds of things you associate with smoking. This is why smoking is thought of as a habit, because it’s so integrated into your life. For a stop smoking program to be effective and successful, it needs to help you address these habits and help you work out how to break them and re-condition your mind. Just think of all the situations: taking a break, finishing a meal, making a decision, concentrating on a demanding task or just completing one, answering the phone, sitting in a traffic jam, drinking coffee, having a beer, seeing another smoker light a cigarette and smelling the smoke.

You will also have conditioned yourself to expect to smoke whenever you feel particular emotions: especially anger and frustration, but also sadness, boredom, anxiety, embarrassment, and even triumph, joy and excitement.

The list is endless. Just about anything that happens, or doesn’t happen, in a smoker’s life can result in the idea of smoking a cigarette.

Fortunately, it is not essential to identify all these cues, especially since it could be quite an insignificant thought or simply a shift in your thinking, like: ‘What shall I do now?"
(Answer "I’ll have a cigarette!’). To be successful, a stop smoking program must help you come up with alternative answer. The main point here is that the desire to smoke, the expectation of smoking, is triggered repeatedly. Something happens and you think, automatically, that smoking a cigarette would be helpful and/or enjoyable. So you light a cigarette.

If you’ve been smoking regularly for a number of years, this thought will be so familiar to you that it can often go unnoticed, such as when you suddenly realize you have a half-smoked cigarette in your hand, with absolutely no recollection of having lit it.

But even though you may not be aware of it, there is always something that initiates the lighting of a cigarette. There has to be some impulse that tells your hand to pick up a cigarette and light it. This is your desire to smoke: you just aren’t conscious of it at times.

And if you’ve used any of the stop smoking programs in the past and have managed to stop smoking for any length of time, the reason you went back to smoking was because you had that same old desire to light a cigarette, and you did so.

Often people say they went back to smoking because of certain circumstances, such as an argument, an accident or a party. But what actually happened was this: the situation triggered a conditioned response - your desire to smoke - which you then satisfied. This may seem obvious, but it’s important to see the whole sequence of events: first the cue, then the desire, then the action of smoking.

If you smoke 40 cigarettes a day, then at least 40 times a day you are experiencing - and satisfying - your desire to smoke. Sometimes you enjoy them and sometimes you don’t. Sometimes they seem helpful and sometimes they are little more than a nuisance. Always, you are smoking not because events somehow magically make you reach out and light up a cigarette, but because they act as a trigger to your addictive desire.

Why do you have this desire to smoke? The answer is simply and entirely because of all the smoking you have done in the past. Smoking is ‘learned behavior’ (something that nearly all stop smoking programs fail to address). And you have reinforced your desire to smoke with every cigarette you ever smoked. You satisfy the desire, and you reinforce it at the same time.

If you had only ever smoked ten cigarettes, then your desire to smoke would only have been reinforced ten times. Unfortunately, people who have only smoked ten cigarettes usually aren’t motivated to stop smoking or fully understand how smoking effects your lungs. So they go on reinforcing the desire until they have smoked as many as a quarter of a million cigarettes before they really get serious about trying to stop.

Some smokers set up boundaries for themselves, or go along with boundaries set up by others, and don’t smoke in certain circumstances – this is something you can and should do regardless of what if any stop smoking program you get involved with. For instance, some people never, ever smoke in certain rooms, such as the bedroom. Others never smoke during breakfast or in their cars, and many never smoke during work situations, such as while teaching, in an office or interviewing people.

In these situations, the desire to smoke doesn’t usually get triggered because the association either has never been made in the first place or has already been broken. But you are certainly smoking as habitually and addictively at other times.

A desire to smoke is a thought that comes to your mind, regardless of how much nicotine there happens to be in your body at the time. Your body doesn’t need more nicotine just because you’re on a coffee break. Your body’s nicotine level doesn’t fall dangerously low the moment a friend comes to visit and lights up in your kitchen. What happens is that you are reminded of smoking when break-time comes along, or the smoking friend shows up, and you anticipate another opportunity to get your nicotine buzz. So before you pay out good money for one of the stop smoking programs, spend some time and think about your habits and how you can change or break them, and recondition your mind to come up with new answers to what you should do instead of lighting up.

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In fact, what you have done is to form a psychological attachment to the physical sensations you get from smoking. The nicotine has an effect on your body, but it’s your mind that desires the effect. It’s your mind that believes you need nicotine. It’s your mind that registers satisfaction when you get your buzz, or can object in the most dramatic ways if the desire is not satisfied. .And it’s your mind that decides whether you’ll go on smoking or face the challenge of quitting cigarettes for good.

Physical withdrawal doesn’t determine whether you will be successful at stopping smoking. It’s your mind that determines whether or not you will go through that experience, and - most crucially - whether or not you go back to smoking, long after those physical changes are over.

When you stop, after some temporary physical changes, your body will be much healthier and happier, since you are no longer putting so much poison into it. But your mind may not be happy because, unlike your body, it does not make the change to not smoking automatically. It remains the mind of a smoker, but it’s the mind of a smoker who isn’t smoking. And that inevitably sets up a conflict

All this is the process of the psychological side of nicotine withdrawal, and unless it’s dealt with correctly you may very well be smoking again weeks or months after the physical withdrawal is over.

If you are still not convinced, it may help to look at other addictions that have nothing to do with the ingestion of a drug. People can become addicted to a whole variety of things, such as gambling, computer games or even exercise. These people can experience very similar symptoms when they stop, such as intense compulsions or cravings, feelings of deprivation, anger, irritability, anxiety, depression and panic.

You Can Work it Out

I am not saying that it’s all in your mind, therefore you are imagining all your problems and they don’t really exist. The problems are real, and so is the addiction.

What I am saying is that in order for you to successfully stop smoking and stay stopped, to really take control of this addiction, you will need to change the way you are thinking about this. And you can’t do that by just waiting for it to change: you need to work at it. It requires your active attention and participation.

There’s lots of books that will show you what to do and why and how to do it. But nobody can change your thinking for you.

An addiction is held in place by an elaborate system of deceptions. If you have been deceiving yourself in this way for a long time, it will probably all look very real to you.

What quitting cigarettes - and staying stopped - is all about is discovering the truth. Once you have done that, it’s not so easy to get conned again. If you are willing to put effort into reading, thinking and questioning, you have every chance of real success this time.

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Although nicotine is an addictive, very dangerous, poisonous drug, it is relatively easy to withdraw from. Most smokers perceive that they are ‘addicted’, or that there is something about cigarettes that make it very hard to give them up.

Unfortunately, this may act as a reason for continuing - ‘I’m Just stuck’. That makes quitting harder than it ever needs to be. For that reason it is important to understand the true nature of nicotine addiction, and especially the part it plays in the overall process of cessation. Either way:

• before you can address this part of the problem you must first accept that you are ’stuck’ or ‘dependent’ on your habit.

It never pays to kid yourself, and certainly not in the case of an addiction with life-threatening consequences. This a relatively mild form of addiction. It in fact represents a small part of the overall smoking habit and is usually a minor factor in successful smoking cessation.

Withdrawal, as with any form of drug addiction, involves simply stopping taking the drug. In the case of nicotine, the process is almost always painless although it usually involves different degrees of physical and psychological discomfort from person to person - for two or three days.

The person usually becomes nervous, agitated and irritable. Some say they feel a little edgy, and others experience no discomfort whatsoever. Most smokers are quite familiar with this sort of ‘withdrawal’ discomfort, which they have experienced perhaps hundreds of times. It is what they feel when they have to face a long period without a smoke, or cannot buy a pack because the shops are closed, or have to face a stressful situation without the comfort of a cigarette. It can sometimes be described as ‘mild panic’ such as a person with a phobia for heights experiences, and is likewise psychological rather than physical.

That means you cannot use your addiction as an excuse for not giving up, but nor should you underestimate the ease with which you will get hooked again, even by smoking one cigarette. The best way to reduce that risk is to change the beliefs, habits and lifestyle that will make you vulnerable to relapse. You cannot separate the effects of nicotine withdrawal from the effects of changing the various habits associated with smoking. Both have mental as well as physical implications.

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Although the word addiction may sound strong – that is exactly what the problem is. But the cigarette companies have always had the odds stacked heavily in their favor, because nicotine is the fastest addictive drug currently known to man.

In other articles on this site we have referred to the smoking habit, but we will now address two very different aspects of smoking dependency: physical addiction and smoking habits.

1. Physical addiction. According to the USA Public Health Service Clinical Practice Guideline Treating Tobacco Use and Dependence, nicotine is a very addictive drug. Some cigarette companies have themselves confirmed the highly addictive properties of nicotine.

2. The habits - invariably more than one - associated with smoking behavior that tend to continue to operate automatically even when a person consciously desires to act otherwise. Although all addiction, and indeed behavior, concerns the mind, we can call this second factor psychological addiction.

With a better understanding of these aspects of smoking and cigarettes, quitting smoking for good becomes far less of a hurdle..

Understanding Nicotine Addiction

Nicotine is the fastest addictive drug we know of, and it can take just a few cigarettes to become hooked (on average perhaps four) and just one to become re-hooked after a period of abstinence - in fact a single puff is usually enough to undo days of abstinence.

Its function in the tobacco plant is to act as a natural insecticide. It acts more quickly than a dose of heroin, although it does not have the powerful characteristics of heroin addiction which can result in criminality and more visible antisocial consequences. As we shall see though, the speed of the addictive stimulus is an important factor when it comes to withdrawal, so we need to take account of it.

Within seconds of puffing on a cigarette, nicotine is supplied to the brain and the craving ends. That results in the sense of relaxation that the smoker sometimes associates with the cigarette. It also accounts for any pleasurable or beneficial association between the immediate effect of the cigarette and the behavior related to it - such as lighting up after a pleasant meal, or when receiving a stressful telephone call to regain some feeling of control. Those positive associations, rather than the physical addiction, account for the psychological power of the ‘habit’.

The other side of the coin is that the effect wears off quickly - maybe within a quarter of an hour, and then you need another fix. That explains why most smokers average about 20 a day. Physical addiction is the minor part of the smoker’s problem, however, and one that has long been the subject of myths. So we need to set the record straight.

In 1527 Archbishop de las Casas of Spain wrote about tobacco addiction among Indians, and their reporting their inability to stop smoking.

In 1604 James I, King of England, wrote a denunciation of smoking due to tobacco’s addictive effect of which his doctors had told him.

In 1669 the French Academy of Science (comparable to the USA Surgeon General Committee of today) held a national medical conference on tobacco’s mental effects. The king’s physician, Dr Guy Fagon advised that experience had shown that tobacco use shortened human life.

On 26 March 1699 Dr Fagon reported that tobacco is “a poison that is more dangerous than hemlock, deadlier than opium… Assuredly, when people try it for the first time,  they feel an uneasiness that tells us that we have taken poison.” But continuing, soon “all reasoning, all warning is in vain. He cannot shake off his enemy.. .tobacco alone becomes a fatal, insatiable necessity (addiction), - smoking is a permanent epilepsy.”

In 1798 the Surgeon General (Benjamin  Rush, MD) under General George Washington during the Revolution, reported smoking’s adverse mental effect.

So, if you’re looking for tips on stopping smoking, start to analyze your habits and make notes of the circumstances of when and how you light up a cigarette. Then you will be much better equipped to change those habits and quit smoking for good.

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• The physical effects of tobacco addiction vacate the body within two or three weeks. That’s quick in comparison with a habit that is usually counted in years or decades, even if you add a couple of weeks to get properly prepared before making the break.
• The involuntary craving, or sense of ’something missing’ (as it is often described) disappears in a few days - less time than it will take some readers to carefully read all the articles on this site.
• The psychological or habitual aspects of giving up smoking are no different to other habits and respond to simple changes in behavior.

It is therefore more a matter of:

• Sound information about the habit and giving it up.
• Self-knowledge regarding your attitudes and beliefs about smoking, including why you started and continue. It may help to keep a quit smoking diary, in which you record the specific circumstances that trigger a light-up, what helps you to go for long periods without a cigarette and so on.
• Learning techniques that help the preparation and quitting smoking process.
• Changing a few smoking-related habits and the beliefs that support them. In a future article I’ll explain how you can reprogram your mind to behave in new, non-smoking ways.
• Motivation, or the sincere desire to quit smoking once and for all. Unless triggered by a special event such as a bereavement, the desire to quit is usually a gradual, cumulative process. You acquire information, get to know yourself and realize that there are ways to give up that apply in your particular case.

You need to concentrate on these rather than extraneous facts and standard, product-type remedies. Motivation has proved to be the single most important factor in success, but even lack of motivation need not be a barrier. Your motivation will increase as you understand some simple facts and, most of all, start to imagine the benefits of success and their ripple effects in your life.

Like everything else concerning learning how to quit smoking, even motivation is within your control. In another article (Tips To Quit Smoking - Understanding Nicotine) I address the common questions that concern nicotine ‘addiction’ and smoking ‘habits’.

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You know the feeling. For a moment your heart races and you feel a dizzy kind of intoxication. Extra adrenalin runs through your body. It’s a feeling of excitement, a very brief ‘lift’ or ‘high’. It’s a nicotine buzz.

In a scientific experiment designed to test smokers addictions, the nicotine was delivered gradually, over one hour. If it had been administered quickly the subjects would have been aware of it and it would have felt to them like smoking, delivering a buzz and thus satisfying their desire to smoke.

If you have ever tried using nicotine replacement therapy (NRT), such as gum, patches or lozenges, you will know what I’m talking about. It delivers the nicotine too slowly to be truly satisfying. Some people can get a very mild buzz from it, and can even get hooked on it, just as some get hooked on other slow-delivery methods, like non-inhaling pipe and cigar smokers.

Nicotine in your blood, even if delivered very gradually, will make your heart beat a little bit faster, among other things, but the effect it has is much more subtle. For the vast majority of cigarette smokers, the buzz is the most important thing, and you only get that from a sudden, rapidly absorbed dose of nicotine.

Unfortunately this increased heart rate isn’t real energy - otherwise athletes would smoke during marathons. It’s a false stimulation, and like all artificial highs it’s immediately followed by a depressed state. To make matters worse, cigarette smoke includes many poisons too, so although the heart is beating raster there is less energy-producing oxygen in the blood. This is why most smokers find they have more energy when they’ve stopped. 

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Some methods of quitting smoking show better results than others when you look at the bigger picture of all the different types of stop smoking programs out there. A number of major research studies into the effect of hypnosis on smoking cessation, for example, have shown long-term success rates of over 90 per cent claimed in a study by T. Von Dedenroth, based on 1,000 smokers using hypnotherapy, reported in the American Journal of Clinical Hypnosis.

Based on a one-year follow up, an 88 per cent success rate was recorded and reported in the International Journal of Clinical and Experimental Hypnosis. Published research findings by Hall for Hypnotherapy claim success rates of 88 per cent. Individual hypnotherapists widely claim success rates of over 90 per cent.

An article in New Scientist (October 1992) put hypnosis at the top of the list for effective treatment. The headline ran ‘Hypnosis is the most effective way of giving up smoking, according to the largest ever scientific comparison of ways of breaking the habit’. In fact this study included ’simple relaxation’, so understated the effectiveness of the better, more focused hypnosis treatments at the time, and more so now.

Hypnosis or hypnotherapy, have not enjoyed the sponsorship of the NRT and pharmaceutical industry, so there are few large scale studies to draw upon. There is no tangible ‘product’, and hypnotherapists do not combine to operate as large corporations, so cannot fund long-term research costs.

The aim of stop smoking hypnotherapy intervention is for a permanent cure, of course, and it would take many years to get valid results anyway. In consequence of all this, the approach has not been adopted by the main health and anti-smoking agencies who issue advice.

As if this wasn’t enough to keep stop smoking hypnosis techniques out of the smoking cessation slakes, there are special problems of methodology in conducting scientific studies.

For example, scripts or the words used during the hypnotic trance have not been standardized, so the significance of this aspect of the treatment has not been captured. This explains why the success rates of over 90 per cent consistently claimed, but which clearly just apply to certain skilled practitioners, do not figure in larger studies including good, bad and indifferent practitioners.

In some cases basic relaxation methods and meditation qualify as hypnotherapy. In other cases, while the main smoking-related habits are ‘cured’, because of insufficient preparation and depth others are not even addressed. Therefore, however successful the stop smoking hypnosis technique, any such untreated behavior can - and usually does - result in a relapse.

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In light of the particular addictive properties of nicotine - whatever the dosage or method of intake - this should be blatantly obvious. Continued physical addiction is guaranteed, for instance, by feeding more of the addictive drug. That’s the way addictive drugs work. Worse than that - the craving and stress tend to increase because of the lower, shorter lasting relief. So giving up the drug gets ever harder.

Meanwhile, cigarette manufacturers face a rearguard (though still profitable) action, as sales of NRT products such as patches, gums and inhalers increase apace. ‘It’s an ill wind…’.

This illustrates the almost miraculous, all-pervasive impact of marketing on the sales of both cigarettes and so-called non-smoking remedies. ‘Cures’ involving such products are often short-lived, and thus meet the basic requirement of the commercial success of the product - repeat sales.

Even in the case of NRT the most cited research adopts a six month cut-off point as a ‘cure’ or ‘cessation’. But ’smoking cessation’ applies to cigarettes rather than nicotine, the addictive element in the cigarettes, which the product perpetuates. Extraordinarily, the smoking public accepts remedies that patently fail in the majority of cases, simply because they are ‘accepted’ remedies.

More recently on the market, NRT lozenges fall into the same general category, except that they contain a higher dose of nicotine, so as with all NRT products they perpetuate the physical addiction. As they can be more precisely linked to the ups and downs of the craving than patches, and involve doing something, these may help in replacing part of the habitual aspects of smoking, much like sucking mints does, but it is too early to judge.

Patches and gums generally claim approximate doubling of the chances of success (measured-against the research period of perhaps six months). This is from a very low base line, however, and thus falls near to willpower on the withdrawal success ladder.

Most significantly though, research into these products is almost always linked with some other interpersonal intervention, such as advice, counseling, or a helpline type resource. In fact, it is almost impossible to isolate remedies such as NRT from other variables such as:

• willpower
• motivation
• recourse to family and friends for support
• a recent event increasing the desire to quit
• circumstances such as a new car you want to keep fresh-smelling
• present stressful life circumstances
• a Job that precludes smoking
• the smoker’s immediate social circle
• a recent smoking-related bereavement
• the burden of the expense of buying cigarettes.

Widely used stop smoking remedies such as patches and gums may actually make the problem worse by perpetuating the addiction at a low dosage that does not relieve the withdrawal craving.

Add to this the fact that the smoker continues to incur significant cost, with nothing to show for it in terms of withdrawal from nicotine dependency. Less apparent, the heavy marketing of such nicotine replacement therapy products has a similar, unconscious, conditioning effect to the promotion of cigarettes themselves - and you don’t want to be hooked on patches forever. At best this leaves the smoker confused.

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If you are a young adult or teenager, who sees middle age and sickness as remote possibilities, and smoking as exciting and dangerous, the best attacks on smoking are the way it makes you look and smell.

You can also add the environmental pollution of cigarette ends and the way big business exploits Third World nations, keeping their populations in poverty while they make huge profits by putting land that should be growing food under tobacco cultivation.

Pakistan uses 120,000 acres, and Brazil half a million acres of their richest agricultural land, to grow tobacco. And as the multinationals are now promoting their product very heavily to the developing world, no one who smokes can claim to be really concerned about the health of the Third World. Is this as persuasive an argument for you to stop (or not to start) as any about health or looks?

If you are a more mature woman, looks may be the key. Smoking ages you prematurely, causing wrinkles and giving a pale, pasty complexion. If you smoke you will probably experience the menopause at an earlier age than normal, even in your mid-thirties, which can destroy your plans to have your family after a career.

For men and older women, the prime motivation is better health. The statistics for men and women in their sixties who smoke are frightening. More than a third of men who smoke fail to reach pension age. So giving up smoking has an impact on everybody’s life literally all over the world.

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My father/grandfather smoked 20 a day and lived till he was 75. Everyone knows someone like that, but they conveniently forget the many others they have known who died long before their time. The chances are that you will be one of those, rather than one of the lucky few.

People who don’t smoke also have heart attacks. True. There are other causes of heart attacks, but 70 per cent of all people under 65 admitted to coronary care with heart attacks are smokers, as are 91 per cent of people with angina considered for coronary bypass surgery.

I believe in moderation in all things, and I only smoke moderately. That’s rubbish. We don’t accept moderation in mugging, or dangerous driving, or exposure to asbestos (which incidentally causes far fewer deaths from lung cancer than smoking). Younger men who are only moderate smokers have a much higher risk of having a heart attack than non-smoking men of the same age. The figures are even worse for women.

I can cut down on cigarettes, but I can’t stop. It won’t do you much good if you do. People who cut down usually inhale more from each cigarette and leave a smaller butt, so that they end up with the same blood levels of nicotine and carbon monoxide. You must stop completely.

I’m just as likely to be run over in the road as to die from my smoking. In the UK, about 15 people die on the roads each day. This contrasts with 100 deaths a day from lung cancer, 100 from chronic bronchitis, and 100 from heart attacks, almost all of which are due to smoking. Of every 1,000 young men who smoke, on average 1 will be murdered, 6 will die on the roads, and 250 will die from their smoking habit.

I have to die from something. In my experience this is always said by someone in good health. They no longer say it after their heart attack or stroke, or after they have coughed up blood, and when they are on deaths door.

I don’t want to be old, anyway. We define ‘old’ differently as we grow older. Most of us would like to live a long time, without the inconvenience of being old. If we take care of ourselves on the way to becoming old we have at least laid the foundations for enjoying our old age.

I’d rather die of a heart attack than something else. Most of us would like a fast, sudden death, but many heart attack victims leave a grieving partner in their early fifties to face 30 years of loneliness. Is that really what you want?

Stress, not smoking, is the main cause of heart attacks. Not true. Stress is very difficult to measure and it is very hard to relate it to heart attack rates. In any case, you have to cope with stress, whether you smoke or not. Smoking is an extra burden that can never help, and it does not relieve stress. It isn’t burning the candle at both ends that does the harm, but burning the cigarette at one end.

I’ll stop when I start to feel ill. That would be fine if the first sign of illness were not a full-blown heart attack from which more than a third die in the first four hours. It’s too late to stop then. My friends first sign of lung cancer was the one that he died of only a few short weeks later.

I’ll put on weight if I stop smoking. You probably will, because your appetite will return and you will be able to taste food again. But if you have learnt about changing your eating habits to control your weight better, than you will lose any extra weight anyway. In any case, the benefits of stopping smoking far outweigh the few extra pounds you may put on.

I enjoy smoking and don’t want to give it up. Is that really true? Is that not just an excuse because you can’t stop? Ask yourself what your real pleasure is in smoking, and try to be honest with the answer.

Cigarettes settle my nerves. If I slopped, I’d have to take a tranquillizer. Smoking is a prop, like a baby’s dummy, but it solves nothing. It doesn’t remove any causes of stress, and only makes things worse because it is another promoter of bad health. And when you start to have symptoms, like the regular morning cough, it only makes you worry more. It will also make it more difficult for you to control your weight.

I’ll change to a pipe or cigar - they are safer. Lifelong pipe and cigar smokers are less prone than cigarette smokers to heart attacks, but have five times the risk of lung cancer, and ten times the risk of chronic bronchitis, than non-smokers. Cigarette smokers who switch to pipes or cigars continue to be at high risk of a heart attack, probably because they inhale.

I’ve been smoking now for 30 years - it’s too late to stop now. It’s not too late, whenever you stop. The risk of sudden death from a first heart attack falls away very quickly after stopping, even after a lifetime of smoking. If you stop after surviving a heart attack, then you halve the risk of a second one. It takes longer to reduce your risk of lung cancer, but it falls by 80 per cent over the next 15 years, no matter how long you have been a smoker.

I wish I could stop. I’ve tried everything, but nothing has worked. Stopping smoking isn’t easy unless you really want to do it. You have to make the effort yourself, rather than think that someone else can do it for you. So you must be motivated.

So the effects of smoking affect pretty much every area of your life - and the list of reasons not to stop are comprehensive. If you really want to learn how to quit smoking, you need to take contol of your emotions and habits. Don’t keep putting it off - tomorrow could be too late.

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You know the feeling. For a moment your heart races and you feel a dizzy kind of intoxication. Extra adrenalin runs through your body. It’s a feeling of excitement, a very brief ‘lift’ or ‘high’. It’s a nicotine buzz.

There has been (and continues to be) a lot of research into how to stop smoking. In the many experiments that have been performed to test how much smokers need the nicotine, as against how much they desire the effects (as listed above), the nicotine was delivered gradually, over one hour. If it had been administered quickly the subjects would have been aware of it and it would have felt to them like smoking, delivering a buzz and thus satisfying their desire to smoke.

If you have ever tried using nicotine replacement products, such as gum, patches or lozenges, you will know what I’m talking about. It delivers the nicotine too slowly to be truly satisfying. Some people can get a very mild buzz from it, and can even get hooked on it, just as some get hooked on other slow-delivery methods, like non-inhaling pipe and cigar smokers.

Nicotine in your blood, even if delivered very gradually, will make your heart beat a little bit faster, among other things, but the effect it has is much more subtle. For the vast majority of cigarette smokers, the buzz is the most important thing, and you only get that from a sudden, rapidly absorbed dose of nicotine. This buzz is something we need to be aware of when we try any of the stop smoking methods, as willpower alone is not always enough.

Unfortunately this increased heart rate isn’t real energy - otherwise athletes would smoke during marathons. It’s a false stimulation, and like all artificial highs it’s immediately followed by a depressed state. To make matters worse, cigarette smoke includes many poisons too, so although the heart is beating faster there is less energy-producing oxygen in the blood. This is why most smokers find they have more energy when they’ve stopped.

Getting It Right

As you are no doubt aware, the buzz is stronger when you haven’t smoked for a while. It’s at its best when a dose of nicotine rapidly enters a brain and body that contain relatively low levels of nicotine. Like the first cigarette of the day, for example.

But the balance has to be right, because for most smokers, if you smoke too infrequently the sensations are too strong and can even make you nauseous. So you need to keep smoking a certain amount in order to maintain some tolerance.

On the other hand, if you smoke too frequently you don’t get enough buzz. This is the bad news: the buzz is subject to "rapid acute tolerance". This means that after the first puff of the first cigarette you’ve had in a while, you get a much weaker sensation. Quite probably, most of the cigarettes you smoke in a day don’t manage to deliver a good buzz, but you keep trying anyway. I know I did.

This is the reason why smokers can still have a desire to smoke even though they’ve got plenty of nicotine in their body. For some smokers there are times when smoking a cigarette doesn’t satisfy the desire, so that they still feel a craving while actually smoking.

That’s because they are still wanting the buzz but just not getting it. For some this can develop into chain-smoking, which is a continuous and largely unsuccessful attempt to satisfy their desire to smoke. So when you’re giving up smoking you need to find a replacement for this buzz that your body is striving for.

It’s a never-ending tease, delivering the prize just often enough to keep you interested. You try to get that buzz feeling as often as you can, waiting in between cigarettes for as long as possible for the nicotine level to drop a bit, so that it feels strong enough when the nicotine goes in. This is why cigarettes are particularly enjoyable after physical exercise and after a meal: the nicotine level has been brought down, giving you a better buzz when you smoke.

So one of my tips to quit smoking is to be aware of this buzz, and look for something to replace it. Exercise is a great (and healthy) way to get a similar sort of buzz – honestly. Try it – you’ll see.

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Most therapies and techniques encourage this dream. Those people, who threaten, needle, shock and hypnotize smokers into stopping focus on a process that reinforces the decision to quit, promising permanent success if this first step is taken.

But it is one thing to stop smoking and quite another thing to stay stopped. In one article, a hypnotist claims a 90 per cent success rate. Another, in his book, claims that 80 per cent succeed with his methods. But neither gives any reference to how long these ex-smokers remained ‘cured’.

Five minutes? Five weeks? Without that information, these claims are virtually meaningless.

According to research at the University of London (published in the medical journal Addiction in 2005) more than 85 per cent of smokers who have given up return to smoking within a year.

Perhaps you could say that if these people go back to smoking later on, it’s their own fault. But could it be that there are crucial flaws in the techniques employed; flaws that will inevitably lead die great majority of ex-smokers back to their old ways?

This website is all about how to stop smoking and stay stopped for good – it regards stopping smoking not as an event, but as part of a process. The process begins even before stopping and continues for some time after your last cigarette has been extinguished.

This is because stopping smoking is really about changing the way you think about smoking. It’s a matter of becoming aware of the kind of thinking that supports the addiction, and resolving the conflicts it creates. And that doesn’t happen in an instant, like magic.

For you, this is both good news and bad news. The bad news is that it’s not just a matter of deciding to stop and toughing it out for a few days. Most smokers have already done that at some time and still gone back to smoking after weeks or months of abstinence.

The good news is that if you recognize and understand the mental aspects of the addiction, you have a far greater chance of long-term success than if you try to pretend that it isn’t there.

Every smoker is different, but they all have much in common: a powerful, insidious and often underestimated drug addiction. If you cannot grasp how this addiction works, no amount of motivation or willpower will enable you to succeed in the long term.

To stop smoking is the first giant step, but it’s not just a matter of stopping. It’s learning the skill of staying stopped that’s the real challenge. And that’s what this site is all about.

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