These quitters are winners

Dr Deepak Verma

Smoking is a habit that you may acquire at will but coming out of it can be virtually impossible for many. There has been a constant research going on to figure out the best to kick the butt, but only two out of three smokers try to quit it every year. And only half of those who try succeed. Addiction to tobacco, especially smoking, is a major health problem globally and is the cause for serious respiratory diseases such as asthma, chronic obstructive pulmonary disease (COPD), as well as tuberculosis and lung cancer. Adolescents who smoke are more likely to suffer chronic respiratory disorders and risk permanent damage to their lungs. The lungs continue to grow well into adulthood, but inhaling the toxins found in tobacco smoke, especially nicotine, slows this process and causes potentially irreversible lung damage. 

Nicotine abuse similar to heroin

Anyone who starts using tobacco, especially during their teens, can become addicted to nicotine: The younger you are when you begin to smoke, the more likely you are to become addicted to nicotine much like cocaine, heroin or other drugs. The repeated, compulsive seeking or use of a substance despite its harmful effects and unwanted consequences is addiction which is also marked by a mental or emotional dependence on the substance. 

Using tobacco products regularly leads to addiction as they are easily absorbed into the blood through the lungs and quickly spreads throughout the body. Nicotine causes pleasant feelings and distracts you from unpleasant feelings, when taken in small amounts. It reaches the brain within seconds after taking a puff and the chemistry of the brain and central nervous system affects the mood of the user and makes the user want to use more. 

When the effects of nicotine start to wear off after a few minutes, the user may start to feel irritated and edgy and may experience irritability, nervousness, headaches, and trouble in sleeping, though it does not amount to serious withdrawal symptoms. As the body adapts to nicotine, smokers tend to increase the amount of tobacco they take in which raises the amount of the substance in their blood, eventually creating tolerance. 

Smoking erodes vascular walls

Nicotine works much like other drugs and energises the reward circuits of the brain with a chemical called dopamine and also gives adrenaline rush that is enough to speed up the heart and raise blood pressure. Each time an extra level of nicotine reaches our brain, it causes the body to activate its fight or flight stress defenses which immediately releases stored fats, intended to be used to provide the instant energy needed to the stress factors, into the bloodstream. 

Nicotine also affects the blood vessels and causes erosion of the vessel wall, known as endothelium. The substance promotes functional and structural changes in vascular walls and stimulates catecholamine release, responsible for altering heart rate variability, increasing risk of ventricular and supraventricular arrhythmias, myocardial infarction, i.e. heart failure. In fact, smoking is the most complex cardiovascular risk factor and researchers have found that abstaining from smoking for as less as eight weeks can help reverse the endothelial damage caused by smoking but may still risk your heart.

People who have used tobacco regularly for a few weeks or longer will have withdrawal symptoms if they suddenly stop or greatly reduce the amount they use. There’s no danger in nicotine withdrawal, but the symptoms can be uncomfortable. Trying to quit smoking or using any other form does not limit itself to the physical abstention, it also calls for tremendous mental and emotional stamina, and professional guidance to this end is an absolute must for better returns. Systematic approach through medication and Nicotine replacement therapy (NRT) can help reduce the severity of urges and cravings. 

— The writer is consultant, internal medicine, Columbia Asia Hospital, Ghaziabad