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Tobacco Withdrawal and Coping Techniques

Abstract:

Smoking is one of the biggest problems that has hunted our society for decades. The usage of cigarettes, cigars, and pipes has led to a dangerous and addictive cycle attributing to the deaths of more than 100 million adults. This is because tobacco, the substance found in all these smoking methods, is made up of more than  chemicals, with more than 250 which are lethal such acetone, found in nail polish remover, arsenic, used in rat poison, carbon monoxide, released in car fumes and the most addictive, nicotine, used in insecticides.1 All of these toxic chemicals put the user at a dangerously high risk of developing at least 69 types of cancers and tens of other related diseases. 2 Thankfully, millions of smokers across the world decide to quit tobacco use. However, breaking this addiction is a physically and psychologically strenuous process. So much so that 95% of all Americans who want to quit tobacco use, fail. This is due to psychological and physical symptoms that occur when the body is attempting to remove tobacco out of its system, and heal. Coping mechanisms such as nicotine patches and counseling have developed overtime to help the user successfully pass withdrawal symptoms. As a result, those who break out of the chains of this addiction successfully experience a decrease in the risk of developing these diseases and lead a healthier and more fulfilling life.

Introduction

“How do I quit?” That is the first question millions of smokers across the world have to face when deciding to withdraw tobacco use. Smoking is an addictive cycle that puts its users at more substantial risk for physical and psychological illnesses. However, those who quit are met with a challenge, breaking this addiction. Smoking cessation is the process by which a user begins to withdraw tobacco use. Toxic and addictive chemicals within cigarettes dramatically change the chemical composition of the brain and all areas of the body. As a result, when tobacco use is lowered, the body goes through changes to and begins to heal. This is associated with symptoms such as severe cough, appetitive changes, depression, and more.  

Background

Why quit?

Cigarettes, pipes, and cigars are the most common sources of tobacco, which carry more than 7000 chemicals, 250 of which are severely virulent. As a result, they put users at risk of developing at least 69 kinds of cancers, including lung cancer, colon cancer, kidney cancer, pancreas cancer, and tens of other diseases such as COPD, and stoke. 3, 4 Lastly, smokers experience suppressed senses of smell and taste, staining of teeth, bad breath, and increased likelihood of oral infections.5 Quitting tobacco use would allow all smokers to be at a significantly lower risk of developing any of these diseases, eventually down to the level of a non-smoker, promising a much healthier and long-lived life.

What is the withdrawal period like?

Unfortunately, tobacco withdrawal is a very physiological and physically demanding process that lasts from one to three months. During this time, the body removes nicotine out of the system and beings to revamp proper function and chemical balance. As a result, ex-smokers experience mild to severe symptoms in response to this change, which peaks three days after the last cigarette. Most often, these are signs that the body is healing and regaining control.6 Below is explained what affect tobacco withdrawal has on some of the different organs of the body, and how these influences are correlated to symptoms.

The Cardiovascular System

Cigarettes are made up of many dangerous chemicals including benzene, used in crude oil such as gasoline, tar, and acetone.1 In just one smoking puff, these chemicals contaminate and travel throughout the bloodstream. As a result of overloading and hazardous chemical interactions, they cause tremendous damage to the vessels and heart.6 Over time, blood thickens, making it harder for it to travel in thin blood vessels, and vessels grow weaker, increasing the likelihood of rupturing. Furthermore, plaques are more prone to building up in arteries; this increases the likelihood of higher blood pressure, lowers the amount of oxygen delivered to cells, and increases the likelihood of blood clots, heart attacks, and strokes. 6 Thankfully, once tobacco use is stopped, the cardiovascular structures can begin to go back to normal. Vessels begin to grow stronger, and toxic chemicals are filtered out of the blood. As a result, circulation efficiency begins to improve, and oxygen levels in the blood rise, causing a tingling sensation throughout the body. 5,6

The Nervous System

As nicotine travels through the bloodstream, it eventually reaches the brain, where it activates certain brain structures called receptors. These receptors release a chemical called dopamine which is in charge of regulating mood, sleep, attention, motivation, and movement.2 With a higher intake of nicotine, these receptors and dopamine levels increase, also causing this sensation of relaxation and pleasure to augment.6 This causes our brain to depend on this molecule to keep a baseline level of happiness and function.

During withdrawal, these receptors are not receiving the necessary amount of nicotine to release dopamine molecules.6 As a result, the dysregulation of dopamine triggers sleep disruption, insomnia, low concentration, and even depression. 5 For many smokers, tobacco use is a coping mechanism for ulterior stress and anxiety. As a result, removing this source of psychological “comfort and happiness” can have profound emotional effects. Ex-smokers might also get easily irritated and angry and experience tobacco craving, especially during situations when the user used to habitually smoke, for example when having alcohol. Unfortunately, smoking a cigarette is the easiest way to ease these symptoms, however, getting through them is the only way to successfully quit. This is the hardest part of tobacco withdrawal and the reason why 95% of Americans fail to give up smoking, regardless of their desire to do so.

With time, the number of nicotine receptors lower in number, causing fewer and fewer cravings for a cigarette, and the levels of dopamine and other chemicals restore to normal. In just a week, these symptoms dramatically decrease.

The Pulmonary System

The pulmonary system is also a significant target of tobacco use. Our lungs have a biological mechanism of filtering and removing harmful chemicals from our pulmonary cavities. This is regulated by cilia, tiny fingerlike projections, and mucous found in the nasal cavity, respiratory tract, and lungs, in charge of maintaining the airways and protecting cells from experiencing damage. During excess smoking, there is an extreme abundance of harmful chemicals that fill these spaces, causing the cilia to get overworked, immobilized, and eventually flatten out.6 Meanwhile, the mucus absorbs these substances causing a lot of damage to these areas.

During tobacco withdrawal, these chemicals begin to decline, and the cilia are able to stretch out and clean out mucus and pulmonary spaces. As a result, the body must eliminate most of these substances by coughing them out; as a result, many experience a severe cough or sore throat during the first two weeks. 5,6

The Immune System

Lastly, one of the things that have captivated the interest of scientists who study tobacco withdrawal is how our immune system behaves. Interestingly, our immune system detects high levels of cytokines, specifically interleukin-1 beta, and interleukin-6, which are a group of signaling proteins released from white blood cells, stimulate the inflammatory response. 7 This same response is activated when tissues experience trauma, are harmed by bacteria, toxins, or other flu-like causes. As a result, the ex-smoker experiences fatigue, muscle aches, and appetite changes, which are all experienced in acute diseases.7As a result, many consider these symptoms part of the “tobacco flu.” 6

What are some coping methods used for tobacco withdrawal?

Though the symptoms and tobacco cravings fade after the first few months of withdrawal, many turn to coping mechanisms to help guide them through the withdrawal period. Below are some of the most common techniques smokers use to successfully give up their addiction. It is important to note that all these methods contain many positives and negatives which will all be explored at greater depth.

Nicotine Patches

First introduced by prescription only in 1992 in the US, nicotine patches are some of the most widespread methods of nicotine secession. Nicotine patches are similar to clear square bandages usually placed in the forearm, which provide the user with a steady supply of nicotine which is delivered through the skin to the blood throughout the day. 8 A single cigarette contains from 8 to 24 mg of nicotine. Nicotine patches’ dosage varies from 21mg to 7 mg of nicotine per day. 8 Their intensity varies based on how much and how often they smoke. Over time, the dosage in patches should decrease, allowing for a gradual decrease in nicotine along with muted and more balanced out symptoms. Unfortunately, many experience redness or irritability where the patch is applied, muscle pain, vivid dreams, diarrhea, and insomnia. 8 Due to considerable tobacco cravings, many abuse patch dosages which can lead to nicotine overdose. Nevertheless, there are no long term dangers associated with nicotine patches when following the appropriate guidelines.

Nicotine Gum

Nicotine gum is also a popular alternative to the patches, introduced just months before them in 1992 in the US. Nicotine gum comes in doses of two to four mg; users are advised to only use ten pieces of gum per day, to prevent nicotine overdose. Nicotine gum requires a very specific way of consumption; the user must slowly chew the gum for a very short period of time and then circle it throughout their gums and cheek where the nicotine will be absorbed. 9 This process could be repeated every one to two minutes. It should take around 25 minutes to properly consume it.9

There are much higher risks associated with nicotine gum than nicotine patches. Unfortunately, many consumers don’t know or respect the correct way of consumption. As a result, their saliva fills with a large dosage of nicotine which damages the gastrointestinal tract and creates pain. This also causes nausea and dizziness. Furthermore, many users get a sense of relief when using this gum and take such large quantities of it that it can induce nicotine overdoses. Since the amount is something that the consumer controls, many get addicted to the gum alone, and fail to fully withdraw. 9

Counseling

Lastly, some users also turn to professional counseling to help guide them through this process. These meetings can occur individually or in small groups for a short period per week. Trained professionals prepare clients for symptoms and teach them to fight the cravings during smoking cessation and later on. 6 Furthermore, they help patients who use smoking as a way of coping with depression or anxiety to improve these issues so that the withdrawal process is less extreme for the rest of the body. 2 Unfortunately, there is a lot of stigma around asking for professional help for something as addictive as tobacco; though counseling has proved to be very helpful and successful, it is a less preferred alternative for smokers.

What happens after quitting?

After quitting tobacco use, the body begins to slowly regenerate and heal. Key signs of improvement in the body can be seen within days, hours, weeks, months, and years after smoking the last cigarette. In just 20 minutes, heart rate and blood pressure decrease, and eventually, in eight to twelve hours, carbon monoxide levels lessen. Nicotine levels in the body are depleted within three days which is why the most extreme symptoms range in this period of time. Within nine months, coughing and shortness of breath decrease, and after a year, the risk for a heart attack decreases by more than 50%. Finally, in five years to ten years, the chance of a stroke and lung cancer drops to that of the average adult. 

Conclusion

Though the withdrawal process requires a lot of strength and persistence, it is utterly necessary. Smoking is one of the most dangerous addictions, placing more and more users at significant risk of developing a deadly disease. Through quitting these dangers are restored, and all past users have a chance of living a perfectly healthy and normal life.

If you or someone you love smokes, it is never too late to quit. Don’t hesitate to reach out for assistance and advice on how to quit, and support those who are going through this process; remember, the struggle will not last forever. It will all be worth it in the long run! 

References

  1. “What’s In A Cigarette?”. 2020. Lung.Org. https://www.lung.org/quit-smoking/smoking-facts/whats-in-a-cigarette.
  2. “What You Need To Know About Smoking And Your Brain”. 2020. Healthline. https://www.healthline.com/health/smoking/smoking-effects-on-brain#nicotine-effects.
  3. “What Are The Health Risks Of Smoking?”. 2020. Nhs.Uk. https://www.nhs.uk/common-health-questions/lifestyle/what-are-the-health-risks-of-smoking/.
  4. Ritchie, Hannah, and Max Roser. 2020. “Smoking”. Our World In Data. https://ourworldindata.org/smoking#the-global-distribution-of-smoking-deaths.
  5. “Effects Of Quitting Smoking On The Body”. 2020. Healthline. https://www.healthline.com/health/effects-of-quitting-smoking#withdrawal-symptoms.
  6. “Nicotine Withdrawals: What Are They And How Can I Overcome Them?”. 2020. Webmd. https://www.webmd.com/smoking-cessation/understanding-nicotine-withdrawal-symptoms. 
  7. “Nicotine Withdrawal Woes Shown To Be Similar To Inflammatory Response”. 2020. Sciencedaily. https://www.sciencedaily.com/releases/2002/02/020222074202.htm
  8. Can The Nicotine Patch Help You Quit Smoking?”. 2020. Verywell Mind. https://www.verywellmind.com/the-nicotine-patch-2825025 
  9. Jr, Dennis, and MPH Lindsey Marcellin. 2020. “What You Need To Know About Nicotine Gum – Smoking Cessation Center – Everydayhealth.Com”. Everydayhealth.Com. https://www.everydayhealth.com/smoking-cessation/nicotine-replacement-therapy.aspx

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