Smoking and How You Get Hooked

Our intern, Adidtya Das, who enjoys doing health research in areas of self-improvement in his spare time, was inspired by some of his classmates (who are smokers) to create this blog on smoking addiction. This blog will address the multi-faceted nature of why one gets hooked and what can be done to get off the addiction hamster wheel.  

Smoking addiction is influenced by a combination of biological, psychological, and environmental factors. Nicotine, found in tobacco, makes you feel good by affecting your brain’s reward system. It releases a chemical called dopamine, which makes you feel pleasure. This in turn makes smoking feel good, so you want to do it again. Over time, your brain gets used to the extra dopamine so you need to smoke more to get the same pleasure effect.  “Having too much or too little dopamine in some parts of the brain is linked to some mental illnesses including depression, schizophrenia, and psychosis.” (Healthdirect, 2023)

One key aspect of smoking addiction is the development of tolerance and dependence. With repeated exposure to nicotine, people will need higher doses to achieve the same effects, leading to increased consumption. Dependence can also result in withdrawal symptoms when attempting to quit, further reinforcing the addictive cycle.

Besides nicotine’s effects on the body, social influences like friends who smoke or seeing smoking in social media/movies can appear to make smoking ‘cool’ and contribute to the development of addiction. Feeling stressed, anxious, or sad can encourage smoking because people feel that the dopamine hit will help them feel better – and these psychological factors will lead individuals to use smoking as a coping mechanism, further reinforcing the habit.

How Your Genes Fit

Did you know that for some people, smoking addiction can be genetic? For this group, variations in genes impacting the nicotine and feel-good dopamine pathways can affect the rewarding impact of nicotine, making them more prone to addiction. And certain genes related to nicotine receptors and dopamine can make smoking feel more rewarding. Not a good combo!

Knowing how genes affect smoking addiction can help health professionals find better ways to help people quit. And understanding how people’s bodies process nicotine differently can guide treatments to fit each person’s needs. The enzyme cytochrome P450 2A6 (CYP2A6) is primarily responsible for allowing nicotine in the liver. Variations in the genes encoding CYP2A6 can result in differences in nicotine removal rates, influencing the duration and intensity of nicotine exposure. People who process nicotine quickly might need more of it to feel the same effects, which can make them more likely to get addicted. In other words, if your liver does a great job of clearing the nicotine, you may get punished with addiction.

Additionally, genetic factors can contribute to the risk of co-occurring mental health disorders, such as depression and anxiety, which are also associated with an increased risk of addiction.

Your Income and Social Class Matter

Your socioeconomic status can affect how likely you are to smoke. People with lower income might not have adequate access to education and healthcare, so as a result, smoking is more common and acceptable. They might also have more stress and fewer ways to deal with it, making them more likely to get addicted. Plus, tobacco companies often target poorer communities with their ads and products, making smoking even more common there.

Smoking addiction often goes hand in hand with the abuse of other drugs or addictive substances. The coexistence of smoking addiction with alcoholism or illicit drug use can aggravate health effects and complicate treatment outcomes. It’s essential to understand how different kinds of substance abuse interact so we can create treatments that help everyone who needs them.

In a nutshell, understanding smoking addiction is challenging because it’s complicated. To tackle it, we need to look closely at all the different parts of the problem. And understanding the various factors at play will help researchers develop more effective strategies for prevention and treatment.

How to Quit Smoking

Stopping smoking, can be challenging but achievable. Here are some methods that can help:

What do your genes say? Knowing your genetic predisposition to smoking can be a powerful motivator to quit. If you are prone to addiction based on your genetic make-up, you may need to be more vigilant about quitting and staying tobacco-free. Talk to your provider or cessation counselor about availability of testing.  But genetics is only one piece of this complex puzzle.  Some things to know about genetic testing:

Set a Quit Date: Choose a date to quit smoking within the next two weeks. This gives you enough time to prepare but isn’t so far away that you might lose motivation. And talk to your healthcare provider about your desire to quit smoking. You can also get free confidential coaching NOW. Call: 1-800-QUIT-NOW

You can sign up for the Quit App:

And text alerts to help you quit:

Other resources:

Use Nicotine Replacement Therapy (NRT): NRT can help reduce withdrawal symptoms and cravings, making it easier to quit smoking. Talk to your healthcare provider about which NRT options might be right for you. Two good alternatives are Zyn and Lucy products, which fall within the category of nicotine replacement therapies (NRTs) and are intended to assist individuals in their efforts to quit smoking or reduce tobacco use. These products aim to deliver nicotine in a controlled manner without the harmful effects of inhaling tobacco smoke, tar and all the other toxic substances.

Medications: Please talk to your provider about what medications may be available. Varenicline is one prescription medication that can help reduce withdrawal symptoms and cravings by affecting nicotine receptors in the brain. And your provider will prescribe this 1-2 weeks before your quit date. Additionally, bupropion, an anti-depressant has been shown to be effective for smoking cessation by reducing withdrawal symptoms and cravings. This is also typically prescribed before the quit date.

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