Substance Cessation

Did you know that in 2020, the government spent RM6.2 billion to treat three major smoking-related diseases- twice more than the RM3 billion revenue generated from tobacco sales? Not only does smoking cause diseases such as lung cancer and heart disease, it is also a risk factor for diabetes. The more you smoke, the higher the risk. 

Now, I think most smokers know these risks but many of them still continue this habit. Why is quitting hard?

It is because of the nicotine dependence cycle. 

Image taken from: About quitting tobacco. Boston Medical Center. (n.d.). https://www.bmc.org/programs/tobacco-treatment-center/about-quitting-tobacco

Nicotine dependence is a complex cycle, which affects the smoker physically and psychologically. When a person inhales tobacco smoke, nicotine swiftly enters the bloodstream, reaching the brain within seconds. Once in the brain, nicotine stimulates the release of dopamine, a neurotransmitter associated with pleasure and reward. This pleasurable sensation creates a powerful psychological reinforcement, leading individuals to crave the euphoria associated with smoking. Over time, as the body becomes accustomed to nicotine, tolerance develops, prompting smokers to increase their intake to maintain the desired effects. Attempting to quit often results in withdrawal symptoms such as irritability, anxiety, and cravings, further solidifying the dependence cycle. 

So where do you start if you’ve decided that you want to quit?

- Stopping cold turkey is often not the way

- Recognise triggers

- Avoid high risk situations

- Identify your barrier

- Develop coping skills

How else can we get the high that we feel from dopamine release? Exercise. During exercise, your brain releases “feel-good” chemicals, including serotonin, dopamine, and endorphins. Even brief bouts of exercise may work to help the temporary spike in cravings. There are also nicotine replacement therapies available for successful quitting, for example, nicotine gums and patches. Quitting is beneficial at any age and time. Of course, the younger, the better. But even immediate cessation cuts the risk of having a heart attack by 50%! 

But remember, breaking free from nicotine dependence requires a comprehensive approach, addressing both the physical and psychological aspects of addiction. Therefore, do not hesitate to ask for a professional’s help if needed. 

References:

1. Money spent to treat smoking-related diseases doubles revenue from ... (n.d.). https://www.nst.com.my/news/nation/2022/07/816948/money-spent-treat-smoking-related-diseases-doubles-revenue-tobacco-sales

1. Kelly, J., & Clayton, J. S. (2021). Foundations of Lifestyle Medicine Board Review Manual (3rd ed.). ACLM.