Nicotine addiction and quitting smoking

December 11, 2013

By Joelle Thirsk Fathi, DNP

The presence of tobacco dates back at least 8,000 years in the world’s history. Throughout time, this plant was central to religious ceremonies, thought to have healing powers, delivered as gifts, traded for goods, and smoked by many. As early as the mid 1700s tobacco was formally manufactured and distributed in the form of cigarettes. Interestingly doctors were featured in promotional cigarette ads in the 1930s. However, the ill effects of tobacco were identified long before this and Massachusetts state law banned smoking in public in 1632.

Nicotine is a stimulant and a very addictive substance contained in tobacco. It is extremely easy to become addicted to nicotine. With repeated exposure to the chemical, the brain’s nicotinic receptors crave more and drive the need to smoke at higher levels. Nicotine is well known for its pleasurable physiological and psychological side effects. These pleasurable side effects result in addiction to the substance and make it difficult to quit smoking, even when an individual is highly motivated to stop. Tobacco companies have complicated this addiction by adding numerous other addictive chemicals that strengthen the difficulty in quitting, making cigarettes the most common form of chemical dependency in this country.

Use of cigarettes in the United States (U.S.) has dropped considerably since an all-time consumption high of 640 billion cigarettes in 1981. Currently the U.S. consumption is about half that volume but smoking remains the leading cause of preventable illnesses and death in this country; attributing to 1 out of every 5 deaths in America.

Overall consumption of cigarettes has declined since the 1990s and has plateaued at 20% of the American population. However, even with this fall in overall societal consumption of cigarettes, the smoking cessation (quit) rates in the last 20% of smokers has not fallen; people are still smoking at the same rate.

Most people understand that smoking cigarettes is dangerous for their health but the addiction trumps this understanding any day of the week. The physiological and psychological impact of the nicotine and other cigarette chemicals are powerful, explaining the difficulties and inability to quit. Additionally, there are many other motivations and triggers for people to continue to smoke that need to be considered when approaching quitting.

Smoking in public has become off-limits and often smokers are forced to smoke in hiding and scorned for this activity whereby negatively impacting their ability to quit. It is difficult for people to quit smoking and often smokers are not able to attempt quitting with success because they are going it alone. It is common for smokers to have multiple failed attempts at quitting before they are successful. Relapsing in the quitting process can cause smokers to feel very discouraged and even ashamed.

As fellow humans, health care providers, friends, and family members we need to find a way to support those who are smoking, in quitting. The nicotine addiction epidemic is a problem for all of us, even if we are not smokers. We all have a stake in helping others quit smoking and the only way to do this is by adopting positive and supportive ways in helping, one person at a time. To learn more about this addiction, methods of quitting, and systematic approaches in quitting, or to download our resource guide to help someone quit smoking, What You Need to Know When Quitting Smoking, visit