Asst. Prof. Muhammet Sait Toprak
Faculty Member - Istanbul Kent University, Faculty of Pharmacy, Department of Biochemistry
"No age is too late to quit tobacco products!"
Smoking Addiction

What is cigarette addiction?

Every day, 19,100 people (approximately 7 million per year) die from diseases caused by smoking in the world. While 83,100 people die from smoking-related causes in Turkey every year, 252 thousand children and 14.5 million adults use tobacco products.
Nicotine is a chemical in tobacco that makes you want to smoke. Nicotine reaches the brain within seconds of taking a puff. Nicotine increases the release of brain chemicals called neurotransmitters in the brain. This situation helps regulate mood and functioning. One of these neurotransmitters, dopamine, is secreted widely in the brain and causes pleasure and mood enhancement.
The more you smoke, the more nicotine you need to feel good. Nicotine quickly becomes part of your daily routine and becomes intertwined with your habits and emotions.

Common situations that trigger the urge to smoke include

  • Drinking coffee or taking breaks at work
  • Talking on the phone
  • Drinking alcohol
  • Driving your car
  • Spending time with friends
  • To overcome your nicotine dependence, you need to become aware of your triggers and plan for dealing with them.

Risk factors

Anyone who smokes or uses other forms of tobacco is at risk of becoming dependent. Factors that influence who will use tobacco include:

  • Age: Most people begin smoking during childhood or the teen years. The younger you are when you begin smoking, the greater the chance that you'll become addicted.
  • Genetics: The likelihood that you will start smoking and keep smoking may be partly inherited. Genetic factors may influence how receptors on the surface of your brain's nerve cells respond to high doses of nicotine delivered by cigarettes.
  • Parents and peers: Children who grow up with parents who smoke are more likely to become smokers. Children with friends who smoke are also more likely to try it.
  • Depression or other mental illness: Many studies show an association between depression and smoking. People who have depression, schizophrenia, post-traumatic stress disorder or other forms of mental illness are more likely to be smokers.
  • Substance use: People who abuse alcohol and illegal drugs are more likely to be smokers.

Symptoms of cigarette addiction

For some people, using any amount of tobacco can quickly lead to nicotine dependence. Signs that you may be addicted to include:

  • You can't stop smoking. You've made one or more serious but unsuccessful attempts to stop.
  • You have withdrawal symptoms when you try to stop. Your attempts at stopping have caused physical and mood-related symptoms, such as strong cravings, anxiety, irritability, restlessness, difficulty concentrating, depressed mood, frustration, anger, increased hunger, insomnia, constipation or diarrhea.
  • You keep smoking despite health problems. Even though you've developed health problems with your lungs or your heart, you haven't been able to stop.
  • You give up social activities. You stop going to smoke-free restaurants or stop socializing with family or friends because you can't smoke in these situations.

Complications of cigarette addiction

  • Tobacco smoke contains more than 60 known cancer-causing chemicals and thousands of other harmful substances. Even "all natural" or herbal cigarettes have harmful chemicals.
  • You already know that people who smoke cigarettes are much more likely to develop and die of certain diseases than people who don't smoke. But you may not realize just how many different health problems smoking causes:
  • Lung cancer and lung disease: Smoking is the leading cause of lung cancer deaths. In addition, smoking causes lung diseases, such as emphysema and chronic bronchitis. Smoking also makes asthma worse.
  • Other cancers: Smoking increases the risk of many types of cancer, including cancer of the mouth, throat (pharynx), esophagus, larynx, bladder, pancreas, kidney, cervix and some types of leukemia. Overall, smoking causes 30% of all cancer deaths.
  • Heart and circulatory system problems: Smoking increases your risk of dying of heart and blood vessel (cardiovascular) disease, including heart attacks and strokes. If you have heart or blood vessel disease, such as heart failure, smoking worsens your condition.
  • Diabetes: Smoking increases insulin resistance, which can set the stage for type 2 diabetes. If you have diabetes, smoking can speed the progress of complications, such as kidney disease and eye problems.
  • Eye problems: Smoking can increase your risk of serious eye problems such as cataracts and loss of eyesight from macular degeneration.
  • Infertility and impotence: Smoking increases the risk of reduced fertility in women and the risk of impotence in men.
  • Complications during pregnancy: Mothers who smoke while pregnant face a higher risk of pre-term delivery and giving birth to lower birth weight babies.
  • Cold, flu and other illnesses: Smokers are more prone to respiratory infections, such as colds, the flu and bronchitis.
  • Tooth and gum disease: Smoking is associated with an increased risk of developing inflammation of the gums and a serious gum infection that can destroy the support system for teeth (periodontitis).
  • Smoking also poses health risks to those around you. Nonsmoking spouses and partners of smokers have a higher risk of lung cancer and heart disease compared with people who don't live with a smoker. Children whose parents smoke are more prone to worsening asthma, ear infections, and colds.

When to see a doctor?

You're not alone if you've tried to stop smoking but haven't been able to stop for good. Most smokers make many attempts to stop smoking before they achieve stable, long-term abstinence from smoking.
You're more likely to stop for good if you follow a treatment plan that addresses both the physical and the behavioral aspects of nicotine dependence. Using medications and working with a counselor specially trained to help people stop smoking (a tobacco treatment specialist) will significantly boost your chances of success.
Ask your health care team to help you develop a treatment plan that works for you or to advise you on where to get help to stop smoking.

Methods to avoid

Electronic cigarettes are not safe, nor are they more effective than nicotine replacement drugs in helping people quit smoking. Many people who use electronic cigarettes to quit are using both products instead of quitting.
It is not a good idea to replace smoking with another form of tobacco. Tobacco is not safe at all. Avoid these products:
  • Dissolvable tobacco products
  • Smokeless tobacco
  • Nicotine lollipops and balms
  • Cigars and pipes
  • Hookahs

No age is too late to quit tobacco products!

  • If a person is not exposed to any smoke immediately after quitting smoking, their body immediately begins to repair itself. Their pulse rate and blood pressure return to normal, and the likelihood of developing coronary artery disease decreases.
  • If you quit in your 30s, your life expectancy increases by 10 years.
  • If you quit in your 40s, your life expectancy increases by 9 years.
  • If you quit in your 50s, your life expectancy increases by 6 years.
  • If you quit in your 60s, your life expectancy increases by 3 years.

World Health Organisation (2020). ICD-11 for mortality and morbidity statistics last version. https://icd.who.int/browse11/l-m/en

Nicotin dependence. Mayo Clinic. 

Perez AH, et al. Addiction to tobacco smoking and vaping. Rev Invest Clin. (2023).

Siddiqi K, et al. Global burden of disease due to smokeless tobacco consumption in adults: an updated analysis of data from 127 countries. BMC Med. (2020).

Banks E, et al. Tobacco smoking and all-cause mortality in a large Australian cohort study: findings from a mature epidemic with current low smoking prevalence. BMC Med. (2015).

Fowler CD, Turner JR, Imad Damaj M. Molecular mechanisms associated with nicotine pharmacology and dependence. Handb Exp Pharmacol. (2020).

Picciotto MR, Kenny PJ. Mechanisms of nicotine addiction. Cold Spring Harb Perspect Med. (2021).

Kawazoe S, Shinkai T. Nicotine dependence. Nihon Rinsho. (2015).

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