Why is it convenient to quit smoking and why is it difficult?
A few tips for smokers.

In many cultures, smoking has been popular for centuries and it served various roles. Regular smoking, however, is dangerous for health and may cause addiction. Yet, many people reach for a cigarette or a pipe. Why? There are many reasons. Apart from pharmacological effects of nicotine, there is also a social, symbolic, and psychological dimension associated with smoking.

At work or at school "going for a cig" during break may be an opportunity for a conversation, making friends and building relations with others. It can also provide a context for group identification - just like ritual smoking in Indian tribes. There are people who associate the act of smoking with something elegant and reserved for grown-ups, especially when parents or other significant people presented such forms of behaviour. Imitating these habits may be a symbolic form of coming close and feeling alike or united with these individuals. On the other hand, there are also smokers who feel a need of doing something forbidden or unaccepted by parents - in this way they can unconsciously demonstrate their autonomy.

For most addicted smokers a cigarette becomes a reward and a "tranquillizer". Not only is it associated with being physiologically addicted from substance - nicotine in this case. There are also complicated psychological mechanisms involved. Specialists talk about an addictive way of regulating emotions. When you feel irritated, nervous or sad and cannot calm down by yourself or you don't know other, healthier strategies to cope with stress, you are then prone to become an addict. Because smoking is a risk factor associated with many diseases, you should know the consequences of smoking, as well as alternative solutions to help yourself.

Why is smoking dangerous?
The fact that smoking is dangerous is no mystery. Every pack of cigarettes will contain sinister slogans to remind you of this, whether or not you try to ignore them or imagine they do not refer to you. Do you know why smoking is destructive for your body? Scientists report that...

1. There are about 4000 poisonous chemicals in smoke; 40 of them are regarded carcinogenic.
2. Regular smoking is associated with increased risk of cardiac and respiratory diseases, as well as cancer.
3. Nicotine addiction leads to problems with erection in man and with fertility in women.
4. When you smoke, you create danger to yourself and your relatives (both active and passive forms of smoking are equally harmful).
5. Smoking during pregnancy is harmful for the baby's health and proper functioning.
6. If you practice sports, you will soon discover how your performance is reduced by smoking.
7. Becoming an addict, you become a slave!

Seven reasons for quitting:
1. You will save money.
If you smoke approximately 20 cigarettes a day, you simply burn about 190 Euro a month. A couple of heavy smokers may spend ca. 6,000 - 9,500 Euro a year on cigarettes.
2. You will improve your fitness. You will not be panting for breath every time you climb up a few stairs or do some simple physical exercises. Your general health will improve, as well as skin condition or breathing. These changes will be especially visible if you practice any sports.
3. Your sense of smell and taste will improve. You will be able to detect subtle differences in flavours. You may also realise that your carpet or objects of everyday use which are permeated with the smell of cigarettes really stink!
4. You will become more attractive! Your skin will look healthier and younger. You will get rid of the smoke odour in your mouth and stains on your teeth and skin.
5. Your house, car, clothing will smell much nicer- not necessarily like an ashtray.
6. You will improve the quality of your life and your lifespan will increase. Breathing difficulties and other symptoms related to smoking cause discomfort and suffering. Why not living a healthier life!?
7. You will save your family from the effects of being a passive smoker. Having the child accompany his or her smoking parents produces similar results, as if the kid had personally smoked a few cigarettes a day.

Are you a nicotine addict?
Use the FagerstrĂśm's questionnaire to test yourself!

Question Answer points
1. How soon after you wake up do you smoke your first cigarette? 0 - 5 min
6 - 30 min
31 - 60 min
after 60 min
2. Do you find it difficult to refrain from smoking in places where smoking is not allowed (e.g. hospitals, government offices, cinemas, libraries etc)? Yes
3. Which cigarette would you be the most unwilling to give up? first in the morning
any of the others
4. How many cigarettes do you smoke per day? 10 or less 11-20 0
5. Do you smoke more during the first hours after waking than during the rest of the day? Yes
6. Do you smoke even when you are very ill? Yes

If you scored less than 7 points...
You are probably not pharmacologically addicted. Your smoking may be a learnt or socially-dependent behaviour. To quit, you may require: a strong motivation to become an abstainer, implement a self-control programme, find considerable support from your milieu. Instructions from a psychologist or a psychotherapist may be useful. They will help you analyse psychological factors associated with smoking and teach you methods of stress reduction.

If you scored 7 points or more...
It is highly probable that you are pharmacologically addicted. If you stop smoking, you may experience some withdrawal symptoms - a strong craving for nicotine accompanied by anxiety, trembling muscles, and nervousness. Apart from self-control and psychotherapy, you should consider a nicotine replacement therapy (NRT) and/or pharmacotherapy according to your doctor's advice.

Tobacco Use Disorder (TUD)
When smoking becomes an addiction it is not easy to fight it. In many cases physiological and psychological mechanisms are both involved. People suffering from TUD feel a strong desire to smoke a cigarette and they find it difficult to control their craving. They are frequently unable to reduce the number of cigarettes they smoke. In stressful situations, smoking would be an immediate habitual response. When the saturation of nicotine in body drops down, they experience withdrawal symptoms - obsessive thinking about smoking, nervousness, anxiety, discomfort and frustration, inability to relax and concentrate, lowered mood, as well as sleep disorders. These symptoms may be accompanied by physiological changes, e.g., slower heart rate, lower blood pressure or increased appetite.

Just like in other forms of addiction, the body becomes increasingly resistant to the substance (nicotine tolerance). You need to smoke more frequently to obtain similar results you had before, when less nicotine was required. Over time, smoking may dominate different areas of life - one will avoid places where smoking is prohibited. The smoker will concentrate his or her mind on how to obtain a cigarette. Situations associated with limited chances to smoke (e.g. in an aircraft) usually produce much tension and apprehension. Tobacco addicts are then apt to break regulations and risk unpleasant consequences, just to gratify their craving. Even though they are aware how harmful smoking is, it does not stop them.

The therapy of nicotine dependence is not easy. A professional help of a doctor and a psychotherapist specializing in the tobacco use disorder is usually required. An integration of several therapeutic modalities is also recommended. A comprehensive programme of TUD should include:

1. Pharmacotherapy
Psychiatric medicines which affect the nervous system (e.g., the parts of brain responsible for substance craving) are used. Nicotine addicts are often prescribed varenicline or bupropion SR.

2. Nicotine replacement therapy
It refers to the use of various forms of nicotine delivery methods intended to replace nicotine obtained from smoking (including the nicotine patch, nicotine inhaler, nasal spray, chewing gum, sublingual tablet, and lozenge). It prevents against the withdrawal symptoms. Gradually, according to the treatment plan, the intake of nicotine is reduced.

3. Psychotherapy
It is a kind of talking-therapy with a specialist. It aims at analysing the sources of stress and psychological factors associated with smoking. A programme in stress control and other behavioural exercises may be used to develop alternative and healthier coping strategies.

4. Natural remedies for stress reduction
The Nicotine-Use Disorder treatment may be aided with remedies which reduce tension and balance emotions. Bach Flower Remedies are a good option because they restore equilibrium in a natural way, produce no side effects nor cause sleepiness. Smokers often use the following remedies:
Rescue Remedy spray or pastilles - recommended in stressful and frustrating situations (e.g., facing problems at work, being stuck in a traffic jam when you are late for an important meeting or nervousness before a public speech).
Walnut supports the smoker in the process of giving up smoking, it will help your body adapt to a new way of functioning.
Chestnut Bud is recommended to people who have tried to quit smoking a number of times but with little success. It is a remedy for those who repeat the same behavioural patterns over and over.