Smoking Research Articles & Resources

Catrina Cowart

Last updated: Mar. 08, 2023

Erin L. George, MFT

Medical editor

What Is Smoking?

Smoking is an action involving the inhalation and exhalation of burning plant material. When referring to "smoking" and "quitting smoking," most people are talking about tobacco products. (1)

Tobacco is a nicotine-containing plant that is typically dried and rolled or stuffed into cigars, pipes, and cigarettes. Tobacco products also contain additives that help maintain and preserve their shelf life. As a result, tobacco products can release over 4,000 chemical compounds when burned.

Smoking — In The News

Smokers Fare Worse After Heart Procedures, Study Finds

MONDAY, March 16, 2015 (HealthDay News) -- Heart patients who continue to smoke after undergoing artery-opening procedures have a much higher long-term risk of heart attack, stroke and premature death than those who quit smoking or never smoked, a new study finds. The study included nearly 1,800 people... Read More

E-Cigarette Use in College Tied to Other Risky Behaviors

FRIDAY, March 13, 2015 (HealthDay News) -- College students who use tobacco, marijuana and/or binge drink are more likely to use electronic cigarettes, researchers report. The study included more than 1,400 students, aged 18 to 23, at four colleges/universities in upstate New York who took part in an online... Read More

Raise Legal Smoking Age to 21, U.S. Expert Panel Says

THURSDAY, March 12, 2015 (HealthDay News) -- Raising the legal age to buy tobacco products from 18 to 21 would save hundreds of thousands of lives and substantially reduce the number of smokers in the United States, a new report finds. Such a change would result in 249,000 fewer... Read More

What are the Risks of Smoking?

Smoking is highly toxic. It has a negative impact not only on the person smoking but also on those around them. This unintended exposure to so-called secondhand smoke subjects non-smokers to the byproducts of cigars, cigarettes, etc.

Smoking risks include the potential exacerbation of conditions such as cardiovascular disease and lung cancer. Smoking may cause its own set of challenging symptoms, such as:

Dizziness
Vomiting
Nausea

To understand smoking as an addiction, it's important to define three terms.

Tolerance refers to how the body gets used to a given amount of a particular substance, like nicotine. Over time, most people will need to consume increasing amounts of a given substance to achieve the same "high" or surge of positive feelings.
Dependency is the need to use a substance to function normally. Someone may not psychologically want to use the medicine, but if they're dependent on it, they may not be able to stop using it without experiencing withdrawal.
Addiction refers to the psychological or neurological inability to stop using a substance, such as nicotine/tobacco products.

As the body creates more nicotine receptors, those who smoke develop a tolerance to nicotine-laden products. The body becomes physiologically dependent on the chemical nicotine as a result. A psychological addiction to the process of smoking itself and sometimes related to an oral fixation may also occur.

Those who are dependent on or addicted to smoking may experience withdrawal symptoms when they attempt to stop smoking. Symptoms of withdrawal include: (1)

A depressed mood
Persistent cravings
Anxiety
Weight gain
Irritability
Trouble concentrating

Due to withdrawal and the persistent cravings people may deal with, it is possible to have both a psychological addiction to smoking products as well as physical dependency.

How to Quit Smoking

Using Medications to Quit Smoking

Using medications to quit smoking makes quitting easier and helps minimize the likelihood of withdrawal symptoms. Nicotine Replacement Therapies (NRT) that include nicotine gums, patches, and lozenges provide cessation support. NRTs deliver nicotine without exposing the body to further harmful chemicals like those found in cigarettes. (2)

When using NRTs, the treatment reduces in strength over time. This helps the brain get used to having less access to nicotine, so withdrawal symptoms are less likely. The person using the treatment doesn't need as much nicotine throughout the day as a result.

Two other medications provide support during smoking cessation as well. These are:

Bupropion helps by blocking chemicals in the brain that make smoking feel pleasurable. It lessens cravings and withdrawal symptoms caused by nicotine.
Varenicline reduces the release of dopamine in the brain when a person smokes, minimizing the positive feelings associated with smoking. It does this by mimicking the effects of nicotine. Using this medication lessens the urge to obtain and smoke nicotine-containing products. Varenicline may also help reduce withdrawal symptoms. (2)

Options for Quitting Smoking Without Medications

Gradual Withdrawal

Gradually decreasing the amount of nicotine in a routine is the primary method of cessation without medications. As an example for someone who usually smokes ten cigarettes a day, the first week of cessation may focus on reducing down to nine cigarettes. Gradual smoking withdrawal usually takes longer than other methods of quitting tobacco and tobacco-related disorders, but it has the potential to lead to successful cessation. (3)

Going "Cold Turkey"

The second option is to go "cold turkey." Going cold turkey means stopping cigarettes all at once. There's no step-down process or medication put in place of the nicotine. (3)

Going cold turkey is the most difficult form of quitting. Those who go cold turkey are more likely to relapse than those who choose to use cessation aids.

Why Is Smoking Addictive?

Smoking leads to addiction because nicotine, in small amounts, encourages the release of dopamine within the brain. (4) Dopamine, known as the body's feel-good chemical, produces positive feelings, allowing people to feel motivation, satisfaction, pleasure, and peacefulness.

Nicotine enters the bloodstream quickly once inhaled, spreading throughout the body and reaching the brain. (5) There, the brain and central nervous system react to the nicotine chemical and release dopamine. The brain also releases adrenaline, causing an "adrenaline rush" that encourages the heart to beat faster and the blood pressure to rise.

The person smoking the cigarette begins to feel positive, pleasant feelings in response. That feel-good moment is a hook that results in people wanting to use nicotine-containing products. However, the initial positive impacts quickly wear off, lasting only a few minutes.

With repeat usage over time, both physical and psychological cravings will develop. Cravings lead to more frequent use of cigarettes, causing dependency and subsequent addiction.

It becomes difficult to stop smoking because of the physical dependency and psychological addiction to nicotine. At the same time as these, the body may develop a tolerance. That means it takes more nicotine to reach the same feel-good effects. The new tolerance leads to heavier usage and withdrawal symptoms when trying to cut back.

How to Help Someone You Know Quit Smoking

When someone decides to stop smoking, they need support, understanding, and patience. Their support system should follow these simple tips. (6)

Respect that they want to quit.
Ask them what support they need/prefer.
Take steps to make smoke-free environments available.
Thank them for prioritizing their health and the health of those around them.
Offer praise for trying to quit, even if a relapse occurs. Encourage them to try cessation again.
Avoid judging, preaching to, or nagging a person trying to quit.
Avoid offering cigarettes as a way to soothe withdrawal.
Celebrate milestones, such as a week without cigarettes or two weeks of reduced usage.
Wash clothing that smells of cigarettes to eliminate a possible scent trigger.
Ask the person to do new or different things (that are still positive or healthy), such as watching a movie, to distract themselves from the cravings.
Give the person a chance to talk about how quitting feels and what challenges the process brings.

With medications and cessation aids, as well as a strong support system, those who want to quit smoking have a better chance of successful cessation. To learn more about how to quit smoking, visit our Tips for Quitting Smoking page.

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