Smoking and Recovery

Smoking is everywhere. From old men and women in their 80s and 90s to teens who are too young to legally smoke, ‘everyone’ smokes. While the number of active smokers in the U.S. has declined from over 24.7% of the population in 1997 to just 15.1% as of 2015, smoking is often depicted as cool, sensual, and exciting, and you can see smokers almost everywhere. Nearly 36.5 million Americans smoke, but unlike on television, nearly 16 million of those suffer from a smoking related disease such as lung disease, COPD (Chronic Obstructive Pulmonary Disorder), or lung cancer. And, more than 480,000 people die of smoking related causes each year, more than by alcohol, drug use, HIV, vehicle injuries, and firearm related incidents combined. Smoking is responsible for as many as 1 in 5 of all preventable deaths in the United States, making it one of the most dangerous habits you could choose to have. While many of us begin to smoke to fit in, to look cool, or to deal with stress, we often find ourselves addicted and facing repercussions that affect our budgets and our health. Unfortunately, while quitting smoking can save your health, it’s often not as easy as putting down a cigarette and walking away. Nicotine is highly addictive, and the longer you’ve been smoking, the more difficult your process of withdrawal and recovery will be.

A Cultural Glorification of Nicotine

From the vintage cowboy flicking a glowing cigarette to the action hero lighting up after winning a fight, Hollywood, and all media, has celebrated cigarettes for over a century. Many of us start to smoke out of the perceived idea that it’s cool, that it helps us to fit in, and that it won’t leave us sitting watching drinks while our friends cozy up outside with a cigarette. However, while this romanticized image of smoking presents a picture that’s easy to love, the reality is often quite different. The average smoker, who smokes just 15 cigarettes a day, spends an average of $4 per day on cigarettes, while causing damage to his or her lungs and heart. Smoking affects the heart, the lungs, the immune system, the reproductive system, diabetes, and the eyes, causing myriad health problems that worsen as we age.

An Addictive Drug

Almost everyone knows that tobacco contains nicotine, but not everyone knows what it is or how it works. Nicotine is a highly addictive drug which is released in tobacco smoke. In smoke form, it takes just 30 seconds to go from the nasal passages to the brain, where it attaches to neurotransmitters known as acetylcholine. The acetylcholine neurotransmitter affects your respiratory function, heart rate, memory, alertness, and muscle movement. Once attached, nicotine creates a flood of dopamine in the brain, which causes relaxation and happiness. While lower than the dopamine release from harder drugs like heroin, the process is the same, except opiates take much longer to reach the brain. It then affects your system for 1-3 days after smoking. Because dopamine is highly addictive, even relatively light smoking can result in addiction.

The Average Recovery Process

Recovering from any addiction is difficult, requires perseverance, and often requires outside help. Recovering from nicotine dependancy is no different. In most cases, recovering from a smoking addiction is plagued by relapses, which often only cease when the smoker gets additional help.

1. You have your last cigarette
2. Cravings hit, typically between 2 and 4 hours after your last cigarette
3. Restlessness and anxiety kick in between 4 and 10 hours after your last smoke.
4. After about 10 hours, you will likely feel angry, irritable, and unable to sleep.
5. After 2-3 days, nicotine starts to leave your body, resulting in withdrawal headaches, anxiety, stress, and possibly cold sweats. You will likely cough, may have heartburn, will most likely be fatigued, and will have a reduced appetite.
6. At day 5, your symptoms will start to reduce, tapering off.
7. On day 8, you feel more secure, your symptoms are gone, and you feel confident that you’ve beaten your addiction. Unfortunately, this is when most people relapse. That boost of confidence may convince you that it won’t hurt to have just one more.
8. Week 2-4 – Your symptoms will vanish, your appetite will return to normal, and your energy levels will improve.

In most cases, the first 3-5 days of smoking recovery are the most difficult. Physical withdrawal can be painful and frustrating, especially if you work at a busy job. However, most people relapse after making it through physical withdrawal. In fact, while 70% of smokers have tried to quit, it takes an average of 6-30 times to quit, thanks to a combination of peer pressure, overconfidence, and the ready availability of cigarettes.

Co-Addiction and Comorbidity

Smoking is closely related to health problems, other substance-use disorders, stress, and mental disorders. Some studies suggest that as many as 40% of all cigarette smokers have a comorbid or coexisting addiction or diagnosis. Nicotine and alcohol use play into each other, making the user less likely to quit smoking or drinking. An estimated 70-80% of all persons entering addiction treatment smoke. Co-curring disorders including mental disorders, PTSD, and substance abuse will affect your ability to stop smoking. If you suffer from any of them, it is important to get help.

Medication to Treat Nicotine Dependence

Medical treatment for nicotine dependence has been shown to improve recovery, although long-term results vary a great deal depending on the treatment and the counseling included with it. Nicotine Replacement Therapy – most people are are aware of nicotine patches and other replacement nicotine sources to help them quit smoking. These tools are intended to replace the source of nicotine while you break the habit of smoking, and then to allow you to taper off your nicotine usage gradually to avoid withdrawal symptoms. Nicotine replacement therapy includes over-the-counter and prescription solutions including patches, gum, lozenges, nasal sprays, and inhalers. These can help you to taper off your nicotine usage, but require discipline, because if used incorrectly, only prolong your addiction. Non-Nicotine Medication – If you choose to seek out treatment for nicotine addiction, your doctor will likely prescribe you medication to reduce nicotine withdrawal symptoms and reduce cravings. There are several medications your doctor may choose to prescribe, but the most common include Bupropion, Varenicline, and Nortriptyline.

• Bupropion – Bupropion, commonly sold as Zyban, is an antidepressant that boosts dopamine levels and minimizes the side effects of smoking cessation by producing norepinephrine. In most cases, your doctor will put you on a Bupropion schedule that begins 1 week before you have your last cigarette.
• Varenicline – Varenicline or Chantix directly affects the acetylcholine neurotransmitters in the brain, preventing nicotine from binding with them effectively. This reduces the effect of nicotine, forcing your brain to withdraw from it, even if you continue smoking.
• Nortriptyline – Nortriptyline or Pamelor is typically a last option that your doctor may use if the first two do not work. This drug produces large amounts of norepinephrine in the brain, which works to impede nicotine in the brain. However, side effects can be more considerable than with other options.

Counseling – Studies show that smokers who adopt a combined approach of medication and counseling see the best smoking cessation results. Counseling can typically be found through rehabilitation clinics, group therapy, and through a therapist.

Tips to Improving Your Smoking Recovery

Recovering from a smoking addiction requires a great deal of perseverance and dedication on your part. For this reason, you should take steps to plan your recovery so that you have the tools to quit when you try.

1. Plan to Succeed – While quitting smoking is often labelled as difficult, approaching quitting with the attitude that it can’t be done is setting yourself up for failure. Over 48 million adults have quit smoking, and you can successfully quit.
2. Get Help – Counseling and medication greatly improve your chances of quitting and staying away from cigarettes in the future. Even a doctor will be able to help you manage your nicotine replacement, or will be able to offer prescriptions to manage withdrawal and other symptoms.
3. Start Early – Going cold turkey is almost never a good idea with drugs because side effects can be considerable. Instead, start reducing the number of cigarettes you smoke each day. Tapering off is one of the best ways to quit smoking with fewer withdrawal symptoms, but it does prolong cravings over a much longer period.
4. Get Support – Talk to your friends and family, look for support groups like Nicotine Anonymous, and announce your quit date on social media. Trying to quit alone can seem safer in case you fail, but accountability can provide extra motivation to stay cigarette free.
5. Identify Triggers – Triggers are times, people, places, things, situations, and feelings that are most likely to make you want to smoke. For example, if you typically smoke in the morning, at lunch break, when stressed, when stuck in traffic, etc., you have to recognize those triggers and work to avoid them. In most cases, this will mean replacing smoking with another stress releasing habit such as using a stress ball, short mindfulness or breathing exercises, or exercise.

Stopping smoking will improve your health, your energy, will save money, and may even help your recovery from drug and alcohol addiction. However, you will have to go through physical withdrawal and then recover from mental addiction, which can take months or even years. Getting help, including medical treatment and counseling can greatly boost your ability to quit and recover, because you will have support and help at every step of the way. The Oceanfront Recovery Addiction Treatment Program can help you or your loved one through the process of recovery from addiction. Our clinicians focus on bringing the underlying causes of addiction to the surface with a modern and effective recovery program in a closed setting. Contact Oceanfront Recovery today for a confidential assessment, and begin the journey of recovery today.