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Why is quitting smoking so hard?

Posted in Personal Health 28 Jun, 2012

Quitting smoking is difficult. Anyone who has ever tried to quit smoking, successfully or not, will no doubt confirm just how tough is it to kick the habit. This is partly because the routines smokers build up around their addiction can become quite concrete. Cigarettes in the morning, during a coffee break or after each meal; the list of instances goes on. But the real problem, and what makes quitting smoking so hard, is the chemical addiction that forms around nicotine.

Nicotine is a nitrogen-containing chemical, or alkaloid. Nicotiana tabacum, specifically, is the form of nicotine contained within tobacco plants, although it can also be produced synthetically, and is used as the basis of cigarettes. The compound in humans produces a variety of effects, ranging from an increase in heart rate and oxygen consumption to the "rewarding" and pleasurable feelings experienced in the brain.

This function is the key to the nicotine addiction smokers experience and explains why it is so difficult to give up smoking. When nicotine is absorbed in the blood, it moves toward the brain before passing through the blood-brain barrier. Eventually the chemical reaches the chemical neurotransmitters known as acetylcholine, which are responsible for multiple functions including energy and activity levels. The effect of nicotine's presence is an increased production of acetylcholine, which produces an increase or boost of energy.

It also stimulates the brain to increase production of a further neurotransmitter called dopamine. Dopamine is responsible for the feelings of pleasure inside the brain and any increase means that general mood and positive feelings will be lifted. When smokers feel good from smoking, it is this part of the process that is giving them that gratification.

How Nicotine Works

The problem of addiction comes in over time, because the brain now begins to rely on nicotine's action of increasing levels of dopamine and pleasurable stimulation. But as with any addiction, a tolerance is also built up slowly which makes it more difficult to experience the same pleasure each time. Once reliant, removing nicotine from the body causes withdrawal due to the brain having become accustomed to the high levels of dopamine for so long.

This is what makes quitting smoking so hard and can cause smokers who are trying to give up to experience feelings of depression, anxiety and irritability. However, a recent article published by Science Daily suggests that researchers may have found a new and innovative way to help people quit smoking. Traditional smoking cessation treatments have focused on either replacing the source of nicotine, such as gum or skin patches, or by blocking the function of the brain receptors that interact with nicotine. Both have helped smokers quit to some degree, the latter being more successful as it removes the reward from smoking although it has received criticism for acting on the brain directly.

The new treatment would involve a vaccination injected directly into the blood stream. The vaccine would distinguish itself from other treatments in that it wouldn't act on the receptors or replace nicotine, instead it contains antibodies designed to "eat" nicotine.

Dr. Ronald G. Crystal, chairman and professor of Genetic Medicine at Weill Cornell Medical College, where the research was conducted, commented on this action.

"As far as we can see, the best way to treat chronic nicotine addiction from smoking is to have these Pacman-like antibodies on patrol, clearing the blood as needed before nicotine can have any biological effect," Dr Crystal said, going on to suggest how this would help smokers quit. "Our vaccine [also] allows the body to make its own monoclonal antibodies against nicotine, and in that way, develop a workable immunity."

A function like this would mean that smokers would be able to gradually reduce the amount of nicotine they are absorbing when they smoke, as opposed to the supply of nicotine being stopped suddenly and completely, as is the case with methods like "cold turkey". This would make withdrawal symptoms less severe, and also help remove the "reward" element from the habit. Individuals who are considering smoking, if they received the vaccination, would also in all likelihood not even feel the effects of nicotine to begin with.

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