How long does it take to get addicted to nicotine?

L O N D O N, Sept. 12, 2000 — Scientists have confirmed a suspicion held by some smokers but never proven: It could take just a few cigarettes to become addicted.

Some 12- and 13-year-olds showed evidence of addiction within days of their first cigarette, according to research reported this week in the British Medical Association journal Tobacco Control.

“There’s been a suspicion that many people become addicted very quickly, but this is really the first hard evidence that we’ve had that this occurs,” said Dr. Richard Hurt, director of the Nicotine Dependency Unit at the Mayo Clinic.

Experts have tried for years to determine how long people have to smoke before becoming addicted, and “the best answer to date had been 1-2 years,” said Hurt, who was not involved in the study.

Addiction Biology

He said the findings will help scientists better understand the biology of nicotine addiction and lend more plausibility to the idea that some people may be more genetically susceptible to it than others.

“The really important implication of this study is that we have to warn kids that you can’t just fool around with cigarettes or experiment with cigarettes for a few weeks and then give it up,” said Dr. Joseph DiFranza, who lead the research at the University of Massachusetts. “If you fool around with cigarettes for a few weeks, you may be addicted for life.”

The study, conducted in 1998, followed 681 12- to 13-year-olds in central Massachusetts for a year and tracked their smoking habits.

The researchers did not label any of them addicted because the standard definition of nicotine dependence assumes addiction cannot happen without prolonged heavy smoking. The scientists simply recorded symptoms that indicate addiction.

Addiction Symptoms

These include cravings, needing more to get the same buzz, withdrawal symptoms when not smoking, feeling addicted to tobacco and loss of control over the number of cigarettes smoked or the duration of smoking.

Ninety-five of the youths said they had started smoking occasionally — at least one cigarette a month — during the study. The scientists found that 60, or 63 percent, had one or more symptoms of addiction.

A quarter of those with symptoms got them within two weeks of starting to smoke and several said their symptoms began within a few days.

Sixty-two percent said they had their first symptom before they began smoking every day, or that the symptoms made them start smoking daily.

The researchers found that the symptoms began soon after the teens started smoking.

Even though some people who have never smoked on a daily basis can find it hard to quit, the assumption that smokers only become addicted after smoking a lot of cigarettes over a long period of time came from observations that some people can smoke five cigarettes a day for many years and not become addicted, the study noted.

However, it has never been proven that daily smoking is necessary for addiction to begin, the study added.

The scientists suggested there may be three types of smokers: Those who become addicted very quickly, those who get hooked gradually after more regular smoking and those who can smoke lightly or pick up and drop the habit without becoming addicted.

It is also possible that adolescents could be more sensitive to nicotine and that addiction may take longer in people who start smoking at a later age, they added.

How Do I Know I’m Really Addicted to Nicotine?

A pack-a-day smoker smokes a cigarette about once hour, says Erik Augustson, PhD, MPH, a behavioral scientist and program director in the Tobacco Control Research Branch of the National Cancer Institute in Bethesda, Maryland. If you were to stop or even cut back, you would start to go into nicotine withdrawal — and that’s what drives smokers to smoke their next cigarette.

How soon you reach for a cigarette in the morning is a good indication of the severity of your nicotine addiction. According to the Fagerström Test, which evaluates nicotine dependence, if you have your first cigarette of the day within five minutes of waking up, your addiction is pretty strong. If it’s within 30 minutes, it’s moderate, and if it’s within 60 minutes or later, it’s somewhat lower.

Other signs that you have a nicotine addiction include:

  • You smoke even when you’re sick.
  • You go outside to smoke even if it’s freezing or raining.
  • You find it difficult to smoke in places you shouldn’t, like a church, library, school, movie theater, or hospital.

Another way to know you’re addicted to cigarettes is if you try to stop and you experience withdrawal symptoms. The most common nicotine withdrawal symptoms are:

  • Irritability and anger
  • Restlessness
  • Depression
  • Physical sensations, like you have a mild case of the flu
  • Headaches and dizziness
  • Inability to sleep uninterrupted
  • Cravings for cigarettes
  • Weight gain, though typically less than 10 pounds

“Nicotine withdrawal can be unpleasant for most smokers,” Augustson says, “but it’s not physically dangerous and most smokers can find ways to manage it, especially if they use medication and counseling.”

The unpleasant side effects of nicotine withdrawal are the most intense when you first quit. They begin to subside somewhat after a week and even more after a month. Withdrawal symptoms can linger, but it does get easier. Eventually, the time between cravings will grow longer and longer, and eventually stop altogether.

The cravings themselves are like waves, Augustson explains. “Cravings can be very intense, but they will crest and fade even if you don’t have a cigarette. They will go away naturally on their own. Cravings won’t last more than 15 to 20 minutes for most smokers. Finding a way to get through that 15- to 20-minute period is a key part of developing a quit plan.”

Augustson suggests saying to yourself: “I know it’s unpleasant now, but if I wait 15 to 20 minutes, I can wait it out and I can be very proud of myself because I did.”

Other strategies for quitting include:

  • Find a distraction. Go for a walk, wash the dishes, or play a game with your kids. “Find something that will distract you enough to get through those cravings,” says Augustson.
  • Remind yourself why you want to quit. The most important reason to quit is the one that matters to you. Write a list of the top five reasons why you should stop smoking — such as you don’t want to get lung cancer or you can save $75 a week by not buying cigarettes. Keep the list with you and review it when you feel the urge to smoke.
  • Avoid situations where you are likely tempted to smoke. Common triggers include feeling stressed, being bored, or drinking alcohol. Know what situations cause you the most stress and try to come up with coping techniques, such as deep breathing or practicing yoga. Plan activities so that you’re not bored. Stay away from bars and other places where you often drink — especially when you’re first starting in your efforts to quit. If you must have something, switch to non-alcoholic beverages.
  • Seek support. Let friends and family members know of your intention to quit. Also, find a support group. The National Cancer Institute operates a quitline at 1-877-44U-QUIT (1-877-448-7848). You can find support online or in person with groups that meet locally.

Because nicotine is addictive, quitting is never easy. But with the right help and the right attitude, you can overcome your addiction.

All it takes is one cigarette to get addicted to smoking!

Up to now, it was thought it took a few years for smokers to become addicted, but the latest research shows addiction takes place in days.

Scientists have confirmed a suspicion held by some smokers but never proven: it could take just one cigarette to become addicted.

Experts have tried for years to determine how long people have to smoke before becoming addicted, said Dr Richard Hurt, director of the Nicotine Dependency Unit at the Mayo Clinic in the United States.

“The best answer to date has been one to two years,” said Dr Hurt, who was not involved with the latest research. “There’s been a suspicion that many people become addicted very quickly, but this is really the first hard evidence that we’ve had that this occurs.”

Research reported in the British Medical Association journal, Tobacco Control, found that several 12- and 13-year-olds showed evidence of addiction within a few days of their first cigarette. Dr Hurt said the findings would help scientists better understand the biology of nicotine addiction and lend more plausibility to the idea that some people may be more susceptible genetically to it than others.

The study was conducted by scientists at the University of Massachusetts in 1998. The experts followed 681 teenagers aged 12 and 13 from seven schools in central Massachusetts for a year and tracked their smoking habits.

Benefits of Quitting Smoking Common Withdrawal Symptoms

The researchers did not label any of them as addicted because the standard definition of nicotine dependence assumes that addiction cannot happen without prolonged heavy smoking. The scientists simply recorded symptoms that indicate addiction. Symptoms include cravings, needing to smoke more to get the same buzz, withdrawal symptoms when not smoking, feeling addicted to tobacco and loss of control over the number of cigarettes smoked or the duration of smoking. A total of 95 teens said they had started smoking occasionally – at least one cigarette a month – during the study.

The scientists found that 63 per cent of them had one or more symptoms of addiction. A quarter of those with symptoms got them within two weeks of starting to smoke and several said their symptoms began within a few days.

Sixty-two per cent said they had their first symptom before they began smoking every day, or that the symptoms had made them start smoking daily.

“The really important implication of this study is that we have to warn kids that you can’t just fool around with cigarettes or experiment with them for a few weeks and then give them up,” said Dr Joseph DiFranza, who led the research team.

If you fool around with cigarettes for a few weeks, you may be addicted for life.

Inhaling from just 1 cigarette can lead to nicotine addiction
Kids show signs of addiction almost immediately
WORCESTER, Mass. — A new study published in the Archives of Pediatric and Adolescent Medicine shows that 10 percent of youth who become hooked on cigarettes are addicted within two days of first inhaling from a cigarette, and 25 percent are addicted within a month. The study found that adolescents who smoke even just a few cigarettes per month suffer withdrawal symptoms when deprived of nicotine, a startling finding that is contrary to long-held beliefs that only people with established smoking habits of at least five cigarettes per day experience such symptoms.
The study monitored 1,246 sixth-grade students in six Massachusetts communities over four years. Students were interviewed frequently about smoking and symptoms of addiction, such as difficulty quitting, strong urges to smoke, or nicotine withdrawal symptoms such as cravings, restlessness, irritability, and trouble concentrating. Of those who were hooked, half were already addicted by the time they were smoking seven cigarettes per month. As amazing as it may seem, some youth find they are unable to quit smoking after just a few cigarettes. This confirms an earlier study by the same researchers.

Ingredients Found in Cigarettes

Recent research has revealed that the nicotine from one cigarette is enough to saturate the nicotine receptors in the human brain. “Laboratory experiments confirm that nicotine alters the structure and function of the brain within a day of the very first dose. In humans, nicotine-induced alterations in the brain can trigger addiction with the first cigarette,” commented Joseph R. DiFranza, MD, professor of family medicine & community health at the University of Massachusetts Medical School and leader of the UMMS research team. “Nobody expects to get addicted from smoking one cigarette.” Many smokers struggle for a lifetime trying to overcome nicotine addiction. The National Institutes of Health estimates that as many as 6.4 million children who are living today will die prematurely as adults because they began to smoke cigarettes during adolescence.
“While smoking one cigarette will keep withdrawal symptoms away for less than an hour in long-time smokers, novice smokers find that one cigarette suppresses withdrawal for weeks at a time,” explained Dr. DiFranza. “One dose of nicotine affects brain function long after the nicotine is gone from the body. The important lesson here is that youth have all the same symptoms of nicotine addiction as adults do, even though they may be smoking only a few cigarettes per month.”

Symptoms of nicotine addiction can appear when youth are smoking as little as one cigarette per month. At first, one cigarette will relieve the craving produced by nicotine withdrawal for weeks, but as tolerance to nicotine builds, the smoker finds that he or she must smoke ever more frequently to cope with withdrawal.
According to DiFranza, the addiction-related changes in the brain caused by nicotine are permanent and remain years after a smoker has quit. This explains why one cigarette can trigger an immediate relapse in an ex-smoker. It also explains why an ex-smoker who relapses after many years of abstinence cannot keep the craving away by smoking one cigarette per month. Unlike the newly addicted novice smoker, a newly relapsed smoker must smoke several cigarettes each day to cope with the craving.
The study was supported by the National Institute on Drug Abuse and appears in the July issue of the Archives of Pediatric and Adolescent Medicine. According to the National Institutes of Health, smoking remains the leading preventable cause of death in the United States, accounting for approximately 440,000 deaths annually.
DiFranza worked on this study with UMMS colleagues Judith K. Ockene, PhD, Judith A. Savageau, MPH, Kenneth Fletcher, PhD, Lori Pbert, PhD, Jennifer Hazelton, BA, Karen Friedman, BA, Gretchen Dussault, BA, and Connie Wood, MSW; Jennifer O’Loughlin, PhD, of McGill University; Ann D. McNeill, PhD, of St. George’s Hospital Medical School at the University of London; and Robert J. Wellman of both UMMS and Fitchburg State College.

How Does the Body Become Dependent on Nicotine?

Every time we light up, nicotine and other chemicals from cigarette smoke are absorbed in the body. Nicotine enters the bloodstream and reaches the brain faster than drugs that enter the body through our veins. Nicotine affects many parts of the body; it changes how the body uses food (metabolism), causes our heart to beat faster, our pulse to quicken, it increases our blood pressure, and our veins begin to tighten causing blood flow throughout the body to become more difficult.

Nicotine works by stimulating our nervous system to release specific chemical messengers (hormones and neurotransmitters) that affect different parts of our brain and body. One hormone that nicotine affects is epinephrine, also known as adrenaline. When nicotine is inhaled, the buzz you feel is the release of epinephrine which stimulates the body and causes your blood pressure and heart rate to increase, and makes you breathe harder. Nicotine also activates a specific part of your brain that makes you feel happy by stimulating the release of the hormone dopamine. The release of dopamine when nicotine is inhaled is thought to be the source of the pleasurable sensations you experience when smoking, which can include relaxation, a buzz, and relief of tension.

Once inhaled, nicotine is rapidly distributed throughout the brain within 10 seconds. The enjoyable feelings you experience from smoking occur very quickly, but after you’ve smoked a few times nicotine begins to weaken your ability to feel pleasure, causing you to need more nicotine in order to sustain the good feelings. This is the cycle of the smoking habit; in order to continue feeling pleasure from smoking, you must continue to smoke more cigarettes, more frequently.

Nicotine Symptoms and Warning Signs

Recognizing Nicotine Addiction

Because of the widespread use of cigarettes, chewing tobacco, and snuff, it can be difficult to spot an actual addiction to nicotine.

In 2011, 26.5 percent of the U.S. population aged 12 and older said they had used a tobacco product at least once in the month before being interviewed.

Many of these people have a nicotine addiction and are in denial. They may be social smokers who only use tobacco while they are out with friends, or they may be smokers who believe they can quit when they are ready. Recognizing the signs of an addiction to nicotine is important to overcoming denial and getting over the addiction.

Common Signs of Addiction

  • Requiring more tobacco to feel satisfaction
  • Experiencing withdrawal symptoms, such as irritability
  • Using tobacco in larger amounts than intended
  • Having a desire to quit or decrease use but being unable to do so
  • Experiencing cravings and intense urges to use tobacco
  • Continued tobacco use despite awareness of consequences and health risks

Physical Symptoms

The physical symptoms of nicotine addiction are caused by withdrawal. Withdrawal from nicotine occurs because the addicted brain can no longer naturally produce adequate levels of certain chemicals, like dopamine. These symptoms can crop up in as little as two hours after not using tobacco and tend to be the worst 2-3 days after quitting.

Nicotine withdrawal symptoms include:

  • Trouble concentrating
  • Anxiety and panic attacks
  • Depression
  • Trouble sleeping
  • Irritability and frustration
  • Increased appetite and weight gain

Psychological Symptoms

Once a person’s brain is rewired for addiction to tobacco, scenarios that are associated with tobacco use (psychological triggers) can cause cravings for tobacco.

Common triggers for people with a nicotine addiction are driving, drinking, music, stress, work, and after meals.

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The Risks of Tobacco

Most people, including those who use tobacco, are aware of the serious health risks associated with using tobacco. There are more tobacco-related deaths each year than all deaths from illicit drugs, alcohol, car accidents and murders combined. Many people with addictions have a desire to quit because they understand the health risks. Therefore, it is unsurprising that about 70% of tobacco users have a desire to quit.

Some of the health risks associated with tobacco use include:

  • Infertility
  • COPD (chronic obstructive pulmonary disease)
  • Asthma
  • Lung cancer
  • Heart disease
  • Mouth and esophageal cancer
  • Stroke

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Tobacco and Cancer

These are only some of the most common health risks associated with tobacco use. Carcinogenic chemicals in tobacco cause genetic changes, putting tobacco users at a higher risk for many types of cancer.

Carcinogens are cancer-causing chemicals that alter a person’s DNA. The carcinogens in tobacco may cause abnormal cell growth that can develop into cancerous tumors. Smoking causes lung cancer deaths in approximately 90% of men and 80% of women.

Nicotine Dependence
Signs and Symptoms

Nicotine is as addictive as heroin and causes release of the pleasure chemical dopamine and other neurotransmitters in the brain within minutes of the first puff, which reinforces continued tobacco use.

Tobacco users get hooked because of that pleasant feeling or “rush” and often continue to use nicotine to prevent withdrawal symptoms.

Some of the complex factors involved in tobacco and nicotine dependence are:

  • How the body handles nicotine, how it is absorbed and removed and how the body responds to it
  • Environmental factors, such as smoking while drinking coffee or after meals
  • Physiologic factors, such as a person’s genetic predisposition to addiction

When you stop smoking, the withdrawal side effects will appear in one to two days, peak during the first week, and then subside within two to four weeks.

Symptoms of nicotine withdrawal include:

  • Anxiety
  • Cravings
  • Depression
  • Difficulty concentrating
  • Impaired performance
  • Increased appetite and weight gain
  • Irritability, frustration and anger
  • Restlessness and impatience
  • Sleep disturbances, such as insomnia or sleeping too much

How to Quit Smoking

Ready to stop smoking? These tips will help you kick the cigarette habit for good.

We all know the health risks of smoking, but that doesn’t make it any easier to kick the habit. Whether you’re an occasional teen smoker or a lifetime pack-a-day smoker, quitting can be really tough.

Smoking tobacco is both a physical addiction and a psychological habit. The nicotine from cigarettes provides a temporary—and addictive—high. Eliminating that regular fix of nicotine causes your body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, you may turn to cigarettes as a quick and reliable way to boost your outlook, relieve stress, and unwind. Smoking can also be a way of coping with depression, anxiety, or even boredom. Quitting means finding different, healthier ways to cope with those feelings.

Smoking is also ingrained as a daily ritual. It may be an automatic response for you to smoke a cigarette with your morning coffee, while taking a break at work or school, or on your commute home at the end of a hectic day. Or maybe your friends, family, or colleagues smoke, and it’s become part of the way you relate with them.

To successfully stop smoking, you’ll need to address both the addiction and the habits and routines that go along with it. But it can be done. With the right support and quit plan, any smoker can kick the addiction—even if you’ve tried and failed multiple times before.

Your personal stop smoking plan

While some smokers successfully quit by going cold turkey, most people do better with a tailored plan to keep themselves on track. A good quit plan addresses both the short-term challenge of stopping smoking and the long-term challenge of preventing relapse. It should also be tailored to your specific needs and smoking habits.

Questions to ask yourself

Take the time to think of what kind of smoker you are, which moments of your life call for a cigarette, and why. This will help you to identify which tips, techniques, or therapies may be most beneficial for you.

Are you a very heavy smoker (more than a pack a day)? Or are you more of a social smoker? Would a simple nicotine patch do the job?

Are there certain activities, places, or people you associate with smoking? Do you feel the need to smoke after every meal or whenever you break for coffee?

Do you reach for cigarettes when you’re feeling stressed or down? Or is your cigarette smoking linked to other addictions, such as alcohol or gambling?

Start your stop smoking plan with START

S = Set a quit date.

Choose a date within the next two weeks, so you have enough time to prepare without losing your motivation to quit. If you mainly smoke at work, quit on the weekend, so you have a few days to adjust to the change.

T = Tell family, friends, and co-workers that you plan to quit.

Let your friends and family in on your plan to quit smoking and tell them you need their support and encouragement to stop. Look for a quit buddy who wants to stop smoking as well. You can help each other get through the rough times.

A = Anticipate and plan for the challenges you’ll face while quitting.

Most people who begin smoking again do so within the first three months. You can help yourself make it through by preparing ahead for common challenges, such as nicotine withdrawal and cigarette cravings.

R = Remove cigarettes and other tobacco products from your home, car, and work.

Throw away all of your cigarettes, lighters, ashtrays, and matches. Wash your clothes and freshen up anything that smells like smoke. Shampoo your car, clean your drapes and carpet, and steam your furniture.

T = Talk to your doctor about getting help to quit.

Your doctor can prescribe medication to help with withdrawal symptoms. If you can’t see a doctor, you can get many products over the counter at your local pharmacy, including nicotine patches, lozenges, and gum.

Identify your smoking triggers

One of the best things you can do to help yourself quit is to identify the things that make you want to smoke, including specific situations, activities, feelings, and people.

Keep a craving journal

A craving journal can help you zero in on your patterns and triggers. For a week or so leading up to your quit date, keep a log of your smoking. Note the moments in each day when you crave a cigarette:

  1. What time was it?
  2. How intense was the craving (on a scale of 1-10)?
  3. What were you doing?
  4. Who were you with?
  5. How were you feeling?
  6. How did you feel after smoking?

Do you smoke to relieve unpleasant feelings?

Many of us smoke to manage unpleasant feelings such as stress, depression, loneliness, and anxiety. When you have a bad day, it can seem like cigarettes are your only friend. As much comfort as cigarettes provide, though, it’s important to remember that there are healthier and more effective ways to keep unpleasant feelings in check. These may include exercising, meditating, relaxation strategies, or simple breathing exercises.

For many people, an important aspect of giving up smoking is to find alternate ways to handle these difficult feelings without turning to cigarettes. Even when cigarettes are no longer a part of your life, the painful and unpleasant feelings that may have prompted you to smoke in the past will still remain. So it’s worth spending some time thinking about the different ways you intend to deal with stressful situations and the daily irritations that would normally have you lighting up.

Tips for avoiding common triggers

Alcohol. Many people smoke when they drink. Try switching to non-alcoholic drinks or drink only in places where smoking inside is prohibited. Alternatively, try snacking on nuts, chewing on a cocktail stick or sucking on a straw.

Other smokers. When friends, family, and co-workers smoke around you, it can be doubly difficult to give up or avoid relapse. Talk about your decision to quit so people know they won’t be able to smoke when you’re in the car with them or taking a coffee break together. In your workplace, find non-smokers to have your breaks with or find other things to do, such as taking a walk.

End of a meal. For some smokers, ending a meal means lighting up, and the prospect of giving that up may appear daunting. However, you can try replacing that moment after a meal with something else, such as a piece of fruit, a healthy dessert, a square of chocolate, or a stick of gum.

Coping with nicotine withdrawal symptoms

Once you stop smoking, you’ll likely experience a number of physical symptoms as your body withdraws from nicotine. Nicotine withdrawal begins quickly, usually starting within an hour of the last cigarette and peaking two to three days later. Withdrawal symptoms can last for a few days to several weeks and differ from person to person.

Common nicotine withdrawal symptoms include:

  1. Cigarette cravings
  2. Irritability, frustration, or anger
  3. Anxiety or nervousness
  4. Difficulty concentrating
  5. Restlessness
  6. Increased appetite
  7. Headaches
  1. Insomnia
  2. Tremors
  3. Increased coughing
  4. Fatigue
  5. Constipation or upset stomach
  6. Depression
  7. Decreased heart rate

As unpleasant as these withdrawal symptoms may be, it’s important to remember that they are only temporary. They will get better in a few weeks as the toxins are flushed from your body. In the meantime, let your friends and family know that you won’t be your usual self and ask for their understanding.

Manage cigarette cravings

While avoiding smoking triggers will help reduce your urge to smoke, you probably can’t avoid cigarette cravings entirely. Fortunately, cravings don’t last long—typically, about 5 or 10 minutes. If you’re tempted to light up, remind yourself that the craving will soon pass and try to wait it out. It helps to be prepared in advance by having strategies to cope with cravings.

Distract yourself. Do the dishes, turn on the TV, take a shower, or call a friend. The activity doesn’t matter as long as it gets your mind off smoking.

Remind yourself why you quit. Focus on your reasons for quitting, including the health benefits (lowering your risk for heart disease and lung cancer, for example), improved appearance, money you’re saving, and enhanced self-esteem.

Get out of a tempting situation. Where you are or what you’re doing may be triggering the craving. If so, a change of scenery can make all the difference.

Reward yourself. Reinforce your victories. Whenever you triumph over a craving, give yourself a reward to keep yourself motivated.

Coping with cigarette cravings in the moment

Find an oral substitute – Keep other things around to pop in your mouth when cravings hit. Try mints, carrot or celery sticks, gum, or sunflower seeds. Or suck on a drinking straw.

Keep your mind busy – Read a book or magazine, listen to some music you love, do a crossword or Sudoku puzzle, or play an online game.

Keep your hands busy – Squeeze balls, pencils, or paper clips are good substitutes to satisfy that need for tactile stimulation.

Brush your teeth – The just-brushed, clean feeling can help banish cigarette cravings.

Drink water – Slowly drink a large glass of water. Not only will it help the craving pass, but staying hydrated helps minimize the symptoms of nicotine withdrawal.

Light something else – Instead of lighting a cigarette, light a candle or some incense.

Get active – Go for a walk, do some jumping jacks or pushups, try some yoga stretches, or run around the block.

Try to relax – Do something that calms you down, such as taking a warm bath, meditating, reading a book, or practicing deep breathing exercises.

Go somewhere smoking is not permitted – Step into a public building, store, mall, coffee shop, or movie theatre, for example.

Preventing weight gain after you stop smoking

Smoking acts as an appetite suppressant, so gaining weight is a common concern for many of us when we decide to give up cigarettes. You may even be using it as a reason not to quit. While it’s true that many smokers put on weight within six months of stopping smoking, the gain is usually small—about five pounds on average—and that initial gain decreases over time. It’s also important to remember that carrying a few extra pounds for a few months won’t hurt your heart as much as smoking does. However, gaining weight is NOT inevitable when you stop smoking.

Smoking dampens your sense of smell and taste, so after you quit food will often seem more appealing. You may also gain weight if you replace the oral gratification of smoking with eating unhealthy comfort foods. Therefore, it’s important to find other, healthy ways to deal with unpleasant feelings such as stress, anxiety, or boredom rather than mindless, emotional eating.

Nurture yourself. Instead of turning to cigarettes or food when you feel stressed, anxious, or depressed, learn new ways to quickly soothe yourself. Listen to uplifting music, play with a pet, or sip a cup of hot tea, for example.

Eat healthy, varied meals. Eat plenty of fruit, vegetables, and healthy fats. Avoid sugary food, sodas, fried, and convenience food.

Learn to eat mindfully. Emotional eating tends to be automatic and virtually mindless. It’s easy to polish off a tub of ice cream while zoning out in front of the TV or staring at your phone. But by removing distractions when you eat, it’s easier to focus on how much you’re eating and tune into your body and how you’re really feeling. Are you really still hungry or eating for another reason?

Drink lots of water. Drinking at least six to eight 8 oz. glasses will help you feel full and keep you from eating when you’re not hungry. Water will also help flush toxins from your body.

Take a walk. Not only will it help you burn calories and keep the weight off, but it will also help alleviate feelings of stress and frustration that accompany smoking withdrawal.

Snack on guilt-free foods. Good choices include sugar-free gum, carrot and celery sticks, or sliced bell peppers or jicama.

Medication and therapy to help you quit

There are many different methods that have successfully helped people to kick the smoking habit. While you may be successful with the first method you try, more likely you’ll have to try a number of different methods or a combination of treatments to find the ones that work best for you.


Smoking cessation medications can ease withdrawal symptoms and reduce cravings. They are most effective when used as part of a comprehensive stop smoking program monitored by your physician. Talk to your doctor about your options and whether an anti-smoking medication is right for you. The U.S. Food and Drug Administration (FDA) approved options are:

Nicotine replacement therapy. Nicotine replacement therapy involves “replacing” cigarettes with other nicotine substitutes, such as nicotine gum, patch, lozenge, inhaler, or nasal spray. It relieves some of the withdrawal symptoms by delivering small and steady doses of nicotine into your body without the tars and poisonous gases found in cigarettes. This type of treatment helps you focus on breaking your psychological addiction and makes it easier to concentrate on learning new behaviors and coping skills.

Non-nicotine medication. These medications help you stop smoking by reducing cravings and withdrawal symptoms without the use of nicotine. Medications such as bupropion (Zyban) and varenicline (Chantix, Champix) are intended for short-term use only.

What you need to know about e-cigarettes (vaping)

While some people find that vaping can help them to stop smoking, the FDA has not approved vaping as a method of smoking cessation. And recent news reports have even linked vaping to severe lung disease, prompting many questions about the safety of vaping. Here’s what you need to know:

  • In the United States, the FDA does not regulate e-cigarette products.
  • The FDA warns that vaping is “not safe for youth, young adults, pregnant women, or adults who do not currently use tobacco products.”
  • It’s hard to always know exactly what’s in e-cigarettes.
  • The liquid used in some e-cigarettes contains nicotine, which has many negative health effects. It can lead to high blood pressure and diabetes and can be especially dangerous to the developing brains of children and teens.
  • There is no information available about the long-term effects vaping can have on your health.
  • Until more is known, federal and state authorities recommend avoiding all vaping.

Alternative therapies

There are several things you can do to stop smoking that don’t involve nicotine replacement therapy, vaping, or prescription medications. These include:

Hypnosis – This is a popular option that has produced good results for many smokers struggling to quit. Forget anything you may have seen from stage hypnotists, hypnosis works by getting you into a deeply relaxed state where you are open to suggestions that strengthen your resolve to stop smoking and increase your negative feelings toward cigarettes.

Acupuncture – One of the oldest known medical techniques, acupuncture is believed to work by triggering the release of endorphins (natural pain relievers) that allow the body to relax. As a smoking cessation aid, acupuncture can be helpful in managing smoking withdrawal symptoms.

Behavioral Therapy – Nicotine addiction is related to the habitual behaviors or rituals involved in smoking. Behavior therapy focuses on learning new coping skills and breaking those habits.

Motivational Therapies – Self-help books and websites can provide a number of ways to motivate yourself to give up smoking. One well known example is calculating the monetary savings. Some people have been able to find the motivation to quit just by calculating how much money they will save. It may be enough to pay for a summer vacation.

Smokeless or spit tobacco is NOT a healthy alternative to smoking

Smokeless tobacco, otherwise known as spit or chewing tobacco, is not a safe alternative to smoking cigarettes. It contains the same addictive chemical, nicotine, contained in cigarettes. In fact, the amount of nicotine absorbed from smokeless tobacco can be 3 to 4 times the amount delivered by a cigarette.

What to do if you slip or relapse

Most people try to stop smoking several times before they kick the habit for good, so don’t beat yourself up if you slip up and smoke a cigarette. Instead, turn the relapse into a rebound by learning from your mistake. Analyze what happened right before you started smoking again, identify the triggers or trouble spots you ran into, and make a new stop-smoking plan that eliminates them.

It’s also important to emphasize the difference between a slip and a relapse. If you start smoking again, it doesn’t mean that you can’t get back on the wagon. You can choose to learn from the slip and let it motivate you to try harder or you can use it as an excuse to go back to your smoking habit. But the choice is yours. A slip doesn’t have to turn into a full-blown relapse.

You’re not a failure if you slip up. It doesn’t mean you can’t quit for good.

Don’t let a slip become a mudslide. Throw out the rest of the pack. It’s important to get back on the non-smoking track as soon as possible.

Look back at your quit log and feel good about the time you went without smoking.

Find the trigger. Exactly what was it that made you smoke again? Decide how you will cope with that issue the next time it comes up.

Learn from your experience. What has been most helpful? What didn’t work?

Are you using a medicine to help you quit? Call your doctor if you start smoking again. Some medicines cannot be used if you’re smoking at the same time.

Helping a loved one to stop smoking

It’s important to remember that you cannot make a friend or loved one give up cigarettes; the decision has to be theirs. But if they do make the decision to stop smoking, you can offer support and encouragement and try to ease the stress of quitting. Investigate the different treatment options available and talk them through with the smoker; just be careful never to preach or judge. You can also help a smoker overcome cravings by pursuing other activities with them, and by keeping smoking substitutes, such as gum, on hand.

If a loved one slips or relapses, don’t make them feel guilty. Congratulate them on the time they went without cigarettes and encourage them to try again. Your support can make all the difference in helping your loved one eventually kick the habit for good.

Helping a teen to quit

Most smokers try their first cigarette around the age of 11, and many are addicted by the time they turn 14. The use of e-cigarettes (vaping) has also soared dramatically in recent years. While the health implications of vaping aren’t yet fully known, the FDA warns that it’s not safe for teens and we do know that teens who vape are more likely to begin smoking cigarettes. This can be worrying for parents, but it’s important to appreciate the unique challenges and peer pressure teens face when it comes to quitting smoking (or vaping). While the decision to give up has to come from the teen smoker him- or herself, there are still plenty of ways for you to help.

Tips for parents of teens who smoke or vape

  • Find out why your teen is smoking or vaping; they may want to be accepted by their peers or be seeking attention from you. Rather than making threats or ultimatums, talk about what changes can be made in their life to help them stop smoking.
  • If your child agrees to quit, be patient and supportive as they go through the process.
  • Set a good example by not smoking yourself. Parents who smoke are more likely to have kids who smoke.
  • Know if your kids have friends that smoke or vape. Talk with them about how to refuse a cigarette or e-cigarette.
  • Explain the health dangers and the unpleasant side effects smoking can have on their appearance (such as bad breath, discolored teeth and nails).
  • Establish a smoke-free policy in your home. Don’t allow anyone to smoke or vape indoors at any time.


New Study Indicates Youth Smokers Become Quickly Addicted to Nicotine

Study Underscores Need for States to Fund Prevention Programs and Increase Cigarette Taxes
August 28, 2002

Washington, DC — A study published today in the international journal Tobacco Control presents powerful new evidence that adolescent smokers become addicted to nicotine much faster and while smoking far fewer cigarettes than previously thought.

The study found that, among adolescent smokers displaying symptoms of nicotine addiction such as difficulty quitting and cravings for cigarettes, half these young smokers displayed such symptoms within two months of when they started to smoke occasionally (at least once a month). Thirty-three percent reported symptoms of addiction when smoking at a rate of only one day a month, 49 percent by the time they were smoking one day a week, and 70 percent before they became daily smokers.

‘This study shows that, far from being a harmless rite of passage for teens, cigarette smoking can be highly addictive at a very early stage and lead to a lifetime of health problems and premature death,’ said William V. Corr, Executive Vice President of the Campaign for Tobacco-Free Kids.

‘This study is powerful evidence that the best way to protect our kids from the dangers of tobacco is to prevent them from ever starting to smoke. We know that cigarette tax increases and comprehensive tobacco prevention programs work to reduce youth tobacco use. This new study is a wake-up call for elected officials that our kids are getting addicted more quickly than we thought and they must act quickly to protect them,’ Corr said.

The study was funded by the National Cancer Institute and conducted by researchers at the University of Massachusetts Medical School, the Harvard Medical School, and the University of London. The study involved 679 Massachusetts adolescents who were interviewed eight times over 30 months between January 1998, when they were in the seventh grade, and June 2000. Among 332 youths in the study who had ever used tobacco, 40 percent reported symptoms of addiction.

Subjects were interviewed about their tobacco use and, in the case of smokers, about the first occurrence of 11 symptoms of nicotine dependence.

In addition to their findings about the speed with which symptoms of addiction appeared and the small amount of tobacco required, the researchers also found that girls displayed these symptoms much faster than boys. Girls with symptoms of addiction displayed these symptoms on average within three weeks of when they started to smoke occasionally, while the average for boys was six months. The lead researcher, Joseph R. DiFranza, MD, of the University of Massachusetts Medical School, said the researchers were unable to explain why girls exhibited symptoms of addiction faster, but have begun a new study sponsored by the National Institute on Drug Abuse to explore these gender differences.

Analyzing their overall findings, the researchers write, ‘Brain development continues into adolescence, and perhaps because of this, the adolescent brain appears to be more vulnerable to nicotine.’

Tobacco use is the leading preventable cause of death in the United States, killing more than 400,000 people every year. Ninety percent of smokers start at or before age 18. Every day, 5,000 kids try their first cigarette. Another 2,000 kids become daily smokers, one-third of whom will die prematurely as a result.

View the full study

Are you finding it difficult to quit? This test confirms that you have a high level of addiction to nicotine. This means that over time your body has adjusted to receiving regular doses of nicotine; withdrawal and cravings may feel very intense when you go a period of time without smoking.

We strongly recommend that you consider using nicotine replacement therapy (nicotine patch, gum, inhaler, lozenge, mouth) or smoking cessation medications (bupropion or varenicline).

Higher doses of nicotine replacement therapy would probably be the best choice for you. The nicotine patch may be very helpful for you since it will supply a steady dose of nicotine to help ease cravings and withdrawal. Keep in mind that you can adjust your use of the various nicotine replacement products to meet your needs. For example, that means that you can use more than one patch at a time or you can use the various nicotine replacement products at the same time if you find the cravings to be very intense. In general it is usually safer to use these products rather than continue smoking.

With a high level of addiction, getting support from other people in your life will be a critical step. Talk to the healthcare providers in your life (such as your doctor, nurse or pharmacist) about your plans to quit smoking. Talk to your family and friends about how they may support you in quitting. Getting regular follow-up and counselling support actually boosts quit rates, so we want to remind you that the Smokers’ Helpline counsellors are here to help! Call 1-800-363-5864 today to speak with a counsellor and get practical tips and advice on smoking cessation medications.

If you are not ready to quit all at once, then you can begin to break your addiction through changing some of your smoking routines and taking steps to cut back your smoking.

Although it may feel very challenging at times, remember it is possible to overcome this addiction. There is lots of support out there. And with a good plan, you can do it!

if E-cigarettes, vaping nicotine, and Juul pods are all the rage. You can buy them in all shapes, sizes, and flavors. While most teens know they contain nicotine – that’s the reason they use them – some think they’re harmless, fruity flavored fun.

That’s not quite the case.

E-cigarettes contain nicotine, and one Juul pod – the most popular form of e-cig right now – contains as much nicotine as an entire pack of traditional cigarettes.

Which means they’re just as addictive as traditional cigarettes, since it’s possible to ingest more nicotine, more easily, and more efficiently.

If you use e-cigs, vaping, or Juuling, and worry you might be hooked, there’s an easy way to find out if you are: take the HONC, a.k.a. the Hooked on Nicotine Checklist. We’ll tell you how to score your results below.


Take The HONC Test

HONC: The Hooked On Nicotine Checklist

Answer yes or no to each of the following questions.

Insert vape, use e-cig, or juul in the place of “smoke” “cigarette” “tobacco” or “nicotine”

  1. Have you ever tried to quit, but couldn’t?
  2. Do you smoke because it’s really hard to quit?
  3. Have you ever felt like you were addicted to tobacco?
  4. Do you ever have strong cravings to smoke?
  5. Have you ever felt like you really needed a cigarette?
  6. Is it hard to keep from smoking in places you’re not supposed to?
  7. Is it hard to concentrate when you can’t smoke?
  8. Are you irritable when you can’t smoke?
  9. Do you get a strong urge or need to smoke when you haven’t for a while?
  10. Are you feel restless, nervous, or anxious when you can’t smoke?

Score the Test

Prepare yourself for the news: since every question on this short checklist indicates a level of diminished autonomy over tobacco use, if you answer yes to just one question, that means you’ve lost full autonomy over your tobacco use. The more yeses, the more autonomy you’ve lost.

You know what that means, don’t you?

It means you’re not the one in control of your behavior any more. In this case, it means tobacco – or e-cigs, vaping, or juuling – is in control of your behavior. It means you’ve lost your independence, and we’re fairly certain independence and autonomy are a big deal to you. They’re important to most people, but to teenagers they’re huge.

If you want to regain your autonomy, you can.

People quit – i.e. regain autonomy – every day, and they do better when they have support.

Check out the website Smoke Free Teen to get help and support designed specifically for teenagers. This government-maintained site offers live chat, advice on planning to quit, a quitting phone app called quitSTART and a quitting text service called SmokefreeTXT.

It’s all free and it’s all there just for you.

Your chances of experiencing the long-term negative health consequences of nicotine addiction decrease the sooner you recognize the fact you may be addicted. And the sooner you start the process of quitting, you increase your chances of quitting successfully.

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