Most people who smoke started when they were young. They probably knew that smoking could cause health problems down the road, but that road seemed awfully long, and those health problems seemed far away. More important back then was bonding with friends and being cool. Perhaps smoking gave young people a distinction and definition that they needed.

Now we have traveled a ways down the road, and we have seen acquaintances, friends and perhaps even ourselves coping with smoking-related illness. We understand more clearly the health consequences of smoking: greater risks of heart disease, cancer and emphysema. We know about chronic bronchitis, smokers' cough and recurring colds. Friends and family members are nagging, scolding, joking and cajoling. Enough, we say, let's quit!

Why do some smokers have a harder time quitting?

No one knows why some people have little trouble quitting, while others struggle for years and make many attempts to quit smoking before they are successful. Many factors are involved. One of the most important is how dependent your body has become on nicotine. In general, the longer you have been a smoker and the more cigarettes you smoke per day, the greater the chance that quitting will be difficult.

 

Some people may have a difficult time quitting because nicotine withdrawal symptoms are especially troublesome for them. These symptoms include not only strong cravings for cigarettes, but emotional symptoms as well, such as depression, anger, irritability, tension and anxiety. Some people have difficulty concentrating and feel more restless than usual. Difficulty sleeping, increased hunger and weight gain can also occur during nicotine withdrawal.

What happens during nicotine withdrawal?

The physical and psychological effects of nicotine are not totally understood, but scientists do know that nicotine has powerful effects on our bodies and brains. Like other strongly addictive drugs (nicotine is as chemically addictive as heroin), nicotine affects brain chemicals, called neurotransmitters, that affect our moods and our emotions. For example, nicotine may disrupt the regulation of serotonin, the neurotransmitter affected by many antidepressants. When nicotine is withdrawn, changes in brain chemistry lead to powerful cravings and emotional distress.