Great American Smokeout: Still Smoking? Don't Give Up on Quitting

Nov 17, 2011, 6:54 PM, Posted by


About 20 percent of Americans now smoke, down from about the half of American adults who smoked in the 1960s. Changes in advertising, physician advice, advocacy messages and social norms are behind the millions who have already quit—but what’s with the 20 percent still smoking?

Experts say current smokers, bombarded with no-smoking messages and obstacles to smoking such as higher cigarette prices and bans on smoking in many public places and workspaces likely have physiologic causes that keep them lighting up. That doesn’t mean they can’t quit, says Richard Hurt, MD, director of the Nicotine Dependence Center at the Mayo Clinic. It means they need combinations of specifically targeted strategies.

Hurt says that we’re all born with the same number of nicotine receptors in our brains but for some people, starting to smoke physiologically increases those receptors—and the dependence on nicotine. “It’s very difficult to give up tobacco when your brain is craving it that much,” says Hurt. Nicotine is always addictive, but the level of physical addiction can vary dramatically from one person to the next. Hurt adds that cigarette manufacturers have refined cigarettes over the years for the maximum delivery of nicotine—and dependence—to the brain.

“Smokers need to know that quitting is a process, most people need several quit attempts,” Hurt says. They also need to work with health professionals who can help adjust numbers of counseling sessions—often phone counseling is as effective as in person therapy—as well as continual adjusting of doses for nicotine replacement and types and amounts of drugs.

Where to start? Hurt suggests a health care professional or one of several gateway websites available 24/7 to help smokers quit. “Be part of a community... Sometimes just understanding what you’re up against, something more than just will power , is very powerful and enriching for smokers hoping to quit,” says Hurt.

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This commentary originally appeared on the RWJF New Public Health blog.