Why do people start smoking?

It has been estimated that 80% of adult smokers begin smoking as children, and about 30% of children have tried smoking by the age of 11.

There is no single reason why young people begin to smoke.

Predisposing factors such low socioeconomic status, adverse childhood experiences and mental illness are generally not easily changed. Influencing factors provide the opportunity for young people to experiment with smoking. Friends and the presence of people around them who smoke are major influencing factors.

In one study, 10% of children who became regular smokers showed signs of nicotine dependence within two days of first inhaling from a cigarette, and 25% within a month.

Why do people continue to smoke?

Because of the effects of nicotine.

The primary reason why people smoke is that they are nicotine dependent.

When inhaled, nicotine reaches the brain in 10 to 16 seconds (faster than if it was delivered intravenously). Regular cigarettes are required to maintain nicotine levels and avoid symptoms of withdrawal.

Nicotine exerts dependence producing effects, in a similar way to amphetamines and cocaine. Nicotine can both invigorate and relax a smoker, depending on how often they smoke. In new users, nicotine improves reaction time and sustained performance, but tolerance soon develops and these effects are not seen in long term users.

Nicotine withdrawal has significant physical and psychological effects starting within hours of the last cigarette and peaking within the first week.

Because cigarettes help people deal with stress

Many people think they need cigarettes to help them relax and cope with stressful situations. Many smokers report they feel calmer and have improved concentration after a cigarette. However, it is more likely that declining nicotine levels begin to cause symptoms of withdrawal including agitation, and smoking another cigarette simply restores nicotine levels alleviating these effects.

It is also worth considering the actions associated with smoking. For example people may go outside to smoke, removing themselves from the stressful environment and creating an opportunity to “clear their head”. Furthermore, the smoke is often inhaled and exhaled in a slow and often deliberate manner – similar to relaxation breathing techniques. Each of these are useful methods in their own right for dealing with stress, so it may be useful to remind people they already have the skills to manage stress, even if they don’t realise it.

Because of concern of weight gain on stopping

Many people, especially young women, believe that smoking helps them to maintain a lower body weight. Following smoking cessation, weight gain occurs in approximately 75% of people,with an average gain of around 14lb.

It is thought some of this weight gained is caused by a decrease in metabolic rate following smoking cessation. This may return to normal over a period of weeks or months. Following smoking cessation, many people have an increased appetite, which may last for two to three months. There are also several behavioural aspects that may influence weight gain. Ex-smokers may miss the familiar mouth and hand actions of smoking and replace this with snacking. People that smoke to deal with stress, boredom or loneliness may replace their smoking rituals with increased food intake.

Weight gain is NOT inevitable. It is important to incorporate a healthy diet and exercise into a quit-plan.

The lifetime benefits of quitting

Many of the major risks associated with smoking decrease within two to five years of quitting smoking. For some conditions a residual risk remains and never returns to the level of a non-smoker.

Illnesses associated with smoking include: Lung Cancer, Throat Cancer, Stomach Cancer, Pancreas, kidney and bladder cancer, Heart disease, Strokes, Poor Circulation to legs, Emphysema and Chronic bronchitis.

Barriers to quitting

There are a number of barriers that make it difficult for people to stop smoking. These barriers vary depending on age, gender and number of cigarettes consumed.

In a survey of 1500 smokers, over 80% wanted to quit, but factors such as enjoyment, craving and stress relief reduced their desire to attempt quitting.

Drugs that aid smoking cessation

Many people who want to quit smoking will try to do so without any assistance, however, for most smokers quitting is a difficult process. Smoking cessation advice includes encouragement to quit as well as information about the different treatments available to help.

Medications available:

• Nicotine replacement therapy (patches, gum, lozenges)
• Nortriptyline
• Bupropion (Zyban)
• Varenicline (Champix)

Speak with your doctor about starting these. Studies show that the success rate with the medication is 2-3x more than without.