This is the question posed by one Michael Burke. He has a doctorate in education and is a Certified Tobacco Treatment Specialist, no less. But I was set wondering what he actually knows about smoking when I came upon what he says as the Program Director of the highly esteemed Mayo Clinic Nicotine Dependence Center.

As usual, I’ll quote from him and add my comments. (I have corrected American spelling to British spelling.)

Despite all we know about the health problems caused by using tobacco, people continue to smoke…This can seem baffling.

It’s not baffling at all – it’s very simple. Tobacco products are available on sale everywhere. There’s no need for this. Youngsters start smoking out of curiosity, peer pressure, or to feel grown up; then they find they can’t stop.

But knowledge, desire, and determination typically are not enough for most to simply stop smoking. In fact research over the past 25 years has shown that, out of 100 people trying to quit smoking cold turkey, only about 3 to 5 of them will succeed for longer than 6 months. In other words, while some people can quit this way, at least 95 per cent of people can’t.

This overlooks the main problem: why have people been smoking for years or decades before they even think of quitting? They then ‘try’, that is, fail, to quit. The idea of trying to quit is meaningless: either you smoke or you don’t. Thus, to say that 95 per cent of people can’t quit smoking by ‘trying’ to do so cold turkey (abrupt quitting), likewise is meaningless, or at best, highly dubious.

When you understand the addictive nature of tobacco, it’s easier to understand why many can’t just quit. Here’s a closer look at why many smokers need a specialised cessation programme to help them to overcome tobacco addiction.

1: Nicotine dependence

What’s the difference between nicotine addiction and dependence? There is none.

Nicotine offers a lightning quick buzz, travelling from the lungs through the bloodstream to the brain in 10 seconds. As a result, smokers develop a strong association between taking a drag and feeling pleasure.

Ten seconds is hardly lightning quick and the idea of pleasure from smoking is illusory. All it means is relief of the discomfort of nicotine withdrawal and this may be perceived as pleasurable. In any case, if you talk to real people who smoke, they rarely mention pleasure as a reason why they poison themselves with tobacco fumes. They don’t say, when they’ve just stubbed out a cigarette, ‘By Golly, that was marvellous – I must do it again!’

2: The smoking habit

Due to how the brain works, and the quick uptake of nicotine through smoking…the body can form so-called habits of continuing to pair behaviours with tobacco to form a strong bond. These then can become triggers.

First we have nicotine addiction, then dependence, and now we have smoking ‘habits’ and ‘triggers’. This unnecessarily complicates matters. It’s sufficient to talk of nicotine addiction.

Over time, the trigger-smoking connection becomes so ingrained that smokers are convinced they can’t pay a bill, talk on the phone or drink coffee without a cigarette in hand. To leave tobacco behind for good, smokers must carefully dismantle their old routines and construct new ones, a doable but overwhelming task—especially alone.

Wrong and wrong – in that order. If something is ingrained, it’s ingrained; it adds nothing to the sense to say it’s so ingrained. We’re also unhelpfully presented with yet another reason for smoking: the trigger-smoking connection. But Mr Burke can’t even leave it at that. He has to add a further pointless complication by advising smokers that they need to dismantle their old routines and construct new ones. The only thing they need to do is to stop smoking; the routines can otherwise stay as they are.

3: Emotional ties to smoking

Though nicotine addiction and the smoking habit are the obvious reasons smokers struggle to quit, don’t underestimate the emotional bonds smokers have with cigarettes.

Now we have yet another reason for difficulty in quitting smoking: emotional bonds!

Consciously or not, those who smoke may consider smoking integral to their identity—as a member of their work crew. Or maybe cigarettes cement the bond between them and their spouse. Or they might consider cigarettes a reward for caring for a sick relative.

This pure speculation. Smoking is not integral to anyone’s identity, nor does it cement a bond. The only ‘reward’ smoking supplies is relief of the temporary discomfort of the withdrawal of nicotine provided by the previous cigarette.

For many smokers, cigarettes serve as a comfort, a reliable companion, an old friend who doesn’t judge. 

How many more reasons for smoking is Mr Burke going to think up? ‘Comfort’ is presumably the same as ‘reward’ mentioned above.

How a specialised cessation programme to stop smoking can help.

You don’t need a cessation programme, let alone a specialised (!) cessation programme, to stop smoking. You just need to stop smoking.

The Symonds Method can show you how to do this without a struggle.

Text © Gabriel Symonds

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