If you’ve ever attempted to quit smoking or watched a loved one take on the task, you’ll know it’s no easy feat.
Unfortunately, giving up smoking takes a lot more than the simple desire to quit. In fact, cigarettes are made with the very intention of keeping you hooked.
If you’ve found yourself wondering why do people smoke, it’s important to understand that there are often a number of elements at play, from emotional triggers to nicotine addiction. We break them down below.
Smoking, As We Understand It Today
Today, the harmful effects of smoking are well-understood.
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We know that tobacco use is linked to 19 types of cancer, 7 forms of cardiovascular disease, chronic obstructive pulmonary disease, and a range of other dangerous health conditions.
In the 1950s and 1960s, reports confirmed tobacco caused a range of serious diseases.
By the 1990s, public health campaigns started to emerge about the harmful effects of smoking on babies and children.
Between 1990 and 2000, anti-smoking groups began to lobby against major tobacco companies, and the Australian Government began imposing significant excise taxes and customs duties on tobacco products to deter people from smoking.
Increased awareness, campaigning, taxes, and anti-smoking advertising about the health effects of smoking has lead to a significant decline in the number of young people picking up the habit.
In fact, between 2001 and 2019, the number of daily smokers between 18 and 29 halved, and the percentage of adults who had never smoked jumped from 48% to 61%.
But it wasn’t always this way.
Why Do People Smoke in the First Place?
Before the health campaigning really gained traction in the ‘90s, smoking was considered ‘rebellious’ and ‘cool’.
Historically, the tobacco industry spent billions of dollars to create and market ads and promotional materials that showed smoking as exciting, and safe.
Smoking also appeared in popular culture content, with TV, movies, and celebrities portraying the habit as glamorous and ‘in’, encouraging young people in particular to take up smoking.
Research shows most long-term adult smokers picked up the habit as teens; reports found 80% began before the age of 20. Some teenagers just ‘wanted to try it’, while others began smoking to appear ‘cool’.
People with friends or parents who smoke are considered more likely to start than those who didn’t have people around them who smoked.
Three out of four high school students who smoke will become adults who smoke, even if they intend to quit in a few years.
While this seductive cigarette messaging has been all but eliminated today, the after-effects of a history of positive reinforcement surrounding smoking still remain.
Causes of Continued Smoking
So, why do people continue to smoke when the risks are clear?
Cigarettes are designed to make quitting incredibly difficult. There are three main factors that keep smokers from quitting; nicotine addiction, situational triggers, and emotional triggers.
Usually a combination of all three are present in any smoker.
Nicotine addiction + emotional or situational triggers = urge to smoke.
This cycle is very challenging to break.
For most long-term smokers, the driving force behind the continued habit is nicotine addiction.
Nicotine is the chemical in tobacco that makes it addictive. It is a naturally occurring substance that is considered as addictive as heroin and cocaine.
As mentioned, smoking habits usually begin in young people. According to the Department of Health, studies have demonstrated that young people get addicted to nicotine faster than adults. They also experience stronger cravings, which makes it harder to quit.
Nicotine and the more than 7,000 other chemicals in tobacco smoke are easily absorbed into the bloodstream via the lungs, which allows nicotine to then be spread throughout the body.
As with other addictive substances, it is the ‘high’ that nicotine gives you that keeps you reaching for a cigarette.
Nicotine stimulates the release of dopamine in the brain, which is the chemical responsible for our pleasure signals.
Nicotine reaches the brain within seconds after you puff, and the effects wear off within just a few minutes.
As the body adapts to nicotine, it needs more of it.
This increases the amount of nicotine in the bloodstream, as more tobacco is needed to get the same effect.
This is known as nicotine tolerance.
People who smoke can quickly become dependent on nicotine and suffer from physical and emotional withdrawal symptoms in as little as a few hours after their last smoke.
This window gets smaller and smaller as nicotine tolerance builds.
Nicotine withdrawal begins the moment you stub out your cigarette.
You may begin to feel irritated, edgy, and anxious.
When you’re continuously smoking, your symptoms won’t reach the point of serious withdrawal because when you reach for another cigarette, the discomfort of the initial withdrawal symptoms are alleviated.
Once you decide you have smoked your last cigarette, your withdrawal symptoms will intensify in each hour that passes since you smoked.
These symptoms tend to hit their peak around three days after your last cigarette, as this is when your body will have cleared itself of nicotine.
The withdrawal symptoms generally begin to decrease in intensity after a week or so, but may linger for up to a month.
Withdrawal symptoms can be both physical and psychological. The psychological symptoms are often the last to go.
Physical symptoms of nicotine withdrawal include:
- Restlessness and irritability
- Weight gain and increased hunger
- Difficulty sleeping
- Flu-like symptoms
- Constipation and Gas
- Chest tightness
- Skin concerns
- Back pain
Psychological symptoms of nicotine withdrawal include:
- Anxiety and/or depression
- Anger, stress, and mood changes
- Difficulty concentrating
These symptoms often present very intensely during the first week of quitting.
This is why many people who attempt to quit end up smoking again — in order to boost the blood levels of nicotine and put a stop to the discomfort.
People who have spent many years smoking often begin to associate smoking with certain other day-to-day activities over time, such as watching TV, talking on the phone, socialising, going out, and relaxing.
Smoking becomes a part of a pattern or routine, which means when you quit, the behaviours you used to associate with smoking become triggers.
So, if you previously smoked every night after dinner while watching TV, you may find this part of your day particularly challenging, and your cravings are likely to intensify during this time.
You will need to create different associations with these activities in order to break the link.
Instead of smoking while watching TV, you might sip on a glass of water or juice. Instead of smoking while relaxing in the afternoon, you might go for a walk with a friend.
You may need to avoid certain situational triggers during this quitting process.
For example, if you commonly socialise in the smoking area of bars, you might need to choose to go out to eat at a restaurant or socialise at a smoke-free bar instead.
The longer you go without smoking, the more these associations will weaken.
Over time, you will build up new associations with day-to-day activities, and your nicotine cravings will eventually disappear completely.
Long-term smokers tend to develop a strong emotional dependence on cigarettes because of nicotine’s ability to affect behaviour, moods, and emotions.
As discussed, nicotine stimulates the release of dopamine through the brain, which is why many people use smoking to cope with negative moods and emotions.
When you smoke, unpleasant feelings are momentarily alleviated due to the flood of ‘happy chemicals’ in the brain.
This can cause emotional dependence to build up over time. As a result, experiencing negative or unpleasant emotions can become a trigger to pick up a cigarette.
Studies show that people who smoke are more likely to suffer from anxiety and/or depression than those who don’t smoke. It is common for these feelings to increase after quitting as your brain adjusts to regulating your emotions without the interference of nicotine.
It’s very important to seek mental health support if these issues arise for you. A mental health professional will be able to work with you and your GP to create a supportive treatment plan. They may suggest additional strategies or tools to make the process easier for you.
Even for those without pre-exisitng or underlying mental health conditions, it’s important to seek support from a GP during this time. They will be able to talk you through the changes occurring in your body and brain, and help you understand how to cope with challenging feelings without nicotine.
Arguments For Smoking
The arguments for smoking touted by tobacco companies have long been considered irrelevant and pale in comparison to the serious health impacts of smoking.
Freedom of Choice
Tobacco companies and allied often use the term ‘nanny state’ in reference to health groups and governments. This suggests that proposed regulations are overbearing and interfere with personal freedom of choice.
However, while the tobacco industry claims the decision to smoke is an adult choice, we know the majority of people start smoking before adulthood. The adolescent brain is still not fully developed and equipped to weigh up the dangers of smoking.
Additionally, the tobacco industry claims that people are aware of the health risks and can stop at any time. We know that many smokers underestimate the severity of disease they are at risk of, and that nicotine addiction makes ‘stopping at any time’ virtually impossible.
As it stands, individuals can still choose to smoke, but interventions have been put in place to ensure people are making an informed decision.
Tobacco companies claim that smoking is a vital contributor to the health of the economy. However, economic presence doesn’t equate to economic dependence.
When resources are no longer given to certain economic activities (like producing tobacco), they are redirected elsewhere.
There is also a claim that the significant tax increases on tobacco will cause an increase in illegal cigarette imports.
However, there are numerous systems in place to mitigate this issue, including record keeping, prominent tax stamps, increased penalties for violations, vigorous enforcement, and banning of in-transit trade.
Labelling Current Policy Measures ‘Ineffective’
The cigarette-producing industry claims that there is insufficient evidence to indicate that plain packaging on cigarettes is effective.
However, we know that since the introduction of plain packaging, smoking rates have continued to decline.
Between 2020 and 2021, just 10.7% of Australian adults smoked. In 2017, 2.2% of secondary school students 12 to 14 were current smokers.
Between 2002 and 2017, the percentage of secondary students who smoked declined significantly; 9% of students smoked in 2002, while this number decreased 4-fold to 2% in 2017.
Studies have indeed confirmed that plain packaging reduced appeal to young people, strengthened the effectiveness of graphic health warnings, and reduced false beliefs about the harms of tobacco.
Tobacco companies claim that youth smoking prevention programs would be more effective. However, analysis has argued that the purpose of the programs is not to reduce youth smoking, but to preserve the industry’s access to youth.
The programs have been criticised for displaying smoking as an adult choice but failing to discuss the true health dangers of smoking.
There is currently no evidence to support that these programs decrease smoking among young people.
Quitting Smoking: The Stats
As it currently stands, two out of three people who smoke want to quit, and 50% of smokers attempt to quit each year.
The 2019 National Drug Strategy Household Survey (NDSHS) found that 77% of people who smoked daily attempted to cut down on smoking in 2018, and 31% who smoked every day had unsuccessfully tried to quit.
Withdrawal symptoms continue to be the factor interfering with quitting success rates.
However, reports tell us that smoking cessation programs improve quitting rates significantly. According to the European Respiratory Journal, only 3 to 5% of smokers who attempted to quit without professional help were successful.
On the other hand, those who sought help from smoking cessation clinics saw cessation rates of 35 to 55% over a six month period.
If you have attempted to quit cold-turkey without success, it’s a good idea to consider chatting to a GP about smoking cessation assistance options.
Your Road to Quitting
When we question, why do people smoke? it’s important to remember that cigarettes are designed to keep you hooked.
Long-term smokers are faced with nicotine addiction, situational triggers, emotional triggers, and withdrawal symptoms in the quitting process.
And you don’t have to do it alone.
GPs are professionals who have helped people wanting to quit smoking succeed by giving them the best path to success. They can create a tailor-made quit journey and give you the right tools to help you on your path to wellness.
You can also talk to GPs using bulk-billed telehealth consultations. These are convenient if you have no time to visit a GP in person. These GPs can provide guidance and prescriptions to help you deal with withdrawal symptoms and cravings.
Nicotine Replacement Therapy (NRT) Products
During the first few weeks of your quit journey, you might feel irritable and have strong urges to buy a cigarette. NRT products contain a small amount of nicotine to help you manage these strong withdrawal symptoms and cravings. NRT products come in the form of lozenges, gums, inhalers, and more.
Nicotine Vaping Products (NVPs)
In case NRTs don’t keep your cravings and withdrawals at bay, NVPs are a second means to keep you off the cigarettes. NVP products sold in pharmacies are made under stringent pharmaceutical standards on the manufacturing process and ingredients, are toxicologically assessed for inhalation, are locally insured, and are specifically designed to help you stop smoking.
The latest Cochrane Review found high-certainty evidence that NVPs are more effective than NRT in helping people quit smoking.
Smoking addiction makes it difficult to quit, even for strongly motivated smokers who want to kick the habit for good. By understanding the triggers of addiction and ways to manage it, along with the right tools and support, quitters have the best chance of successfully quitting.
We know you’re reading this because you want to know more about nicotine addiction. We can help.
Smokefree Clinic gives you access to many medically reviewed and trustworthy resources that can inform and aid you in your path to wellness, so have a look around!
If you’re ready to get started, Smokefree can connect you to bulk-billing Australian healthcare professionals who excel in helping patients quit smoking for good, including using responsible vaping products where appropriate.
Click here to book your bulk-billed telehealth consultation with an Australian healthcare professional and quit smoking today.