Understanding Your Addiction is the Best Way to Overcome It

Smoking is more than just a bad habit. It’s a powerful addiction. That’s why quitting is so tough and why many people have to make several attempts at it. But as impossible as quitting might seem sometimes, it can be done.

There are 52 million Americans from every walk of life who are proof quitting is possible. This course will help you join them and quit smoking for good.

The Three-Link Chain of Addiction

Most smokers know they are addicted to cigarettes but they may not realize there are several aspects to this addiction. We call this the Three-Link Chain of Addiction.

Physical Addiction

You get hooked on the nicotine in tobacco. When the nicotine level in your body gets low, you crave more.

Social Addiction

You get hooked on the connections smoking helps you make with other people. You feel more at ease with a cigarette in hand.

Mental Addiction

You get hooked on the feeling of smoking. The more you smoke in certain situations or when having a certain emotion, the more automatic it becomes to light up the next time you experience the same thing.

You'll have a better chance of quitting—and staying quit—if you address all parts of the chain.

Exploring Physical Addiction

Tobacco products contain thousands of harmful substances. One of these is nicotine, the highly addictive drug that makes smokers physically dependent on lighting up to feel good. The more you smoke, the more nicotine your brain needs to satisfy the craving.

Select each item to learn more about the physical effects of nicotine

Nicotine:

Triggers the pleasure center of the brain, normalizes mood and decreases anxiety

Nicotine:

Suppresses appetite

Nicotine:

Increases heart rate

Nicotine:

Produces withdrawal symptoms when the amount in your system gets low

When someone puffs a cigarette, it takes just 10 seconds for nicotine to have an effect on the brain—faster than any other psycho-active drug.

How Addicted Are You to Nicotine?

Most smokers are addicted to nicotine. The stronger the addiction is, the harder it is to break. The quiz below can help you determine just how strong your addiction may be.

Do you smoke your first cigarette within 30 minutes of waking up? Yes No Do you smoke 20 cigarettes (one pack) or more each day? Yes No At times when you can’t smoke or don’t have any cigarettes, do you feel a craving for one? Yes No Is it tough for you to go more than a few hours without smoking? Yes No When you are sick enough to stay in bed, do you still smoke? Yes No

The more yes answers you have, the greater your addiction is to nicotine and the more likely you will experience withdrawal symptoms when you quit. Luckily there are ways to minimize the discomfort, which you’ll start to learn about next.

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Quit-Smoking Medication May Double or Possibly Triple Your Chances of Quitting for Good

Studies suggest most people trying to quit smoking could benefit from using quit-smoking medications. Quit-smoking medications help smokers overcome physical addiction in two ways:

They reduce your craving for nicotine.

They help relieve physical "recovery" symptoms after quitting smoking.

The chart below provides a basic overview of the medications available.



You can learn more about each medication, including how they are used, length of treatment and side effects by viewing the Medication Chart. The chart is also available in the Resources section of the course.

NOTE: The American Lung Association is neither the manufacturer nor the seller of these products and takes no responsibility with respect to them. Be sure to use any of these products only as prescribed and/or according to the labeling. As with any medication, talk to your healthcare provider for more information.

FAQs: Quit-Smoking Medications

Select any box below for answers to common questions people have about quit-smoking medication.

Are quit-smoking medications okay for everyone to use?

If you fall into one of the following groups, you should NOT use quit-smoking medications without consulting your healthcare provider first:

  • You smoke fewer than 10 cigarettes per day.
  • You are younger than 18 years of age.
  • You are pregnant or breastfeeding.
  • You have a medical condition, including heart disease and depression.

How do quit-smoking medications work to ease nicotine cravings?

There are two basic types of quit-smoking medications:

  1. Nicotine replacement therapy (NRT): These products provide the user with controlled doses of nicotine to reduce the intensity of withdrawal symptoms without increasing cravings.
  2. Non-nicotine smoking cessation medications: These medications work with brain chemistry to reduce the effect of nicotine on the brain and ease symptoms without the use of nicotine.

What about e-cigarettes? Can they help me quit?

The U.S. Food and Drug Administration (FDA) has not found any e-cigarettes to be safe or effective in helping smokers quit. No one knows what the short- and long-term health effects of these products are. Based on this, the American Lung Association does not support the use of e-cigarettes. Instead, we encourage you to talk to your healthcare provider about using one of the seven FDA-approved medications discussed in this course that are proven to help smokers quit.

Are quit-smoking medications expensive? Are there any low- or no-cost options?

The benefits of using quit-smoking medication make them well worth considering. If you are concerned about the cost of quit-smoking medications, we suggest contacting the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872) or talking to your healthcare provider.

Keep in mind:

  • Some quit-smoking medications cost less than others. Your healthcare provider or pharmacist can help you decide if one of the lower-cost options is a good choice for you.
  • Generic, lower-priced versions may be available.
  • With the Affordable Care Act, most insurance plans are required to offer smoking cessation benefits that could include discounted or free quit-smoking medications. Ask your insurance provider for more details.
  • Some county/state health departments have programs to help people get medication at a reduced cost.

Remember, cigarettes cost a lot too. A quick comparison might show it is actually cheaper to purchase quit-smoking medication for the recommended time than it is to keep smoking and buying cigarettes.

Your Medication Plan

Take a moment now to record your plan regarding quit-smoking medication.

Which answer best describes your current thoughts on using quit-smoking medication(s)? Select one:

I am not planning to use any quit-smoking medications.

I am interested in using a quit-smoking medication but want more information.

I already know which quit-smoking medication I want to use.

Select the type of quit-smoking medication(s) you plan to use.

Nicotine gum Nicotine lozenge Nicotine patch Nicotine nasal spray Nicotine inhaler Bupropion (Zyban®) Varenicline (Chantix®)
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Learn more about quit-smoking medications by calling your healthcare provider, pharmacist or the Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).


Lung HelpLine

Exploring Social and Mental Addiction

While physical addiction to tobacco is characterized by specific symptoms that can be managed, social and mental addiction are about how smoking relates to behaviors and feelings. Let’s take a closer look.

Social Addiction: The Root of Your Relationship With Smoking

Smokers are a diverse group. It is an addiction that crosses gender, ethnic, racial, economic and cultural lines. But there is one common thread. Most smokers—almost 90 percent—started before the age of 18.

Social addiction often starts with:

The influence of peers, parents or other family members already using tobacco

The need to identify with a group or fit in

The desire to feel more at ease in social situations

More likely than not, you’ve continued to use smoking as a way to “break the ice” while in social situations or to make connections with other people you encounter.

Social addiction is about using tobacco as a way to build and keep connections with others.

Mental Addiction: Smoking Without Thinking

As you started smoking, likely for social reasons, and you began to get addicted to the nicotine in cigarettes, a mental aspect to the addiction also took root. Mental addiction is when smoking becomes an automatic behavior that links to what you are doing or how you are feeling.

Examples include:

When you smoke because of environmental cues, like the end of a meal

When you smoke to cope with stress and other emotions

When you smoke because you feel pleasure and relief

When you smoke to “self-medicate” feelings such as anxiety

Mental urges can be separate from physical urges. Your body may not “need” the nicotine but your brain thinks it does because you always smoke when you feel or act a certain way.

Overcoming Social and Mental Addiction

Although quit-smoking medications can help you overcome physical addiction, social and mental addiction requires a different set of strategies. You need to learn what things trigger your automatic urges to smoke. Then you need to find better alternatives to replace smoking in these situations.

Triggers are the situations, events, feelings or behaviors that give you the urge to smoke.

  • Triggers are different for different people.
  • Over time, some activities may have become so connected with smoking you cannot imagine doing them without a cigarette.
  • Triggers can also be associated with good or bad feelings.

To see examples of different triggers for smoking, select each person.

Russ smokes when...

  • Feeling stressed
  • Driving
  • Drinking coffee
  • Feeling bored

Sandra smokes when...

  • Drinking socially
  • Finishing eating
  • Seeing someone else light up

Paul smokes when...

  • Waking up
  • Watching TV
  • Talking on the phone
  • Feeling lonely

Social and mental addiction can seem difficult to overcome. While the symptoms of physical addiction ease over time, the triggers for social and mental addiction are likely to stay a part of your life. You can’t avoid them but you can change your thinking and create new positive behaviors.

Pack Tracks, Part 1: Naming Your Triggers

Just as using quit-smoking medications and learning ways to manage your symptoms can help you with physical addiction, pinpointing your triggers can help you make a plan to combat social and mental addiction.

The Pack Tracks tool, which you will find on the Dashboard, will help you see patterns in your smoking behavior including where, when and why you light up. Many people find this to be one of the most valuable activities in the lead-up to Quit Day. You'll use your Pack Tracks to create your Quit Plan in Session 4.

How to Use Pack Tracks

Choose at least three days during the next week to do this activity. On those days, you’ll use Pack Tracks to record information about every cigarette you smoke. You can see full directions for how to use Pack Tracks by selecting View or when you open the Pack Tracks tool on the Dashboard.

view

Here are some tips to help you get the most out of Pack Tracks...

  • Do this activity for at least three days and longer if you can. The more information you record, the more you’ll be able to understand about your smoking patterns.
  • If possible, use Pack Tracks on at least two workdays and one weekend day.
  • Use the Pack Tracks tool on the Dashboard to see your smoking stats all together.
  • If you do not have a smartphone or tablet with you, make notes and then enter the information online later. A printable version of Pack Tracks can be found in the Resources section of this site.
  • You’ll need to complete Pack Tracks before starting Session 4.

Bringing it All Together

You are almost done with Session 2. Now that you have a better understanding of addiction, the rest of the Getting Ready section will be about ways to overcome your addiction, including learning some easy strategies for improving your outlook in Session 3. Until then:

Take care of getting any quit-smoking medication you want to use now. Purchase it once you make up your mind or get the prescription and be ready to use it as directed.

If you need advice about which quit-smoking medication to use call your healthcare provider, pharmacist or the Lung HelpLine as soon as you can.

Use Pack Tracks for at least three days, or for as long as you find them helpful.

At any time, go to the Dashboard and review or add to your Reasons for Quitting as motivation.

Keep saying out loud: “I can quit smoking.” The more you say it the easier it will be to believe.

Remember to keep track of your progress on the Dashboard to make sure you are doing all required activities to earn your certificate.

The links in the Three-Link Chain of Addiction are: Physical, spiritual and mental Physical, social and mental Chemical, physical and social The Three-Link Chain of Addiction includes physical, social and mental aspects. You’ll have a better chance of quitting for good if you have a plan to help you overcome all three. True or False? Using quit-smoking medication is strongly encouraged because it is the only way to quit. True False This is false. Although quit-smoking medications help ease the symptoms of physical addiction, they are not the only way to successfully manage symptoms. If you cannot use quit-smoking medications because of a pre-existing condition—or you simply choose not to—there are many other techniques that can help you quit for good. You’ll learn more in Sessions 3 and 4. How long should you use Pack Tracks? At least one day At least three days At least one week By using Pack Tracks for at least three days, you should be able to gain a good amount of information about your smoking patterns. Any less time and it may be more difficult to establish a plan based on your triggers. Longer is great but you’ll need to be aware of finishing in a timely manner to prepare for your Quit Day.

Before returning to the Dashboard, it might be valuable to go back and review this session to make sure you understand the key points.

You have reached the end of Session 2. We hope you enjoy and learn from your Pack Tracks. If you have any questions about what it’s like to use quit-smoking medications—or to not use them—you can post your questions on the Freedom From Smoking® Community or call the Lung HelpLine for support at 1-800-LUNGUSA (1-800-586-4872). When you come back for Session 3 you’ll learn a great relaxation exercise that can help as you start diving deeper into the Getting Ready phase.

Before returning to the Dashboard, it might be valuable to go back and review this session to make sure you understand the key points.

You have reached the end of Session 2. We hope you enjoy and learn from your Pack Tracks. If you have any questions about what it’s like to use quit-smoking medications—or to not use them—you can post your questions on the Freedom From Smoking® Community or call the Lung HelpLine for support at 1-800-LUNGUSA (1-800-586-4872). When you come back for Session 3 you’ll learn a great relaxation exercise that can help as you start diving deeper into the Getting Ready phase.

Great Job! You have reached the end of Session 2. We hope you enjoy and learn from your Pack Tracks. If you have any questions about what it’s like to use quit-smoking medications—or to not use them—you can post your questions on the Freedom From Smoking® Community or call the Lung HelpLine for support at 1-800-LUNGUSA (1-800-586-4872). When you come back for Session 3 you’ll learn a great relaxation exercise that can help as you start diving deeper into the Getting Ready phase.

Great Job! You have reached the end of Session 2. We hope you enjoy and learn from your Pack Tracks. If you have any questions about what it’s like to use quit-smoking medications—or to not use them—you can post your questions on the Freedom From Smoking® Community or call the Lung HelpLine for support at 1-800-LUNGUSA (1-800-586-4872). When you come back for Session 3 you’ll learn a great relaxation exercise that can help as you start diving deeper into the Getting Ready phase.

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