Quitting smoking

Every second adolescent smokes. In older age only 15 percent still do. The others have died over the years from the habit, or have given up smoking. How best to quit: expert tips from Dr. Alexander Hierl.

Tobacco is addictive, and only five percent manage to quit permanently without help. What causes this strong dependence?

Causes of dependence

It is nicotine, which reaches the brain very quickly via the mucous membranes and lungs into the bloodstream. About seven seconds after a lung inhalation, nicotine floods the brain and, depending on the psychological starting point, acts as stimulating, activating and rewarding, or relaxing, calming and satisfying. In addition, nicotine has a balancing effect on mood swings.

In concrete terms, the smoker has learned that the cigarette lifts them when they are in an emotional low, and calms them when they are tense. This feeling can be intensified by deep inhalations. In addition, each puff activates the reward system and encourages the smoker with a positive feeling to repeat the action constantly. Combined with certain actions, this behaviour is deeply imprinted in so-called addiction memory, which corresponds to classic conditioning.

Typical situations include talking on the phone, waiting at the bus stop, after meals, and during concentrated work. The effects of nicotine are as varied as the individual reasons for smoking. There are pleasure smokers, relaxation smokers, stress smokers, addicted smokers, occasional smokers and smokers who smoke for weight control.

Not smoking starts in the mind

Once the decision to stop smoking has been made, it is best to get support first. A physician trained in smoking cessation can provide valuable help. They take on a coaching role and guide the smoker to becoming a non-smoker. They combine techniques from behavioural and talk therapy and give concrete instructions that enable the smoker to cope with craving attacks. Acupuncture, homeopathy, hypnosis, nicotine replacement or medication can be used in support. With competent support, the success rate for remaining a non-smoker permanently is over 50 percent.