10. The smoking habit can be especially hard to kick

By Tom O'Connell

Mark Twain knew about quitting smoking. He said it was easy to quit, and then added a clause indicating that he had quit many times. He also said you don't throw habits out the upstairs window, you coax them downstairs one step at a time.

Some of what he said was true. Many smokers have quit often and then gone back to the habit. Also, smokers have tried many ways of quitting. Some quit cold turkey, and others wean themselves off the habit by gradually decreasing the daily drug dose.

People in alcoholism recovery often say that it was easier for them to give up  alcohol than the smoking habit. Yet there are others who, when they were ready, found no difficulty at all in eliminating tobacco from their lives.

One important thing to remember about cigarettes is that they are powerfully addictive. Information from the Surgeon General's Report compares alcohol and cigarettes, noting that about 10 to 15 percent of drinkers will go on to become alcoholics, whereas "use of cigarettes, by contrast, almost inevitably escalates to a level characterized as dependent use." Why? Because cigarettes and other nicotine products are "addicting in the same sense as are drugs such as heroin and cocaine," said the report.

I recall that in the early 1980s when I was serving as communications consultant to the American Lung Association of Massachusetts we were committed to an effort designed to make America smoke-free by the year 2000. It was a noble cause.

How are we doing? Well, about 10 years ago it was estimated that about 56 million Americans smoked tobacco, resulting in about 350,000 premature deaths each year. Now the figures from National Institute on Drug Abuse (NIDA) estimate that 62 million Americans still smoke, and even though many millions have given up smoking over the years, about 430,000 Americans will die this year due to their tobacco habit. This impact is greater than the combined death tolls of alcohol, cocaine, heroin, suicide, auto accidents, fires, and AIDS. Also, the number of people who suffer from tobacco-related  diseases and disabilities is beyond our ability to estimate. It's our leading addiction.

Does it make sense? No. Because addiction doesn't make sense. It's irrational. It's all about unhealthy dependence on behaviors that impair our ability to function to full potential. Life-damaging behaviors. Substitutes for healthy living and healthy relating.

It's about craving, compulsion, loss of control despite efforts to control the behavior, and continuation of the behavior despite life-damaging consequences. It's about defense of the behavior, denial, increasing tolerance in the system, and withdrawal symptoms that often drive a person back to the addiction.

Cigarette withdrawal, for example, can lead for a while to headaches, irritability, upset stomach, breathing and circulation problems, trouble sleeping, dizziness, and numbness. But usually this is for just a few days. "No pain, no gain."

On the good side though, freedom from smoking ordinarily eliminates the smoker's cough, along with shortness of breath, and improves heart and circulatory functioning. Senses of taste and smell are restored too. And the risk of cancer and lung disease is reduced. So it's never too late to quit.

It's not easy to quit any addiction, but there are many resources available today. For help, call your local American Lung Association or the local office of American Cancer Society.

If you'd like to update your knowledge about tobacco addiction, there's a wealth of information available to you on the Web at www.nida.nih.gov, and support systems exist at www.recoverynetwork.com.

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