Nicotine is a psychoactive substance that affects brains in a profound way, leading to a combination of stimulation and relaxation - and making quitting almost diabolically difficult.

In an interview with Heart Insight Magazine, Michael Fiore, MD, MPH, MBA, professor, General Internal Medicine and director of the UW Center for Tobacco Research and Intervention summarized the five ways to quit: cold turkey, behavioral therapy, nicotine replacement therapy, medications and combinations of these four.

“I think it’s really important to acknowledge that one size definitely does not fit all for smoking and tobacco dependence and smoking cessation,” Dr. Fiore said. “People have extraordinarily varied responses to quitting.”

He explained the process that happen within the first 10 seconds of inhaling tobacco smoke: nicotine crosses the blood brain barrier and elicits both stimulation and relaxation, among other actions related to an endorphin release. "Most smokers, by the time they quit, have been taking puffs of smoke and delivering those substances for 10, 20, 30, 40, 50 or more years," he said.

“The goal is to quit and I’m not a purist about what method a person uses,” Dr. Fiore said. “However, I tell my patients that the evidence indicates that combining counseling and medicine substantially boosts the likelihood of success.”

In the interview, Dr. Fiore described medications that the Food and Drug Administration has approved to assist with tobacco cessation.

Resources:

• "I want to quit smoking, but my family may hate me," Heart Insight Magazine, Winter 2017