According to the latest CDC data , almost 70% of cigarette smokers want to quit. More than half of them had attempted to quit in the prior year. Discouragingly, less than 10% had succeeded. Some research studies find that the number of attempts required to finally succeed is not 5 or 6, but instead is 30 or more.
Why is quitting cigarette smoking so difficult? Is quitting vaping just as hard, easier, or harder? Why are the treatment outcomes for most smoking cessation programs so much lower than for the treatment of other addictive substances such as alcohol, opioids, or stimulants?
Having treated people with nicotine addiction for many years, I have developed a few ideas about how to address these questions. Over the next few weeks, I plan to share my thoughts on this website in the hope of receiving feedback from readers with an ultimate goal of devising strategies to make the quitting process less difficult.
Where should we start this process? A good first step would be: how best to conceptualize the problem. Most of my patients are inclined to accept a common notion that their smoking is simply a self-indulgent habit that they consider to be a vice – a reflection of their personal “weakness.”
Their attempted solution has often been to attempt to break the habit by a concerted effort – a strategy that allowed them to successfully meet past challenges in other areas of their lives but which rarely works with smoking cessation.
The reasons that this approach usually does not work are worth exploring. I think that there are at least two problems with it:
First, the habit aspect of their nicotine use, albeit powerful, is only one small part of a much more complex process. Such an oversimplification means that other powerful contributing factors go unaddressed.
Secondly, incorporating an implicitly self-critical assumption introduces a handicap into an effort where maximum “positive” energy is essential.
Next week, I will suggest an alternative way to think about nicotine addiction – that is an expression of a bio-psycho-social disease.
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