Reader response to my last Sunday piece on nicotine has made me realize how desperately people wish to break free from tobacco addiction, especially smoking, but lack a scientific understanding of the problem to find a way out.
So, you want to quit smoking?
Actually there is ONLY ONE proven way to manage that miracle.
DO NOT START.
Sounds strange but nicotine being a mind-hacker second only to alcohol, it is near impossible to kick out after it habituates your brain by making it release dopamine.
So, even if you have managed to stop smoking, till you die, you remain a potential slave that can be reclaimed by the great master, nicotine.
But, let us not given.
If you are already enslaved by it, you can still hope be the rare someone who has managed escape from the grip the devil permanently by having a scientific understanding of your problem.
Smoking is a “learned response”. Like a lab rat, nicotine has trained your brain to go through the entire act by providing a self-gratifying release of dopamine as a reward for the act. This makes you go for it again and again, and even more frequently when your brain experiences stress. As brain really loves dopamine, any attempt to stop using nicotine and thus not provide brain with its dopamine fix makes it throw tantrums in form of withdrawals symptoms unpleasant enough for you to reach out for the next cigarette.
But, the real health issue with tobacco use (through any medium) is not really nicotine’s brain-hacking or addiction. Nicotine is actually a horse that pulls a chariot of diseases, as smoking damages lungs and throat while chewing tobacco leads to problems of oral tract. It is clear now that cancer has found one of its greatest allies in tobacco.
So, one of the simplest ideas proposed by science to mitigate problems caused by tobacco use is to supply nicotine to an addict through a non-damaging route like a skin-patch that releases nicotine and reduces the desire. Such nicotine replacement therapies(NRT) work upto a certain extent, but, are not very successful as gratification is a complex ritual. Sans act of sucking into the burning tube, addicts don’t get a complete kick from the nicotine.
Another alternative aimed at a “safer” nicotine delivery system that also provides the “pleasure” of the act is innovation of e-cigarettes. This strategy is not really aimed at helping one to stop smoking but is aimed at reducing the negative effects of smoke on the lungs. But, it is not conclusively safe enough to be considered as a viable solution.
One of the more interesting solutions worked out by looking at the neurological action is a substance known as Varenicline. It has ability to stimulate nicotine-receptors more weakly than nicotine itself so it competes with nicotine and reduces gratification of smoking by taking over the receptors used by nicotine. It fools your brain by hijacking these receptors and reduces the pleasure.
In India, neither nicotine replacement therapies (NRT) nor varenicline have become main-stream due to lack of awareness about the intense power of nicotine as an addictive substance working directly on one’s brain’s reward mechanism. This leads most smokers to opt for abstinence and motivational therapies. Unfortunately, even the strongest of human will finds it very difficult to reach deep within where nicotine takes hold in the brain, making most such efforts fail over a period of time.
It is important to note that human resolve and motivational support are bare necessities for breaking free, but they need to be supported by scientific understanding of the problem of nicotine (or rather dopamine) addiction. To fight the monster of nicotine, we need active participation of the individual and the society around him to ensure that his resolve is maintained but we also need to weaken the neurological hold of the addiction through means like NRT or varenicline that can fight the devil on his home ground in the brain. By working on both fronts, you can slowly wean off this deadly substance that may, otherwise, lead you to a horrible death.