Cravings, which are sometimes strong, are an integral part of the quitting process. Learn how to control them so you don't fail or relapse.
The need for dopamine
To better understand why quitting smoking is so hard, it is important to look at the mechanisms behind tobacco addiction. The nicotine in cigarette smoke is the main culprit. When smoke is inhaled, the nicotine enters the lungs, is absorbed into the bloodstream and then reaches the brain. This process takes less than 20 seconds, which is why the effect of a puff is almost instantaneous.
To produce its stimulating effect, nicotine binds to very specific receptors in the brain. This effect leads to the release of a hormone called dopamine. It causes the feeling of well-being or calm that smokers are seeking. It also leads to the activation of the reward circuit. Over time, addiction sets in. Eventually, not smoking leads to strong cravings and withdrawal symptoms.
The human brain responds to dopamine because it is the hormone of pleasure, gratification and "self-care". It is normal to seek out this type of stimulation and there are a multitude of ways that the brain secretes this hormone and relishes in it. Dopamine plays a major role in all types of addiction (alcohol, drugs, gambling, video games, etc.). Fortunately, its secretion can be stimulated in many other ways that are very healthy: music, artistic activities, a walk in the woods, a bubble bath, etc.
When you quit smoking, you can expect to experience irresistible urges to smoke, strong impulses that are sometimes called "cravings". Additionally, a person who quits smoking cold turkey, without any smoking cessation aids, will experience what is called a withdrawal syndrome, during which they will experience symptoms such as irritability, nervousness, depressed mood, concentration problems, etc.
Cravings can occur at any time, but they are more likely to occur when you are experiencing unpleasant emotions or feelings (sadness, anxiety, anger, etc.) or, on the contrary, when you are experiencing very pleasant situations (vacations, celebrations, meeting friends, good news, etc.). Remember, your brain associates nicotine with comfort and reward. This explains why some people feel strong cravings to smoke even after many years of abstinence!
Smoking cessation aids
These medications are intended to help people in their efforts to stop smoking. Their action consists in reducing withdrawal symptoms and cravings. Without this help, you only have a one in twenty chance of success. Your pharmacist can prescribe the product that is right for you and give you the necessary advice.
There are two main types of smoking cessation aids: oral medications (varenicline and bupropion) and nicotine replacement therapies (e.g. patch, lozenge, gum, inhaler or spray). Some treatments can be combined for greater effectiveness.
Without smoking cessation aids, you may experience much more intense and frequent cravings. It's worthwhile to be well informed and to develop an action plan (your pharmacist can help you).
Some tips on how to manage cravings
A strong urge to smoke generally lasts three to five minutes. These moments of discomfort can be prevented to some extent. However, you should know that they will inevitably occur, so you might as well be prepared and plan your strategies to deal with them. When a craving occurs, it will be beneficial to divert your focus, stay busy, and take concrete actions that will help you ride out the wave.
Here are some tips on how to prevent, reduce or control your cigarette cravings.
- If you have identified factors that trigger or worsen your cravings to smoke, avoid them if possible (e.g. drinking coffee, alcohol or sugary drinks).
- If there are smokers around you, let them know you are committed to staying smoke-free and set boundaries if they encourage you to smoke.
- Avoid situations where you will be in contact with cigarettes.
- When a craving arises, choose a simple activity that will keep your mind busy such as:
- exercise or do housework
- play with a child or pet
- take a shower
- call a friend or loved one
- do a crossword puzzle or sudoku
- watch a show
- play a game on your phone
- Also focus on activities that keep your hands busy or your mouth stimulated:
- play with a stress ball
- eat a healthy snack
- drink an ice-cold glass of water or a beverage (ideally a "healthy" one) slowly and with small sips
- brush your teeth
- chew gum
- Learn breathing exercises or relaxation techniques that will help you when the time comes.
- Ask ex-smokers to share their tips with you.
- Make a list of your strategies and keep it with you.
Pharmacists can support you throughout the smoking cessation process. Make them your ally to increase your chances of success!