When it comes to cigarette smoking, there are two advices: stop smoking or do not start at all. In the first case, the smoker has already become addicted and exposed himself to the associated risks. For these people it becomes vital to stop: ‘This means having the courage to overcome psychological dependence and getting help to tolerate the physical dependence’, underlines Dr. Licia Siracusano, oncologist and referent of the Anti-smoking Center of Humanitas Cancer Center.

Addiction

In the second case, the advice is mainly focused on adolescents: in fact, it is at this age that a cigarette is lit for the first time. As reported by the Higher Institute of Health, the first cigarette is at 17.6 years for boys and 18.8 for girls, but more than 12% of smokers started smoking before the age of 15. This is the most critical age when, for various reasons, someone can become a victim of cigarette smoking. For example, being surrounded by friends who smoke can cause a boy or girl to smoke, ‘maybe you start asking a friend for a cigarette, then another one and so on. After asking for so many cigarettes, you decide to buy the first pack: thus you can say that addiction has arisen’, warns the specialist.

One of the main reasons why we continue smoking is nicotine, a chemical substance found in tobacco. Over time, the body becomes habituated to the presence of nicotine: ‘Therefore the addiction arises as a physical dependence because there is an increase of nicotine receptors at the encephalic level. These receptors – explains Dr. Siracusano – require that the “dose” of nicotine is kept constant in the blood’. Nicotine receptors are the neurons’ receptors for acetylcholine, a neurotransmitter involved in different functions, from muscular to respiration functions. With the nicotine that mimics the action of the neurotransmitter, the release of other neurotransmitters and hormones that regulate appetite, mood and memory is activated.

‘If there is a lack of the “dose” of nicotine that you need, the body doesn’t receive enough of it and you feel the desire to smoke. When you can’t do it, there is an abstinence crisis characterized by anxiety, agitation and irritability. These are all signs of physical dependence’.

Smoking and the (false) “pleasure”

However, there is not only physical addiction: ‘This is also linked to psychological dependence. The receptor/nicotine bond induces the production of gratification hormones, so the brain of a smoker launches this message: “I like smoking”. Nicotine does nothing but activate those areas of the brain that are associated with the production of pleasure and reward feelings’.

That’s why it is hard to quit for many people: the constraints of the addiction that have been created are resistant and concern different aspects. Although it may be hard, between each abstinence crisis, stopping smoking is not impossible, especially with the help of specialized centers, which assist those people who want to stop this addiction forever.