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WHY IS IT DIFFICULT TO GIVE UP SMOKING?
We do not fully understand why it is difficult to break the smoking habit. One idea is that smokers develop a need (dependence) for nicotine. There is some evidence for this; Dr Keith Ball has shown that when the nicotine content of cigarette smoke is reduced (e.g. by changing the brand), smokers may alter their smoking pattern to compensate for the change. On the other hand, it is not established that man develops a true physical dependence on nicotine; quitting cigarettes is not associated with the extreme withdrawal symptoms seen in morphine addicts or alcoholics. Another view is that what smokers enjoy most is the ritual of lighting up and drawing on a cigarette; in Freudian language, smoking offers an oral satisfaction (hence the weight gain in some – but by no means all – who give up the habit).
Certainly we need to know more about why it is difficult to quit, whether the smoker is being separated from his comforter, his nicotine supply or from a social habit deeply engrained by people around him and by the pressures of advertising. The most constructive view is that smoking is a form of learned behaviour; and what can be learned can also be unlearned.
Most successful among the techniques for helping smokers to stop are those which attack the habit aspect.
There is overwhelming evidence, then, that cigarette smokers are at increased risk of diseases of the heart and blood vessels, the lungs and air passages, and other parts of the body. The smoker is prone, not only to heart attack, but to sudden cardiac death, angina, atherosclerosis affecting the legs, aneurysm of the aorta and stroke. It is clear that those who stop smoking are rewarded by a steep fall in the risk of many of these illnesses. Cigarette smoking potently enhances the risk conferred by other factors such as high blood-cholesterol levels and high blood pressure. Sir Richard Doll has shown that non-smoking men over the age of thirty-five are more than twice as likely as smokers to survive until the age of sixty-five years, i.e. to reach retiring age.
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