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Smoking is the leading cause of preventable, premature death in the United States. The American Cancer Society attributes 440,000 deaths due to tobacco-related illnesses every year. Heart disease, various forms of cancer, stroke, chronic lung disease and other illnesses account for this toll.

If one out of every two people who are regular cigarette smokers will die due to their use, why is it so hard to quit?

First and foremost, nicotine is a powerful and addictive drug. Simply put, nicotine and other drugs of abuse provide a feeling of euphoria, an alteration of the brain chemistry. With more use, this euphoric feeling is minimized instead translating into a need. This need is the altered brain, which has developed tolerance to the drug and therefore requires more use of the drug to get the desired effect to feel normal.

When quitting smoking, withdrawal occurs because this need for the drug that has developed within the brain is not being met. Symptoms of quitting can be physical, such as headaches, insomnia, decreased heart rate and increased appetite. Symptoms can also be psychological, including anger, depression, difficulty concentrating, anxiety and irritability. Withdrawal can produce intense cravings, making commitment to a non-smoking goal difficult.

Another psychological effect of smoking often overlooked is the relationship developed with the act of smoking. Cigarettes become an intimate part of life. They are smoked when happy. They are smoked when angry. They are smoked after a meal, before bedtime, after sex, upon waking up, between classes and so on.

The inhaling and exhaling of the smoke manage emotions, with cigarettes becoming a coping tool for regulating our moods. The challenge becomes giving up this unhealthy relationship, being willing to suffer its loss and processing the grief.

For this and other reasons, it is important to develop a support system. Creating a plan for quitting is instrumental in the process. The effective plan will describe how an individual chooses to cut down or quit, such as cold turkey or gradually. This plan will describe who will be a part of that support system, such as family, friends and counselors. This plan will provide tools and mechanisms to confront cravings and avoid triggers, such as nicotine replacement therapy, cravings management medication, behavioral replacements for cigarettes, cognitive restructuring therapy and psychotherapeutic awareness development regarding reasons for use.

Rewarding oneself is important, focusing on short-term, daily goals. Each personalized plan is different, focusing on individual strengths and replacing the meaning and actions of cigarette use with other behaviors.

Ideas to help you get started developing a smoking cessation plan can be found at the Illinois Tobacco Quitline, 1-866-QUIT-YES, which is funded by the Illinois Department of Public Health and managed by the SIUC Center for Rural Health and Social Service Development. Another resource can be found at www.stopsmokingcenter.net. Personal counselors are available at the Wellness Center to assist with any questions and to assist in your smoking cessation goals. The Student Health Center can assist smoking cessation, but only if you take the first step.

For confidential help with quitting smoking and alcohol or other drug issues, contact the Wellness Center at 536-4441.

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