Dying To Quit: Why We Smoke And How We Stop

June 01, 1998

A Research Scientist Looks at What Makes Smoking So Seductive and So Hard to Give Up

We know we shouldn't smoke, so why do we? And why, when we decide to quit, is it seemingly impossible for so many of us to do so? In DYING TO QUIT: Why We Smoke and How We Stop (Joseph Henry Press; $29.95; June 1, 1998), Janet Brigham answers these questions by exploring the convergence of the complex psychological and scientific factors that she and other researchers have been studying and that are largely unknown to the general public. The ways that nicotine affects the body and brain, the emotional comfort and the pleasure of the smoking ritual, the impact of marketing--Brigham shows how all are inseparable parts of the smoking equation.

Brigham, a research psychologist whose principal work is in studying the effects of tobacco, makes accessible the raft of scientific and statistical information in her examination of cigarette smoking. She considers the debate over whether smoking is an addiction or a habit and whether nicotine automatically leads to dependency. She discusses the interconnections between nicotine, caffeine, and alcohol and the link between nicotine and more severe psychological disturbances such as depression and schizophrenia.

She also offers some surprising truths about the 'gains and losses' associated with smoking, citing studies that indicate that a weight gain of 20 or 30 pounds after quitting may be genetically driven and that the small weight gain most quitters experience merely brings their weight up to what is considered normal.

In assessing why so many of us continue to smoke, Brigham explores the behavioral economics of tobacco use. For many smokers, she points out, a cigarette today is worth more than good health 35 years down the road. She notes that in deciding whether or not to quit, smokers' immediate concerns with stress reduction and the pure pleasure of smoking usually win over the seemingly far-off prospect of eventual ill-health or death at an earlier age.

Why can some smokers quit easily while others fail over and over again? Here, Brigham details the myriad behavioral factors at work and discusses not only the symptoms most quitters experience, but the length of those symptoms and the extent to which they disrupt smokers' lives. Sympathetic to the plight of those who want to kick the addiction, she discusses the methods, the treatments, and the products that have proven most successful. While she cautions that less than 5 percent of those who quit remain smoke-free for as long as a year, Brigham maintains that 'learning to quit can involve learning to manage lapse and relapse episodes, turning them from catastrophe to beneficial experience.'

Quitting smoking is a process, not a single event, as the author notes. DYING TO QUIT provides vital information that does away with simplistic notions about the lure of smoking and the problems involved in quitting and gives us an enlarged picture of tobacco's power.

JANET BRIGHAM, Ph.D., is a research psychologist with SRI International in Menlo Park, California, where she studies tobacco use. A former journalist and editor, she has also conducted substance abuse research at the Johns Hopkins University School of Medicine, the National Institute on Drug Abuse, and the University of Pittsburgh. Janet Brigham can be reached via email at jzb@unix.sri.com or phone her at 650-859-2797.

National Academies of Sciences, Engineering, and Medicine

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