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"10 common myths about smoking and quitting", July 16th, 2019

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​Nicotine is the major toxic ingredient in cigarettes

Wrong. Nicotine is the addictive drug in cigarettes but it is the other substances that cause the most harm.

Nicotine in dosages present in cigarettes does not cause heart attacks, cancer or lung damage.It is the other 7,000 toxins and chemicals in tobacco which are harmful, particularly tar and carbon monoxide. There are 70 known cancer causing agents in tobacco smoke.

Nicotine replacement therapy (NRT) is as harmful as smoking

Wrong. NRT (patch, gum, lozenge, inhalator, mouth spray) is always much safer than smoking.

NRT replaces some of the nicotine your body receives from smoking, but at a much lower level.Nicotine from NRT has few side-effects. Most of the harm from smoking is from the tar and carbon monoxide which are not found in nicotine replacement products.

Nicotine from NRT is delivered much more slowly and at lower levels than from smoking. As a result, the risk of becoming addicted to NRT is very small. In any case, long term use of NRT carries very littlerisk and is much safer than continuing to smoke.

Smoking while using NRT is dangerous

Wrong. Smoking while using NRT is no more dangerous than smoking.

Studies have found no significant side-effects from using NRT while smoking. When receiving nicotine from NRT, smokers generally cut down their cigarette intake or smoke less intensely as they need less nicotine from cigarettes.

Using more than one form of NRT (such as nicotine patch and nicotine mouth spray) is unsafe

Wrong. Combining more than one form of NRT can be used safely to help you quit.

Combining a nicotine patch with the nicotine mouth spray, lozenge, gum or inhalator causes no significant increase in side-effects over just using the patch alone. The combination gives better relief of cravings and nicotine withdrawal symptoms and increases the chance of quitting successfully, particularly for those who are very nicotine dependent. Combination therapy is now widely recommended by tobacco treatment specialists.

Smoking helps to relieve stress

Wrong. Research has shown that smoking increases stress levels overall.

Much of the apparent calming effect of a cigarette is simply due to the relief of symptoms (such as irritability, anxiety and restlessness) caused by nicotine withdrawal. Also, some of the relaxation from smoking is from taking a break and a few deep breaths, not the cigarette itself.

Smoking increases stress by causing frequent withdrawal periods during the day between cigarettes. Further stress is created by the guilt and shame of smoking and by concerns about the health effects. Furthermore, nicotine is a stimulant and releases stress hormones such as adrenaline. Research studies have shown that ex-smokers report feeling less stressed than when they were smoking.

​Cutting down your cigarettes or smoking mild cigarettes reduces the harm from smoking

Wrong. Cutting down your cigarette intake or changing to milder cigarettes does not improve your health and does not significantly reduce your risk of dying from a smoking-related disease.

The reason is that smokers subconsciously adjust their smoking when they cut down or smoke weaker cigarettes (compensatory smoking). When you smoke fewer or weaker cigarettes, you smoke each cigarette more intensely to extract more nicotine and keep your nicotine level in the comfort zone. You take more puffs and deeper puffs from each cigarette to compensate for the reduced number or weaker cigarettes.

Smoking just a few cigarettes daily is fairly harmless

Wrong. The research shows the health risks from light smoking are substantial.

Smokers of only 1-4 cigarettes per day have 3 times the risk of dying from a heart attack and 3-5 times the risk of dying from lung cancer compared to non-smokers. Overall their risk of death from any cause is increased by 57% compared to non-smokers.

Other conditions proven to be increased in light smokers include gastrointestinal cancers (oesophagus, stomach, and pancreas), lower respiratory tract infections, cataracts, reduced fertility in men and women, ectopic pregnancy, placenta praevia and reduced bone mineral density.

Hypnotherapy or acupuncture are effective quitting strategies

Wrong. There is no good evidence that hypnotherapy or acupuncture are effective in helping smokers quit.

These treatments generally do no harm and some people will quit successfully due to the placebo effect. However it would make more sense to use other treatments that are proven to be effective.The longer you delay successful quitting with unproven strategies, the more damage is being done to your body.

It is too late to quit. The damage is done

Wrong. The damage from smoking improves quickly after quitting at any age.

Many of the health effects of smoking reverse quite rapidly after quitting at any age. Quitting before the age of 50 reduces your risk of dying in the next 15 years by half. The risk of having a heart attack falls by 50% after about 3 years. In the case of lung cancer, your risk drops to half in 10 years.

The benefits of quitting are greatest when you stop earlier. However, even quitting at 60 years of age increases life expectancy by 3 years compared to those who continue to smoke.

Champix (varenicline) can make you depressed or suicidal

Wrong. There is no scientific evidence that Champix causes these symptoms.

There have been reports that some patients using Champix became depressed, agitated, had changes in their behaviour, suicidal thoughts or actually committed suicide. However, a careful review of all the scientific evidence found no evidence that Champix was the cause. Recently, there have been several studies of Champix in smokers suffering from depression and schizophrenia. The patients using Champix had no more side-effects of this type than those using placebo.

Stopping smoking can cause the symptoms mentioned above and this is probably the main cause of those reports, not Champix. Nevertheless, if you use Champix to help you quit, it is important to report any changes in your mood or behaviour to your doctor.

Champix is the most powerful anti-smoking medication available and has helped many people to quit who otherwise could not. It is safe and well tolerated. Side effects can occur with any drug but should be weighed up against the enormous health risks from continuing to smoke.

For help with quitting smoking contact the Quitline 13 78 48 (13 QUIT) or speak with your health professional.
Visit the websites IcanQuitand QuitNow.

Acknowledgement to Adjunct Associate Professor Renee Bittoun, Tobacco Treatment Specialist, Smoking Research Unit, Brain and Mind Research Institute, Sydney Medical School and Dr Colin Mendelsohn, Tobacco Treatment Specialist, The Sydney Clinic Consulting Rooms - both members of the Australian Association of Smoking Cessation Professionals (AASCP).​​​​​​

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10 common myths about smoking and quitting

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Dispelling common myths about smoking and quitting

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Nicotine addiction and smoking cessation treatments give help to every smoker wanting to overcome their addiction to nicotine.
Effective Treatments for Tobacco and Nicotine Addiction

Extensive research has shown that treatments for tobacco addiction do work. Although some smokers can quit without help, many individuals need assistance in quitting. This is particularly important because smoking cessation can have immediate health benefits. For example, within 24 hours of quitting, blood pressure and chances of heart attack decrease. Long-term benefits of smoking cessation include decreased risk of stroke, lung and other cancers, and coronary heart disease. A 35-year-old man who quits smoking will, on average, increase his life expectancy by 5.1 years.

Read more info on Dangers of Nicotine.

Nicotine Replacement Treatments

Nicotine replacement therapies (NRTs), such as nicotine gum and the transdermal nicotine patch, were the first pharmacological treatments approved by the Food and Drug Administration (FDA) for use in smoking cessation therapy. NRTs are used (in conjunction with behavioral support) to relieve withdrawal symptoms-they produce less severe physiological alterations than tobacco-based systems and generally provide users with lower overall nicotine levels than they receive with tobacco. An added benefit is that these forms of nicotine have little abuse potential since they do not produce the pleasurable effects of tobacco products-nor do they contain the carcinogens and gases associated with tobacco smoke. Behavioral treatments, even beyond what is recommended on packaging labels, have been shown to enhance the effectiveness of NRTs and improve long-term outcomes.

The FDA's approval of nicotine gum in 1984 marked the availability (by prescription) of the first NRT on the U.S. market. In 1996, the FDA approved Nicorette gum for over-the-counter (OTC) sales. Whereas nicotine gum provides some smokers with the desired control overdose and the ability to relieve cravings, others are unable to tolerate the taste and chewing demands. In 1991 and 1992, the FDA approved four transdermal nicotine patches, two of which became OTC products in 1996. In 1996 a nicotine nasal spray, and in 1998 a nicotine inhaler, also became available by prescription, thus meeting the needs of many additional tobacco users. All the NRT products-gum, patch, spray, and inhaler-appear to be equally effective.

Additional Medications to Treat Tobacco Addiction

Although the major focus of pharmacological treatments for tobacco addiction has been nicotine replacement, other treatments are also being studied. For example, the antidepressant bupropion was approved by the FDA in 1997 to help people quit smoking, and is marketed as Zyban. Varenicline tartrate (Chantix) is a new medication that recently received FDA approval for smoking cessation. This medication, which acts at the sites in the brain affected by nicotine, may help people quit smoking by easing nicotine withdrawal symptoms and blocking the effects of nicotine if people resume smoking.

Several other non-nicotine medications are being investigated for the treatment of tobacco addiction, including other antidepressants and antihypertensive medication, among others. Scientists are also investigating the potential of a vaccine that targets nicotine for use in relapse prevention. The nicotine vaccine is designed to stimulate the production of antibodies that would block access of nicotine to the brain and prevent nicotine's reinforcing effects. (learn about: Effect of Nicotine on the Brain)

Behavioral Treatments to Quit Smoking

Behavioral interventions play an integral role in smoking cessation treatment, either in conjunction with medication or alone. They employ a variety of methods to assist smokers in quitting, ranging from self-help materials to individual cognitive-behavioral therapy. These interventions teach individuals to recognize high-risk smoking situations, develop alternative coping strategies, manage stress, improve problem-solving skills, as well as increase social support. Research has also shown that the more therapy is tailored to a person's situation, the greater the chances are for success.

Traditionally, behavioral approaches were developed and delivered through formal settings, such as smoking-cessation clinics and community and public health settings. Over the past decade, however, researchers have been adapting these approaches for mail, telephone, and Internet formats, which can be more acceptable and accessible to smokers who are trying to quit. In 2004, the U.S. Department of Health and Human Services (HHS) established a national toll-free number, 800-QUIT-NOW (800-784-8669), to serve as a single access point for smokers seeking information and assistance in quitting. Callers to the number are routed to their state's smoking cessation quitline or, in states that have not established quitlines, to one maintained by the National Cancer Institute. In addition, a new HHS Web site (www.smokefree.gov) offers online advice and downloadable information to make cessation easier.

Quitting smoking can be difficult. While people can be helped during the time an intervention is delivered, most intervention programs are short-term (1-3 months). Within 6 months, 75-80 percent of people who try to quit smoking relapse. Research has now shown that extending treatment beyond the typical duration of a smoking cessation program can produce quit rates as high as 50 percent at 1 year.

Learn more about Nicotine Withdrawal.

Sources:

U.S. Department of Health and Human Services. The Health Benefits of Smoking Cessation: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1990.

Hall SM, Humfleet GL, Reus VI, Munoz RF, Cullen J. Extended nortriptyline and psychological treatment for cigarette smoking. Am J Psychiatry 161:2100-2107, 2004.

U.S. Department of Health and Human Services. Reducing Tobacco Use: A Report of the Surgeon General. Atlanta, Georgia: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2000.

Henningfield JE. Nicotine medications for smoking cessation. New Engl J Med 333:1196-1203, 1995.

National Institute on Drug Abuse

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nicotine addiction and smoking cessation treatments

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Nicotine addiction and smoking cessation treatments give help to every smoker wanting to overcome their addiction to nicotine.

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Holl Lucy "Nicotine: The Good, The Bad & The Ugly.", https://www.echelon.health/nicotine-the-good-the-bad-and-the-ugly/, Date-NA

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"A call to eliminate geographic smoking disparities in the U.S,." "https://truthinitiative.org/tobacconation", June 28, 2023.

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"Five Myths About Youth Tobacco use." "https://regionten.org/blog/youth-tobacco-use-myths/", May 28th, 2021

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Once you've started it's too late to quit, the damage has been done. This is not true. It is correct, that taking in nicotine can negatively affect your body, but that does not mean it's too late. The effects of it reduce rapidly after quitting at any age. It is never too late, with therapies and treatments, getting back on the path to better heath will come.

Smoking a few times a day is harmless. This is not true. Smoking even 3 to 4 cigarettes a day can having lasting causes. With someone who does this having 3 times the risk of dying to a heart attack and 3-5 times the risk of dying to lung cancer.

Smoking helps to relieve stress. This is wrong. Because dopamine levels are increased in the reward pathways, many would feel stress relieves them for the time that they are smoking, but once that goes away what's left? Stress. Smoking in general brings about increased stress levels. This stress can come from withdrawal from it, and if you think about it, many are stressed without it, this is due to the dependence that they have on it, and every time the pleasure of smoking goes away one will feel stress, overall it's a stress enhancer.

The major toxic ingredient in cigarettes is nicotine. This is wrong. Nicotine is very addictive but there are a lot more substances within the cigarettes that cause problems for your health. Nicotine plays a part in it all but it's really thanks to the other 7,000 toxins that are present within the cigarette.

Cutting down the number of cigarettes or smoking more light cigarettes reduces harm caused. This is wrong. Similar to smoking just a few times a day cutting down the number of cigarettes or even smoking more light cigarettes are not better alternatives. Harm will still be caused.

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 "Biden administration wants to take the buzz out of cigarettes." "https://www.axios.com/2022/06/22/biden-administration-take-buzz-cigarettes", Jun 22 2022

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Nicotine is very addictive, 35 million people each year try to quit, but only 6% are successful. The other percent that stays smoking is likely facing an addiction to nicotine.

Nicotine has various effects on the brain. One reason as to why many cannot stop smoking is because nicotine unlocks reward pathways, which regulates pleasure in the brain. Nicotine increases the levels of dopamine, which is a key main chemical in the brain, nicotine increases the amounts of dopamine in the reward pathways, making it harder to stop.

Nicotine also produces withdrawal symptoms. This is a key in determining if it is addictive, and these symptoms prove that. Irritability, craving, cognitive and attentional deficits, sleep disturbances, and increased appetite are all withdrawal symptoms that someone who is addicted may face.

Nicotine is absorbed at a fast rate. This can be from both chewing and smoking. Some can be exposed to nicotine for 24 hours or more if addicted. Smoking and chewing tobacco can have lasting effects on a person's health.

For many it is hard to stop but it can be broken, the cycle does not have to continue. (NRTs) are used in smoking cessation therapy. This includes nicotine gum and a transdermal nicotine patch, these are both FDA approved. These help break withdrawal symptoms. These help a person to have lower levels of nicotine.