What changes will occur in the body if an old smoker suddenly quits smoking?

Audit expert: Peng Guoqiu

Deputy Chief Physician, Fourth Medical Center, PLA General Hospital

May 31 is World No Tobacco Day. Smoking is called the "fifth threat" to humanity by the World Health Organization (WHO) (the first four are war, famine, plague, and pollution). According to the "China Smoking Hazards Health Report 2020" released by the National Health Commission, there are 350 million smokers in China, 740 million people suffer from the harm of secondhand smoke, 2 million people die from smoking-related diseases every year, and more than 100,000 non-smokers die from exposure to secondhand smoke. Tobacco-induced diseases have placed a heavy burden on individuals and families.

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In fact, now everyone knows that "smoking is harmful to health", and even some veteran smokers will decisively quit smoking for health reasons. However, there are also many rumors about quitting smoking that make people half-believe and half-doubt, such as that the body will get used to smoking for a long time, and that quitting smoking suddenly will make you sick, etc.

Are these claims correct? What exactly are the scientific methods for quitting smoking? Let's talk about them briefly.

Why is smoking addictive?

Nicotine in tobacco is the main substance that causes smoking addiction. After entering the lungs, nicotine is absorbed into the blood, causing the body's blood pressure and heart rate to increase, while also increasing dopamine levels. Dopamine activates the brain's reward circuit, making you feel happy. Studies have found that nicotine also enhances the "pleasure" brought by "visual and musical stimulation", which may be the reason why some people must smoke when playing games.

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However, nicotine is easily metabolized out of the body. As the amount of nicotine in the body decreases, the secretion level of dopamine drops rapidly, and smokers will feel irritable, uncomfortable, nauseous, have headaches, and crave nicotine. Once nicotine is replenished, dopamine will be released quickly again, and smokers will feel happy again, thus forming a nicotine-dependent "reward circuit" in the brain.

Among all kinds of addictive substances, nicotine is even more addictive than alcohol and marijuana. Many people start smoking out of curiosity or even follow the trend, but if they are not careful, they will become addicts. According to relevant data, about 33% to 50% of people will become regular smokers after trying smoking.
Is smoking harmful to health a “hoax”?

There are many studies on nicotine in the world, and there are different opinions on whether it is harmful or beneficial. However, so far, nicotine is not on the list of carcinogens, so some people use the reason that "nicotine does not cause cancer" to "whitewash" tobacco.

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In fact, the smoke produced by tobacco combustion contains more than 7,000 chemical components, of which hundreds of them are harmful substances, such as tar, carbon monoxide, acetone, arsenic, cyanide, etc., and 70 of them are known carcinogens. For example, cigarettes contain benzopyrene, which can enter the human body through inhalation and skin contact, causing serious harm to health and easily leading to a series of diseases such as skin cancer, stomach cancer, and lung cancer. Tar is also produced when tobacco burns, which can inhibit the body's immune function, cause gene mutations, and increase the risk of cancer.

In general, although nicotine does not directly cause cancer, its addictive side effects indirectly increase the harmfulness of smoking.

How does your body react after you quit smoking?

During the process of quitting smoking, the body often experiences some discomfort. These symptoms are called "getting sick after quitting smoking" by some old smokers, but in fact, this is a normal body regulation phenomenon, which is medically called "withdrawal reaction" .

Once withdrawal occurs, the digestive system will be temporarily disrupted, with symptoms such as abdominal distension, abdominal pain, nausea, heartburn, constipation, and diarrhea; the circulatory system will also experience chest tightness, shortness of breath, palpitations, etc. Since nicotine directly affects the brain and nerves, it can also cause anxiety, nervousness, and shallow sleep.

Although withdrawal symptoms vary, they do not cause serious harm to the body. It is more like the body is self-regulating and trying to adapt to the state without nicotine. It is a process of gradual improvement of the body.

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The degree of withdrawal symptoms varies from person to person, depending on one's smoking history, daily smoking volume, and smoking age. Generally speaking, the more you smoke and the longer you smoke, the more severe the symptoms are likely to be.

Symptoms may be most obvious within the first 14 days of quitting smoking, but then they will gradually subside and disappear. Most people's withdrawal reactions last about 1 month, but some heavy addicts may last for more than 1 year.

In general, as long as you persist through the withdrawal period, quitting smoking will be just around the corner.

How to quit smoking scientifically?

Smokers can be divided into two categories: one is non-addicted, and this type of smoker can indeed rely on willpower to quit smoking; the other is patients with tobacco dependence , which is difficult for these smokers to quit smoking by willpower alone, and they need to seek scientific and professional help to quit smoking. According to the 2018 Chinese Residents' Health Literacy Monitoring, the prevalence of tobacco dependence among smokers in China is as high as 49.7%.

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How to quit smoking scientifically?

1. Quitting smoking should be a ritual. You can announce your decision to quit smoking to your family, friends and colleagues. It is very important to get their encouragement and support.

2. Create an environment that is conducive to quitting smoking. It is recommended to dispose of all smoking-related items around you, such as lighters, ashtrays, etc.; try to participate in fewer or no gatherings with smokers.

3. You can prepare some smoking cessation drugs. In the journey of quitting smoking, especially in the first few weeks, withdrawal symptoms may occur. In order to deal with these symptoms, you can use smoking cessation drugs under the guidance of a doctor. Currently, only three types are recommended: nicotine substitutes, varenicline, and bupropion. Among them, the most effective smoking cessation drug is varenicline. If used alone, the success rate of quitting smoking can be increased to 27%.

4. Seek help from professional organizations. To better assist in the process of quitting smoking, smokers can also follow the WeChat public account "Online Smoking Cessation" and participate in online smoking cessation activities; they can go to smoking cessation clinics to receive professional smoking cessation guidance and treatment; they can also call the national smoking cessation hotline (24 hours) 400-888-5531; 400-808-5531 for immediate consultation and support.

5. It should be emphasized that smoking addiction is actually a disease. If you fail to quit smoking, please do not blame yourself or doubt your willpower. It is important to realize that smoking addiction needs treatment. Only by finding the right and scientific method can you move forward more smoothly on the road to quitting smoking.