• image.alt
  • With Mayo Clinic behavioral counselor

    Jennifer A. Kern, M.S., C.T.T.S.

    read biography

Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer
  • Quit smoking blog

  • Oct. 25, 2008

    With nicotine addiction, just one puff puts you on the slippery slope

    By Jennifer A. Kern, M.S., C.T.T.S.

30 comments posted

When going through the process of quitting smoking, I think it can be helpful to know something about how nicotine addiction develops. So here it is, in a nutshell.

Tobacco contains more than 2,000 chemicals. When it is burned, another 2,000 are produced. So when you smoke, you inhale more than 4,000 chemicals. Many of those chemicals are harmful to the body. Although nicotine is one of the chemicals in tobacco smoke, it does not directly cause cancer or other tobacco-related diseases. It is, however, what causes the addiction, making it difficult to stop smoking once you've started.

When you inhale the smoke from a cigarette, nicotine reaches the brain within 7-10 seconds. What it does when it gets there is stimulate the release of your body's own "feel good" chemicals, like dopamine. Because it happens so rapidly, your brain experiences instant gratification (like pleasure, relaxation, even a mild high), and you develop strong urges to want to smoke again.

Soon you develop memory pathways in the brain that connect smoking with the things you do when you smoke (drink coffee or alcohol, drive, talk on the phone, have sex). So even if you aren't smoking and you do these things the memory pathways still trigger an urge to smoke.

Using tobacco over an extended period of time causes chemical and structural changes to occur in the brain. When you continue to smoke, there is an increase in the number of receptors in the brain that are sensitive to nicotine and that react strongly to it. Over time, the brain may then require more nicotine to satisfy those areas (we call that tolerance) — so you gradually smoke more.

Stopping smoking typically leads to feelings associated with withdrawal — irritability, frustration, trouble concentrating, sadness, etc. This is essentially the brain's way of telling you that it wants and needs more nicotine. The proper use of nicotine replacement not only minimizes withdrawal by giving the brain the nicotine it needs, but it also in effect "reprograms" your brain to experience nicotine differently. When using nicotine replacement products, it takes anywhere from a few minutes to a couple of hours for the brain to get high enough levels of nicotine to relieve withdrawal symptoms, compared with 7-10 seconds when you smoke.

What this means is that with nicotine replacement medications, nicotine no longer provides the instant gratification that your brain craves. It's like eating a piece of chocolate, but having to wait minutes or hours to taste it! For most people, if you don't get the pleasurable flavor immediately, then it's not worth eating.

Once your brain realizes that nicotine no longer delivers that "quick fix," the number of receptors that respond to nicotine will gradually return to normal levels. But there's a catch — they never go away completely. Many are merely dormant, so to speak, and they always retain the memory of the effects of nicotine. That's what makes "just one puff" such a slippery slope once you've quit — even months or years later.

30 comments posted

blog index
  • November 17, 2009 7:11 p.m.

    Hi, I'm a student at Metro State of Denver. I'm researching a new product possibility; the product would be a "Quit Smoking" aide that offers a stepping down approach. I am a former smoker myself but I'm addicted to Commit lozenges and they contain nicotine. I would still buy them if they had zero mg of nicotine but they don't offer that. I would like to market a product that does. Anyways, I made this survey for my research project and it would really help me if anyone could take it [smokers, former smokers, and non-smokers are all welcome] Thanks so much. -- Casey Here's the link to the survey. http://www.surveygizmo.com/s/206243/r2zgt

    - Casey

  • November 9, 2009 9:33 a.m.

    I smoked for more than 30-years. I started as a curious 12-year-old walking to school and picked up a butt on the ground along with some matches I had taken from the house (my parents smoked) I became addicted. By the time my mom found out, I was 16-years old and there was no turning back. I am so sorry that I ruined my beautiful lungs. I was athletic when I was younger, but the addiction to nicotine would steal my natural inclination to be active. I finally stopped after being dx with advanced lung disease. Please do not wait to get to this point. Please stop while you are still able to enjoy your life. You will not regret it. I swear. Teach your children about the importance of their lungs. You can't see your lungs so it is important for teach children about how important they are. Take them for walks, and runs, and let them feel what O2 feels like in their lungs. Then make them sit on a chair and tell them not to move from the chair. After 3 minutes they will scream to be let go. Show them that lung disease makes a person tied to a chair forever until death. Please take an active role in being the one that teaches children to never smoke.

    - Victoria

  • September 15, 2009 9:24 p.m.

    Cigarette addiction is just like any addiction: you can't just have one! I believe that cigarettes were the gateway drug for me. It lead me down the wrong path from one addiction to another. Please read my article: http://www.soberliving.com/blog/the-real-gateway-drug-marijuana-vs.-cigarettes

    - Jay

  • September 9, 2009 8:13 p.m.

    I'm at day 30 without smoking. Motivation and a lot of willpower helps. I'm hoping upon hope I can keep this up!

    - CWDC

  • August 26, 2009 9:40 p.m.

    Thanks GOD, Family, Friends and CHANTIX after been a heavy smoker for 28 years today is my fifth month with out a cigarette. Just believe on your self. If I did, You can do it. Best wishes and a good life.

    - Cassia

  • July 16, 2009 9:05 p.m.

    I just completed day 7 of no smoking after many attempts during 50 years of smoking. I agree with couldabeen shelly - you just have to face the fact that you're an addict and only You can make you quit. For me, the quit came down to I was sick of lying to myself that the cigarettes weren't going to kill me (let alone the fact that the price has gone up to $6/pack). The addiction cravings are kicking in tonight, and are worse than the first few days without a cigarette, but I'm going to hang in there until it's time to go to bed. I tell myself every day, You can't get to tomorrow and another smoke free day, if you don't get through today. We all have our own ways of coping and mine just has to be tough love and a brutal reality check. Wish me luck, and good luck to all of you, too.

    - MaudeRose

  • April 24, 2009 11:09 a.m.

    I am a woman in my early 40's who just suffered a heart attack about a month ago. Smoking was one of the things that I knew I had to stop, even though I loved it so. It has NOT been easy but the real trick is not chewing on gum eating veggies or taking walks or whatever. The very bottom line is that you have to face up to your addiction and be stronger than it is and flat out tough it out and not smoke. That sounds harsh but it is the truth. You just have to DO it. I am not a person with much willpower at all, that's why I have smoked for almost 30 years. But I HAVE stared it down and it IS tough but I AM doing it. Stay tough !!

    - couldabeenshelly

  • March 31, 2009 7:52 a.m.

    I agree with most of this post. One item though does concern me. There are studies out there that do show that nicotine alone has caused various cancers in rodents. The other thing is that I am perplexed how even the Health Industry promotes NRTs as a way to Quit smoking. Its comparable to telling an alcoholic to wear a alcohol patch that delivers a smaller amount of rum than what this alcoholic is used to drinking on a daily basis. Do you actually hear what you and others are saying when promoting NRTs. Your saying okay now listen people your addicticted to a chemical and this is why and this is what you need to do continue using it at smaller levels and you will be free of your addiction. I think a 7 year old could deduece that there is something seriously conflicting with this type of promotion. Most professionals will say but this helps addicts get through the withdrawals of quitting. It takes the edge off. No kidding. The reason it takes the edge off is because the addict is getting the substance through a different delivery device. That is basically all NRTs do, it changes the way a person gets his fix. Sure, its a smaller fix but it is still a fix. The key to recovery is to stop taking in the addicting substance. Then and only then is one on their way to recovery. Yea, they go through withdrawals. But after day three they get less extreme and farther apart. Which is alot better than being on a chronic withdrawal for weeks and months using NRTs. Repackaged Nicotine=$$$$

    - Marvin

  • February 12, 2009 8:57 p.m.

    As everyone knows nicotine is not good for our health it effects our body internally. So it is my humble request to all please quite smoking. ============ Liza The Lemonade Diet is the portion of the Master Cleanse where you drink only the Lemonade made from Lemon, Maple Syrup, Cayenne Pepper and Water. It is great for detox and weight loss and has a large following of people who have tried it with great success. The Lemonade Diet Cleanse Directions

    - Liza

  • January 21, 2009 4:04 p.m.

    Beth - I'm on day 17 w/o the butts. Ask your doctor if you can go on the patch. It helps take the edge off. Also, read all you can on how bad cigarettes are for you. I'm sure your baby will be fine as long as you continue to be smoke free ... and remember, one day at a time!

    - Lily

  • January 18, 2009 2:08 p.m.

    Today is only day 1 for quitting smoking for me. I have smoked for 15 years, and I am struggling very bad right now, so I am turning to this blog. I love smoking so much, but with the combination of being 4 1/2 months pregant and going through 2 biology classes that really taught me alot about being healthy, I am trying my best to be strong. Several days last week I was able to go about 10 hours without one, but I feel like today is the day to just do it. I have heard that stress is worse on a baby over a few cigarettes a day, and when I think of that, I just want "one more". So what is true? I am desperately seeking ways to stop myself from going to the gas station really quick. The problem is I know if I have one, then I will convince myself it is ok to have another one, especially since I have another pack. I was smoking up to 3/4 pack a day, but sometimes smoking only 1/2 pack or less, but is my baby ok? I am so worried, and struggling at the same time. I hope to gain so much inspiration, and support from this blog. HELP YOU GUYS! What else can I do to not go get that pack!?!?!?!?

    - Beth

  • January 15, 2009 5:07 a.m.

    I've never smoked in my life. Both my parents smoked. In 2007 I was hospitalised for almost a month due to heart failure. Almost died and the doctors told me it is because of the "second hand" smoke I inhaled. I don't blame my parents. But I have to live with the consequences every day. NOT NICE!

    - Ann

  • January 8, 2009 8:08 p.m.

    A recovering Alcoholic and Addic I am now done with this too. It is just like the other stuff for me I cant have just one puff or i will be smoking a A pack a day today. That is my truth

    - mischelle

  • November 23, 2008 2:23 p.m.

    It is so hard to quit, so sad. It is like loosing your best friend. I miss it, thought I know it is not good for me. Crazy I am disturbed when I hear or see an abusive couple, especialy the one that is being abused, so why do I miss it so much

    - JJ

  • November 20, 2008 1:34 p.m.

    Forgot to say I am using commit lozenges

    - turdle

  • November 20, 2008 1:31 p.m.

    Smoked for 50 years. Became a closet smoker after cancer was detected. Cancer free for 12 years. Tobacco free for one month tommorow

    - turdle

  • November 19, 2008 3:01 p.m.

    I quit by using the nicotine patch. Even after I discontinue using it for several weeks, I still don't smoke. Then, knowing full well that I will become a full blown addict again after one cigarette, I still smoke it because it sounds so good. Plus, after not smoking for several weeks, I lose sight of how bad smoking can make you feel. So with my rested lungs and completely clear of mucous throat, a cigarette only sounds that much better on a crisp autumn morning with a steaming cup of coffee. Right now, I am on the patch again. I have a love/hate relationship with cigarettes...it is hard to picture life without them.

    - Crystal

  • November 18, 2008 10:31 p.m.

    I've been a heavy smoker in the past (2 packs per day) and quit thinking I could never do it but I did and stayed that way for 10 years when the just one puff phenomenon got me back on to smoking during a stressful time. Then I quit again and was good for another few years, until eventually got tired of being over weight. I just stopped 3 months ago ( I was getting symptoms of peripheral vascular disease) and can not say how I did it: avoid the patches, drugs etc they just delay the awful business of stopping doing something you love to do. My experience is you have to just stop, night before throw all smoke things away, do it on weekend when loved ones who don't smoke are around, get through day 1, that is the worst, go for a 5 minute walk when you feel urge to smoke or lie down for 5 if its raining. Day 2 is also hard and day 3 too, then it gets easier although first week and then first month have their challenges. Every day put the money you would have spent into a jar, that helps too especially when you work out what it adds up to in a year. You have to get over seeing smoking as being " a treat" or a bonus or a little holiday from something stressful and see it as contributing to your problems instead. I did it you can too - good luck. Oh by the way, apparently it takes a few attempts before you are successful in the longer term. What is hard is that you can buy cigarettes everywhere. But persist - its worth it.

    - A. Stewart

  • November 18, 2008 4:10 p.m.

    I agree with Dan's arguement about if everyone in the health field and the government knows without a doubt that smoking can cause major health problems or even death, why do we sell them? It's all about the profits from the tobacco people. I know I'm probably in denial but it's hard for me to believe in any health information that is fueled by the money from the very people who are supposedly putting my health in danger.

    - Sally

  • November 18, 2008 1:34 p.m.

    I learned on Sept 15th that my nuclear stress test for my heart showed something was wrong. That is the day I became a non smoker. On Sept 22nd I had 5 bypasses done. I am only 52 and my main risk factor was smoking. I did this to myself and even today I want another cigarette. Having just one puff is my biggest fear, knowing that after just one puff I will start again. I tried Chantix before and couldn't deal with the side effects. I am taking wellbutrin now and hopefully that will help me to stay smoke free.

    - Lori

  • November 12, 2008 10:46 a.m.

    I was a 2 pack a day smoker for over 30yrs and my husband was a 3 pack a day smoker. We both quit November 1, 2006 with Chantix and have been smoke free ever since. This is a wonderful drug, sure there are few side effects, but the outcome is well worth it.

    - Connie

  • November 11, 2008 8:45 p.m.

    It wasn't until after my mother died seven years ago that I realized why I smoked: she was my trigger. Once that realization hit me and I dealt with the emotions tied to it all, I was able to quit smoking in about two weeks. That is NOT to say that I have never wanted another cigarette, but without my buttons being pushed by Mom, it was far easier - for me - to pass it up. While she was alive, I'd tried quitting probably six times, but to no avail. Unfortunately, it took her death for me to get the picture. Additionally, I was diagnosed with Raynaud's Phenomena two years ago, so the "no-smoking" plan is the only way to go - and still keep my fingers and toes. BEST of luck to those fighting the battle of the butt.

    - Maggie's mom

  • November 2, 2008 11:30 p.m.

    I have now been smoke-free for over 90-days. I was very native in that I trusted a Dr. to make decisions about my health. I started taking Chantix on July 23, 2008, I stopped smoking on August 5, 2008. On August 15, 2008 I quit taking the morning dose as the nausea was took much. I saw the Dr. for the one month check up on August 23, 2008. He advised me at the time, in order to decrease my chances of relapse, I should finish any remaining medicine, especially since I was only taking half the recommended amt. When I asked if I would need to see him again for a follow-up appt. he stated that it was not necessary and congradualated me on being able to quit. I took my last dose of Chantix on October 10, 2008. All I can say is that yes Chantix works, but I feel that Chantix is a powerful drug and when used in conjunction with supervision by qualified medical staff , trained to recognize changes in personality, Chantix can be dangerous, especially if is prescribed by a Dr. who does not even have a relationiship, he was my husband Dr. I only seen him to get the Rx. to stop smoking. I survived my Chantix experience with a new found appreciation for sanity. I feel that I had a horrible reaction similiar to a person who is allergic to penicillon, I am slowing getting back reality with the love and support of my family. I am here today because of them. Hindsight is 20/20.33jen

    - jen

  • October 30, 2008 10:15 p.m.

    As a lifelong non-smoker, I’m happy to see the depiction of smoking being taken seriously. It’s a terrible and deadly habit that has been foisted on the public through unscrupulous marketing based on corporate greed.

    - brianna

  • October 29, 2008 10:21 p.m.

    A PUFF AWAY FROM A PACK A DAY. I've heard horror stories about people with years free from cigarettes -- in one case six, and in another case THIRTY -- pick up the habit again after trying just one puff. That led, often not immediately, but within days or a few weeks, to bumming a smoke, then to buying a pack. Within weeks, the person was right back to where he or she was before the first quit. I quit through Nicotine Anonymous. I smoked for 37 1/2 years, and I thought I was going to go to my grave a smoker. I'm free of nicotine for 8 years thanks to Nicotine Anonymous. I keep going to meetings because I want to stay free. - Ladd J.

    - Ladd

Post a comment
Next page

Text Size: smaller largerlarger