Quitting Time?

When smokers want to banish cigarettes from their lives, some try going cold turkey, some try hypnosis, and some replace them with chewing gum or nicotine patches to end the habit.

“Approximately 34 million American adults currently smoke cigarettes, with most of them smoking daily. Nearly all adult smokers have been smoking since adolescence. More than two-thirds of smokers say they want to quit, and every day thousands try to quit,” Robert R. Redfield, M.D., director of the Centers for Disease Control and Prevention (CDC), says in the U.S. Surgeon General’s 2020 “Smoking Cessation” report.

But research by the CDC shows these efforts can go in vain: Fifty-five percent of American smokers said in 2018 that they tried to quit in the previous 12 months, but only 8% actually did.

What are some of the challenges to quitting today?

• According to the surgeon general’s report, nicotine is a highly addictive drug. The National Institute on Drug Abuse says it takes only a few seconds for the nicotine from one puff of cigarette smoke to reach the brain. The drug causes brain cells to release dopamine, a neurotransmitter that plays a crucial role in humans’ feeling pleasure. Over time, smokers’ brains come to demand those regular dopamine bursts, leading to intense cravings when a smoker tries to quit.

• The CDC reports that many smokers make multiple attempts at quitting before they’re successful. While 8% of smokers said they had quit in the past 12 months, the Food and Drug Administration finds that it can take many attempts over months or years for a smoker to fully kick the habit.

• In addition, a 2017 CDC report on “Quitting Smoking Among Adults — United States, 2000-2015,” points out that smokers with private health insurance reported a higher rate of quitting smoking (9.4%) than did smokers who were uninsured (5.2%) or enrolled in Medicaid, including people with dual Medicaid-Medicare eligibility (5.9%). It’s possible that smokers who are uninsured or enrolled in Medicaid may have a harder time quitting because they are less likely to have affordable or no-cost access to smoking-cessation programs and medication regularly covered by insurance, or to see health care providers as often as those who have insurance.

While the CDC finds that cigarette smoking causes about 1 in every 5 U.S. deaths annually, the nation’s smoking rate has steadily fallen — it reached an all-time low of about 14% in 2018. And as of 2018, 55 million American adults had quit smoking. But it’s important to note that e-cigarette use is on the rise — it increased from 2.8% to 3.2% between 2017 and 2018, according to this CDC report, which marks a significant increase in adult e-cigarette use that was detected for the first time.