Quitting Is A Drag, But So Is Lung Cancer

Back when I was a fiscally struggling undergrad (my, how things don’t change), I took a series of lab-rat gigs at VCU. The money wasn’t great, but it paid out right away and I didn’t have to donate anything other than my time, patience and a little blood. The studies were only for tobacco research and required that I be a smoker. This is a preface to the bigger story, the current one of my becoming a non-smoker.

One of the gigs required that I stay overnight, go without coffee two days prior and no cigarettes were allowed 12 hours prior to check-in at MCV hospital.

Once settled in, I was given a series of hourly tests that involved my cognitive reflexes and memory retention. I found it rather interesting that they wanted to know how my brain worked without tobacco.

I interrogated the doctors and researchers about tobacco and the brain to learn just why nicotine is so addictive. Here’s what I’ve learned and why it is so hard for many of us to just quit cold turkey.

Simple science behind addiction

There is a perception out there that tobacco is merely a physical addiction. See, the tricky thing is that your brain is a tangible, physical part of you, but there are also many complex, mysterious things happening inside it that we can’t see. Science has made huge leaps in explaining some of it. Point being, they’re connected—mind and body. Withdrawal isn’t simply about nicotine decreasing in the bloodstream (physical), it is also about the way your neurotransmitters are firing messages (mind).

A smoker is going through nicotine withdrawal the minute they put out a cigarette. Let’s be science-like and call it pain conditioning. Pain conditioning (and pleasure conditioning) involves neurotransmitters that reinforce the neural pathways which develop with newly learned behaviors.

Think of a neurotransmitter as "an automobile wearing ruts in a gravel road."

This applies to all types of behavior and learning—from avoiding touching a hot iron to associating an "A" on a test with a reward. I could go on with the examples but, basically, that "deep neural rut" in your neural pathway is what makes a reaction become automatic.

For smokers, the reactions are provoked by times, meals, activities and emotions.

Nicotine changes the brain

As a smoker, you’re accessing both pain and pleasure neurotransmitters. Pleasure when you light up and pain in the absence of the inevitable, next cigarette.

Essentially, and there is more science involved, a smoker’s brain has been re-wired and is different from a non-smoker’s brain. The brain has a very important receptor in it, acetylcholine, that is responsible for improving a number of activities and behaviors throughout the whole brain, for example, concentration and memory.

Strangely enough, the natural chemical nicotine binds with those receptors.

Although the use of heroin will create neural pathways, heroin doesn’t have an affinity for major receptors in your brain like nicotine does. Hence, this is why people say it is harder to quit smoking than to quit heroin.

Hope you’re still with me.

It gets weirder. When you smoke chronically, nicotine changes the pattern of release of acetylcholine and other receptors. The brain has to adjust, so it responds by creating a balance of this new activity. As above, a smoker’s brain has been re-wired. Nicotine burrows deep into the brain and affects a smoker in physiological and psychological ways.

To the point: No wonder it is hard to quit. Obviously. There are people still desperate to spark-up cigarettes despite losing a larynx, lung or trachea.

Makes me wonder if tobacco were discovered today, would it be classified as a more dangerous drug?

Quitting Assistance

For me, cold turkey belongs on a sandwich. It didn’t work when it came to smoking. Some heroes can do it, but most people need assistance. I’ve really enjoyed smoking for the past two decades, but it’s time to stop. It goes against a culture of health that I want to create and it’s starting to mess up my ability to run up and down a basketball court. While Virginia has the lowest cigarette tax in the nation, these neural-receptor-altering goodies are getting too pricey. Beware; it’s only going to go up from here.

Enter Chantix, or shall we say enter Sandman, because the most common side effect of the medicine is vivid dreaming, or nightmares. Chantix is a one-to-three month prescription that runs almost $200 and isn’t covered by most insurance.

Some of the other listed neuropsychiatric side effects are suicide, depression and hallucinations.

Awesome. The hallucinations and vivid dreaming, I mean.

Listed side effects of Chantix include:

Some people have had changes in behavior, hostility, agitation, depressed mood, suicidal thoughts or actions while using Chantix to help them quit smoking...

If you, your family, or caregiver notice agitation, hostility, depression, or changes in behavior, thinking, or mood that are not typical for you, or you develop suicidal thoughts or actions, anxiety, panic, aggression, anger, mania, abnormal sensations, hallucinations, paranoia, or confusion, stop taking Chantix and call your doctor right away...

The most common side effects include nausea (30%), sleep problems, constipation, gas and/or vomiting...

You may have trouble sleeping, [or experience] vivid, unusual or strange dreams while taking Chantix...

How It Works

I’ve always laughed at those pharmaceutical commercials that suggest they can cure your ailment but at the cost of say, uncontrollable projectile vomiting.

Chantix was appealing to me because I know people who have taken it, they’re still alive and, even better, they’re smoke free.

There is a science behind Chantix that boosts our chances of quitting.

It brings two weapons to this kicking-the-habit fight. First, it targets and partially activates those acetylcholine receptors, which eases the withdrawal. My guess is this helps battle the harder part of re-wiring your brains receptors. Chantix blocks nicotine from reaching the receptors.

The second way it helps combat the acute withdrawal is by interfering with the pleasure/pain conditioning. Chantix blocks the nicotine receptors and, by doing so, triggers a little release of dopamine.

When a smoker takes a puff, a jolt of pleasurable dopamine hits the brain. The smoker craves dopamine once it wears off and there you have the vicious cycle of smoking.

The first week on Chantix, you actually smoke. After the medicine is built up in the body, Chantix begins to block nicotine from activating the nicotine receptors. So even if there is a relapse, the smoker won’t get the usual pleasure from their cigarette.

Basically, the pleasure, enjoyment, sexiness—all that is gone. I’ve been left with a dull, expensive, unrewarding, stinky thing in my hand.

I’m on day seven as I write this. Today the medicine doubled and I can definitely tell. I’ve cut my smoking down drastically and when I do smoke, the flavor and satisfaction are gone.

There are still tons of triggers and emotions happening, which is part of the process. Twenty years of habit isn’t broken overnight.

So be kind to me if you see me around town.

Alix Bryan is a Production Assistant at CBS6. She covers a variety of topics for Richmond.com and hopes you send your story tips and suggestions to her. Alix has visited every state in America except Alaska, and is happy to be back in Richmond. Give her a follow on Twitter.