<p>“During Tuesday’s meeting, the San Francisco Board of Supervisors voted to approve two bills further limiting where and when city residents can smoke tobacco.”</p>
<p>Good moves, but how is it that the smoking rate is still in the neighborhood of 15%?</p>
<p>Studies have shown that smoking is on the rise in "young’ people. I think from my totally unscientific viewpoint that it’s because they didn’t grow up in a house where their parents smoked and don’t really get how disgusting it really is, let alone dangerous.</p>
<p>Because some folks are having a very, very hard time quitting. Working in health care, I see this frequently. People who are being killed by the habit, yet can’t stop smoking, despite the offer of all sorts of interventions. Now the interventions are being tweaked more, because it is realized that those who have quit easily have already done so. </p>
<p>Of course there is a certain amount of arrogance in some of the remaining smokers. Why should I quit? They like smoking, and don’t like the health care world telling them what to do.</p>
<p>when someone tells you repeatedly not to do something, it gets you really curious. I’ld honestly love to try smoking just once, but I won’t. not everyone restrains themselves though</p>
<p>1) Nicotine is a staggeringly addictive drug. By a fluke of nature, nicotine molecules bind to a particular set of receptors in the brain that trigger dopamine releases. Dopamine releases in the brain is the reward mechanism that reinforces behavior – the same reward pathways as cocaine and heroin addiction. The nicotine hits the brain 8 seconds after the first puff, pretty much like crack cocaine. Trigger these reward pathways 20 or 30 times a day and you not only have an intense physical addiction with strong withdrawal component, but very effective behavior training to associate every daily activity with the drug fix. It is a ridiculously hard addiction to break.</p>
<p>2) The current approach to “helping” people quit smoking is completely screwed up and counter-productive. You don’t “help” someone break a drug addiction by encouraging them to continue using the drug in a different form. Smoking rates declined steadily until the introduction of over-the-counter nicotine gum and patches. The success rates for cessation stopped in their tracks. Over 90% of the ex-smokers in the world quit cold-turkey (just stopped using the drug, got thru the withdrawal, and moved on). The “experts” (not to mention the drug companies who sell drugstore nicotine) now tell smokers to not think about trying to quit that way. It is nearly impossible to quit smoking while continuing to be a nicotine junkie. No other delivery mechanism comes close to the effectiveness of inhaling nicotine, so even someone who has chewed nicotine gum for years is at incredible risk of smoking again.</p>
<p>3) Some studies have shown that some people show signs of physical addiction after smoking just a few cigarettes. One hypothesis is that babies born to smoking mothers are actually born with dormant nicotine addiction that is re-triggered very quickly if they experiement with smoking. Statistically, almost nobody starts smoking as an adult. The addiction almost always starts in the teen years.</p>
<p>In the case of two family members that I know, both are extremely addicted. There is also a bit of the “you’re not the boss of me” mentality. People who refuse to wear seat belts seem to fall in this category as well.</p>
<p>Taking the challenge one step further. Nicotine completely swamps these brain receptors. As a defense mechanism, the brain desensitizes or “down-regulates” the receptors. Now, nothing that is supposed to trigger a dopamine release (a good meal, etc.) can do so. The next hit of nicotine is required. That’s why nicotine junkies can’t finish a meal without the powerful need for a cigarette. The whole reward mechanism in the brain is hijacked and remains hijacked.</p>
<p>A study did brain imaging of this reward center. They had smokers quit for a week or so, then had them smoke one cigarette. Just one completely hijacked all the receptors again. Just one puff hijacked over half the brain receptors. So, people quit smoking, think they can have just one, and the first puff triggers the full physical addiction again.</p>
<p>I quit. I haven’t thought about smoking in years. But, I know that one puff would almost certainly result in a progression back to a pack a day. You really have to think of it in the same way as heroin addiction.</p>
<p>I never liked smoking when I tried it. I found it overwhelming to my concentration to be holding a little fire in my hand. Couldn’t focus on anything else, and didn’t find it particularly enjoyable. </p>
<p>It was clear how addictive it was to some people, though. I’ll never forget commuting and seeing people able to walk briskly away from the PATH train, having lit a cigarette without breaking stride, all in the first four steps (not exaggerating).</p>
<p>What is amazing to me is how sharply the smoking rate dropped from about 1975 to 1990. Truly remarkable. Not talking about statistics, but just observation of work environments.</p>
<p>From my equally unscientific viewpoint, I agree with you.</p>
<p>My parents smoked. They used to smoke and chat after dinner, after the kids left the table, and put out their cigarettes on their plates. It was my job to wash the dishes, so I had to scrape those plates. I found this so disgusting that never in my life have I been able to bring myself to smoke anything (not tobacco, not marijuana).</p>
<p>Thank you, Mom and Dad, for having such a disgusting habit and for the inexplicable absence of ashtrays from our dining room table.</p>
<p>I also can’t bring myself to eat anything with ketchup on it because I had to scrape the ketchup off their plates, too. But this is a small price to pay for a lifetime of freedom from tobacco.</p>
<p>VH, my dad as well, age 74. I often think about how he and my kids might have developed satisfying adult relationships, as they’re following in his footsteps in so many ways. But he left the hospital after his first stroke, and bought a pack before going home. </p>
<p>Marian, the smell of bacon and cigarette smoke are tied together from my earliest memories. Never have liked bacon, just a nauseating smell. My dad would cook the weekend breakfast while smoking. I totally understand!</p>
<p>I am the poster child for second hand smoke. My childhood was a never-ending stream of asthma, bronchitis, pneumonia, repeated ear infection (and now hearing loss), etc. Still couldn’t get my mom to quit. I am highly allergic to tobacco, something we found out later. I know my mom feels incredibly guilty and a small part of me is angry because I wouldn’t have had these issues if she hadn’t had an addiction. My ex smoked and even when he would smoke outside and come back in, I would start having physical reactions. </p>
<p>Now that my mom has a severe form of Graves Disease, she finally quit (mostly). I have a few friends that smoke cigarettes but luckily not many. Actually, come to think of it, I don’t know a single person at school that smokes. All the smokers I know are those back home who never went to university. Hmmm… </p>
<p>Personally, I don’t get it. It’s nasty and I have severe physical reactions to it. Michigan going smoke free in buildings is one of the best things that’s ever happened to me. I can now go out to eat without paying greatly for it. When I travel out of state, I forget that it’s not universal and I purposely look for restaurants that are smoke free. </p>
<p>Even if you don’t think it’s disgusting physically, it’s SO expensive. That would deter me even if the physical things didn’t.</p>
<p>You have to feel for the guy. Being a nicotine junkie is a horrible way to live. Waking up every morning in drug withdrawal. Feeling the stress of drug withdrawal every hour or two, until you can smoke or chew a piece of gum.</p>
<p>That all goes away a few months after they stop using the drug, but it’s so hard for the addict to believe they can get their freedom.</p>
<p>When I see people huddled outside in the rain smoking, my mental image is the standing in a circle injecting themselves with syringes. Same thing… it’s sad. It really is horrible to be trapped like that. This day and age, they are treated like lepers.</p>
<p>GLM, that’s interesting – my mother was also 74. She started smoking at age 14 and a few months before she died was diagnosed with what she referred to as “a touch” of emphysema. That always struck me as being “a little bit pregnant,” but – whatever.</p>
<p>Okay, so it’s extremely addictive. But why are all these young kids starting up? I know I know, youthful rebellion. But that’s not the same as drinking, which can be a positive experience when done responsibly. There is no responsible use for cigarettes.</p>
<p>They have been told from infancy that smoking is bad, and I’ll bet even if their parents smoked they told them not to start. I just don’t get it</p>