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Brain scans of smokers taken before and 24 hours after quitting showed increased activity in certain areas of the brain that cue the person to crave a drag when they view photographs of others smoking, according to research published online Jan. 5 in Psychopharmacology.

“We saw activation in the dorsal striatum, an area involved in learning habits or things we do by rote, like riding a bike or brushing our teeth. Our research shows us that when smokers encounter these cues after quitting, it activates the area of the brain responsible for automatic responses. That means quitting smoking may not be a matter of conscious control,” researcher Joseph McClernon, an associate professor in the department of psychiatry and behavioral sciences at Duke University Medical Center, said in a news release issued by the school.

“So, if we’re really going to help people quit, this emphasizes the need to do more than tell people to resist temptation. We also have to help them break that habitual response,” he added.

“Only five percent of unaided quit attempts result in successful abstinence,” McClernon said. “Most smokers who try to quit return to smoking again. We are trying to understand how that process works in the brain, and this research brings us one step closer.”

Study co-author Jed Rose, director of the Duke Center for Nicotine and Smoking Cessation Research, said previous research he conducted showed that wearing a nicotine patch and smoking a cigarette with no nicotine breaks the learned behavior.

“The smoking behavior is not reinforced, because the act of smoking is not leading them to get the nicotine,” Rose said in the news release. “Doing this before people actually quit helps them break the habit so they start smoking less. We’re seeing people quit longer this way.”


From the department of the obvious comes this advice.

If you smoke and you’re pregnant or planning to become pregnant, it’s especially important to kick the habit now. The toxic chemicals inhaled when you smoke are easily passed to the unborn baby.

The American Pregnancy Association offers these suggestions to help you stop smoking during pregnancy:

  • Make a list of all of the health benefits of quitting for yourself and your baby.
  • Replace smoking with healthier habits, such as having a snack or a cup of tea with your newspaper, instead of a cigarette.
  • Surround yourself with nonsmokers.
  • Have a friend or family member ready to call when you need support.
  • Ask your doctor for ways to help you quit, including tips on which smoking cessation aids are safe for you and baby.
  • Set a goal date for quitting.


The American Lung Association developed the Quit Smoking Action Plan under the guidance of a team of experts on cigarette smoking.  It offers specific recommendations for selecting a personalized plan to free yourself of cigarettes and stay that way.

To help you better understand your options, the material is presented in the following 3 Steps of a Quit Smoking Action Plan, along with charts to guide you through each step.

A Deadly Combination: Addiction and Behavior

Nicotine is a powerful drug that raises mood, reduces anxiety, and, in those accustomed to it, increases alertness. Over time, it causes changes in smokers’ brains that make them need nicotine. Then, when they try to quit, smokers have unpleasant symptoms such as irritability, craving for cigarettes or difficulty concentrating.

An additional obstacle to quitting is the many daily behavior patterns that smokers may not even realize they have, such as morning or before-bed cigarette routines, or smoking with friends, co-workers or spouses. Each person’s smoking behavior is different, but these established patterns link smoking to many activities of daily life. These are called triggers.

People who are fairly dependent on cigarettes need to incorporate multiple sources of help in their quitting plan to maximize their odds of success. Those who are less dependent on cigarettes may be successful by using only a few sources of help. However, the more help you have, the better your chances of quitting and staying smoke-free.

Be a Smart Quitter!

There are many programs to help you quit smoking. The cost of these programs may vary from almost nothing to hundreds of dollars. A higher cost does not guarantee success. Many health plans and worksites provide free quit-smoking programs and some health plans cover the cost of medications to help you quit. Check with your insurance carrier or employer for more information.

Before investing your time or money in a program, ask questions such as:

  • Is there a cost to you?
  • Is the program convenient for you?
  • Is the staff well trained and professional?
  • Does the program meet your needs?
  • What is the success rate of this program?

A program representative should be able to answer your questions. If they can’t, keep looking. There are no tricks or magic bullets to make you stop smoking. If a program seems too easy, guarantees you will quit, or claims a success rate that sounds unrealistic, look elsewhere.

Examining Your Options


STEP #1: Preparing to Quit

What You Need to Do

1. Identify your personal reasons for quitting.

2. Set a quit date, usually within 10 days to several weeks. If you smoke mostly at work, try quitting on a weekend. If you smoke mostly when relaxing or socializing, quit on a week day.

3. Identify your barriers to quitting (such as your spouse smokes or you’ve relapsed before due to depression or weight gain). You’ll find sources of help in this booklet to overcome these barriers.

4. Make SPECIFIC plans AHEAD OF TIME for dealing with temptations. Identify two or three coping strategies that work for you (such as taking a walk or calling a friend).

5. Get cooperation from family and friends. They can’t quit for you but they can help by not smoking around you, providing a sympathetic ear and encouragement when you need it and leaving you alone when you need some space.

STEP #2: Using Medications

What You Need To Know

When you smoke a cigarette, a high concentration of nicotine enters your body rapidly and travels to your brain. Nicotine medications provide you with a safer alternative source of nicotine that enters the body less rapidly and in a lower concentration than cigarettes. There is much unfounded concern about the safety of nicotine medications even though they have been extensively tested and used by millions of people. Unlike cigarettes, which contain thousands of harmful chemicals, nicotine medications contain small doses of nicotine alone to combat cravings and urges to smoke.

To optimize your chances of success, generally medications should be a component of your Quit Smoking Action Plan. However, not everyone who decides to quit smoking will want or need to use them. Depending on the medication you use, you may need a prescription. As with any medication, consult the package directions or your pharmacist before using. If you are pregnant, consult your physician; if you are taking other medications, consult the doctor who prescribed them or your pharmacist. The flip side of this would be the use of a product that did not have any medication in it nor tobacco, such as the product Smoke Away

Your goal in using nicotine medication is to stop smoking completely. If you plan to take nicotine medications, begin using them on your quit day. If you continue to have strong urges to smoke or are struggling to stop smoking completely, ask your healthcare provider about additional help.

If you take the non-nicotine medication,  it should be started about 7-10 days before your target quit date.

Other Tips for Using Medications:

  • Ask your physician or pharmacist for advice if you are uncertain about which medication to use.
  • Learn to use the medication you choose (examples: apply patches properly, use nicotine gum, nasal spray or inhaler as recommended on package labeling).
  • Many experts believe nicotine medications are often taken for too short a time to be of full benefit to users. For this reason, your healthcare provider may advise you to use your medication for a longer period of time or in combination with another medication. However, if you take these medications on your own, do not deviate from package directions.

STEP #3: Staying Smoke-Free

What You Need To Remember

After quitting and getting through the first couple of weeks, staying off cigarettes is critical—and not always easy. Research indicates that continued support and encouragement from health providers, family, friends and other sources are extremely helpful. 

Your friends and family won’t automatically know how to encourage you. Talk to them ahead of time about what they can do. Also, think about who you want to give you encouragement—someone who will stay positive even if you have some problems along the way.

The average person makes two to four attempts at quitting before they are able to stay smoke-free. If you return to smoking, it doesn’t mean you can’t quit. It just means you need to try again by figuring out what caused you to slip and improving your plan for next time.

You may want to use medications this time if you have tried to quit without them in the past. Or you may want to try a different group, individual counselor or other source of help if you’ve been unsuccessful at quitting on your own.

Some smokers wrongly believe they can reduce their health risks and continue to smoke by substituting other forms of tobacco. Low tar/nicotine cigarettes are not safer than cigarettes, nor do they reduce your risk of smoking-related disease. Smokeless tobacco, pipes and cigars also are not safe. Remember in the end, it will be up to you, and your support network that ultimately decides whether this will be your final quit.

Here is a video that will make you think the next time you or your friend takes a drag on a cigarette.

And another…

On the lighter side, or maybe not?

Now that you have seen what smoking can do to you, as if you had not already known that, isn’t it time you did something about it?

Quit Smoking Card

1-800-Quit-Now is a national router number which accepts callers from throughout the nation, seamlessly directing them to the appropriate state quitline. In an effort to promote this valuable resource, the Smoking Cessation Leadership Center has developed a small, plastic card the size of a credit card to help promote the new national quitline, 1-800-Quit-Now. If there is no state-run quitline, the call goes to the National Cancer Institute (NCI) quitline. By the end of the year, every state will be able to offer smokers this valuable service.Quitlines are toll-free telephone centers staffed by trained smoking cessation experts. For clinicians, they can provide an easy, fast, and effective way to help smokers quit. By simply identifying smokers, advising them to quit, and sending them to a free telephone service, clinicians can save thousands of lives.

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