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Category: Addiction

Why Smokers Do and Don’t Quit Smoking

My father-in-law is in his 70s and still smokes every day. He’s tried to quit before, but in the recent years has decided that he was old enough to live his life however he wanted, and that included smoking. Nevermind the fact that he has had a quadruple bypass operation for his clogged arteries (and other coronary operations), is on polypharmacy, leads a sedentary lifestyle, and has been nagged by his doctors and us about quitting smoking for years.

I know that many doctors – especially internists and general practitioners/family doctors – often encourage their smoking patients to quit smoking, citing the harms of smoking and the benefits of not smoking relative to the patient’s capacity to heal. Even those of us who do not practice medicine but work in the healthcare field know that smoking wreaks havoc on a variety of bodily functions right down to the molecular level.

Earlier this year, three Greek researchers published a study on why smokers quit or don’t quit smoking in Harm Reduction Journal (source: Harm Reduction Journal, March 29, 2006, 3:13 doi:10.1186/1477-7517-3-13). What they found may give some insight not just to medical doctors with an interest to helping their patients quit smoking, but for those of us with a personal interest to help either our loved ones or ourselves to quit smoking.

A popular assumption many doctors have about smokers quitting smoking is to introduce cognitive dissonance – an emotional state of mind where two beliefs are in conflict with each other. A person experiencing cognitive dissonance will move to resolve that conflict of belief. If a smoker believes that smoking is harmful to one’s health yet continues to smoke, the smoker experiences this contradiction and would move to resolve that contradiction. One would assume that the smoker would then stop smoking – right?

I doubt that smokers would deny the harmful effects of smoking. We can see from what’s happening in society that this is not the case – people still smoke even when they’ve been exposed to anti-smoking campaigns, nagging from friends and loved ones (I admit, I am one of those annoying people who remind their friends that smoking is bad for them), and shock-and-awe pictures of lungs blackened by chronic smoking.

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Target for Addictions Identified Deep in the Brain

“Man becomes cigarette smoker. Man suffers from stroke. Man completely loses urge to smoke.”

This sums up the neon lights that have been blinking nonstop in the media around the scientific paper, “Damage to the Insula Disrupts Addiction to Cigarette Smoking” that was published in the January 26, 2007 issue of Science magazine (pages 531-534). The magazine also ran a commentary, “Brain Damage Sheds Light on Urge to Smoke” on the paper.

The key? A brain region called the insular cortext, or insula, deep within the cerebral cortex. This region has been implicated in other addictions, including cocaine addiction. Signals that trigger this region has been linked to the stimulation of addictive desires. This means insula is a potential therapeutic target – in other words – drugs or treatments that affect insula’s ability to stimulate addictive desires become a therapy for addiction. (more…)

Interview on Self-Injury

Dr. Jane Chin: What are the biggest misconceptions or “myths” people have about self-injury?

Dr. Deborah Serani: I’d have to say that the biggest misconception about self-injury is that most people think that those who cut or self-injure are suicidal. Though any behavior that puts a person in harm’s way requires clinical evaluation, the basic reason individuals cut or self-harm comes from the wish “to control” or to “numb away feelings.”

Dr. Chin: Why is cutting or self injury such a difficult subject for people to talk about?

Dr. Serani: There is a lot of shame associated with this behavior. Seeing the scars or scabs serves as reminder to the person that they cannot find a better way to move through pent up feelings. They feel like they have failed or are flawed in some way, which exacerbates there negative feelings even more. (more…)

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