Smoking Addiction

Smoking is the largest single cause of death and disease in Australia. As with other forms of addiction, it is not the volume consumed that defines it as an addiction but the intense desire or craving for the next cigarette.

Each week nearly 300 people die from smoking related conditions. To give that figure some perspective, imagine if there were 300 deaths from car accidents on our news reports every week. Over a year that makes a staggering 15,600 people.

Overall, more men are killed by smoking than women and smoking usage rates are higher among people living in rural areas, people with lower levels of education and other disadvantaged socioeconomic groups. Compared to the general population, Aboriginal and Torres Strait Islander residents are 2.6 times more likely to die from smoking-related conditions including stroke, heart and vascular disease.

Research has shown that around a quarter of cancer deaths and a third of respiratory deaths can be attributed to cigarettes. Smoking leads to many life-changing conditions including cancer, stroke, heart disease, emphysema and blindness.

Other facts about smoking including:

• The average life expectancy of a smoker is roughly 10 years less than that of a non-smoker.
• Nearly half of all smokers will die of a smoking-related disease.
• Roughly 60% of smokers say that they would struggle to last a day without smoking.
• There are over 4,000 chemical compounds in tobacco smoke.
• Around 33% of Australians living with mental illness also smoke, this is more than double the national usage rate (around 13% of the population). The rate is even higher for those experiencing psychosis (66%).

Not only does cigarette smoking create multiple problems for the smoker but can also impact on the health of those who inhale the smoke second hand. Bans on smoking in workplaces and enclosed public places have now been in place for a number of years with the aim of benefiting both the smoker and the people around them.

Public education programs at federal, state and local levels have gone a long way to changing behaviours and smoking prevalence in Australia has been on a steady decline over the last few decades. There are now more ex-smokers than there are smokers. However the National Drug Strategy Household Survey (2010) found that there are still 2.8 million people aged 14 or over in Australia who smoke daily (15.1%). As a result, there is an ongoing focus on continuing the decline in smoking use to reduce both the social and economic costs to the community.

Why do people smoke?

With all of this information available many non-smokers may wonder why smokers take up the habit in the first place. The reasons can be quite complex and not always immediately apparent even to the individual smokers themselves. Some of the more common reasons include:

• Boredom – Some people see smoking as something pleasant to do to fill in time.
• Imitating parents – Studies have shown that a child is three times more likely to smoke if both parents smoke.
• Self-expression – Those who want to stand out from the crowd may see smoking as part of their image.
• Social acceptance – Smoking can also be a way to fit in with a crowd as being the only non-smoker in a group of smokers can be socially isolating.
• Stress – Many people start or continue to smoke as a way of dealing with stress.

When they first took up smoking many older people were not really aware of the widespread effects that it would have on their future. Cigarettes were advertised heavily and often associated with favourite TV and movie characters so it seemed like a normal thing to do.

Since research has proven that the effects of cigarette smoking are real and can be devastating the general mindset of the population has changed dramatically. Now cigarette advertising has been banned in most forms and advertising now revolves around various ‘Quit’ campaigns. Support and resources to help people to stop smoking are now more accessible than ever.

Health effects of smoking

Smoking has been proven to increase the risk of developing more than 50 health conditions. Some of the most serious of these include:

• Cancer - of the lungs, throat, mouth, oesophagus, liver, pancreas, bone marrow and many other parts of the body.
• Stroke – smokers are around 33% more likely to suffer a stroke than non-smokers
• Heart disease – Smoking causes a number of serious and potentially fatal heart conditions. Nearly one third of all cases of heart disease in Australia are related to smoking.
• Chronic Obstructive Pulmonary Disease (COPD) - includes conditions such as emphysema and small airways disease. It is rare for a non-smoker to develop emphysema.
• Chronic bronchitis – This recurring cough associated with increased and frequent phlegm occurs in around 50% of all heavy smokers.
• Lung conditions – Smoking can greatly reduce lung function, impair lung growth and cause a range of other serious respiratory issues including asthma.
• Peripheral vascular disease – Cigarette smoking is the most common cause of this disease which involves a narrowing or blockage of the leg arteries. In some cases this can result in amputation.
• Abdominal aortic aneurysm (AAA) – Smoking is also the main risk factor for this disease. When the lower part of the aorta leading from the heart bursts, it can be instantly fatal.
• Eye diseases – Smoking is associated with a range of eye conditions including macular degeneration and cataracts.
• Hormonal issues – Both male and female smokers run a strong risk of decreased fertility. Women can also experience menopause around 2 years before non-smokers of the same age.
• Decreased immunity and healing capacity – Cigarette smoking is a high-risk factor for a number of immune system disorders such as Rheumatoid Arthritis. It also slows the body’s rate of healing, including after surgery.
• Decreased bone density – This can result in increased fractures particularly in older smokers.
• Dental diseases – Smoking can cause many diseases within the mouth including periodontitis and tooth loss.
• Problems during pregnancy and childbirth. – Both mother and child have a high risk of developing complications including uncontrolled bleeding, pre-mature labour, lung problems for the child and of the child dying from Sudden Infant Death Syndrome (SIDS).
• Sexual problems – Smokers can experience impotency and other issues with sexual function.
• Premature aging – Long term smokers often look much older than non-smokers of the same age as they generally have more lines, wrinkles and skin discolouration.
• Other conditions – Smoking is known to worsen the symptoms of many other health conditions including dementia, diabetes and multiple sclerosis.

Emotional effects of smoking

Often the emotional impacts of smoking may be just as significant as some of the physical effects. Regular smokers have a constant feeling of weakness or guilt that they are unable to give up. This pressure may come from others or from within. While non-smokers may think quitting is simply a matter of making a decision, in reality it is much more complex. The smoker often needs lots of support to help them through this period.

During the withdrawal process the body needs to go through a detoxification period. The person may experience mood changes, increased hunger, fatigue and poor concentration amongst other symptoms. They may also have a number of attempts to quit and can get very frustrated and angry with themselves each time they relapse. Professional counsellors can provide valuable support and strategies to help someone break their smoking addiction.

What are the benefits of stopping smoking?

Physical benefits

While cigarette smoking has so many negative effects on health, as soon as a person stops smoking the body starts to heal itself almost immediately.

Within 6 hours

• The heart rate slows and blood pressure decreases.

Within one day

• Nearly all nicotine has left the system and the level of carbon monoxide in the bloodstream has greatly reduced.

Within a week

• There are more antioxidants in the bloodstream.
• The senses of taste and smell are heightened.
• There is less mucus and tar in the lungs

Within 2 months

• The immune system is more able to cope with infection
• Blood flow to the hands and feet has improved so they feel much warmer

Within 6 months

• Lung function has dramatically improved and the lungs produce less phlegm
• Stress levels may be lowered.

After 1 year

• The lungs and heart are healthier and breathing is much less restricted.

Within 2 to 5 years

• The risk of heart attack, stroke and many cancers is significantly reduced.

Giving up smoking will not only improve the health of the smoker but it will also benefit the people around them by reducing their risk of developing serious health complications.

Financial benefits

As many people develop their smoking addiction over time, the financial costs may not be immediately obvious. However they are certainly significant. Not only are cigarettes expensive but not smoking can save on future health costs.

If a packet of 25 cigarettes costs $21 and a person had been smoking a pack a day then after only one day of quitting they would have enough to buy lunch for work or buy some magazines.

After 2 days they could go to the movies or a sports game.

By the end of the first week they will already have saved $147; enough for a massage treatment or a night out.

In one month the savings will have reached $640. This would cover petrol costs, new clothes or a weekend away.

In 3 months they will have saved $1,900. Enough for a new computer or lounge suite.

By the 6 month mark there will be $6,800 in savings. Perfect for an overseas holiday.

At the end of the first year the person will have saved $7,700 so in 10 years’ time there would be $77,000 their bank account. That would pay for a couple of family cars or it could make a huge difference on a mortgage.

Emotional benefits

Breaking an addiction takes an enormous amount of hard work, commitment and courage. Overcoming all the challenges gives the person a strong sense of achievement and self-confidence. These positive emotions often have a flow-on effect in other areas of their life such as their relationships, careers and personal goals.

Help to stop smoking

Around two thirds of smoking addicts really want to quit but the ability to overcome the cravings may be too overwhelming for a person to deal with alone. There are a variety of professional services available that are highly effective. These include individual behavioural counselling, group therapy, telephone help lines and medication. Often a combination of several therapies achieves the best results.

Cognitive Behavioural Therapy (CBT)

This form of professional therapy is based on the premise that our thoughts control our actions. When we identify the problem patterns or beliefs we can then analyse them and find new ways of approaching them.

Smoking is often used to relieve stress in an emotional situation or the smoker may have formed the habit of lighting up after dinner. In an individual or group therapy session, a counsellor will help the smoker(s) to identify their own personal triggers and then encourage them to seek alternative ways of coping.

One-on-one counselling sessions create a more personalised atmosphere and allow more time to explore issues in depth. Group sessions provide peer support and the opportunity to share thoughts and experiences with people in similar situations.

Telephone counselling and quit helplines

Australia is fortunate to have a number of outstanding telephone and online support services. They are usually anonymous as well as being accessible and affordable (if not free). People may simply want help with accessing information or resources or they may need the help of a dedicated telephone counselling service.

Nicotine replacement therapy (NRT)

Nicotine replacement therapy is a very effective way for a person to diminish their craving for nicotine without experiencing the side effects and toxicity of smoking a cigarette. It is generally available in patch form and while it doesn’t provide a ‘hit’ it does help to supress the physical cravings.

Stop smoking medicine

There are some medications that help to reduce cravings by working on chemical processes in the brain instead of replacing nicotine in the body.

A GP can advise on the best therapy and medication options for each individual.

What should I be looking for in a counsellor or psychotherapist?

In Australia there are currently no laws that specify what qualifications or training a counsellor needs to have before being allowed to offer addiction counselling services. However there are a number of tertiary and professional development courses that are available. Practitioners can also apply to be registered with the Australian Counselling Association (ACA), the Psychotherapy and Counselling Federation of Australia (PACFA) and other industry associations.

It is generally recommended that people struggling to overcome a substance addiction undertake a detox program alongside CBT or similar therapy. Finding a professional with experience in smoking addiction would be very beneficial.

See the resources page for information on appropriate support services in your area.

Related Additions

• Alcohol
• Drugs
• Gambling
• Internet
• Sex