“Mum, you’ll die from smoking!” The more often my son threw his hands over his head in horror when he saw me smoking, the less I could justify the habit. So I quit. That was in 2019.
Two months later, I was still a non-smoker. Addiction physician Tobias Rüther was thrilled by my smoking cessation. He heads the special outpatient clinic for tobacco addiction at the Ludwig Maximilian University Hospital in Munich.
“When you stop smoking, a lot of positive things happen in your life very quickly,” Rüther said.
A lot of changes, very quickly
After just eight hours, the body receives a much better supply of oxygen, Rüther explained to me. After just one to two days, many people smell and taste better again. After two weeks, lung function often improves significantly, which is more noticeable during sports. However, I felt just as fit after I quit smoking as I did before.
“You may get a stronger cough than you had before,” Rüther said. “This is because the lungs are starting to clean themselves out.” That spring cleaning, he said, takes about a month. “Also, after a month, your immune system is much stronger.”
After three months of abstinence, you can also look forward to a much better night’s sleep.
“Smokers experience nicotine withdrawal at night. You don’t wake up from that, but you sleep much more restlessly. After three months, sleep has returned to normal,” said Rüther.
Danger from cigarette number 3
Before I could decide on complete abstinence, I thought that merely smoking fewer cigarettes would automatically be . But that idea is not completely true, because more than two cigarettes is enough to harm the body.
“The cardiovascular risk, i.e. the risk of having a stroke or heart attack, is barely increased between three and twenty cigarettes,” said Rüther. But it’s a different story with . There, the risk increases with every single cigarette.
“It’s really great that you’ve quit,” Rüther kept saying. His joy is contagious — my own enthusiasm had so far been limited.
Yet one in two smokers dies because of their tobacco addiction, and 50% of them before age 70. Rüther was certain that by the age of 50 at the latest, I would have felt the consequences of smoking.
Relapse rate: 95 percent
such as nicotine patches, hypnosis or acupuncture were not necessary to keep my hands off cigarettes. The fact that my will alone was enough might have something to do with the fact that I joined the smoking team so late — not until I was 21. Another positive, according to the addiction doctor.
“Most smokers start between the ages of 12 and 16, when the brain is still maturing. Nicotine is an extremely active neurotransmitter that has a major impact on the development of neural connections in the brain,” the doctor said.
The result is a lifelong addiction that can hardly be overcome by sheer willpower, Rüther explained.
But, he added, “out of 100 smokers who quit without help, like you, 95 relapse in the first year.” Well, great.
The smoker’s illusion
One reason for a relapse could be the “smoker’s illusion,” a nasty psychological trick of . Rüther emphasized that in cigarette addiction, psychological dependence is very strong. That’s why I, too, fell for the smoker’s illusion: for years I convinced myself that smoking would calm me down, take away stress and give me a short break.
“In reality, however, every cigarette increases the heartbeat and makes you more restless,” said Rüther.
The fact that smoking made me feel calmer was simply because I was experiencing withdrawal symptoms after a long period without a cigarette, and my addicted body was craving new nicotine.
“So the cigarette just takes away the restlessness you wouldn’t have had in the first place if you weren’t smoking,” Rüther said.
Pavlov’s dog
The first cigarette-free evening with friends, music and wine was pretty weird. Something was missing and it didn’t feel right. For years, I had successfully conditioned myself to believe that smoking was simply part of certain situations: with coffee, with wine, with a break.
“It works like Pavlov’s dog: you give the dog something to eat and ring a bell at the same time. At some point, the ringing is enough for the dog to salivate,” Rüther explained.
With smokers, this bell rings permanently. Smoking is for relaxation or in order to get in the swing of things. As a reward after work, after a meal, while waiting for the bus or after sex. The list could be continued.
“The crux is that cigarettes are so firmly integrated into the everyday lives of smokers,” said Rüther.
I want to quit. But how?
Anyone who wants to quit is faced with difficult task. As such, Tobias Rüther initially reassures his patients that failure is normal and part of the process.
“When patients tell me that they have already tried to quit five times, I first acknowledge these attempts. After all, it seems to be an important concern to them,” he said.
Not smoking, he said, is like learning to ride a bike: falls are part of the process, the important thing is just getting back on the saddle. “Decatastrophizing the relapse,” the physician calls it.
In addition, it’s important to signal to the brain that something has changed.
“Sit in a different chair than usual in the morning. Drink tea instead of coffee. Put the plant in a new place at your workstation.” That, according to Rüther, is how to trick the Pavlovian dog in the smoker’s head.
And even if the will doesn’t always hold, it doesn’t have to be a relapse. As Tobias Rüther said, “one cigarette is a slip. It’s not a relapse until the second one.”
This article is translated from a German version published in May 2023.
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