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Why Do Smokers Struggle to Quit? A Look At Research and Effective Cessation Methods

Addiction involves a compulsive need to engage in a specific behavior despite adverse consequences. These consequences can be biological, social, or even legal. Our previous post emphasized tobacco as the leading cause of preventable death despite official bans like the Evin law restricting smoking activity. Tobacco cravings can be severe, and individuals may feel a “[terrible] need” to indulge in their addiction.

Vulnerability to addiction is a result of various factors, encompassing genetics, environment, and personal experiences. Yet, the consequences of addiction are uniformly damaging. This makes it paramount to identify why smokers struggle to quit and explore methods to break free from the clutches of nicotine dependence. Let’s take a closer look below.

Understanding the struggle to quit

The addictive nature of smoking is largely due to the effects of nicotine. Nicotine, the primary psychoactive compound in tobacco, triggers the release of neurotransmitters like serotonin and dopamine in the brain. While these neurotransmitters play vital roles in mood regulation and cognitive function, chronic nicotine exposure creates a dependency that extends beyond mere physiological cravings.

Nicotine addiction is also deeply rooted in psychology. Attentional bias involves a heightened sensitivity to substance-related cues in the environment, fueling a strong inclination towards substance-seeking behaviors. A 2023 article in the IJMHS on attentional bias explains how this can manifest internally among smokers attempting to quit. Notably, individuals emphasizing positive smoking aspects exhibited higher nicotine dependence levels and lower intentions to quit. This can intensify the focus on cravings and withdrawal symptoms and significantly impede the initiation and maintenance of smoking cessation efforts.

These findings highlight the need for personalized interventions, as well as new avenues for targeted cessation approaches.

Tips for smoking cessation


A major glimmer of hope for smoking cessation first emerged in the 1970s with the introduction of Nicorette chewing gum. Pharmacotherapy has since evolved, introducing more user-friendly alternatives. A notable addition is nicotine pouches, with popular brands ZYN and On! launching in 2014 and 2015, respectively. The discreteness and diverse flavor options of pouches have led to immense popularity, with 46.6% of American tobacco users aware of pouches in 2021.

More options continue to be developed and refined today. A new addition, nicotine pouches from White Fox, have entered the US market, offering extra strong options with concentrations ranging from 12mg/g up to 30mg/g. This innovation caters to smokers with heavy consumption of nicotine, allowing for a smoother transition to tobacco-free alternatives. Smokers with lower nicotine consumption can also opt for pouches with lower nicotine concentrations. The key is to explore all available options and choose the one that seamlessly integrates with your lifestyle.


Quitlines offer a lifeline to those who may lack access to traditional cessation resources. These telephone-based services provide counseling, support, and personalized cessation plans, bridging the gap for individuals who might face financial barriers to seeking help.

Research indicates that smokers utilizing quitlines are more likely to achieve long-term abstinence. Quit rates in the Standard Quitline alone show a 7-day point prevalence abstinence, reflecting an insignificant difference with quit rates in the Specialized Quitline + Social Needs Navigation. This is largely because all quitline programs have a structured nature, often incorporating behavioral therapy and pharmacotherapy guidance to align with evidence-based practices. You can start by searching online for quitlines that cater to your local area or opt for the national quitline (1-800-QUIT-NOW).

Support systems

The third and equally crucial tip for smoking cessation is the establishment of robust support systems. Support groups create a sense of community, allowing individuals to share experiences, challenges, and triumphs on the journey to cessation. This can manifest in various forms, from the unwavering encouragement of family and friends to the structured assistance provided by support groups or individual counseling.

Counseling alone can range from the 2 As + R, 5 As, motivational interviewing, cognitive behavior therapy, or acceptance and commitment therapy. All of these focus on behavior modification and are a deeply personal approach designed to adapt to individuals. That’s why it is crucial that you consult your healthcare provider on the best counseling technique and plan for you.

The journey to quit is laden with complexities, so having a multifaceted support system ensures that individuals are bolstered on all fronts. As we continue to refine our understanding and interventions, a smoke-free future can become an increasingly attainable reality for those grappling with the chains of nicotine addiction.


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