I have to smoke because of all my stress

Joined: 11 Nov 2008, 19:22

17 Jun 2010, 02:24 #61

Joel's life's work has been our education cornerstone since shortly after his arrival here at Freedom on January 20, 2000.  One of the real treats has been watching as year after year, study after study proves the validity of another of his core lessons.  Below is the latest installment. 

Joel teaches that stress is an acidic event within the body that accelerates renal elimination of the alkaloid nicotine from the bloodstream.  That smoking does not satisfy the underlying stress factor but only nicotine's absence.   To show just how contrary Joel's basic stress lesson is from what nearly all others are teaching, this is what's currently being taught at the United States government's leading quit smoking site: 
The stress-smoking link "Stress is a reason why many people smoke. When you have a bad day, it can seem like your cigarettes are your only friend. Cigarettes can help you calm down, relax, and feel like you are pampering yourself. Sound familiar?"     
Sadly, most of the lessons taught at government quitting sites are the exact opposite of what's taught here at Freedom and WhyQuit.   Most damaging of all is the lesson that quitters should not be hard on themselves for "slipping" and smoking a cigarette now and then.  It's the use rationalization the nicotine addict who wants to have their quitting cake and eat it too is dying to hear. It  evidences that those writing U.S. quitting lessons have little or no experience in actually working day to day with smokers and quitters. 

Other contrary lessons include government assertions that planning is key to success (when industry studies show unplanned attempts are twice as successful),  that you need to pick a memorable quitting date like your birthday, the Great American Smokeout or New Years, that it's nearly impossible to quit cold turkey (when in fact cold turkey will produce more successful ex-smokers this year than all other quitting methods combined), that key to quitting is changing your entire life (drinking tea instead of coffee, watching different television programs, and creating a host of quitting crutches), and hiding from your use cues (taking different routes home and avoiding smoking friends).      

More than 400,000 US smokers will run out of time and chances this year.  With 40 percent of U.S. smokers making a serious quitting attempt of at least 24 hours each year, it isn't matter of not wanting to quit but of not knowing how.  I've tried this past year to motivate government health officials to make their quitting web pages reflect the truth about how most ex-smokers succeed, and to incorporate the latest study findings.   I've failed.  It doesn't mean I won't keep trying. 

Recent events have many questioning the competence of government officials in regard to safety issues associated with deep sea oil drilling and coal mine safety.  I have similar concerns that those in charge of both national smoking cessation policy and youth smoking prevention either lack  competence, leadership skills or the desire to get it right.   How many more must die before someone in government cares that what we taught them during their final attempt before disaster struck was flat out wrong?  Am I holding out hoping that that someone stumbles upon this Freedom post?  You bet but I'm not holding my breath.

My greater hope is that Joel's lessons are someday soon so widely shared across the Net by successful long-term ex-smokers that government health officials begin paying for studies to prove Joel wrong.  I believe it may already have happened more than once ; )  If so, how many more times must Joel be proven correct before they update their web site's quitting advice?  That part continues to have me baffled.

Breathe deep, hug hard, live long,

John (Gold x11)

The effect of stopping smoking
on perceived stress levels
Journal:  Addiction, June 7, 2010 [Epub ahead of print]

Authors:  Hajek P, Taylor T, McRobbie H.

Queen Mary, University of London, Wolfson Institute of Preventive Medicine, Barts and The London School of Medicine and Dentistry, Charterhouse Square, London EC1M 6BQ, UK.


Aims:  Many smokers believe that smoking helps them to cope with stress, and that stopping smoking would deprive them of an effective stress management tool. Changes in stress levels following long-term smoking cessation are not well mapped. This longitudinal project was designed to provide more robust data on post-cessation changes in perceived stress levels by following a cohort of smokers admitted to hospital after myocardial infarction (MI) or for coronary artery bypass (CAB) surgery, as such patients typically achieve higher continuous abstinence rates than other comparable samples.

Design:  A total of 469 smokers hospitalized after MI or CAB surgery and wanting to stop smoking were seen in the hospital and completed 1-year follow-ups. Ratings of helpfulness of smoking in managing stress at baseline, smoking status (validated by salivary cotinine concentration) and ratings of perceived stress at baseline and at 1-year follow-up were collected.

Findings: Of the patients, 41% (n = 194) maintained abstinence for 1 year. Future abstainers and future smokers did not differ in baseline stress levels or in their perception of coping properties of smoking. However, abstainers recorded a significantly larger decrease in perceived stress than continuing smokers, and the result held when possible confounding factors were controlled for (P < 0.001).

Conclusions:  In highly dependent smokers who report that smoking helps them cope with stress, smoking cessation is associated with lowering of stress. Whatever immediate effects smoking may have on perceived stress, overall it may generate or aggravate negative emotional states. The results provide reassurance to smokers worried that stopping smoking may deprive them of a valuable coping resource.

PMID: 20528815

Source Link:  http://www.ncbi.nlm.nih.gov/pubmed/20528815



Joined: 11 Nov 2008, 19:22

17 Jun 2010, 11:53 #62

Below are additional papers relevant to this issue:  

Does cigarette smoking
cause stress?
Journal:  The American Psychologist, October 1999, Volume 54(10), Pages 817-820.

Author:  Parrott AC.

Department of Psychology, University of East London, Great Britain. [url=mailto:andy2@uel.ac.uk]andy2@uel.ac.uk[/url]


Smokers often report that cigarettes help relieve feelings of stress. However, the stress levels of adult smokers are slightly higher than those of nonsmokers, adolescent smokers report increasing levels of stress as they develop regular patterns of smoking, and smoking cessation leads to reduced stress. Far from acting as an aid for mood control, nicotine dependency seems to exacerbate stress. This is confirmed in the daily mood patterns described by smokers, with normal moods during smoking and worsening moods between cigarettes. Thus, the apparent relaxant effect of smoking only reflects the reversal of the tension and irritability that develop during nicotine depletion. Dependent smokers need nicotine to remain feeling normal. The message that tobacco use does not alleviate stress but actually increases it needs to be far more widely known. It could help those adult smokers who wish to quit and might prevent some schoolchildren from starting.

PMID: 10540594 [PubMed - indexed for MEDLINE]

Nicotine renal excretion rate
influences nicotine intake
during cigarette smoking.

Journal:  The Journal of Pharmacology and Experimental Therapeutics, July 1985, Volume 234(1), Pages 153-155.

Authors:  Benowitz NL, Jacob P 3rd.

Abstract We examined the hypothesis that rate of elimination of nicotine affects nicotine intake during cigarette smoking. Elimination rate was altered by administering ammonium chloride or sodium bicarbonate throughout the day. Nicotine intake during unrestricted cigarette smoking was measured using metabolic clearance data obtained after i.v. nicotine infusion together with blood and urinary nicotine concentrations measured during 24-hr periods of cigarette smoking. Compared with placebo treatment (urine pH 5.6), urinary acidification (pH 4.5) increased (208%) renal clearance and, to a lesser extent (41%), total clearance and increased (by 7.2 mg) daily urinary excretion of nicotine. Urinary alkalinization (pH 6.7) resulted in a decrease (78%) in renal clearance with a small decrease (3.7 mg) in daily nicotine excretion. Average blood nicotine concentrations were similar in placebo and bicarbonate treatment conditions, but were 15% lower during acid loading. Daily intake of nicotine was 18% greater during acid loading. The compensatory increase in nicotine consumption was only partial, replacing about half the excess urinary nicotine loss. This is the first direct demonstration that rate of elimination can influence self-determined drug consumption in humans.

PMID: 4009497

Effect of grapefruit juice
on cytochrome P450 2A6
and  nicotine renal clearance
Journal: Clinical Pharmacology and Therapeutics. 2006 November, Volume 80(5), Pages 522-530.

Authors:  Hukkanen J, Jacob P 3rd, Benowitz NL.

Division of Clinical Pharmacology and Experimental Therapeutics, Medical Service, San Francisco General Hospital Medical Center, and Department of Medicine, University of California, San Francisco 94143-1220, USA.


BACKGROUND AND OBJECTIVE: Grapefruit juice is an inhibitor of the cytochrome P450 (CYP) 3A4 enzyme and transporters such as P-glycoprotein and organic anion transporting polypeptides, leading to clinically important interactions. Our objective was to study the effect of grapefruit juice on the pharmacokinetics of nicotine, which is primarily metabolized by the CYP2A6 enzyme.

METHODS: Ten volunteers were given a 2-mg oral dose of deuterium-labeled nicotine on 3 occasions together with 1 L of water, full-strength grapefruit juice, or half-strength grapefruit juice. Concentrations of nicotine and its metabolites were analyzed in plasma and urine for 8 hours.

RESULTS: Grapefruit juice inhibited the formation of cotinine from nicotine (area under the plasma cotinine concentration-time curve from 0 to 8 hours of 6807 min.ng/mL, 7805 min.ng/mL, and 8007 min.ng/mL for full-strength grapefruit juice, half-strength grapefruit juice, and water, respectively; repeated-measures ANOVA, P=.009). The time to peak plasma concentration of cotinine was delayed (216 minutes, 159 minutes, and 147 minutes, respectively; ANOVA, P=.011), and the peak plasma concentration was lower with grapefruit juice compared with water (18 ng/mL, 21 ng/mL, and 22 ng/mL, respectively; ANOVA, P=.010). Oral clearance, peak plasma concentration, and time to peak plasma concentration of nicotine were not affected. Grapefruit juice increased the renal clearance of nicotine (231 mL/min, 219 mL/min, and 123 mL/min, respectively; ANOVA, P=.045) and cotinine (19 mL/min, 14 mL/min, and 16 mL/min, respectively; ANOVA, P=.002).

CONCLUSIONS: Grapefruit juice inhibits the metabolism of nicotine to cotinine, a pathway mediated by CYP2A6, and increases the renal clearance of nicotine and cotinine. Nicotine oral clearance is not affected by grapefruit juice because the inhibition of hepatic metabolism is offset by the increase in the renal clearance of nicotine. However, other compounds metabolized by CYP2A6, as well as other drugs excreted via renal clearance mechanisms similar to those of nicotine, may be susceptible to significant pharmacokinetic grapefruit juice interactions.

PMID: 17112808
Last edited by JohnPolito on 17 Jun 2010, 12:33, edited 9 times in total.

Joined: 17 Aug 2010, 16:35

28 Aug 2010, 15:51 #63

Thanks for bringing this one up. The great thing about this site is not only the awesome arsenal of essential information--but the ease in finding it at just the right moment in a beginning quit.
Gratefully Gold

I escaped from the prison of smoking on August 14, 2010.  
[font]The best revenge is quitting well![/font] 

Joined: 13 Nov 2008, 14:04

02 Jan 2011, 14:08 #64

Above video 2010 response to member encountering stress that ties into this string.

Links to other videos addressing smoking and stress:

"I'll be a nervous wreck forever if I quit smoking"
"I am climbing the walls because I quit smoking"
Why Do Smokers Smoke?
Last edited by Joel Spitzer on 02 Jan 2011, 14:13, edited 1 time in total.

Joined: 13 Nov 2008, 14:04

02 Feb 2011, 09:48 #65

Last edited by Joel Spitzer on 02 Feb 2011, 09:50, edited 1 time in total.

Joined: 13 Nov 2008, 14:04

02 Jul 2013, 12:05 #66

Section of video "Why do smokers smoke" that addresses stress issue

Joined: 13 Nov 2008, 14:04

28 Feb 2014, 16:10 #67

Last edited by Joel Spitzer on 01 Mar 2014, 14:53, edited 1 time in total.

Joined: 13 Nov 2008, 14:04

22 Jan 2016, 14:08 #68

It seems that a large portion of people in the East Coast of United States are going to be experiencing weather conditions similar to the ones that prompted this article.