Wednesday, December 3, 2008

For some of the people, some of the time...

Apparently, nicotine isn't addictive to everyone, all the time.

Of all the teenagers who experiment with cigarettes, only about a third go on to smoke regularly.

From The Tipping Point by Malcolm Gladwell.

This is why the tobacco companies can get away with saying it isn't addictive.

Even among those who do go on to smoke--some do so regularly and consistently and others don't. I used to know them as "social smokers"--you know, the ones who only smoke when enjoying a beer or wine or whatever. However--smoking IS highly addictive for some people, like me. In fact--there's some thought that the underlying susceptibility to being addicted to smoking is the same as that which predisposes one to become depressed. (oops, sorry to go all grad paper speak on you!) Gladwell puts it much better:

Drugs like Zoloft and Prozac work because they prompt the brain to produce more serotonin: they compensate, in other words, for the deficit of serotonin that some depressed people suffer from. Nicotine appears to do exactly the same thing with the two other key neurotransmitters -- dopamine and norepinephrine. Those smokers who are depressed, in short, are essentially using tobacco as a cheap way of treating their own depression, of boosting the levels of brain chemicals they need to function normally.

So, yeah, I've been a bit depressed.

I do have some Wellbutrin (a trade name for Buprion). I had used it before, about two years ago. I'd managed to quit smoking for about a month. I had thought all it did was take away the cravings. But, it does more. Gladwell quotes Andrew Johnston, head of psychiatry division at the pharmaceutical company Glaxo Wellcome:

"Buprion does two things. It increases your dopamine, so smokers don't have the desire to smoke, then it replaces some of the norepinephrine, so they don't have to agitation, the withdrawal symptoms"

It's been hell. It could have been less hellish, I suppose, if I'd used my medication more consistently. But when I did use it, before, --it was like I flat-lined emotionally. That was a different kind of hell--and it frightened me, somehow, more than the explosive anger I've been experiencing this time around. Anger flares up and goes away. You can go outside when you are angry. You can ask everyone to leave the house for the day if you sense it's going to be a bad one.

But flat lining emotionally is a sort of death--there is no escape--and returning to cigarettes, at that time, felt like a return to life and feeling and all things normal. So, this time, I only took the Wellbutrin for the first few days to help de-amplify the cravings.

And so, here we are. These are my stats, as of today:

Your Quit Date is: Wednesday, October 22, 2008 at 12:00:00 AM
Test Time Smoke-Free: 42 days, 5 hours, 3 minutes and 59 seconds
Cigarettes NOT smoked: 1055
Lifetime Saved: 8 days, 1 hour
Money Saved: $471.24

I do not feel like I have yet "quit"--not once and for all and never again done quit-- I still feel like I have to have my guard up, like I have to be careful. I still have the odd passing thought that a cigarette sure would be nice. So far, I've been able to just let that thought go.


scb said...

"Keep on keeping on" as my Grandma used to say. 42 days is definitely something to celebrate. It will get better. {{{hugs}}}

drwende said...

Well, the depression connection sure makes sense. One of my grad school colleagues who specialized in public health rhetoric said that most of the behaviors we classify as addiction may be self-medication for underlying problems.

42 days is great. 43 days is even better. Keep on moving up the mountain!

Kerry said...

You're doing really well!

From the fieldwork I'm doing for an audit, I can tell you you're right--with a lot of the SA treatment patients, it's not a question of if there's a co-occurring mental health problem, but which one and how severe is it. And they all smoke according to their files.

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