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The Doctor is In: Part 2 – The Difficulty of Quitting Smoking
By the Quitter's Circle Staff
July 05, 2017

The Doctor is In: Part 2 – The Difficulty of Quitting Smoking

Once you decide to quit smoking, you may want to move forward as though nothing is stopping you. Unfortunately, this is not always the case (but keep up that enthusiasm!). Quitting smoking is difficult, and the reality is that it may take many quit attempts before you become smokefree for good.

In the second installment of our three-part series with Dr. Rizzo, Chief of Pulmonary and Critical Care Medicine at the Christiana Care Health System in Delaware and the American Lung Association’s Senior Medical Advisor, Dr. Rizzo explains the reasons why a motivated person might want to quit smoking, as well as the reasons why they might need to try more than once. Keep in mind that although it might be difficult to quit, Dr. Rizzo is here to say: It’s important to keep trying.

In our last conversation with Dr. Rizzo, he spoke about seeking help from a healthcare provider. Be sure to check back for the third installment of our series for more of Dr. Rizzo’s insights. Until then, help yourself to facts, tips, and discussions with members of the Quitter’s Circle Community about quitting smoking.

Many of our readers may be long-time smokers. Why might they decide that now is the time to quit smoking?

Dr. Rizzo: The realization that it is time to quit varies from person to person. Maybe they want to be healthy when they start a family. Maybe they’ve watched a loved one pass away from a smoking related problem, a mom or dad; maybe they realize it’s time to get off the cigarettes because they have a family history of COPD or lung cancer. Maybe they were diagnosed with a chronic problem caused by smoking that makes them think “I should have stopped smoking years ago.” A lot of the desire to quit smoking is based on what’s happening in a person’s life at that time, and whether they’ve tried to quit before.

Have you noticed any similarities among people who come to you and want to quit smoking? Whether they’re similar ages or at certain points in their life?

Dr. Rizzo: I’ve said it already, but I really do think that a lot of it is based on what’s going on in that person’s life at the time. It varies from person to person. One person might want to quit before they get diagnosed with an illness, but another might not even consider quitting until after they’re sick. I have seen patients who are on oxygen for chronic lung conditions and continue to smoke, which really speaks to the power of a smoking addiction. There’s a lot of variability.

Some people continue to smoke after receiving a diagnosis of a smoking-related illness – you mentioned this last time too. What do you say to patients who continue to smoke?

Dr. Rizzo: Sometimes a patient’s disease process will motivate them to quit. For many though, the fact that they’re still smoking with a significant disease just frustrates them and makes them feel like a bad person. They aren’t. Physicians should remind their patients that quitting is hard and the difficulties they’re facing are not reflective of their ability to quit, but the addictive nature of nicotine.

Patients should try to look at it from a positive standpoint. Even if their diagnosis was related to smoking, they can still make the effort to quit. No matter what age you are or how long you’ve been smoking, quitting smoking is one of the best things you can do for your health.

If someone is able to cut down before quitting completely, I congratulate them for smoking less than before. However, when they smoke just a few cigarettes a day, it’s not as much the urge to smoke as it is the social aspect or the routine – that means they are very close to becoming smokefree! Even one cigarette a day is detrimental and they should still make the effort to quit completely – and keep trying, even if it takes some time.

Building on that, can you speak a little bit more about why it is so common to have to make multiple attempts?

Dr. Rizzo: Nicotine is among the most addictive substances we know of. It affects the pleasure centers in the brain, so after years of smoking, especially if a person started young, their brain has adapted to having nicotine daily.

Nobody expects quitting smoking to be easy. I tell patients that it may require several attempts to quit because nicotine is so addictive. Having a support system and possibly using medication provides the best chance of quitting cigarettes.

What do you tell your patients who get discouraged after multiple quit attempts?

Dr. Rizzo: I remind them that just because they have tried to quit a number of times in the past doesn’t mean the next attempt is going to be the same. I tell them that, on average, patients try to quit smoking six to eleven times before quitting. But no matter how many times you’ve tried before, you can still quit. In fact, if you’ve tried to quit many times, you can use information from those attempts to prepare for your next attempt. Think about what worked and what didn’t before, and try something new this time. This preparation may help you become smokefree.

This is second of three interviews with Dr. Rizzo. You can read the first interview here

If you’re wondering how to start the conversation with your doctor, you can download our Doctor Discussion Guide. To find a healthcare provider in your area, or speak to one on the go, visit our healthcare provider page.


See additional quit smoking resources from our partner American Lung Association.