Peter Hibberd, M.D., is a doctor whose advice is based on more than 28 years of hospital outpatient and inpatient experience. He is an experienced emergency medicine physician, surgeon, and consultant. Dr. Hibberd is certified by the American Board of Emergency Medicine. He is also a fellow and active member of the American Academy of Family Physicians, an active member of the American College of Emergency Physicians, and a member and fellow of the American Academy of Emergency Medicine. Dr. Hibberd has earned numerous national and international professional certifications, memberships, and awards.
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Why Can't I Quit Smoking?

Wednesday, 23 Jun 2010 11:44 AM


Question: I quit smoking 17 years ago because I had a heart attack and the cardiologist told me that if I did not quit smoking I would have another one. I was 49, and I quit a three-pack-a-day smoking habit that I had for 35 years. I chewed 35 to 40 pieces of nicotine gum for six or seven months and then about 20 pieces for about five or six months. My doctor would not renew my prescription so I got the gum from others at work. I was down to about 10 pieces a day when I ran out of options and had to give up the gum. I still want to smoke but I know I can’t—I had a quadruple bypass 11 years ago. I drink wine and gamble when the urge gets really bad. Why do I still want to smoke?

Dr. Hibberd's Answer:
You illustrate very well how addicting nicotine can be. PET scans of brains have confirmed the same areas that light up with the intake of cocaine in a cocaine addict light up in the cigarette smoker. When you see these images, it makes a believer of anyone who has any doubt about the addiction potential of nicotine.
This of course explains your continual urges, and you do recognize that you are an addiction-prone individual. You would be well advised to seek professional counseling and avoid indiscriminate nicotine supplementation. Nicotine is a drug, and is harmful to cardiac patients and patients with vascular disease.
The nicotine gum is intended to help ease you off the high doses the cigarettes were providing, not intended to become a long-term replacement drug. Seek out a qualified addiction specialist with the help of your primary care doctor, and consider a referral to a psychiatrist qualified in cognitive behavioral therapy (CBT).
Some patients do well with hypnosis, so this may also be considered as an option for you. Thanks for your note. You may help save someone else's life by your portrayal of your addiction, and possibly dissuade another reader from ever starting to smoke cigarettes. This habit can be deadly and very disabling!

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