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Smoking and Tobacco

Nicotine (and Derivatives) in System

03/15/2011

Question:

I went from being an active smoker to a very occasional smoker about 10 years ago. I quit in Aug 2009 and then had a pack (20 cigs)over a period of 3 days in mid-Oct 2010. I have not touched a cigarette since then. I am wondering if the nicotine and derivatives would have worked out of my system since I occassionally feel the urge for a cigarette (I can control it much better now than I was able to 10 years ago). Does the urge ever competely stop?

Answer:

First, congratulations on quitting. This is one of the world's toughest addictions and certainly the most dangerous drug on the planet because of the total effect of smoking on both your body and those around you. 1.2 billion people are addicted and 5.4 million die each year from smoking.

The nicotine and all metabolites (derivatives) are certainly gone from your body. However, the effects unfortunately are not. Your lungs probably experienced some level of permanent damage and you elevated your risk of 15 different types of cancer, while decreasing your risk every day you remain abstinent. However the increased risk never goes completely away. By now, your heart disease risk has probably diminished markedly compared to when you were smoking.

You've also noticed that your brain has also been permanently affected. A pack-a-day smoker shocks his brain with free-base nicotine 70,000 times a year. The chemical receptors in the brain are remolded by this potent neurotoxin (nicotine) and now you still feel cravings as a result. People who smoke or who have been long-term smokers also have higher rates of mental illnesses than the rest of the population.

For many people the intensity of "the urge" does diminish markedly over time. In the meantime, do yourself a favor and resist. Very regularly I see folks in my office who have stopped for many years, and then gradually restarted only to find they cannot stop again, until they have a heart attack, or get cancer.

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Response by:

Rob  Crane, MD Rob Crane, MD
Clinical Associate Professor of Family Medicine
College of Medicine
The Ohio State University