Trying to quit smoking? The odds may be stacked against you — and the temptation triggers begin the moment you leave your house.
Smoking is considered the leading preventable cause of death in the US — it’s responsible for about one in five deaths each year, according to the American Cancer Society.
Besides lung cancer, smoking greatly increases the risk of heart disease, stroke, diabetes and chronic obstructive pulmonary disease.
And according to researchers in behind a new study, understanding the daily environments that influence smoking behavior is critical to reducing the habit and the health burden it creates.
“For people who smoke and recently quit smoking, tobacco retail exposure is consistently associated with increased cigarette craving, purchase urges, and impulse purchases,” said study authors said.
Using smartphone applications, researchers assessed the behavior patterns of 273 regular cigarette smokers who had their geolocation and tobacco retail exposure tracked during a 14-day period.
Test subjects self-reported their craving and when and how much they smoked.
The study found that on days when participants had greater levels of retail exposure, they reported both higher levels of craving and smoked more cigarettes.
“It goes back to the neurobiology of addiction. Somebody who has a substance use disorder has already established the neuroadaptive patterns of seeing something, thinking about something, craving something, and then that directly being linked to an incease in use,” Dr. Tejal Desai, DO, addiction medicine lead of the CATCH Team at Northwell Staten Island University Hospital told The Post.
She described retail exposure as a Pavlovian response in smokers, creating repetitive cycles that lead to the maladaptive patterns of addiction.
And, according to Desai, tobacco companies purposefully prey on this engrained response: “This is used strategically by these tobacco advertisers and sellers, they’re doing this very intentionally.”
She noted the prevalence of power walls, the advertising space behind cash registers as a key marketing offensive.
“They’re in the direct line of vision as someone is trying to check out. We have to educate our patients about potentially why that area is so high risk. Some people don’t even realize that they’re doing it,” she said.
In this situation and others, awareness is the crucial first step in defusing a trigger.
“Knowledge about these things and knowing that they trigger cravings and they might trigger impulse buys helps patients have more autonomy and power and confidence to maybe say, ‘OK, I already know that’s going to happen. I will try my best to just pay and leave,” she said.
In her counseling sessions for tobacco users, she routinely talks about the importance of changing environments to reduce cravings and triggers. In a home environment, she frequently recommends laundering all clothing to get rid of the tobacco smell.
In relationship to work or a work commute, that change looks like strategic avoidance.
“Whether its their commute, their walk to work, their 15-minute break or their lunch break you can figure out an alternative,” she said.
“I’ll say, ‘OK. You work in the middle of Manhattan,’ and just in that three-block vicinity, there are five smoke shops and you usually go to get lunch at this location. Plan out a different route, create an alternate plan. This is the way we can avoid these direct spots that trigger you.”
For those looking to quit or resist a tobacco trigger, Desai recommends a five minute strategy for staying on track.
“If you can push past your craving for about five minutes, you will statistically have a less chance of picking up whatever that initial thought is,” she said. “Take a walk, take two walks, do something like that to come up with ways to let time pass so that that trigger is gone.”
Research also suggests avoiding certain trigger foods may help those trying to quit.
In addition to impacting health, smoking also puts a big dent in your wallet: WalletHub’s 2019 report “The Real Cost of Smoking by State Report” found that New Yorkers spend $226,000 on tobacco products in a lifetime.
Researchers say that 1.2 million lung cancer deaths worldwide could be prevented over 70 years by banning the sale of cigarettes and other tobacco products to people born between 2006 and 2010.
