By Dr. Daniel Seidman
First, the good news: The 46 million people (20.6 percent of all adults) who smoke in the U.S. are now outnumbered by former smokers. Between 1965 and 2004, smoking rates dropped by more than half, from 42.4 percent to 20.9 percent. About a month ago, New York City announced that just 14 out of 100New Yorkers are still smoking. That’s a 35 percent decline, or approximately 450,000 fewer adult smokers since 2002. So obviously people want to and can quit smoking.
Yet while most people quit relatively easily and without smoking cessation therapies like nicotine replacement therapy or counseling, other smokers struggle for years, further compromising their health. Some former smokers say quitting is the hardest thing they have ever done. Clearly, when it comes to quitting, all smokers are not alike.
For those who struggle mightily with quitting smoking, the belief that “some people just can’t quit” resonates with their broken confidence in their ability to quit. Emotional beliefs and cognitions crop up around the physical realities of addiction such as: “I can learn to keep this under control,” or “I need this to cope with stress” or “I just can’t quit.” The biology of addiction and withdrawal and the psychological dynamics of smoking addiction conspire to undermine the smokers’ self-confidence, which is a central component of long-term quitting success (1). The addiction itself destroys smokers’ confidence that they can quit, good therapy rebuilds it so they can restore themselves to a smoke-free life.