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Cutting back on the number of cigarettes you’re consuming each day isn’t the same as going “cold turkey” and restraining yourself from touching another cigarette. Cutting back implies you’re trying to wean yourself gradually from your nicotine addiction. On one hand, deciding to quit cold turkey signals a “do or die” mindset.

I quit cold turkey cartoon

The Ineffectiveness of Going Cold Turkey

According to MedScape, a huge number of smokers choose to quit cold turkey:

More than 90% of patients who attempt to quit smoking stop cold turkey. Professional group therapy or counseling achieves an initial cessation rate of 60-100% and a 1-year cessation rate of approximately 20%. Hypnosis and acupuncture are popular programs that might encourage renewed attempts by people for whom other techniques have failed, but these modalities have not been shown to be any better than placebo.

Yet, the American Lung Association says that going cold turkey isn’t effective for smokers:

Smoking is very addictive and quitting “cold turkey” generally isn’t effective. The majority of smokers need help quitting, which means getting support from your friends and family, signing up for a smoking cessation program, and taking a medication that can help you quit. Also, think about your previous quit attempts and use those to plan your next quit. If you keep trying and keep learning from your experiences, you will be able to quit for good!

What Happens When You Suddenly Quit?

It may surprise a lot of people to know this, but the effects of quitting can be felt less than 20 minutes after you had your last cigarette. According to the CDC, your heart rate would have already started dropping back towards normal levels. Here’s an infographic to help you visualize what happens to your body once you stopped smoking:

What Happens After You Quit Smoking

Expect your heart rate and blood pressure to stabilize to near normal levels after two hours without a cigarette. The tips of your fingers and toes may also start to feel warm as your peripheral circulation improves. Nicotine withdrawal symptoms usually begin to manifest about two hours after your last cigarette. Early withdrawal symptoms include:

  • intense cravings
  • anxiety, tension, or frustration
  • drowsiness or trouble sleeping
  • increased appetite

How long does each symptom last? The Filter by the Action on Smoking and Health (ASH) Wales UK provides the following timetable:

how long withdrawal symptoms last

Based on the timetable provided, going cold turkey increases one’s appetite and causes weight gain. Through a balanced diet and regular exercise, you can keep your metabolism from going awry, which will cause you to gain weight after you quit smoking.

What to Do When You Fall Off The Wagon Too Many Times?

The idea of going cold turkey scares most smokers because they know they’ll be facing a period of extreme hardship as they try to overcome their cravings for nicotine. They have to go out of their way to avoid social triggers, such as the sight of someone smoking and the smell of tobacco in the air. No wonder falling of the wagon is common among smokers who tried to quit this way.

“Falling off the bandwagon is all part of the process of breaking the habit,” says renowned behavioral change expert Dr. Carlo Di Clemente to in an interview. Smokers should take this relapse as a great opportunity to do some kind of risk-reward analysis of their plan and identify the flaws in the process. Around 30 years ago, Dr. Di Clemente formulated the following five stages to making lifelong changes to bad habits, including smoking:


  • Precontemplation stage: This is where you might recognise the need for change but don’t really seriously consider it. Like when a smoker might say “I probably should think about quitting” while lighting up.
  • Contemplation stage: This is realising the need for change, but not actually doing anything about it. When the smoker starts to realise they actually do want to stop smoking, but takes no active steps to quit.
  • Determination stage: Sometimes considered the hardest part, this stage is about planning and really making that decision to change your behaviour. It’s probably the time you’ve done your research about gym memberships or even joined up, but haven’t quite hit the floor just yet.
  • Action stage: And then you get to action, where you stop smoking cold turkey, get those trainers out of the box and go for that first run, or pack a healthy lunch instead of grabbing a burger.
  • Maintenance stage: And inevitably you’ll fail. That’s not the time to give up, Dr Di Clemente says, but the time to reassess the plan and figured out where it all went wrong. Then try, try again.

brain scan

MRI Scans Can Predict Which Smokers Would Kick the Habit Sooner

Many smokers have successfully stopped using cigarettes through behavioral counseling along with Nicotine Replacement Therapy (NRT) and pharmacological treatment. But, not everyone responds to these traditional methods. It’s not because they don’t work; sometimes, it’s because a part of the smoker’s brain may not be working as well as expected.

Joseph McClernon, an associate professor of psychiatry and behavioral sciences at Duke University School of Medicine, ran MRI scans of 85 smokers who puffed more than 10 cigarettes a day. The smokers were then randomly assigned to continue smoking their brand or to smoke low-nicotine cigarettes, along with nicotine replacement therapy, for 30 days. All of the people in the study were then told to stop smoking and given nicotine replacement for 10 weeks.

Those who relapsed during that time tended to have lower activity in the insula, particularly in the connections between the insula and other motor areas that translate cravings into action, while those who successfully kicked the habit showed more robust activity in this brain region. The pattern remained strong despite how many cigarettes the smokers smoked.

“We’ve known for a while that some people seem to be able to quit and other people can’t,” says McClernon. “This gives us a better sense of what neural mechanisms might underlie those differences.”

A quick scan of the brains of long-time cigarette users would reveal which of them would have a hard time quitting. They’re the ones who would “benefit from more intensive, longer duration or even different types of interventions to stop smoking,” according to Prof. McClernon.

So, what else can you do when traditional NRT tools, such as gums, transdermal patches, and inhalers, fail to work on you? If you were one of those with a weakened insula in the brain, then you could try one other solution: electronic cigarettes.

Specifically, you could try advanced personal vaporizers (APVs) that let you regulate the amount of nicotine you consume each day without worrying about the amount of tar and other cancer-causing chemicals found in tobacco. The nicotine-containg liquids that e-cigarette users vaporize and inhale only contain moisture, flavoring, traces of propylene glycol and vegetable glycerin in addition to a measured amount of nicotine extract in liquid form.