THURSDAY, July 10, 2025 (HealthDay News) — According to the U.S. Centers for Disease Control and Prevention (CDC), in 2022, the majority of the 28.8 million U.S. adults who smoked cigarettes wanted to quit; approximately half had tried to quit, but fewer than 10% were successful.
Many folks say quitting smoking was the hardest thing they have ever done. This includes people who have climbed mountains, corporate ladders, tackled childbirth and raised families.
Successfully overcoming tobacco addiction is a process, and it takes time. It can’t be done at once. Individuals taught themselves how to smoke, vape or chew tobacco products and practiced for so long that the behavior became as automatic as breathing, eating or sleeping.
Quitting, then, is a process of overcoming addiction and learned behaviors.
Individuals must learn to manage nicotine addiction, unlearn their automatic behavior of tobacco use, and replace it with healthy new alternatives.
Because tobacco dependence is a chronic relapsing condition, Freedom From Smoking® identifies quitting tobacco use and maintaining abstinence as a process in which a person may cycle through multiple periods of relapse and remission before experiencing long-term lifestyle and behavior change.
The CDC suggests that it takes eight to 11 attempts before quitting permanently.
It’s essential to understand three challenges associated with quitting and create a plan to address each with proven-effective strategies:
1. Psychological Link of Nicotine Addiction
What is it?
Over time, using tobacco products becomes an automatic behavior that needs to be unlearned.
After quitting, emotions can overwhelm a person.
Grief can also play an important role in the quitting process.
How to overcome it:
Create support systems through counseling classes, and among family, friends and co-workers.
Mark a calendar for every day you are tobacco-free and reward yourself for days you avoid use.
Use positive self-talk when cravings arise, such as “the urge will pass whether I smoke or not” or “smoking is not an option for me.”
2. Sociocultural Link of Nicotine Addiction
What is it?
Certain activities and environmental cues can trigger the urge to smoke.
As people mature, social factors or cues play a role in continuing use.
People who use tobacco may be reluctant to give up those connections or routines.
How to overcome it:
Identify your triggers and use replacements such as cinnamon sticks, doodling on a notepad or finding another activity to keep your hands busy.
Create change and break routine by using the 3 A’s — AVOID (the situation), ALTER (the situation) or ALTERNATIVE (substitute something else).
Keep a quit kit/survival kit with you at all times with items you can use to replace tobacco product use when the urge comes.
3. Biological (Physical) Link of Nicotine Addiction
What is it?
Addiction occurs when a substance — like nicotine, alcohol or cocaine — enters the brain and activates the brain’s receptors for that substance, producing pleasure.
When a person quits, the brain’s nicotine receptors activate, creating cravings and withdrawal symptoms.
Over time, the receptors become inactive, and the withdrawal symptoms and urges to use fade away.
How to overcome it:
Use cessation medications approved by the U.S. Food and Drug Administration (prescription or over-the-counter) in the proper doses for the full time period recommended by a clinician. Do not stop treatment early.
Exercise alternative ways to release dopamine such as physical activity or listening to music.
Use stress management techniques, including deep breathing and relaxation exercises, daily if possible.
Nearly 2 in 3 adults who have ever smoked cigarettes have successfully quit, according to the CDC You can, too! To learn more about strategies for countering the challenges associated with the three-link chain of nicotine addiction, visit Quit Smoking & Vaping | American Lung Association.
About the expert
Dr. David Hill is a member of the Lung Association's National Board of Directors and is the immediate past chair of the Northeast Regional Board of the American Lung Association. He serves on the Leadership Board of the American Lung Association in Connecticut and is a former chair of that board. He is a practicing pulmonary and critical care physician with Waterbury Pulmonary Associates and serves as their director of clinical research. He is an assistant clinical professor of medicine at the Yale University School of Medicine, an assistant clinical professor at the Frank Netter School of Medicine at Quinnipiac University, and a clinical instructor at the University of Connecticut School of Medicine.