WHY MOST SMOKERS CAN'T QUIT

Four million smoking-related deaths happen yearly worldwide. Knowing this information, any smoker with common sense would have quit a long time ago. But only a small few manage to stop smoking. Have you ever wondered why most smokers find it difficult to quit?

In my second-year Pathology class in medical school, we were shown gross specimens of a normal lung and a lung of a patient who smoked and had emphysema. Emphysema is a chronic disease that destroys lung tissue over time. Culprits can be air pollution, environmental or occupational hazards, but the main cause has always been smoking.

To make my recollection more vivid and share them with you, the normal lung shown to us looked like this.

The emphysematous lung of the smoker looked like this.

There is a stark difference between the two, right? As my Pathology professor said, "In the exam, it's easy to tell which is the smoker's lung."

There were a lot of "ooohhs" and "aaahhhs" from the class that day --- mainly from my smoking classmates --- who were terrified and grossed out by their imagination and suspicion of how their lungs might look like when they die.

But you think that made them quit smoking?

No. The scary part stopped with the "ooohhs" and "aaahhhs." Many of them continue to smoke today.

If doctors --- who are presumed to know the ill-effects of smoking --- smoke, what would you expect from most people?

By this time, you can already deduce that this isn't all about having COMMON SENSE. Smoking is really an addiction. An addiction so intense that people with weak wills can't fight off.

But there is hope for the hooked.

A report published today in the journal Science identifies brain receptors in mice that may help explain why it's so hard to quit compounds such as nicotine to act on brain cells. Researchers had previously identified so-called nicotinic acetylcholine receptors as important in cigarette addiction.

Henry A. Lester of the California Institute of Technology and his colleagues created genetically engineered mice that had alterations in these receptors. They found that animals with a mutation in the "alpha4" subsection were particularly sensitive to nicotine's effects.

Mice with the alpha4 mutation showed signs of addiction at lower doses than did normal mice and, once exposed to the chemical, the altered neurons responded more strongly to large doses of it than regular neurons did. [Scientific American]

This study offers fresh insight for other scientists to come up with drugs which might target that "alpha4" subsection of the brain which is responsible for nicotine addiction.

It's still a long shot. And it might take years and years to develop this drug. Obstacles like fierce opposition from most cigarette or tobacco manufacturers are also to be expected. Today's Inquirer editorial said that much and the issue isn't about drugs for nicotine addiction. The Inquirer editorial was lamenting the recently passed "sin-tax bill", but it described the extent of influence of cigarette manufacturers as such:

Perhaps worse, the tobacco lobby is by no means a monolith. Fortune Tobacco has lobbied for the shift from specific to ad valorem tax, while Philip Morris has pushed for the retention of the specific tax, but with a fixed rate across the board. The divided lobby is worse because it means a divided House: one set of lawmakers is doing the bidding of Fortune, another set is doing the bidding of Philip Morris. In such a context, the House couldn't come up with a unified stand. It has thus been weak in confronting the tobacco lobby, which is united in blunting the effect of any new tax measure on their profit margins.

The tobacco lobby is legendary and powerful. Last year, Congress was able to pass the no-smoking law only after much opposition from tobacco manufacturers. The fact that there are still no implementing guidelines more than a year after the law was passed should indicate that the lobby remains strong and insidious. [PDI Editorial, Nov 6 2004]

As long as a group of powerful businessmen place more priority and value on profits than public health, this fight will be long and bitterly fought.