Smoking cessation consists of stopping tobacco consumption to overcome tobacco dependence. One cigarette contains about 2,500 chemical compounds, which become more than 4,000 during combustion. These include tars, toxic gases (carbon monoxide, nitrogen oxide, hydrocyanic acid, ammonia) and heavy metals (cadmium, lead, chromium, mercury). Nicotine, a psychoactive alkaloid, induces rapid dependence even at low consumption.

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Health consequences of tobacco

Smoking is the leading cause of preventable mortality in France, accounting for nearly 75,000 deaths annually. It is classified as a proven carcinogen: one in three cancers is attributed to it, mainly lung cancer, but also those of the throat, mouth, pancreas, kidneys, bladder and lungovarian. It also promotes cardiovascular disease and chronic obstructive bronchopneumopathy (COPD), as well as various metabolic and eye diseases (diabetes, gastritis, cataracts, age-related macular degeneration).

Tobacco alters sexual and reproductive function: erectile dysfunction, longer design time, reduced chances of success in medically assisted reproduction. It also degrades the quality of the skin and teeth. Passive exposure affects almost 30% of 15–75 years, with particularly harmful effects on the foetus in pregnancy.

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Mechanisms of addiction

Tobacco addiction is based on three dimensions:

• Physical dependencenicotine stimulates dopamine release, resulting in habituation and withdrawal symptoms (irritability, anxiety, depression, sleep disorders, difficulty concentrating).
• Psychological dependence: consumption is associated with sensations of relaxation, reward or stress management.
• Behavioural dependence: gestures and rituals related to cigarettes (light, inhale, exhale) anchor in specific social or temporal contexts (after a meal, with coffee, during a break).

These dimensions may persist after nicotine cessation, making withdrawal complex.

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Smoking cessation strategies

1. Assess addiction: use tools such as the Fagerström test to measure the severity of addiction and distinguish the physical part from the behavioral part.
2. Medical and psychological support: addictologist for clinical follow-up, psychologist for emotional support.
3. Choose a stopping method: abrupt discontinuation or progressive reduction, with suitable nicotinic substitution treatments (patch, gum, inhalers).
4. Clarify motivationsHealth, finance, quality of life. Benefits must be identified and monitored.
5. Replace ritualssubstitute tobacco-related gestures with alternatives (hydration, physical activity, chewing). Delete associated objects (ashtrays, lighters).
6. Strengthening motivationReward daily, see physical and psychological improvements.
7. Managing relapses: consider them as learning steps, analyze triggers and adjust strategies.

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