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Beating Nicotine Addiction

Each year 438,000 people in the United States die from cigarette-related illnesses. About 20% of the population currently smokes cigarettes. Those who smoke face a set of difficult challenges. Up until several decades ago, cigarettes were marketed as being “suave and sophisticated.” They were in vogue. Smoking was the cool thing to do. Those already hooked on tobacco found themselves to be the new social pariahs, or outcasts. There is a largely unspoken belief that cigarette smoking is simply a bad habit and that smokers should “just quit.”

Far worse than social stigma is the fact that nicotine addiction may be the most difficult addiction to overcome. When someone inhales tobacco smoke, nicotine reaches the brain in 7 to 10 seconds, creating temporary feelings of pleasure. The positive emotional state dissipates within minutes, leaving the smoker edgy, agitated, and irritable. Powerful and complicated changes in brain chemistry make it difficult to overcome nicotine addiction. Failure to break the habit is not a question of will power or personal character. About 50% of the problem in breaking the addiction is genetic. But not everyone has the gene that makes quitting so difficult. My father smoked for more than 20 years. He had quietly made up his mind to quit and one day, after finishing a pack of cigarettes, he announced that he had smoked his last cigarette—and that was the case. For him, will power and determination were enough to break the habit, but I suspect he lacked the gene that makes smoking cessation very difficult.

The Brain High

Nicotine acts on three major neurotransmitters, namely dopamine, serotonin and GABA. Dopamine is the key. It’s one of our feel-good neurotransmitters, producing feelings of pleasure and well-being. The dopamine receptor site is where amphetamines and cocaine work. It’s also where chocolate works as well as sexual orgasm. Nicotine raises the brain level of dopamine, and has a related function. In every synapse, the space between two neurons, there’s a natural compound called MAO, which has the job of breaking down excessive amounts of neurotransmitters in the synapse. The MAO associated with dopamine is inhibited by nicotine. Ordinarily, with an excess of dopamine, MAO will break down that excess and eliminate it. But nicotine raises dopamine levels and by impairing MAO, dopamine levels rise even higher.

Health Risks

Cigarette smoke contains more than 4,000 toxic chemicals and tar. The tar increases the risk of lung cancer, emphysema and other lung disorders. Cigarette damage to the cardiovascular system is even deadlier than the cancer risk. One of the actions of nicotine is to raise adrenaline levels, which leads to constriction of blood vessels (vasoconstriction). In addition, cigarette smoking leads to high levels of free radicals, or oxidative stress. Oxidative stress rips electrons off artery walls. Carbon monoxide in cigarette smoke increases the risk of cardiovascular disease. The combination of carbon monoxide, vasoconstriction, and oxidative stress leads to the high incidence of heart attack and stroke caused by smoking. Given that heart attack is the number 1 killer in America and stroke is the number-three killer, one can understand how cigarette smoking reduces life span by about seven years.

In 1988 a meeting of the United Kingdom tobacco industry was told of plans by Philip Morris to spend “vast sums of money” on research by scientists who would dispute the health risks of passive smoking. During the first half of 1998 the tobacco industry reportedly spent more than $43 million on lobbying against federal tobacco legislation sponsored by Senator John McCain. Between 1998 and 2005, nicotine content in cigarettes increased by 1.6% per year.


In order to break the habit, a multi-pronged approach needs to be used. That approach can include: 1) drugs, 2) nutritional supplements, 3) diet, 4) acupuncture, and 5) coping strategies.

If you’re a smoker who has tried to stop, you probably know about Nicorette gum, which provides a way to increase nicotine levels, in a controlled way, as you are stopping smoking. Nicotine skin patches do the same thing.

The anti-depressant bupropion (Wellbutrin) has been used to assist with nicotine withdrawal, because bupropion helps raise dopamine and norepinephrine levels. Bupropion for nicotine addiction is called Zyban.

Nutritional Supplements

Most addiction programs begin the day you decide to quit smoking. I’m proposing something different. Build up your system, head to toe, for four weeks in order to become healthier overall. Think of the overall process as: Phase I - rebuilding and restoring, and Phase II - stopping smoking.

Dopamine chemistry appears to be the lynch pin of nicotine addiction. To build dopamine, supplement with the amino acid L-tyrosine. For adults 1000 mg twice a day will work. Take 40 mg of P-5-P (pyridoxal-5-phosphate, the active form of Vitamin B6) to activate tyrosine and help it convert into dopamine. Tyrosine will also increase brain levels of norepinephrine, which will improve memory, concentration, and mood.

To restore brain serotonin levels, take the amino acid L-tryptophan. It gets into the brain much more easily than does 5HTP, which is popular, but not well proven to boost serotonin levels. Take P-5-P to allow tryptophan to convert into serotonin. GABA is our calming neurotransmitter. Take 1000 mg 2 to 3 times a day.

A multiple B vitamin is needed to deal with the stress created by nicotine. Vitamin C gets quite depleted by nicotine. Cigarette smokers burn through twice as much vitamin C than nonsmokers.

The body needs vitamin C to regulate nerve impulses and neurotransmitters that handle worry, fear, irritability and anger. Take 1000 mg 3 times a day or higher.

You’ll want to take omega-3 fatty acids, as they are soothing to the nervous system. In order to restore minimal levels of all essential nutrients, take a multivitamin and a multi-mineral capsule 1 to 2 times a day.

Many experts recommend niacin (vitamin B3) to help with nicotine withdrawal. Niacin has many functions, one being vaso-dilation (dilating the blood vessels). This is helpful because nicotine causes blood vessels to constrict.

Because cigarette smoke causes a great deal of oxidative stress, you’ll want to counteract that with a multi-anti-oxidant.

More importantly, earthing products, which connect us directly to the earth’s natural bioelectrical field, dramatically reduce oxidative stress. Oxidative stress is one of the causes of unwanted skin changes caused my cigarettes.


Nicotine decreases the amount of insulin released by the pancreas. Insulin is involved with blood sugar. Low insulin levels slightly raise blood sugar levels. High blood sugar suppresses appetite.

A few days ago I was evaluating a man for anxiety and insomnia. When I asked him what he ate for breakfast, he replied, “Coffee and cigarettes.” His first actual meal, around noon, is fruit. His diet had almost no protein in it. Coffee and cigarettes appeased his appetite. I noted that he was 5 foot 11 inches and weighed 130 pounds. He looked like his frame could hold 180 pounds. I explained to him what amino acids are, namely the building blocks of protein, neurotransmitters, and hormones. Based on his diet, I did not see how he could not be protein deficient. I asked him if he was experiencing muscle wasting and muscle weakness. He was surprised at the question and said, “Yes, I’ve noticed a lot of muscle loss.” I explained to him that, if we are protein deficient, our body will start to break down muscle protein. Protein is 100% amino acids, and when muscle breaks down, amino acids pour into the blood to perform countless essential functions.

Nicotine addiction is complex and often leads to body chemistry spiraling out of control. What was obvious to me was that this man did not understand what a “normal” meal is. In order to help get real food, real fuel into his system, I suggested he start his day with a protein smoothie with 25 grams of protein, a tablespoon of flaxseed oil, and fruit, thereby providing protein, fat, and healthy carbohydrates. I suggested he blend it with ice, put the smoothie into a cooled container and sip on it through the day. I believe this suggestion will improve his life, for he was keeping his body energized, without food.

Many people make the mistake of eating sugar for energy when they quit smoking, which results in fluctuations in blood sugar. Unstable blood sugar makes you irritable and fatigued. In addition to starting the day with a protein smoothie, eating small protein snacks every couple of hours helps to stabilize blood sugar.

Most cigarette smokers have serious nutritional deficits, so making a major change in diet will help pave the way for stopping smoking, and will also fortify someone who is not yet ready to quit smoking, but is in need of major nutritional support in order not to develop serious illness.

Many cigarette smokers focus entirely on stopping smoking. That desire is usually shrouded in doubt and self-recrimination. Not only does society now label smokers as “bad,” smokers can be their own worst enemy, thinking of themselves as failures, or “too weak willed to quit.”

While you are pondering if you are going to try to quit smoking, or “when” you’re going to quit, treat your body with love, respect, exercise and good nutrition. By so doing, you will counteract many of the health risks caused by smoking. You can work at one thing at a time. Build yourself up simply because it’s the right thing to do for your body and mind. You can do good things for yourself while you are still doing something that’s not good for you.

Meanwhile, while you’re thinking about “when” to stop, the suggestions in this article will prepare you for nicotine withdrawal. This is a difficult addiction to break, but every day people quit. Start doing things to strengthen your body now.

2 Steps to Freedom

Smoking cessation is a two-phase process.

Phase I - Restoring Healthy Total Body Chemistry.

The most important nutritional supplements to take during Phase I (4 weeks prior to quitting) are: tyrosine, P-5-P, omega 3 fatty acids, vitamin C, multiple B vitamin, multivitamin, and a multi-mineral. Begin the dietary recommendations (protein smoothie) during Phase I.

Phase II - Quitting and Dealing with Withdrawal

Withdrawal symptoms peak at 48 hours and include: Tingling in the hands and feet, sweating, intestinal disorders (cramps, nausea), headache, anxiety, irritability, and cold symptoms.

Continue all the Phase I items listed above. Add tryptophan, GABA, niacin, and antioxidants. Increase Vitamin C to 1000 mg every 4 hours for 3 days, then taper down to 1000 mg twice a day. Loose stools are an indication that you’re taking too much vitamin C.

Addiction experts have different ideas about how to deal with nicotine withdrawal. One suggestion is to try sublingual L-glutamine powder to help stop intense cravings.

Introduction to Coping Techniques

Part II in this series will deal with coping strategies, new ways of thinking about cigarette smoking, and a variety of techniques to empower you. The combination of physical and mental treatments will add to your recovery. Spend this month by starting on the nutritional supplements as well as the dietary changes. Some of you will find your craving for nicotine dropping away without doing anything other than making these changes. Others will want to prepare their bodies, get healthier, and begin the strategic mental techniques next month.

During the next month give yourself a mental break from thinking about smoking. Many of you think about quitting every day. For the next month, do not try to quit. You have 4 weeks to give yourself a vacation from the endless thoughts about quitting. Unless cigarettes give you up, you’re on a month vacation from even thinking about it.

After 4 weeks in Phase I (nutritional preparation), followed by strategic mental preparation, you’ll be empowered and stronger to finally quit.


David Gersten, M.D. practices Nutritional Medicine and Integrative Psychiatry out of his Encinitas office and can be reached at 760-633-3063. Please feel free to access 1,000 on-line pages about holistic health, amino acids, and nutritional therapy at and