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One Cigarette Wouldn’t Do Any Harm – Would It?

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Just over half of the “ever-smokers” (those who ever became regular smokers) in the United States are now “ex-smokers”. Of course for all ex-smokers, the possibility of relapse is real, and the shorter the time since your last smoke the greater the risk of going back. As many as 40% of those who go a whole year without a smoke will lapse and have another cigarette or more in the next few years, while for those who havn’t smoked for five years or more the chances of going back to smoking are much lower.

I suspect that most visitors to the Healthline.com website are not current smokers, but that a sizeable proportion will be ex-smokers, many of whom gave up long ago (5 years or more). Most long-term ex-smokers are very happy and relieved to have successfully quit, but many will admit to getting occasional urges to smoke. Being in situations where you previously smoked (e.g. a bar) or doing an activity that was associated with smoking (e.g. walking the dog) or even just being in a certain mood state can trigger thoughts about smoking, even if you hadn’t thought about it at all for weeks or months. On many of these occasions you won’t have any tobacco available and the thought will pass in a matter of a few seconds. But certain things seem to be associated with stronger cravings and relapse risks. Some of these things are very obvious practical factors, such as the availability of cigarettes. Some are factors that serve to lower our inhibitions or lead us to believe that we “deserve” a smoke (e.g. drinking alcohol, being at a celebration or being on vacation). Even though alcohol can trigger cravings directly, sometimes I suspect that consuming alcohol also causes an indirect effect whereby the ex-smoker believes that being intoxicated somehow gives them an acceptable excuse.

One other psychological factor that increases relapse risk is the thought that, “one cigarette won’t do any harm.” This type of thought is very seductive because on the surface it may seem like a very reasonable point. One cigarette on its own is very unlikely to trigger a serious illness. Ex-smokers entertaining this train of thought often find themselves thinking further rationalizing thoughts such as, “and if I hang out in that smoky bar all evening I’ll probably breath in a whole cigarette’s worth of smoke just from other people’s smoke…so whats the difference?”. But the important thing to remember is that the biggest risk from smoking a single cigarette, is that it greatly increases the risks that you will smoke another and then another and so on. We don’t fully understand the mechanism for this type of relapse but some of it likely occurs at a neurobiological level. Even laboratory rats that have learned to press a lever for nicotine may get a sudden reinstatement of bar pressing if they are given a single injection of nicotine. But there is also a cognitive component to it, that is referred to as the “abstinence violation effect”. This is the process whereby an ex- smoker who has a lapse cigarette then finds him/herself thinking, “oh well, I’ve broken my good record now…I may as well finish the pack” (something that the lab. rat probably doesn’t think).

So it is far better to be very clear in your mind that one cigarette could do a great deal of harm, (by prompting a return to pack-a-day smoking) and that “not-a-puff” abstinence is the way to go.
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About the Author


MA, MAppSci, PhD

Dr. Jonathan Foulds is an expert in the field of tobacco addiction.

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