Hello, I am Dr. Jang Dong-seon. One of the scariest addictions is drug addiction, and among them, nicotine addiction is particularly frightening. If we look at alcohol addiction, cocaine addiction, or marijuana addiction, these are not substances that can be used multiple times a day. In the case of nicotine, the frequency of use is higher than the intensity. Because nicotine can be supplied to the brain several times within an hour, it can be considered one of the most addictive substances. 

So, what do we need to do to quit smoking? This is an important topic. I will start by sharing my own story of quitting smoking and then discuss nicotine addiction today. By the way, today's video is supported by the production of Nicorette ES, a smoking cessation aid. Why do we fall into addiction? The brain helps us survive by continuously seeking out good things.

하고 싶어하는 것은 뇌 안에 있는 보상 회로가 작용하고 있습니다. 예를 들어, 에너지를 제공하는 음식을 섭취했을 때 기분이 좋고 맛있다고 느끼는 것은 도파민이 많이 분비되기 때문입니다. 그래서 이거 또 먹어야지라는 생각이 드는 것이죠. 뇌는 이 경험을 기억하고, 강화 학습이라는 과정이 생겨나 여러 음식 중에서 가장 달콤하고 맛있는 것만 선택하려는 경향이 생깁니다. 그런데 중독이란 언제부터 시작될까요? 반복적으로 이러한 강화 학습이 이루어지면, 특정 물질이나 음식에 대해서만 기쁨을 느끼게 되고, 도파민이 분비되지 않게 됩니다. 이렇게 뇌가 변화하면 우리는 중독에 빠졌다고 말하게 됩니다. 중독이 무서운 이유는, 뇌가 중독 상태가 되면 보상 시스템 자체가 변해버리기 때문입니다.

Because of this, it often becomes difficult for me to quit or break free solely based on my willpower. The reward network has changed, which often means that the amount of dopamine released has decreased. A typical example is nicotine addiction in smokers, whose dopamine levels are about 15% to 20% lower than those of non-smokers. What this means is that the entire brain has shifted to a state of lower dopamine release. Initially, when tobacco is introduced, it feels good; it brings relaxation and enhances concentration. However, once a state of addiction is reached, it is no longer the positive effects that drive the behavior. Instead, if tobacco is not present, one feels abnormal. This is the frightening aspect of addiction: what starts as something enjoyable eventually leads to a state where not using the substance results in feeling abnormal. Therefore, to maintain some level of normalcy, one feels compelled to use the substance.

The fact that one can become addicted is really frightening. When an alcoholic reaches a severe level of addiction and ends up in the hospital, they are given alcohol. This is because, without alcohol, their body cannot function normally. The same goes for cocaine addiction; treatment involves gradually reducing the dosage to help the person recover from their addiction. It's not as simple as just quitting. This is why addiction is so terrifying. 

We tend to think that alcohol and nicotine are not as dangerous compared to other drugs, mainly because there are so many people around us who drink and smoke. However, the substance that is actually the hardest to recover from is nicotine. Let's take a look at why it is so difficult based on data.

Let's examine how long it takes, on average, for 50 out of 100 people who have decided to quit smoking to actually do so, by looking at different substances. In the case of cocaine, the average time is about 4 years. For marijuana, it takes an average of 6 years. With alcohol addiction, the average time is 16 years. However, for cigarettes, the average time is a staggering 30 years. About 70% of people think, I should quit smoking, but they end up smoking again within a week. Unlike alcohol, cocaine, or marijuana, which are not typically used multiple times a day, nicotine is different because it can be consumed several times in an hour. This frequent supply of nicotine to the brain makes it particularly difficult to quit, leading to a high level of addiction.

It can be difficult to understand how challenging it is. Let's take a look at one of the cases where quitting is particularly hard. The onset of nicotine addiction often begins during adolescence, making it even harder to quit. In cases where individuals start smoking at the age of 14 and develop nicotine addiction early on, the prefrontal cortex shows reduced activity. This makes it more difficult for them to make good judgments, exercise self-control, and increases the likelihood of engaging in self-destructive behaviors. Consequently, quitting smoking becomes more challenging, and the probability of starting other drugs also increases. Additionally, they are more likely to engage in various harmful behaviors throughout their lives without being able to control themselves. Isn't that frightening? The effects are not only produced by traditional cigarettes; the same effects occur even when addiction develops through e-cigarettes.

For reference, I think electronic cigarettes are less harmful than regular cigarettes, but broadly speaking, electronic cigarettes can be divided into two types: the stick type and the liquid type. In the case of the stick type, the nicotine content is not significantly different from that of traditional tobacco. And I think that smoking the liquid type will not introduce harmful substances into the lungs, but the liquid type also causes nicotine addiction, so the changes that occur in the brain are not very different. So, how do we quit smoking? This is a more important question. The doctor quit smoking after several attempts. He didn't quit all at once; he thought, I want to quit, and whenever he made up his mind, he would quit, but after a few months...

When I quit smoking, I was able to endure for a long time, sometimes even six months to a year. However, once I started smoking again due to some circumstances, it felt like I had reset my progress. I have experienced this many times, which is why I firmly decided to quit. There should be absolutely no leniency; it is a strict rule that one must adhere to. The first week after deciding to quit smoking is the hardest. This is because during this period, not only cravings for cigarettes but also symptoms like increased appetite, anger, anxiety, and depression manifest most strongly. In other words, if you can endure the first week, your chances of successfully quitting smoking increase significantly. In fact, research shows that among those who maintained their quit status during the first month, the long-term success rate of quitting after 12 months is more than double compared to those who did not. Therefore, if I truly want to succeed in quitting smoking, I must definitely stop.

the first step in quitting smoking is to endure the initial phase. However, if I have repeatedly smoked and have already become addicted to nicotine, my brain's dopamine and acetylcholine networks have changed, and chemical changes have begun to occur in my brain. At this point, quitting solely through willpower becomes very difficult. Therefore, seeking help from medications can be a good option. There are medications available, such as nicotine replacements, which can significantly aid in overcoming nicotine addiction. In fact, the Ministry of Health and Welfare and the World Health Organization have recognized nicotine replacements as a primary smoking cessation aid. The nicotine levels in a smoker's blood fluctuate throughout the day, and when smoking, the blood nicotine level can increase dramatically within seconds. And

Nicotine promotes the secretion of dopamine, which provides a rewarding effect and satisfaction. However, over time, as nicotine levels drop, withdrawal symptoms appear. This is when individuals tend to smoke again. To help manage the craving for smoking when it arises, nicotine replacement therapy (NRT) provides a small amount of therapeutic nicotine without the other harmful substances found in cigarettes. The available forms of NRT include gum and patches. The nicotine patch continuously and steadily supplies nicotine, reducing the overall withdrawal symptoms for smokers. During moments of sudden cravings, chewing nicotine gum can help control the desire to smoke. Today's video focuses on one of the representative nicotine substitutes, Nicorette.

You have been supported in the production of ES. You can use two forms of Nicorette nicotine replacement patches, which can be purchased without a prescription at pharmacies. Because it is a medication, you should not chew it like regular gum. You need to gradually reduce the amount used and follow the correct usage to overcome nicotine addiction. It is difficult to overcome nicotine addiction solely with willpower. If you find yourself in that state, seeking help from nicotine replacement products can be a good option. One of the best ways to overcome addiction is to return to its essence. What is the essence of addiction? It is a state where the brain's dopamine system has changed to the point where you cannot feel pleasure without a specific substance or behavior. Dopamine is not only released through specific substances or actions; it can also be released through other healthy methods.

It is important that people focus primarily on quitting addiction. At the same time, it's essential to consider where we can find other sources of pleasure. For instance, starting a new study or trying a new sport can be significant. I believe it is crucial to engage in activities that can stimulate dopamine production. Typical examples include exercise addiction, running addiction, and acceptance addiction. These types of addictions are not necessarily bad, and through them, we can promote dopamine release and restore the joys of life. I would like to recommend these methods.

In fact, I used to smoke, but I have quit now for various reasons. The first reason is that I have allergic asthma, and my respiratory system is somewhat weak. Smoking in my twenties made my condition significantly worse. My lung capacity decreased, and I often found myself short of breath during physical activities.

Seeing my abilities diminish made me think, This is not right. So, initially, I quit smoking for health reasons. Secondly, when people quit smoking, they often get called tough or harsh. To me, that is the highest praise. I am someone who quits smoking; I am someone who can do it. Even if others find it difficult and can't manage it, I can do it, and in the end, I accomplished it. This boosts my self-efficacy significantly. Therefore, I believe it's very important to maintain a positive mindset. Instead of thinking, I am an addict; I struggle to quit, I think, I am someone who can do it, and overcoming this challenge can empower me in other areas as well. I think approaching quitting smoking with this mindset could be beneficial. Of course, it's not an easy path, but it’s not impossible.

The less you rely on nicotine, the greater the release of dopamine in your brain will be when you achieve something, and the joy, pride, and happiness you feel will be even greater. I hope you can experience how much greater the happiness from quitting is compared to the happiness gained from smoking. I support you all. Let's do this!

마약보다 중독성이 강한 니코틴 중독에서 벗어나는 법

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