Summary
Smoking is when someone burns tobacco and breathes in the smoke it produces. Cigarettes contain nicotine, which is highly addictive, as well as thousands of other chemicals. Many of these substances are harmful and can damage the lungs, heart and blood vessels. Smoking also increases the risk of serious illnesses, including heart disease, stroke, lung disease and cancer.
People can start smoking for lots of different reasons. They might be curious, want to fit in, feel pressured by friends or family, enjoy the social side of smoking, or use it to cope with stress or difficult feelings. For some people, what starts as occasional smoking can become regular use as their body becomes dependent on nicotine.
Smoking can affect everyday life too. It can cause coughing, shortness of breath, reduced fitness and tiredness, and can make physical activities such as running or playing sport more difficult. Cigarettes can also become expensive, particularly when someone is smoking regularly.
For young people, starting smoking can make it easier to develop nicotine dependence because the brain is still developing. Nicotine can create cravings and withdrawal symptoms, meaning someone may feel irritable, restless, anxious or unable to concentrate when they haven’t smoked. This can make it difficult to stop, even when they want to.
Smoking doesn’t just affect the person smoking. Cigarette smoke can also affect people around them through second-hand smoke, which can be particularly harmful to children and people with existing health problems.
What does nicotine do
Nicotine is the main addictive substance in cigarettes. When someone smokes, nicotine is absorbed into the bloodstream and reaches the brain very quickly. It affects the brain’s reward system, causing the release of chemicals such as dopamine. This can create short-term feelings of pleasure, calmness, alertness or improved concentration, which can make someone want to use nicotine again.
With regular use, the brain starts to adapt to nicotine and becomes used to having it. This can lead to dependence, meaning someone may feel that they need nicotine to feel normal or to manage cravings. They may start smoking more often or find themselves thinking about when they can have their next cigarette.
When someone who is dependent on nicotine goes without it, they can experience withdrawal symptoms. These might include strong cravings, irritability, restlessness, difficulty concentrating, anxiety, low mood, headaches or changes in sleep and appetite. These feelings can be uncomfortable, but they are temporary and usually become easier over time after stopping.
Nicotine can also have effects on the body. It can increase heart rate and blood pressure and can cause blood vessels to narrow. This is different from the wider harms caused by smoking, which come largely from the many toxic chemicals produced when tobacco is burned.
For children and young people, nicotine is particularly concerning because the brain continues developing into the mid-20s. Nicotine exposure during this period can affect brain systems involved in attention, learning, memory, mood and impulse control, and young people can become dependent on nicotine relatively quickly.
Nicotine can also create a cycle that makes smoking feel like it helps with stress. Someone may smoke and temporarily feel calmer because the nicotine relieves their withdrawal symptoms. Once the nicotine wears off, cravings and withdrawal can return, which can make them feel stressed or irritable again. This can make it seem as though smoking is reducing stress when it is partly relieving the withdrawal caused by nicotine dependence.
How to help myself
If you smoke and want to cut down or stop, you don’t have to do it perfectly or all at once. Nicotine can be addictive, so finding it difficult to stop is not a sign of weakness. Understanding your smoking habits and having a plan can make it easier to take back control.
Think about when you usually want to smoke. You might notice cravings when you’re stressed, bored, upset, with certain people, after eating or when you’re having a break. Understanding your triggers can help you prepare for them and find alternatives.
When you get a craving, try waiting for a few minutes before smoking. Use the time to do something else, such as listening to music, going for a walk, playing a game, having a drink or talking to someone. Cravings can feel intense, but they usually pass.
Having something to do can help distract you from cravings. You could chew gum, have a drink, doodle, play a game, exercise, make something or keep your hands busy with a hobby.
If you usually smoke in particular places or at certain times, try changing what you do during those moments. Breaking the connection between a situation and smoking can make cravings easier to manage.
Write down your reasons for cutting down or quitting. This could be improving your health, saving money, having more energy, improving your fitness or simply wanting to feel less dependent on cigarettes. Keep your reasons somewhere you can look at them when you’re struggling.
If you smoke when you’re worried, angry or overwhelmed, try another coping strategy first. Slow breathing, grounding exercises, listening to music, talking to someone, getting outside or doing something you enjoy can help you manage difficult feelings without relying on nicotine.
Let a parent, carer, friend, teacher, school nurse, GP or another trusted adult know that you’re thinking about cutting down or stopping. Having someone who understands what you’re trying to do can make it easier to manage cravings and stay motivated.
You don’t have to rely on willpower – a GP, pharmacist or stop-smoking service can help you understand nicotine dependence and find support that is appropriate for you. If you’re under 18, a healthcare professional can also help you access age-appropriate advice and support.
If you smoke after deciding to stop, it doesn’t mean you’ve failed. Think about what happened, what triggered the cigarette and what you could try next time. Quitting often takes more than one attempt, and every attempt can teach you something useful.
How to help a loved one
If someone you care about smokes, the most helpful thing you can do is be supportive rather than judgemental. Nicotine is addictive, so stopping can be difficult even when someone genuinely wants to quit. Try to understand why they smoke and what situations make them want to smoke, such as stress, boredom, social situations or certain routines. Give them space to talk about their smoking without making them feel ashamed or pressured, and ask what kind of support they would find helpful.
If they want to cut down or stop, you can help them identify triggers and make a plan for managing cravings. You could encourage them to try activities that distract them from smoking, such as going for a walk, listening to music, playing a game or spending time together. You can also help them change routines that are strongly linked to smoking and support them in avoiding situations where they are more likely to smoke. If you smoke yourself, consider whether smoking around them could make quitting more difficult.
Try not to focus only on whether they have managed to quit completely. Cutting down, delaying a cigarette or getting through a craving are all steps forward. If they have a setback, avoid making them feel like they have failed. Instead, help them think about what happened and what might make things easier next time. Quitting can take several attempts, and having someone supportive around can make the process feel much more manageable.
It’s also worth thinking about why they smoke in the first place. If smoking has become a way of coping with stress, anxiety, low mood or difficult situations, simply taking away cigarettes may not address what they are struggling with. Encourage them to find other ways of managing these feelings and, where appropriate, support them to speak to a GP, school nurse, pharmacist, stop-smoking service or another healthcare professional.
Most importantly, you cannot make someone stop smoking. You can encourage them, listen to them and help them access support, but the decision to change has to be theirs. A calm and understanding approach is much more likely to keep communication open than criticism, threats or shame.
Myth Buster
Myth: Smoking is a good way to manage stress.
Truth: Nicotine can create a short-term feeling of calm or relief, but as the body becomes dependent on nicotine, cravings and withdrawal can cause irritability, anxiety and restlessness. Smoking then temporarily relieves these withdrawal symptoms, which can create a cycle that makes it feel like smoking is helping with stress. Finding other ways to manage difficult feelings can help break this cycle.
Myth: Stopping is simply a matter of choosing not to smoke. Nicotine is addictive, and regular smoking can lead to dependence, meaning someone may experience strong cravings and withdrawal symptoms when they try to stop. This can make quitting difficult, but it doesn’t mean they can’t quit. Support from healthcare professionals and stop-smoking services can make the process easier.
Myth: The effects of smoking are limited to breathing.
Truth: Smoking can affect almost every part of the body, including the heart, blood vessels, brain, mouth and immune system, and increases the risk of serious illnesses such as heart disease, stroke, lung disease and cancer.
Myth: Occasional smoking is completely safe.
Truth: There is no risk-free level of smoking, and even smoking less frequently can expose the body to harmful chemicals. Occasional smoking can also become more regular over time as nicotine dependence develops.
Myth: Quitting is purely about willpower.
Truth: Nicotine changes the brain’s reward system and can create physical dependence, making cravings and withdrawal difficult to manage. Getting support isn’t a sign of weakness – using support can make it more likely that someone will successfully quit.
Support
There are lots of different ways someone can get support if they smoke or want to stop. They don’t have to be ready to quit completely before asking for help. Talking to someone can help them understand their smoking, work out what they want to change and find support that works for them.
A GP, pharmacist, school nurse or other healthcare professional can provide advice about smoking and nicotine dependence and help someone access appropriate support. They can also talk about any physical or mental health concerns that may be connected to smoking.
NHS stop-smoking services offer free support to help people quit. Depending on where someone lives, this may include one-to-one appointments, group sessions, telephone support and help making a personalised quit plan. They can also provide information about treatments that can help manage nicotine cravings.
Trusted adults can provide practical and emotional support. A parent, carer, teacher, youth worker or another trusted person can listen without judgement, help someone manage cravings, encourage them when things are difficult and support them if they decide they want to quit.
Friends and family can also help by being encouraging rather than critical. Spending time together, providing distractions when cravings happen and avoiding smoking around someone who is trying to quit can all make a difference.
If smoking is being used to cope with stress, anxiety, low mood or other difficult feelings, it may also help to speak to someone about what is happening underneath the smoking. Getting support for these difficulties can make it easier to find healthier ways of coping.
Therapy interventions
Therapy may not focus on smoking itself. Instead, it can help with difficulties that may be connected to smoking, such as stress, anxiety, low mood, peer pressure, low self-esteem or difficulty managing emotions. For someone who is dependent on nicotine, behavioural support is often a key part of quitting. At the same time, therapy can be particularly useful when smoking has become a way of coping with other difficulties.
- Cognitive Behavioural Therapy (CBT) – Helps someone understand the connection between their thoughts, feelings and behaviours. It can help identify situations that trigger smoking and develop healthier ways of responding to cravings, stress or difficult emotions.
- Motivational Interviewing (MI) – Helps someone explore their own reasons for wanting to change their smoking. Rather than telling them what to do, it supports them in considering the benefits and challenges of stopping and making their own decisions.
- Behavioural therapy – Focuses on changing habits and routines linked to smoking. This can include identifying triggers, planning for cravings, changing routines and finding alternative activities.
- Emotion regulation work – Helps someone recognise and manage difficult emotions such as stress, anger, anxiety or boredom, particularly when smoking has become a way of coping with these feelings.
- Anxiety and stress management – Can help someone develop alternative ways to manage worry and stress without relying on cigarettes. This might include relaxation, grounding, problem-solving and other coping strategies.
- Self-esteem and confidence work – Can help someone develop confidence in their ability to make changes and cope with difficult situations, particularly if they feel that smoking is part of their identity or social life.
- Family-based support – For children and young people, involving parents or carers can help create a supportive environment around stopping smoking. This can improve communication and help adults understand how best to support the young person without criticism or shame.
Helplines
Childline
Childline is a free service for young people to talk to a counsellor about anything. The service is available 24 hours a day, 7 days a week. Childline is available to anybody who is 18 years old or younger.
Phone: 0800 1111
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
You can also find helpful resources, speak to a counsellor online or send a message on their site.
Website: www.childline.org.uk
For adults concerned about a child, the NSPCC can be contacted
NSPCC
NSPCC is a children’s charity that works to protect children and prevent abuse and neglect. They provide support and advice for adults about child abuse, neglect, child safety, online safety and children’s mental and emotional wellbeing.
Phone: 0808 800 5000
Opening times: 10 am–4 pm, Monday–Friday
Email: help@nspcc.org.uk
Email opening times: 11 am–4 pm, 7 days a week
Website: www.nspcc.org.uk
NHS Smokefree Helpline
The NHS Smokefree Helpline provides free advice and support for people who want to stop smoking.
Phone: 0300 123 1044
Opening times: 9am–8pm, Monday–Friday; 11am–4pm, Saturday and Sunday
Website: www.nhs.uk/better-health/quit-smoking
Shout
Shout is a free, confidential text messaging service that provides support to anyone who is struggling to cope. It can help with a wide range of issues, including stress, anxiety, low mood, loneliness, relationship difficulties, bullying, self-harm, suicidal thoughts, feeling overwhelmed and other mental health challenges.
Text: SHOUT to 85258
Opening times: Available 24 hours a day, 7 days a week, 365 days a year
Website: www.giveusashout.org
FRANK
FRANK is a service providing information, advice and support about drugs and alcohol. It covers drug and alcohol use, effects and risks, peer pressure, addiction, concerns about someone else’s drug or alcohol use and finding local support.
Phone: 0300 123 6600
Opening times: 24 hours a day, 7 days a week
Text: 82111
Live chat: 2 pm–6 pm, 7 days a week
Email: frank@talktofrank.com
Website: www.talktofrank.com
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