247 points•alephnerd•9 days ago•335 comments•

335 comments

UntitledNo48 days ago
Tabex (https://en.wikipedia.org/wiki/Cytisine) is what helped me (and my boyfriend) quit smoking after many years (~30) of smoking and several failed attempts to quit using nicotine gum and patches. We have now been smoke-free for over 5 months, which is still not long, but much longer than we have ever lasted before.

It seems strange to me that with all the talk about the importance of quitting smoking that Tabex is not well known. A course of treatment lasts 25 days, costed me €35 for the whole course, you can buy it online, you stop smoking on the 5th day, and it makes quitting a lot easier. Really.

It does still require motivation in certain situations when you used to smoke before (going out drinking, clubbing, etc.) but it's still much easier than with anything else we tried, and after the first couple of weeks your brain rewires itself. Five months in, going out with friends who still smoke, we were both not tempted to take a cigarette from them. This is huge for us.

If you really want to quit smoking and everything else failed so far, give it a try.

If you do buy online, just make sure it's not a counterfeit. I don't have any advice regarding that, we got ours at a pharmacy on a trip to Poland.

SOLAR_FIELDS8 days ago
The cravings do go away entirely eventually. It took me probably 2-3 years after I quit before the random cravings stopped, I used to want make the smoking motion with my hand and that finally went away as well. It’s a fairly linear drop off I think, you just get them with less and less frequency as time goes on.
RobotToaster8 days ago
It's an old drug so can't be patented, so nobody will pay for studies on it, which means no health service will approve it.
redeeman7 days ago
for 35€ is it really needed? it will pay for itself many times over
altcognito7 days ago
It needs influencers!
herbst8 days ago
This so much. I am still confused how well tabex works and how few people know about it.

Combine with a dopamine booster for the first weeks (or masturbate a lot) and quitting suddenly feels easy.

I bought it online but directly from a Polish or Slovakian pharmacy.

KellyCriterion7 days ago
Cytisine is the organical base for the synthethic https://en.wikipedia.org/wiki/Varenicline

May I ask: The side effects listed under https://en.wikipedia.org/wiki/Varenicline#Side_effects

-> how hard did any of these hit you in your time?

stasomatic6 days ago
tabex

Not available in the US. I quit smoking 8 years ago but can't wean myself off of vaping. Not that I really tried though and I can easily do a transatlantic flight. The problem with vapes is that they become 24x7 pacifiers, my nicotine intake must be a lot higher.

S0y8 days ago
Here's what I did to get rid of my nicotine addiction (vaping):

- Gradually lower the strength of my liquid until it was at the minimum.

- Stop all vaping and switch to nicotine gum

- Gradually increase the time between each gum

- Stop the gum altogether

This process took probably 3 months and tbh it was pretty miserable the whole time. It's 100% worth it tho, You don't realize how much it controls your life until you stop. You will also still get random cravings for a year or two afterwards, Heck it's been 4 years and I still sometimes get dreams where I'm vaping.

JKCalhoun8 days ago
Stopped smoking cold turkey when my first daughter was born.

For the first year I wanted a cigarette every fucking day.

Years later, I still had dreams where I would light up…

20+ years on, a distant memory.

ivanvanderbyl8 days ago
My father did the same thing. He used to smoke a pack a day and the day that I was born he quit and never touched it again, and then when I was old enough to understand cigarettes, he taught me to never start smoking and I never have.
drooopy8 days ago
Went cold turkey during the first covid lockdown. It was a combination of not being able to go out to buy cigarettes and also the fear of dying since I was a heavy chainsmoker.

Honestly, I didn't miss it once.

pc868 days ago
I don't know the movie or show but there is a scene where someone asks a woman who quick smoking a long time ago (10 years maybe?) if she ever thinks about smoking and she says "every time someone lights up next to me at the bar I want to suck the smoke out of their lungs."

I smoked more than a pack a day for probably 7 or 8 years and quit a couple years after college, not quite cold turkey but basically just trying to wait a little longer between each cigarette. Eventually when the last half of the pack is stale and disgusting but you smoke them anyway because they're expensive, you just kind of stop one day. It was many, many years of no nicotine at all before I stopped thinking about it every day though.

kakwa_8 days ago
Having a motivation, even minor, helps a lot.

For me, it was the requirement to be nicotine free for a few months around a surgery.

I went the patch route and it was a somewhat difficult 3 months, but it has been a blessing not have to clear-out my through every morning or anxiously anticipating stuff like a long flight or train ride.

I also got the "oh shit, I relapsed" dreams for about a year after I quit.

fzeindl8 days ago
I combined a couple of methods:

- stop smoking in certain situations (no cigarette at the bus stop, no cigarette after lunch, …)

- allow myself to put out a cigarette halfway when I’m smoking. I lapsed and lit one, but that doesn’t mean I have to finish it.

- try to feel the downsides of the cigarette while smoking. The nicotine high mostly overrides this, but it’s possible to concentrate on the yucky feeling in your mouth, your lungs being burned etc.

- telling myself that I am sure I want to stop smoking at some point in my life so I might as well stop now.

simoncion8 days ago
> Heck it's been 4 years and I still sometimes get dreams where I'm vaping.

It has been way more than four years for me, and I'll smell some cigarette smoke when I'm in a mood and be all like "Man, wouldn't it be nice if I got me one of those?".

But, I can say the same sort of thing about my reaction to the odor of coffee or caffeinated tea. Despite the fact that the very same place I get my coffee and tea from sells cigarettes -and wouldn't even card me because I'm so very obviously old- I've been able to quit nicotine. I've never been able to quit caffeine.

idiotsecant8 days ago
How do people not just do the easy pleasurable thing? I am incredibly prone to addictions and I don't understand how some people aren't.
tpm8 days ago
I have never been addicted to nicotine so can't compare but it's quite easy to quit caffeine, I'll get headaches for a few days and then it's gone. But then what? Caffeine makes it easy to concentrate and work, enables me to get anything done at all. Other drugs that do that are illegal. Maybe one day, when I'm no longer working, I'll quit it for good. Not yet.
fibonachos8 days ago
In my late 20s and early 30s I would frequently join my coworkers outside while they took a smoke break. I would generally try to stay at the periphery or upwind when possible. Over time, I found myself having inexplicable cravings for a cigarette despite never having smoked one. Presumably this was due second hand exposure. (Acknowledging it would have been smarter to simply stay indoors.)

That eventually faded after our careers took us in different directions, and landing remote roles or at places with fewer or no smokers.

I can’t imagine how difficult it must be to quit. Props to anyone who makes the attempt, successfully or otherwise.

w-ll8 days ago
thats how we all get started. its a social thing, your in or your out. sucks. but its what it is.
nerdawson8 days ago
I vaped for around a year and each attempt to quit ended in failure.

The first attempt, quite early on, I hadn't realised how dependent I'd become and thought it would be easy. Sure, I enjoyed vaping, but I didn't "have" to do it. Give it a couple days and I'll be back to normal. Predictably that went poorly.

Various other attempts I'd now look back on as thinking I could outsmart addiction and try to ease out of it, when in reality it was little more than procrastination.

Oh, I'll start to limit the times I vape. Only between certain hours. Or I'll go outside and do it, make it inconvenient and less appealing. I'll buy flavours I don't enjoy as much and change the association.

For me the only way to stop was to accept the unpleasantness of going cold-turkey. I knew going in that the first 48-72 hours would be brutal but that it would get significantly easier afterwards. There's always a reason to delay but everything I attempted short of actually stopping feels like self-deception.

dasKrokodil9 days ago
A while back I saw this on reddit... in case you don't want to click the link, it's a picture of a cigarette with the caption "This plant-based alternative promises to help high schoolers stop vaping".

I would have never thought that people would be stupid enough to try this for real, but here we are...

https://www.reddit.com/media?url=https%3A%2F%2Fpreview.redd....

EvanAnderson9 days ago
hn_throwaway_998 days ago
That was hilarious but I hate how hard The Onion has to compete with reality now.
userbinator8 days ago
Bonus virtue-signaling points for "plant-based alternative", although I had a different plant in mind when I read that phrase.
d--b8 days ago
You're being judgmental but I think you're just misinformed.

Vaping can be difficult to stop because:

- it's more accepted

- it's smoother on the throat, and there's plenty of tastes.

- there is no "dose", if you want to you can just vape non stop, and you can pace yourself. With a cigarette, you can't smoke slowly, or you'll loose half the cigarette.

All in all, it's just more convenient and cheaper to vape. If you're hooked, I can see it quite a challenge to stop. You can always say : "oh I am just taking x drags a day".

Personnally I didn't like vaping much, cause it was the beginning, the tastes were weird, the gear was not great battery-wise. So I kept going back to smoking. Eventually going cold turkey from cigarettes was way easier than through vaping.

axospaxos8 days ago
Heroin is even less accepted, offers less tastes and is more serious about correct dose.
anigbrowl8 days ago
You're missing the very basic point that taking up cigarettes is just as bad and likely considerably worse.
thin_carapace8 days ago
while tobacco is indeed more viscerally addictive than vaporized nicotine, i still believe it is wrong to label the act of switching from vapes to cigs as blanket stupidity. a cigarette has a defined start and end point around which the brain may optimize, while vapes have no off switch. from the outside in, it may be difficult to see that this factor may weigh in significantly ... so ill bolster my point by suggesting tobacco is a valid method to control schizophrenia symptoms, i dont believe that high dose nic vapes have the same effect.
busymom08 days ago
People are even vaping on public transit nowadays. Never seen that for smoking.
vonunov8 days ago
Have you read gwern on nicotine? Particularly, in this case, regarding MAOIs in tobacco, so I suppose the hop through gwern isn't entirely necessary, but it's where I first heard of this, anyway.

https://gwern.net/nicotine#addictiveness

prohobo8 days ago
People don't understand that cigarettes are self-limiting because they literally hurt your throat and lungs. Most people simply can't chain smoke and they need about an hour break in between smokes.

With vaping that limit is completely gone. A vaping addiction can keep escalating until you want a puff every 30 seconds, especially once you start breaking down mental barriers like "no vaping indoors" or "no vaping while on the computer", etc.

So in terms of pure addiction I would 100% argue that cigarettes are better than vaping.

m-chrzan8 days ago
Are you speaking at all from experience?

>Most people [...] need about an hour break in between smokes.

I've never seen anything like that. When there's a group of social smokers standing around, it's very common for something like "Oh, I just finished mine and you're only half-way through yours, I'll light up another one to keep you company" to happen. I've seen plenty of people who aren't chain smokers (yet), but can easily go through 2-4 cigarettes in a row if they're suddenly in a stressful situation and smoking "to relax".

>So in terms of pure addiction I would 100% argue that cigarettes are better than vaping.

But that's not a metric that's in any way helpful for a health decision. Nicotine in and of itself is not particularly physically harmful - it's toxic at high doses and elevates heart rate for a bit, but that's about it. The delivery method is what causes most of the harm, and smoking is 100% known to cause a lot of harm in a lot of different ways. And "With vaping that limit is completely gone" is also not accurate. Unlike the Navier-Stokes equations, dopamine receptors don't experience infinite blowup in finite time. So choosing a delivery method based on the amount of nicotine taken daily is not going to change much in terms of addiction (if you're already heavily addicted, you'll remain heavily addicted), but can have a huge impact on physical health.

andoando8 days ago
Speaking from personal experience, vaping is far more addicting. For one the amount of nicotine, especially in the US where 5% is the standard, is easily 5-10x the amount from a pack of cigarettes a day.

Second, its much easier to take a puff than it is to find a suitable place to light up a cigarette and smoke for 5-10 minutes. You can very easily end up becoming psychologically conditioned to taking a puff litteraly once every 20 seconds, all day long from waking up to going to bed.

I too have considered picking up smoking to quit vaping. I remember of the times I did, I could smoke 3-4 a day and be fine. I don't know the long term effects of vaping physically, but just mentally the amount of nicotine is absolutely draining and at this point I rather do some damage to my lungs than keep this going.

saberience8 days ago
Vaping to smoking is like shooting heroin is to doing a line of coke. And I say this as someone who has smoked and vaped.

Smoking is addictive and was kinda hard to quit. Vaping is insanely, insanely addictive and about 100X as hard to quit (for me anyway). It took me about 3 tries to quit smoking. Its taken me about 100 attempts to quit vaping.

Also, you end up vaping all day and night since there is no reason you can't do it anywhere. In the toilet at work? Vaping. In bed at night, Vaping. Jerking off? Vaping.

It's just insanely bad.

rsynnott8 days ago
Yeah, as an ex-smoker with lots of friends who are still smokers, I don't think this 1 hour limit thing is a thing at all.
tomcam7 days ago
> Unlike the Navier-Stokes equations

deep cut

beezlewax8 days ago
This is not true.. you can chain smoke for hours if you get used to smoking. Drunk people do it all the time. When your nicotine addiction ramps up enough you'll get cravings to do that always.
bityard8 days ago
Maybe that's the case for you, but that would make you the exception. In the 80's when and where I grew up, it was very common for adults to estimate cigarette consumption in terms of, "packs per day."
mtlmtlmtlmtl8 days ago
There is probably some truth to what you're saying, but also keep in mind that tobacco contains more active compounds than nicotine alone, including MAO inhibitors in the form of harmala alkaloids. These can synergise with nicotine and make it more addictive.

Also, I'm dubious about your claim that most people need breaks, or at least any more than vapers do. I was a smoker for over a decade. I don't remember ever feeling like "that's enough, my throat hurts". It's just that smoking was triggered by the onset of withdrawal, which begins after about an hour, and becomes urgent after maybe 2-3 hours. So I'd typically smoke at an interval of 1-3 hours depending on how convenient it was to do so. And cigarettes are expensive, so that factors into it too.

Sometimes though, especially when drinking, I could chain smoke for a couple hours straight while hanging out in a park with friends, especially in the summer.

After I switched to vaping though, I have at times ended up puffing so enthusiastically that I've made myself nauseous from the nicotine. So there's certainly a limit there too.

Edit: another interesting thing I've noticed. Nicotine withdrawal seems much less severe after I switched to vaping. It takes several hours longer to become noticeable, and also feels less intense. When smoking, it took me 1 hour to start craving a cigarette, by 3 hours I'm becoming irritable with strong craving, and by 5 hours I'm extremely irritable, light-headed, and the only thing on my mind is smoking, completely incapable of focusing on anything except how to get some cigarettes and how to get to somewhere I can smoke em.

For vaping, it takes me maybe 7-8 hours to get to the 3 hour mark for smoking. I certainly get cravings long before that, maybe starting at 2-3 hours, but I'm able to push it out of my mind much more easily, for much longer. I don't know why this is. My theory is something to do with the lack of MAO inhibitors. It's also possible that it's a pharmacokinetic phenomenon, but that seems counterintuitive. If I'm ingesting higher doses of nicotine compared to smoking, blood levels will take longer to go to zero. But then I should also have higher tolerance, and therefore a higher threshold for the onset of withdrawal, since tolerance and chemical dependence are more or less the same thing.

SmirkingRevenge8 days ago
> Nicotine withdrawal seems much less severe after I switched to vaping.

I noticed this too. I was a chain smoker. I became a chain vaper, managing to quit tobacco in the process.

Eventually, I was able to cold turkey vaping in a way I could never manage with tobacco.

It took being sick for about 2 weeks so I couldn't vape. Once I was better, I just didn't do it again, and it was... actually kind of easy.

Similar situations have happened to me over the years when I was on tobacco, but I could never just walk away like I did with vaping.

Maybe part of it was that, with tobacco, you really organize a lot of your day around it. Going to the store, going outside for breaks, driving a little extra so you can fit in a smoke in the car, etc - vaping can really scramble all that up so you have fewer situational triggers.

saberience8 days ago
I've vaped so much I've physically thrown up, and that never happened with smoking. In fact, I've vaped until I've not been able to walk I've been so dizzy.

Vaping is equivalent to shooting heroin or doing crack, it's so much more intense and addictive than smoking. I found quitting smoking to be incredibly easy compared to quitting vaping.

andoando8 days ago
If you smoke enough you get over the terrible feeling in your throat and the smell, but those effects are definitely bad enough that they act as a meaningful deterrent to wanting to smoke more.

If I smoke a cigarette now Ill usually regret it cause Ill be thinking about the terrible taste in my mouth the next 20 mins.

Vaping? Its like eating fucking candy with a million different flavors to try when youre bored of one

abalashov8 days ago
Yup. This was my main takeaway from vaping in the 2010s, after I 'quit' smoking.

However, the vast majority of my nicotine usage after quitting was chewing nicotine gum -- for 11 years! It also has the qualities you mention. You can be chewing all the time, anywhere, everywhere, and without any of the vaping restrictions places have.

Nicotine gum isn't for everyone, but if you're one of the people for whom it really takes as an addiction of its own, it's that much more difficult to quit because it's discreet, there's essentially no stigma, and you can do chew absolutely anywhere, doing practically anything.

sph9 days ago
For the past 3 years I have replaced my ADHD stimulant medication with nicotine patches and they’ve been great, cheap, and legal in the country I live in now.

Recently I got the urge to try vaping again, bought all the paraphernalia and started vaping like a chimney 24/7. Got light nicotine poisoning as well. After two days, I caught myself compulsively reaching for the vape.

So I threw everything away and I’m back to patches. Took me a week to forget the compulsive hand-to-mouth urge. I now believe intradermal nicotine is the superior method of administration. At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.

dasKrokodil9 days ago
> At least with cigarettes the smoke is such an intense irritant you self-regulate pretty quickly compared to a cupcake flavoured vape you can just suck on all day long.

In my experience: no, you don't. You just arrange your life around the fact that you need to smoke all the time.

sph8 days ago
I've been a heavy cigarette smoker for 12 years (pack a day min.). When I switched to vaping, I vaped continuously the entire day.

There is no human on earth that can smoke continuously the entire day for very long. A pack a day smoker means smoking one every ~30 minutes circa.

nom8 days ago
it also stops being unpleasant once your brain has associated it deeply with the dopamine

if anything, the strong smell and taste sensations makes it even more addictive

ravenstine8 days ago
I, too, have experimented with the patches over the last year. Nicotine is great in a lot of ways, but whether it's a tool or a crutch depends on both the person and the delivery method.

The patches are different, not just because it lacks that same connection to compulsive and ritualistic activity, but it simply doesn't provide the same quick "hit" that makes smoking far more addictive.

On the other hand, someone prone to addictive tendencies probably shouldn't even use the patches. Even the patches can be a gateway to vaping and smoking for such a person. I have simply never been the type to become addicted to any drug or substance, other than the occasional overeating. This isn't to say that I don't have the potential to get hooked on more powerful drugs, but my innate desire to use them is a lot less than I think is average. Even during times where I've habitually drunk copious amounts of alcohol, I've always been able to realize "this kinda sucks so I think I'm gonna stop" and then I just do without really much struggle other than some brain fog for a few days. Similarly, I sometimes use phenibut, and people talk about how easy it is to become dependent on it and how hard it is to get off it, and that hasn't been my experience in the slightest. Someone without a clear objective around how they use substances like that will be much more likely to end up suffering.

That said, the patches are great for focus and anxiety when used in low doses in moderation. I don't necessarily advise that everyone use them as I have, but I also don't think they're anywhere near as harmful as one might assume. I don't feel the need to ever switch to smoking or vapes, or even gums and pouches.

paulpauper8 days ago
That said, the patches are great for focus and anxiety when used in low doses in moderation

There is almost no good evidence of this. Effect sizes are tiny, if any. Just placebo and anecdotal. The effect is so small it's not even worth it from

altairprime8 days ago
Hey, another person with addiction-intolerant ADHD! I have run into so few people who encountered and noted it. Most people can’t just treat a compulsion by curtailing it through willpower, though I still don’t comprehend why. Ironic that the willpower disorder wins the day versus the baseline.
snarfy8 days ago
I smoked my first cigarette at 6, really started at 13 and smoked 2 packs a day for 30 years. Patches are the best way.
gerdesj8 days ago
I smoked for roughly 30 years and was not in very good shape when I gave up eight years ago - that improved rather a lot.

The problem is that nicotine is not the only addictive substance involved. If it was then you could chew gum, wear patches or whatever and off you go. There is an extremely complicated set of chemicals involved in fag smoke. There is also the habit effect and other complications.

In the end I think that boring old will power is the only way and any trick or tool or whatever that you can deploy to bolster that is how you give up.

My initial plan was to vape but I soon found that unsatisfying and it looked to me like trying to substitute one habit with another.

Once I started stopping, I didn't want to stop! It was extremely hard but I always reminded myself that I had got so far and that that time would be wasted if I had to start again. I followed doubled up time periods - one day, two days, 1/2 a week, a week, a fortnight, a month, two months ("cripes, this might work") and so on.

A mental tool I developed was a couple of mantras: "I don't want to smell" and "I don't want to die". Whenever I felt the cravings I repeated those to myself and I have no idea why but it did work for a while at a time. Gradually the need tailed off (say around two years)

I remember having quite vivid dreams where I would "crack" and start smoking again. I had to do quite a lot of mental verification to prove to myself that it was just a dream. At one point I even smelt my clothes to prove to myself it was all a dream.

We are all different and there is no right or wrong way to quit. One thing we can all agree on is it is hard, very hard but not impossible. Pick a strategy that might work for you and be prepared to change it but please do have a go. It really is worth it.

onemoresoop8 days ago
How did you taper off patches? Are you still on them?
Spooky238 days ago
I always wondered if ADHD and smoking were related.

I’m ADHD boy for sure, and my dad and his younger sister are both very much not like my aunt, who is more like me. Shes in her 80s now, and was the only smoker - literally smoked cartons a week for about as long as I remember.

sph8 days ago
I deleted my comment talking about it because it usually goes badly with the HN audience and their preconceived notions.

But I have had the hypothesis (as a layman) that growing around smokers affects the brain of a child, they self-medicate with tobacco, and the cycle continues, and it has for many generations until today when smoking is frowned upon and self-medication is no longer readily available. I don’t think smoking is the cause of all of ADHD, but we’ll eventually learn that dopamine dysfunction has a lot of different causes.

onemoresoop8 days ago
ADHD people get hooked to smoking quite easily. Nicotine's a stimulant after all.

Read the full thread on Hacker News →

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