How come is that? Author Gillinder Bedi says, "When people are exposed to things that they associate with a drug they use, they often feel an increase in craving."

The new twist her team discovered is that the impact of such cues apparently does not weaken as the period of abstinence lengthens.

"This means that quitting smokers may find that they are surprised by having a strong craving response when they come into contact with cues related to smoking, even after they have gotten through the initial withdrawal," she added.

In this research, Bedi and her colleagues focused on 86 healthy male and female smokers who had not yet kicked the habit and weren't trying to do so.

They were divided into three groups: one instructed to stop smoking for a week; the second instructed to stop for two weeks; and the third instructed to stop for five weeks. As an incentive, they all were paid $30 a day to try to quit.

Each participant was exposed to a series of randomly presented cues designed to be either "neutral" or smoking-related on the last day of each group's abstinence period. The smoking-related cues included viewing photos of smoking situations while holding a lit cigarette, while the former involved viewing neutral photos while holding a pencil cut to the length of a cigarette.

Researcher found that cravings triggered by exposure to smoking-related cues actually increased the further down the abstinence road a former smoker went.

Cue-induced cravings were found to be more prevalent among the smokers at the five-week abstinence mark than among those asked to stop for just a week. Similarly, those exposed to smoking-related imagery along the way showed more cravings at the five-week point than at the two-week point.

As a result, the authors suggest that clinicians should consider the possibility that ex-smokers might actually face a more difficult long-term struggle with cravings than previously thought.

Dr. Adam O. Goldstein, director of University of North Carolina's Tobacco Intervention Programs in Chapel Hill, said that cues for cigarettes could be stronger than similar cues for alcohol and opiates.

"People underestimate these cues," said him. "That's one of the real take-home lessons of this kind of research. They are very powerful, and the return to smoking when these cues come can be rapid. But they are treatable."

"Coping strategies can moderate the effect of these kinds of cues," he explained. "Cognitive therapy can help. And people who plan for how to deal with those smoking-related cues do better than those who don't."

"There are also some pharmacologic interventions that work better than others," said him. "For example, some people should have some nicotine lozenges at hand, because if they get a smoking cue I'd much rather have that person pop a lozenge to relieve that cue than turn to a cigarette."

"The bottom line," Goldstein said, "is that we really have to follow people not just for three or six months but for a year, and even after a year to be on the lookout for a cue-induced relapse."


Health Day: For Ex-Smokers, Some Cigarette Cravings May Never Leave

Some reasons why quitters ussually gain weight.

Smoking burns calories.
Smoking increases your metabolism and elevates your heart rate. when you quit, you burn about 100 fewer calories a day. It can take weeks or months for your metabolism to rebound after you quit smoking.

Smoking suppresses hunger.
Nicotine raises your blood-sugar level slightly and suppresses appetite. Until your metabolism adjusts, expect to gain about a pound a week.

Smoking makes you feel good.
Nicotine increases the levels of dopamine (a chemical associated with pleasure) in the brain. High-calorie foods (candy, cookies) and alcohol produce much the same effect. So after quitting, you may be tempted to replace cigarettes with them. This mechanism may explain why bupropion (Zyban), an antidepressant that works on the brain’s dopamine system, has shown to be helpful for smoking cessation.

Smoking gives you something to do with your hands and mouth.
So does eating. Eating makes you feel less deprived by your decision to quit.

Foods have better taste and smell.
Smoking dulls your taste buds. After you quit smoking, food begins to taste and smell better, so you may find yourself wanting to eat more.

Smoking is reliable when other things are not.
People use both cigarettes and food as a way to deal with boredom or stress, as a reward, or as a crutch in social situations.


How to control your weight after quitting.

Conquer your smoking triggers.
For example, if you were used to smoking after a meal, get up from the table and brush your teeth instead. 

Sidetrack that oral fixation.
Experts recommend chewing celery, carrots, sugar-free gum or candies, or playing with a straw or toothpick. 

Try cognitive-behavioral therapy.
This can help you focus on taking care of yourself—quitting first and then working on weight control.

Smaller portion but frequent.
It will increase your metabolism and avoid getting so hungry that you overeat.

Protein and fiber.
Eat high-protein, high-fiber foods because they fill up your stomach more.

Exercise.
Instead of going to smoke or grab a high callories snack, take a walk or go to the gym. Keep in mind that moderate exercise, such as a walk during lunch, will actually decrease your appetite, because as you exercise fat breaks down and enters your bloodstream. The extra muscle mass you gain by exercising will also help increase your metabolism, not to mention that exercise helps you deal with stress, boredom, and tension.


Source: How to Quit Smoking Without Gaining (Much) Weight