A Journey from Despair to Freedom
“I never thought I could quit smoking,” my patient, Mirella, confessed during our last session. A woman over 50 with three decades of smoking behind her, she had tried everything: patches, gum, hypnosis, and support groups. Nothing seemed to work until she started a protocol involving transcranial magnetic stimulation combined with ketamine therapy. Within months, she not only quit smoking but also experienced deeper sleep, better breathing, and more laughter. The cigarette, once her constant companion, had lost its power.
The Dual Nature of Tobacco
Mirella’s success made me reflect on the duality of tobacco—sacred to indigenous peoples and a devastatingly addictive, highly profitable industry in human history.
Sacred Plant
For millennia, tobacco has held a special place among the ancestral cultures of the Americas. It was considered a bridge to the divine in shamanic rituals, with smoke purifying subjects and facilitating spiritual communication during healing ceremonies.
Today, in the Amazon, fine tobacco powder mixed with other plants (rapé) is still used in nasal rituals to cleanse and open individuals to spiritual connection. The rustic, potent mapacho tobacco is also smoked or blown as an offering and protection tool.
This ceremonial tobacco has a very different purpose than commercial cigarettes: it’s used in small quantities, within ritual contexts with deep respect for the plant. It represents the memory of tobacco before colonization.
European arrival transformed this sacred plant into merchandise. Tobacco ceased to be an offering and became a product, its industrialization making it one of the most powerful industries in the 20th century. Aggressive marketing positioned it as a symbol of glamour, success, and rebellion, turning medicine into addictive merchandise.
The Biological Trap
Why is it so hard to quit smoking? Nicotine, activating brain nicotinic receptors, releases dopamine and hijacks the reward circuit. This fleeting burst of pleasure creates dependence, reinforcing the habit in a difficult-to-break cycle.
We now know that tobacco is the leading preventable cause of disease and death worldwide. The World Health Organization reports that tobacco kills over eight million people annually, including passive smokers. The healthcare costs caused by tobacco are immeasurable, especially in poor countries with overwhelmed healthcare systems.
From Cigarettes to Vaping
Fortunately, the last two decades have seen a significant drop in cigarette consumption, especially among youth. Public health campaigns, taxes, and regulations have been effective. However, a new adversary has emerged: vaping.
Though e-cigarettes arrived promising to be a less harmful option, recent studies have shown significant risks, including lung damage from chemical substances and exposure to heavy metals. Moreover, they can be a gateway to nicotine addiction for young people. Attractive colors and flavors have captured a generation that might not otherwise smoke traditional cigarettes.
An Integrative View of Addiction
Integrative medicine encourages us to view smoking differently. Complete abstinence is ideal, but it’s not always realistic. Thus, reducing the tobacco index can be a valuable first step.
The crucial aspect is to de-stigmatize smokers. Stop viewing smoking as a moral defect; it’s simply an anxious brain seeking calm. Addiction isn’t resolved with willpower alone; it requires deep understanding of the body, mind, and individual’s personal history.
That’s why integrative medicine now discusses complementary interventions, including proper nutrition, breathing techniques, meditation, therapeutic accompaniment, support groups, and community. We aim to heal the emotional root of addiction.
New Treatments
Thankfully, science has advanced. Today we have:
- Nicotine replacement therapies (patches, gum, aerosols) that help gradually reduce dependence.
- Transcranial magnetic stimulation, which modulates brain activity related to cravings.
- Psychedelic-assisted therapy, like ketamine, showing promising results in clinical trials to help individuals reconnect with their purpose and free themselves from harmful habits.
Tobacco serves as a reminder of how the sacred can turn toxic when we lose respect for nature. It also invites us to view addiction with compassion and without judgment.
Mirella managed to quit smoking because she found a treatment that allowed her to reconcile with her body and mind. That’s the true essence of medicine: accompanying and healing by opening new possibilities.
Today, more than ever, we need to combine science and tradition to offer a real way out for those who smoke. Because behind every lit cigarette is a heart seeking help.
Key Questions and Answers
- Q: What is the duality of tobacco? A: Tobacco has been sacred to indigenous peoples for millennia, used in rituals for spiritual connection. European colonization transformed it into a commercial product, leading to widespread addiction and health issues.
- Q: Why is quitting smoking so difficult? A: Nicotine activates brain receptors, releasing dopamine and hijacking the reward circuit, creating a cycle of dependence.
- Q: What are the new treatments for smoking addiction? A: Nicotine replacement therapies, transcranial magnetic stimulation, and psychedelic-assisted therapy like ketamine show promise in helping individuals overcome tobacco addiction.
