The deadliest addiction: Israel is fighting a war against cigarettes and nicotine

• Fear for personal safety: Constant rocket attacks, air raid sirens, and the looming threat of violence create ongoing anxiety.

• Hostage crisis: The uncertainty surrounding kidnapped civilians and soldiers deeply affects families and the national psyche.

• Economic hardship: Job losses, business closures, and financial instability have significantly increased stress levels.

• Mental health crisis: An estimated three million Israelis are struggling with war-related PTSD, depression, and anxiety, with inadequate access to care.

• Political uncertainty: Some Israelis feel disillusioned with leadership, believing that political motives are interfering with war efforts and hostage negotiations. Others do not share this view but remain deeply concerned about the government’s plans regarding the war in Gaza, the nuclear threat from Iran, and the uncertainty surrounding potential US negotiations with Iran, which may not fully align with Israel’s security needs.

• International pressure: Criticism from foreign governments and shifting diplomatic relations further add to the national stress.

• Displacement: More than 250,000 Israelis have been displaced from their homes, leading to loss of social support and increased mental health risks.

• Family separation: Too many soldiers have fallen in battle, leaving the surviving family members, which includes many children, in unbearable pain. Also, soldiers on extended duty and evacuated families experience emotional strain and disrupted relationships.

SO WHY am I writing about nicotine addiction? While reviewing the literature, I was surprised to learn the following:

Before the war, 23% of Israelis were regular cigarette smokers, with smoking being more common among men (30%) and less frequent among high-income earners (15%). E-cigarette use stood at 12% of the population, with higher prevalence among young adults aged 16 to 24 (18%).

Public health experts note that stress-related smoking spikes have been observed in previous conflicts, and anecdotal evidence suggests that this war has reversed years of declining smoking rates.

The spike in smoking highlights the urgent need for mental health support and public health interventions to help individuals manage stress in healthier ways.

Worldwide, tobacco products kill five million people every year. This should come as no surprise when considering that cigarettes contain 4,000 toxic chemicals, 200 of which are carcinogenic. Some of these harmful chemicals are benzene, formaldehyde, ammonia, acetone, tar, hydrogen cyanide, arsenic, and carbon monoxide.

Additionally:

• One in three cancers in the body is directly linked to tobacco use.

• 70% of lung cancer cases are caused by cigarette smoking.

• Smoking can cause infertility in both men and women and is linked to impotence in men.

If smoking is so harmful, why do people get hooked? Neuroscientists explain this phenomenon well.

Nicotine use releases excessive amounts of dopamine and norepinephrine (adrenaline) in the brain’s reward centers, producing feelings of relaxation while enhancing alertness and boosting energy. This pleasurable effect creates a cycle of addiction, where individuals seek nicotine both to experience the positive sensations and to avoid withdrawal symptoms.

Once the smoking addiction sets in, cognitive patterns and emotional states become intertwined. For example, smokers who are feeling depressed and hopeless may associate cigarettes with relief, making them crave a cigarette when confronted with these emotions.

External triggers – including people, places, and situations – can also reinforce smoking behavior, leading to repeated tobacco use whenever these cues appear, such as craving to buy cigarettes when seeing them displayed at a place where they were previously purchased.

Although most smokers say they want to quit, their deep psychological and physical dependence on the habit makes it extremely difficult to do so.

Twenty years ago, I created a smoke cessation program called SmokeQuitters. I treated many smokers both individually and in groups, and helped many people quit smoking. My program was very structured, and my approach supportive and tailored to each person’s unique emotional issues. The program works well, and the results are long-lasting.

If you are not a smoker, my message is simple: Don’t start. However, if you are using cigarettes and cannot stop, get help. There is no question that smoking is deadly, but its dangers are entirely preventable. Quitting smoking is a decision that no one ever regrets. 