Ep. 5 - Nicotine Addiction: Why Your Brain Can’t Let Go with Leisha Atwood

If you’ve ever thought “Why can’t I just stop?” this conversation puts real words to what your brain and body are doing and how to work with it instead of fighting blind. Brittnee sits down with Leisha Atwood, Hope Cancer Resources’ nationally certified tobacco treatment specialist, to talk about what tobacco addiction actually is, why cravings can feel immediate, and how people move from stuck to steady progress.

We get into the science of nicotine dependence, including how nicotine can hit the brain in seconds and activate the reward pathway. From there, we zoom out to the everyday reality: vaping can be harder to quit because it’s easy to use constantly, often without noticing how much. We also unpack smokeless tobacco and nicotine pouches, why higher nicotine levels can raise dependence, and why “you can’t even smell it” sometimes makes the habit easier to hide and harder to break.

We also connect the dots between tobacco and cancer prevention, cancer treatment, and healing. Leisha explains why tobacco use can affect energy, breathing, immune function, and even surgical timelines when someone is told they must quit before an operation. Most importantly, we talk about shame, relapse, and the very normal reality that many people need multiple quit attempts before it sticks, plus the practical support that helps: weekly coaching, trigger planning, coping skills, and nicotine replacement therapy options.

If you or someone you love wants to quit smoking, quit vaping, or quit smokeless tobacco, listen now and share this with a friend who needs it. Subscribe, leave a review, and tell us what trigger you want help tackling next.

Transcript

Welcome To Hope Unscripted

SPEAKER_00 0:05

Hey there and welcome to Hope Unscripted, a podcast of Hope Cancer Resources. Here we're having real conversations about cancer from prevention and education to support resources and the stories that remind us that we are not alone. And we're your host. I'm Jamie Dietrich. And I'm Brittany Harmon, and we're so glad you're here. Now let's talk about hope, healing, and the journey unscripted. Hi guys, welcome back to the Hope Unscripted podcast. I'm Brittany. I am here with Leisha Atwood, who is our tobacco treatment specialist at Hope Cancer Resources, and she has been with us for a very long time. Leisha, why don't you tell me about what your title is and how long you've been with Hope?

SPEAKER_01 0:48

I have been with Hope for seven years. And I'm a tobacco treatment specialist and have a national certification in tobacco treatment practice and a certification through the American Heart Association for tobacco treatment as well.

SPEAKER_00 1:06

Okay. So how do you go about getting some of those certifications?

SPEAKER_01 1:12

There is like a big there's like a four-day training that you do just for your um first certification. And then there's a test for the national certification, and then there's another test for the American Heart um certification. So you know what you're doing. Yeah, I've been doing it for a whole long time.

SPEAKER_00 1:31

I was gonna say, how many patients do you think you've seen over the years? It's gonna be a rough estimate. Oh, it have to be a couple thousand for sure. I can imagine. And then that may be short of what it really is. All of those patients, when they come to you, they're not always already cancer patients, are they?

SPEAKER_01 1:50

No. Okay.

SPEAKER_00 1:51

So what does that look like?

SPEAKER_01 1:53

So some of the patients that I'm working with are community members, so just they live in the community, they are maybe high risk. Um, they've been smoking for a long period of time, um, typically, and so um they're able to come into the tobacco treatment and and me work with them and help them quit. So hopefully prevent a cancer diagnosis for their future.

SPEAKER_00 2:18

So and for the patients that are already struggling with cancer and some type of a diagnosis, do you see them as well?

SPEAKER_01 2:25

Yes. So if anyone that lives in the four counties um diagnosed with cancer, any type of cancer or receiving treatment here in Northwest Arkansas, then also work with them and help them quit.

SPEAKER_00 2:42

Does somebody who has cancer now versus not is their treatment different? Like when you do their kind of a program, does that look a lot different?

Why She Chose This Work

SPEAKER_01 2:54

Not a lot different. Okay. Um there is some time constraints that we have. Like, so if I have a person who doesn't have a cancer diagnosis, I don't have as much time to spend with them as far as like I'll do like a 12-week program with them. So we'll do like three months of of the tobacco treatment, but it's still the same process as far as like when I'm working with them, it's the same strategies, the same um resources and and that kind of thing when I'm working with both groups.

SPEAKER_00 3:27

What made you want to go into this practice? I mean, this to me, like whenever I started working with Hope, I had no idea that that was something that was even offered. I had a husband who dipped tobacco for years, and it would have been helpful to have somebody other than me nagging him to quit. Um, and luckily he finally did. It took a long time, but he finally did. But I'm just thinking, like, what brought you to want to do that as a profession?

SPEAKER_01 3:54

Well, I originally I got I got trained in it and learned about it at a previous job. And I was helping people quit, but I didn't really have all the certifications and um really that to be able to kind of like deep dive and really help them. So when this position came open at Hope Cancer Resources, it was kind of very specific just doing tobacco treatment. And it was exciting to me, but also scary because I didn't, I wasn't for sure if I I knew what I was doing, but like I didn't have those certifications yet. So then I was able to get those certifications, learn more. Um, I think it is very rewarding as well, like being able to see somebody's life very changed in a way, um, when they're able to quit and break free of an addiction that they've had for so long. Yeah.

How Nicotine Rewires The Brain

SPEAKER_00 4:49

That's super impactful, honestly. And I've I would feel rewarded by that to watch somebody I was able to help go through something. So, and even somebody who recently just started smoking and has decided that they don't want it, but their brain is triggered. So when tobacco hits your brain, let's go through that and what that looks like. Because people do, they get so absorbed in it, and there's so many different kinds. So, what does that look like?

SPEAKER_01 5:14

So you can become addicted very quickly within sometimes even just one use of a nicotine product. Um, for some people it may take a little bit longer, but essentially the nicotine is going um to your brain within seven to ten seconds, especially if you're smoking it, um, because it's going through your lungs. So it's getting there very quickly. You do get kind of like a high, if you will, like where you feel um this euphoria type feeling. Um, and that's just where the nicotine is um when it's hitting your brain, it's binding to those receptors in your brain and then releasing those um, I call them like feel-good hormones as far as like those endorphins, is that what dopamine, or nephrin, serotonin? So then that reward pathway is happening in your brain, and that kind of starts the whole cycle for warm.

SPEAKER_00 6:08

Okay. So when uh tobacco is a very large topic, I feel like because there's so many different kinds. What do you see as the biggest struggle as far as types of tobacco?

SPEAKER_01 6:23

Um, I that's hard. I would say it's it's almost becoming vapes now. I feel like it's almost easier for people to quit smoking because they can rely on that than vaping. Um, what I've found when I've been working with people recently is like if they are vaping, they're using it so many times throughout the day that they're not even really aware of how much they're using it. So then when it's like, okay, it's it's scary to them to even just not have it in their hand.

SPEAKER_00 6:54

But it's like I've seen people like anxiety-driven because they can't find it or they they dropped it or they left it at home or it's in their car or something like that. So it's intense to think about relying on something so hard heavily like that. I saw a commercial recently and it was a young girl laying in her bed. I only vape every once in a while, and I only have like one in my backpack and one in my car. And then it just like consumes her because they don't realize how often they're doing it.

SPEAKER_01 7:22

Yeah, I think most people that I talk to have like two or three and have backups, or they have Lave Laks kind of like stockpiled, which people do that with other tobacco products too. But um I think there is there is like because you're able to use it all the time and in indoors and you know, even places that are considered non-smoking, sometimes they're still using them. Yeah, um, the addiction and the dependence is even higher.

SPEAKER_00 7:54

I mean, I've walked through Walmart and see people doing it in Walmart, and it just blows my mind because that would never happen if you were smoking. You get run out so fast. And so um, I also think about the chew or chewing tobacco, smokeless tobacco, and how even like the Zen pouches, people get addicted to those super easily too.

SPEAKER_01 8:14

Yes. Um, and that's like I think a new trend. Well, it's not really new anymore, but it is a newer trend when it comes to the tobacco products, and it's that has like grown astronomically, like the cells have grown in the States, and so it's become very, very popular. Um, and it is it's considered a tobacco product, even though it's made synthetically, so it technically doesn't have tobacco in it, um, but it has nicotine in it.

SPEAKER_00 8:43

So same response that your body's getting, but the health effects can be yeah, if not worse, at least the same, right?

SPEAKER_01 8:51

Yeah, you're still gonna have some health issues from it. I mean, you're getting the nicotine, so that's one thing. Um, so the addiction is there. A lot of people tend to have like issues with their gums and some of the dental stuff that you have with the smokeless tobacco, too. Um, so there's um things that you have to be cautious with with those.

Why Relapse Is Part Of Quitting

SPEAKER_00 9:12

And like I said, I do think about my husband, and whenever he was 14, probably when he started chewing tobacco, which seems so young. But now it seems to be younger and younger that you start to see kids vaping and things like that. But he did it, I mean, he would go through two cans a day at one point. And when we started dating, it didn't bother me because I couldn't smell it, so I would just let it go. And then you would catch, I would get caught with the call, hey, can you pick me up a can of snuff? And it's annoying, but I don't have to smell it, so fine, you do you, and it's fine. And then the day that he decided he was just ready to try to give it up, he was able to get an herbal supplement. And it's not something you can buy over the counter, unfortunately. It was very frustrating, but I didn't want to spend a lot of money on it either, in case it didn't work. So I order a few cans of it. Then he comes and he's already gone through these cans and he's hurting, like, and it is because it is you're literally your body's going through a withdrawal. Yes. And by the time I was able to finally get him, he had finally stopped and he's been tobacco free for almost nine years, and so I'm very grateful that he's done that. But I know other people who've really struggled with it and gone back to it because they may be able to quit for a short period of time, but that linger is always there, and so when you see some of your patients, I know that they come back once or twice before they're ready. How often does that happen?

SPEAKER_01 10:33

I would say pretty often there I'm I'm gonna have repeats. And for me, it's it's understandable because I know how the addiction works. Yeah, and I know like we're also human and we make mistakes and we mess up, and um and statistically, people are gonna have seven to ten attempts at quitting before they successfully quit. Okay. And so I think what I also try to do is when I'm working with people is just normalize that a little bit so that there's less shame, less guilt of like having to come back and do it again. Um because it's it, and I always tell them too like just the fact that you're willing to try again is a big deal. Yeah. Um, because it's frustrating. Yeah, it's very frustrating for them.

SPEAKER_00 11:26

Because they don't want to do it. Yeah. But if your body is dependent on it, and there's there's some level of coping in that, right? If you're having a really bad time in your life going through a cancer treatment or a loved one going through that, um, even just regular daily stressors sometimes. Um, I can imagine that's an easy thing to rely on. That's there, not gonna go away. Um, so I just seven times like that's shocking to me. I didn't realize it was that many.

Helping Families Reduce Secondhand Smoke

SPEAKER_01 11:52

I don't think people realize that. So yeah, it's it's normal. I think a lot of people come to me and they're like, I've tried to quit so many times. Like, what's wrong with me? Why can I not quit? And it's like nothing's technically wrong with you. Yeah, it's just we haven't found the right way to quit yet. Or um, you know, the circumstances haven't been the way that they needed to be. Like, because you can't control everything, you can't control your stress, or if something happens in your family or you or you get a cancer diagnosis, like that's something that you can't always control. So um I really work with them too. It's like, how are we gonna cope with things? What can we do to manage stress for the future as well?

SPEAKER_00 12:34

So thinking about prevention for people, we talk a lot about the treatment of trying to get them to quit. Are are you doing anything with their families too to try to prevent them from starting?

SPEAKER_01 12:47

We don't really have any um like programs for prevention as far as with the family specifically. Yeah. But if a family member does use tobacco products and they want to quit, then we will help them quit too. Just to support the one. Okay. To support the one who's going through the cancer diagnosis. Sometimes the patient themselves is not a tobacco user, but maybe they live with um a daughter or somebody that does smoke. Um, and so for them being around it, if they're around secondhand smoke, that's obviously you know, something that you don't want them to be around when they're going through um, well, in general, but when you're going through cancer treatment as well. So for sure, helping them stop so that that patient is um in an environment that's good for them as well. Yeah.

SPEAKER_00 13:38

What would you say to people who would be seeking some prevention type things or if they have a younger child, because that's a thing right now, all the vapes in school is a hot topic that I hear about all the time, even in the schools. And from I have an aunt that's a counselor and she sees it sometimes. So, how would you address a parent whose child might be struggling with addiction and they don't even understand or realize it?

SPEAKER_01 14:00

Yeah, I mean, I think the first thing is like even just having the conversation with the child about if they are using those products. Because I think sometimes parents don't even know because they haven't paid attention. Yeah. Um, and it's life happens and you're busy and you're doing lots of things. And also they're very, um, it's very easy to hide them. So that's the other thing. So I think just being aware and then having that conversation with the child about um, you know, what is what how are they getting them? That's the other thing. That's the other thing. Right? Yeah. You're not supposed you can't buy them until you're um 21. So, you know, there's something happening there. But talking about the dangers of them, um, I think a lot of people don't understand the dangers, but also don't still understand how addiction is.

SPEAKER_02 14:50

Yeah.

SPEAKER_01 14:51

And so I think that's a hard conversation to have with a child or with someone, an adolescent. Sometimes they don't really understand like how much that's going to impact the rest of their life. Um, I know for me, like with and obviously my experience is different because I'm working with people all the time. But when you have someone on the phone that you're working with and they're crying because they want to quit so bad and they're addicted to something and they're struggling so hard with it, like sometimes I want to be able to share that with the younger generation of like, here is this whole generation who started when they were 10 or 11, and now they're finally working on quitting. And it's devastating for them how hard it is. And like you have, you know, a 15-year-old who's very flippant about it, and like, oh, whatever.

SPEAKER_00 15:45

Yeah, you have like it's no big deal, and they don't understand. Like, yeah, wow. That's just crazy to me. I could not and it does scare me as a parent, like at some point he's gonna get exposed to that. And I realize it's hard talking about my husband did it too. So if my son does it, how do I address that? Because you don't want to be judgmental and you don't want to say, well, this is the worst thing ever, but it kind of is. So, how what would you suggest to somebody like that in that situation where it's a parent trying to make sure that their kids don't do something like that, but they did it too? Like, is there anything that you can say to that?

Why Smokeless Can Be Harder

SPEAKER_01 16:28

I think really listen to your kid to like what they're saying, if there's any, you know, are they dealing with anxiety? Are they dealing with things like that that maybe that needs to be addressed? Um, or they're scared about something or they're nervous about something, and they may be using a vape to help them deal with that instead of going to a trusted adult and talking to them about it. So maybe even just having those conversations. Um, there are some great like uh websites and things that are good for parents to help them like start those conversations with their children. And so I think that's always helpful. Okay, is like just having maybe even um some starting questions to help you get it's kind of opening the opening a little bit, your child.

SPEAKER_00 17:20

And when you see like snuff chewing tobacco users, is that harder sometimes because you don't smell it? Is that somebody like when you see a patient like that, is it harder to get them to quit? It can be more difficult.

SPEAKER_01 17:35

Um, I find with my patients or community members who use like snuff or smokeless that um they typically use a lot of it. Um, and sometimes it may be just because they're taking it out and putting new in, uh, you know, very often. Constantly, yeah. Um, so they're going through a lot, but also the nicotine concentration is higher in smokeless tobacco. Um, so usually the nicotine dependence is higher, like there's more dependence on it. Um I also think because it's in their mouth all the time almost, like it's just they're so used to it. You know, you put it in and you don't have to think about it because it's a comfort blanket. Yeah, and it's kind of like it's something that's always there. So they're not really having like for someone who smokes, you have to make the effort to go get a cigarette, go and smoke. It's like you put effort into that. And people do with smokeless too, but it stays in for so long sometimes.

Tobacco Linked Cancers And Surgery Deadlines

SPEAKER_00 18:37

It's like just there for and I feel like people can sneak that inside places pretty easily, too. Like it's a lot less noticeable at times, unless you just got a giant wad of it in your mouth, but it sticks out like sort of thought. Um, thinking about tobacco and cancer together, most people just automatically assume lung cancer, which it is a lot of that. But there's also so many other cancers that that can be tied to as a carcinogenic, that's the right word. Get it that out. I didn't sound stupid. Okay. Um, but thinking about all those different cancers, lung, mouth, it can be related to esophageal cancer, especially with the smokeless, I would feel like. Um, I've read the pancreas, bladder, kidney, cervix cancer, cervical cancer, also stomach, liver, colon, like all of these can be increased risks. And then a lot of times, if you're smoking and you have one of these or using tobacco, your surgeon may not operate on you right away because of the healing. Do you have some patients that struggle with that, like where they're frustrated because they need to have their health taken care of, but they're struggling over here and they can't complete their treatment?

SPEAKER_01 19:57

Yes, I would say that happens pretty often, where they may come to me or get referred to me and have a surgery coming up in a month or two months. And I've been told like I have to quit before this surgery and can't sometimes also not use any nicotine products, so no like patches or things like that as well. So it's it can be kind of a desperate situation where they're they're kind of like on a time frame as well. And I I kind of hate that for the patient because I think it just increases all the anxiety that they're already dealing with. And then there's this anxiety that I have to quit and it has to be at this time or by this time, or else I can't get the surgery that I need. Yeah. Um, so I think it's it's very frustrating for them. Um for sure. Yeah.

SPEAKER_00 20:52

So whenever you see some of the patients that do um already are impacted by cancer, is there any specific type of diagnosis you say more of? Or is it just kind of all over the board?

SPEAKER_01 21:07

It's probably all over the board, but I I mean, I do definitely see more lung, more head and neck, and more breast cancer, probably than any. I mean, obviously, I think lung and breast, those are there's something hard. Yeah. So that kind of makes sense as well. But but yeah, there's definitely some all different so yeah.

SPEAKER_00 21:29

Why is tobacco treatment such an important part of cancer support?

SPEAKER_01 21:34

Oh, that's a that's a big question. Cause I I feel like it's such a huge thing for the patient to be able to find help and to help them quit. I mean, not only just the quitting part and the process of quitting, it's huge in helping them get to the point of quitting, but also just for their health when they're going through treatment to be able to feel better. like you're already getting if you're getting chemo and radiation when you're already going through like your body's going through a lot already um surgery as well obviously but your body's like getting hit constantly and then if you're smoking on top of it that's also gonna make you just are at automatically at a lower point like your um immune system your oxygen level all those things are not gonna be as as good as they could be if you weren't smoking um so I think that's huge and then also just like daily living stuff like being able to feel good enough to get up and and move around um shortness a lot of people have shortness of breath when they smoke so um that helps them be more active when they're not dealing with that you know if that if they are able to quit and then that decreases they feel better they have more energy quality of life is just so much better as well for sure um when you see some patients that are successful in it do they ever come back to you and talk to you about it later on every once in a while um I'll get like a random call um I got a random call from a patient not too long ago who was who called just to tell me like he still quit just yet it it just it really made my day yeah um because we'd worked together and he worked so hard on it and he did such a good job on quit he was using smokeless and he's he was using um the smokeless pouches and so we worked through that process and he was able to quit and yeah I was just it was be proud of him and he's proud of himself and needed to tell you that's incredible.

SPEAKER_00 23:49

Those are the stories that we love to hear the most than when they can be successful um getting to that point can always be difficult but just getting there. So is there anything else so with hope cancer resources the people who walk in the door and if they want to go see Hannah at Wellness Center after they've seen you and if they're feeling better to the point that they can do that is that something you prefer over just to get their bodies back?

Weekly Coaching And Nicotine Replacement

SPEAKER_01 24:14

Yeah absolutely like if it's something that we've touched on um or maybe they've mentioned to me like that they want to do something or get more active um then I'll always recommend them to like the wellness center or um or even just encourage them to do their own thing too if they if they can um just getting out and walking and um using exercise as a way to cope because it does help like give you those same endorphins um that you sometimes get well that you get from smoking. So it can be a good coping mechanism and also kind of like replacement um for those endorphins.

SPEAKER_00 24:54

So if someone's listening right now and considering trying to stop smoking or or know someone that is, what would you say to them? I would say try it.

SPEAKER_01 25:08

Just give it a shot. Give it a shot I would say find um you know reach out to us to help cancer resources that's always an option um if you don't feel like doing that find find some sort of support system whether that's like a friend or a family member um I think that's really big is like having someone to support you through the process. And I do think someone who's trained in it as far as like a tobacco treatment specialist is optimal because you get a lot of there's a lot of resources there with that person as far as knowledge and just like ideas and things that you can do to help deal with the triggers.

SPEAKER_00 25:48

Some of the resources that you do offer because I know it's the treatment itself but then just that weekly support and some stuff like that.

SPEAKER_01 25:56

Yeah. So I do weekly calls with with people that I'm working with we come up with a plan or a type of strategy of like how we want to go through the process. We deal with the behavior side of it. So like habits, routines, triggers, things like that that come up and it's always very different with each person. And um and then also dealing with the withdrawal symptoms. So in that case we do provide nicotine replacements um nicotine patches gum laws and just things like that to help make the the withdrawal symptoms a little bit less uh difficult.

How To Get Help Today

SPEAKER_00 26:34

It doesn't take it away completely but it helps a lot and then um the one-on-one counseling that we do each week is just kind of getting into the nitty gritty of like okay if a trigger is um your back porch when you're having your coffee how can we start to break those associations yeah and work on so it gets really really detailed and I think that's something that a life habitual almost like if you do every single morning go outside and do that like that is an odd habit to have to break because you still want to enjoy that. Yeah but you got to take a little piece of it out. So that's that's good to know that that's there and having that extra support person along with having a support outside of that as well. So if someone wants help what should they do like right off the gate um I would say if you want our help at Hope Cancer Resources call us go to our website hope cancer resources dot org there is a tab for programs I believe that has tobacco treatment and there is an application on there that you can fill out and once it's filled out it comes to me and I can reach out to you and talk about getting started.

SPEAKER_01 27:49

If you want to do your own thing there's also like the the state quit line there's Arkansas Be Well who does tobacco treatment um stuff as well um so I think I think the main thing is just get a plan together like one step even if it's something really small and simple even if it is um I'm gonna wait 10 minutes after eating before I have my first cigarette. Yeah like even if it's just something like that just work on that accomplish that and then you know set your next starting small you don't have to rip the band-aid on the way up it doesn't have to be a cold turkey and I think that's where a lot of people struggle is like they want it so fast and quick and which I understand and a lot of people want to just be you know take it be done throw them away which sometimes that works. Yeah um but sometimes you just see you take a a little step.

SPEAKER_00 28:44

Yeah so well we've got about a minute left is there anything else you want to add to our lovely tobacco talk today I would say um don't be embarrassed to ask for help there's no um shame in asking for help and I think there's a lot of fear for people when they use tobacco products that they're gonna get shamed or um treated differently possibly or even just told like you should have already quit like what are you doing kind of thing um so I think just understanding that don't have fear um that you're gonna get um shamed yeah people are judgmental and that's just part of life unfortunately but and knowing that you don't have to do it alone yeah and you don't if you want to see it's a hook cancer resources Alicia is the lady and she will take good care of you. Alicia thank you so much for helping talk about such a big topic because I know it can be very controversial for a lot of people and trying to understand how tobacco is really affecting people's bodies smokeless or not um conversations like these are how we spread cancer awareness and just overall health awareness as well. So we want to keep these conversations going as long as we can thank you guys so much for listening to Hope Unscripted I hope we see you next time thanks so much for listening to Hope Unscripted join us next time as we share real stories meaningful resources and reminders that you're not alone until then keep choosing hope