There is a satirical saying in regard to using animals for medical research:

The rat is an animal which, when injected, produces a paper.

We could say something similar in regard to the smoking problem:

Smokers trying to be non-smokers are a group of people who, when investigated, produce research papers.

Such an aphorism is illustrated in a Research Report recently published in the journal Addiction, with the wordy headline:

Understanding the role of cessation fatigue in smoking relapse: Findings from the International Tobacco Control Four Country Smoking and Vaping Survey

And what, in the name of all that’s holy, is cessation fatigue? To find the answer we are referred to a paper of 2002 published in the same journal. Here is a quote from the Abstract, but please be warned, you may fall asleep before you’ve finished reading it:

In this paper, we suggest that the conceptual model of relapse proneness (RP) described originally by the National Working Conference on Smoking Relapse can serve as an ecumenical organizational framework that may be used to integrate and conceptualize relapse data in ways that could generate new strategies for relapse research and inform treatment design. As an illustration, we sketch a preliminary model of RP which postulates that physical withdrawal, stressors/temptations, and cessation fatigue each make independent, time-shifted contributions to relapse risk. (Yawn.)

Back to the 2025 paper. At the beginning of the Abstract, we are informed:

Relapse risk among people who formerly smoke is influenced by task difficulty. Cessation fatigue (CF) may be a better predictor than measures such as reported strength of urges to smoke (SUTS) and abstinence self-efficacy (ASE). It may also be affected by quit length and use of other nicotine products. The current study investigated whether post-quitting CF predicts higher relapse risk, its predictive utility relative to ASE and SUTS and whether the CF-relapse prediction was moderated by time since quitting. (Yawn, again.)

Where do they learn to write like this?

The point is put more concisely in a related commentary by the Society for the Study of Addiction (16 October 2025) in a paper headed: ‘Psychological fatigue poses major risk for returning smokers.’ It starts thus:

The most reliable predictor of an ex-smoker’s relapse isn’t strong urges to smoke or low confidence in the ability to stay off tobacco – it’s weariness with the efforts to remain a non-smoker.

And here’s another quote from the same source:

Smoking is notoriously hard to quit. About 95 per cent of unassisted attempts to quit ultimately end in relapse, and even when evidence-based treatments like nicotine patches are used, relapse rates are still high.

Could it be that it’s the evidence-based treatments, that is, using nicotine to get rid of nicotine addiction from smoking, are the reason why smoking seems notoriously hard to quit?

Out of the hundreds of smokers I’ve treated, before they put themselves in my hands, not a single one mentioned weariness from the efforts to remain a non-smoker as a reason for difficulty in quitting. If this were true, which it isn’t, it would be another reason why smokers would have condemned themselves to smoke for the rest of their lives. Picture the poor smoker, desperately trying to return to and remain in the happy state (assuming other things are equal) of being a non-smoker, who is in danger of collapsing from fatigue due to the effort of trying to refrain from repeatedly poisoning himself or herself with a further few lungfuls of tobacco smoke.

Isn’t this absurd, or isn’t it?

Furthermore, let’s note that they say, ‘smoking is notoriously hard to quit…even when evidence-based treatments like nicotine patches [or vaping] are used.’

Here we have the key to the whole conundrum. The poor smoker, failing in the notoriously hard task of quitting, is struggling not because of fatigue, but because of the hindrance resulting from putting nicotine into his or her body with nicotine products including vapes. The reason for this is that if you put nicotine into your body by any means, you will want to go on putting nicotine into your body.

Therefore, if you’re a smoker who wants to be a non-smoker again, the most important thing is to stop using nicotine – in any form. And then what will happen? You’ll collapse with fatigue as if you’re suffering from narcolepsy or you’ll feel like jumping out of the window? No. What will happen is – nothing much. You may be mildly anxious and irritable, or mildly irritable and anxious, or feeling as if something’s missing. And what is it that’s missing? It’s the nicotine! Good, that’s what you want. You want nicotine to be missing and staying missing for the rest of your life. This is marvellous – a matter for rejoicing!

In other words, it all depends on approaching quitting with the right attitude. If smokers can be helped to do this – very simple – it’s usually straightforward for them to become and remain non-smokers for the rest of their lives. Certainly, they can do this without a struggle, and without the risk of falling asleep from lack of nicotine.

Text © Gabriel Symonds

Picture credit: Aleksandar Cvetanovic on Unsplash