Nicotine is the only known psychoactive ingredient in tobacco smoke. Addicted smokers smoke for one principal reason – to get their accustomed doses of nicotine. Therefore, most smokers realize that smoking is addictive. This means that when you stop smoking, you are likely to experience unpleasant symptoms such as irritability, sensitivity to sounds, light, and touch, and sudden, irrational mood changes. Many nonsmokers think that smokers smoke only to avoid such withdrawal symptoms. But research has shown that in addition to preventing withdrawal, nicotine seems to provide a surprising variety of desirable psychological effects.
The Rewards of Smoking
The average smoker takes ten puffs per cigarette. For the pack-a-day smoker, this works out to about 200 puffs per day. Each “hit” of nicotine reaches the smoker’s brain within seven seconds, about twice as fast as a syringe full of heroin injected into a vein.
Once nicotine enters the brain, it starts to mimic the brain’s most powerful chemical messengers. The result is a temporary improvement in brain chemistry that is experienced by the smoker as enhanced pleasure, decreased anxiety, and a state of alert relaxation.
As a result of this positive reinforcement many dozens of times per day, smoking becomes thoroughly a part of every aspect of the smoker’s life. These positive effects of smoking explain why the smoking habit holds its victims in such a tenacious grip.
Most smokers will say that smoking helps them concentrate, keeps them from being bored, and helps reduce the perceived level of tension in their lives. As well, smoking helps them cope with an over-stimulating environment, gives them positive pleasure, helps them relax, reduces their feeling of distress, helplessness, and loneliness, helps them keep weight down, and makes them feel more at ease in social situations. Smoking can even provide a burst of energy when feeling tired, and can even help a smoker concentrate more effectively. In fact, smoking helps a smoker control his moods. Understandably, these substantial benefits would be difficult to give up.
These “rewards” of smoking go a long way toward minimizing the negative consequences, and an even longer way toward ensuring that the act of smoking will be repeated again and again, until it becomes a habit so well ingrained that you do it without even thinking about it.
But smoking is not just a habit – it is also an addiction. The nicotine in cigarettes is a powerful addictive drug that makes smokers feel good. Each time you smoke, the positive biological effects of nicotine add to all the other positive rewards of smoking, which makes the smoking habit even stronger.
The Effects of Nicotine
Nicotine affects almost every system in the body. When you take a puff, your heart beats faster, your pulse quickens, your veins constrict, your blood pressure increases. Your adrenal glands pump out adrenaline that increases your heart rate, relaxes many of your smooth muscles, and raises your metabolic rate. Even the electrical activity in your brain changes.
These are powerful biological effects. Indeed, nicotine is a very powerful drug. In fact, it is one of the most toxic of all drugs, comparable to cyanide. Take enough nicotine and it can kill you. But the amount of nicotine in a single cigarette is only 8 to 9 milligrams on average.
The amount of nicotine that smokers inhale from each cigarette is even smaller. Most popular brands of cigarettes deliver less than 1.5 milligrams per cigarette. This amount may be somewhat higher or lower for each smoker, depending on how deeply you puff and how many puffs you take from each cigarette.
But nicotine is so potent that even this small dose causes significant changes in the functioning of numerous organs and systems in your body. When people first take up smoking, these physiological changes seem extremely unpleasant. Beginning smokers usually experience nausea, dizziness, headache, stomach upset, coughing and other uncomfortable symptoms. But people who continue to smoke soon develop a tolerance to these symptoms, until they become unnoticeable.
Tolerance is a term used to describe an important feature of addiction. Tolerance has developed when, after the repeated administration of a drug (in this case, nicotine) produces a decreased effect. As well, tolerance has developed when increasingly larger doses must be administered to obtain the effects observed with the original dose.
What does this mean for the smoker? The small dose of nicotine delivered by several puffs on a cigarette may make people feel ill the first few times they try smoking. But after they’ve been smoking for a week or so (repeated “self-administration” of nicotine), several puffs and even an entire cigarette no longer have that effect. Now they’ll feel ill only if they smoke several cigarettes one after another (a larger dose).
Psychologically, tolerance to the unpleasant effects of nicotine allows the smoker to focus on nicotine’s pleasurable physiological effects. Many smokers don’t realize that nicotine’s effects on the heart, the nervous system, and the endrocine system are significant contributors to the relaxation, alertness, stress relief, and other good feelings they experience.
This combination of physiological and psychological effects provides so many positive reinforcements that smoking quickly becomes an established habit.
As the term tolerance implies, a smoker actually becomes accustomed to having a certain level of nicotine in his or her body. In fact, research studies have shown that (without realizing it) smokers regulate the number of cigarettes they smoke in order to maintain their own personally preferred level of nicotine. For example, smokers who are given a very high nicotine cigarette will puff less often than usual, so they don’t take in more nicotine than their preferred amount. Likewise, with a low nicotine cigarette, the smoker will take more puffs than usual, in order to get that preferred amount of nicotine.
When no cigarettes are smoked for a while (when someone is trying to quit), the smoker doesn’t get any nicotine. And it is the lack of nicotine that produces unpleasant physiological symptoms in the body. Medically, these symptoms are called “withdrawal effects.”
To relieve these withdrawal effects, many smokers must continue to take in their usual amount of nicotine. This is a sign of “physical dependence” on nicotine. Doctors define physical dependence as a change in the body’s functioning that is produced by repeated administration of a drug, such that continued doses of the drug are needed to prevent withdrawal symptoms.
But that’s not all. Smokers also become accustomed to the psychological effects of smoking. After the smoking habit is established, the smoker needs to smoke in to feel “normal.” In other words, the effects produced by nicotine, and the behaviors associated with smoking, become necessary to maintain the person’s optimal state of well-being. This condition is referred to as “psychological dependence.”
At the extreme, many smokers who run out of cigarettes or are unable to smoke, become totally preoccupied by thoughts of having a cigarette. This behavior is often referred to as “compulsive drug use.”
Is Smoking An Addiction?
Physiological and physical dependence, withdrawal, and compulsive drug use are the defining characteristics of “drug addiction.” Does this mean that smoking is an addiction? Certainly, the smoking habit meets many of the criteria needed to qualify as an addiction, including:
1) A highly controlled or compulsive pattern of drug use. The experienced smoker has a lot of smoking patterns that (if broken) are disturbing.
2) Psychoactive, or mood-altering effects involved in the pattern of drug taking.
3) Drug functioning as a reinforcement to strengthen behavior and lead to further drug ingestion. It’s the nicotine that keeps people smoking.
Using these criteria, the U.S. Surgeon General’s Report (in 1988) on smoking made several major conclusions:
• Cigarettes and other forms of tobacco are addicting.
• Nicotine is the drug in tobacco that causes addiction.
• The pharmacological and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.
All smokers show signs of physical and psychological dependence on nicotine. Their bodies crave nicotine, and they will smoke until their bodies have taken in a certain level of nicotine. Thus, addiction is more a matter of degree. Its not if you are addicted but how addicted you are.
Triggering The Habit
It’s important to remember that smoking is both a habit and an addiction. There are many times when you tell yourself you’re going to have a cigarette, but often, the smoking you do is just out of habit.
Habits are affected by your environment. Something you see or do in your daily life (a cue or a trigger) gets them going. Triggers are the stimuli associated with smoking.
What are smoking triggers? Think back to when you had just started to smoke. At first you’re only positive reinforcement might have been social acceptance by your friend, that reward helped to fight against the initial negative consequences—nausea, bad taste in your mouth, tearing eyes, and burning throat. The more you smoked, the less you were bothered by the physical discomfort. And almost without realizing it, you quickly began to enjoy smoking for many new reasons:
• You often smoked during the happy times you spent with friends. As a result, you’re now likely to smoke whenever you want to feel happier.
• You found that you ate less when you smoked, and that’s helped you to control your weight. As a result, you now light a cigarette whenever you feel hungry but don't want to eat. You may even smoke between courses at a meal.
• Phone calls from your family members may sometimes be stressful. When they call, you frequently light up a cigarette to help yourself stay calm. Now you find yourself reaching for a smoke whenever you make a phone call or answer the phone, no matter who’s on the line.
• If you’re alone and have nothing to do, you tend to think about your worries and anxieties. You’ve found that smoking relaxes you and makes you feel happier. Cigarettes have become like “a friend” to you. In fact, you realize that you smoke the most when no friends are around and you’re feeling lonely, worried, sad, or just bored.
People often say cigarettes are a “crutch” because smokers lean on their cigarettes for help in so many situations—being with friends, eating, talking on the phone, or just feeling bored. Triggers can be any number of things, bad and good. And different smokers have different triggers. You may connect a cigarette so strongly with a particular activity that you’d have trouble carrying out that activity without a cigarette.
For instance, some smokers always smoke when they have a cup of coffee. Other smokers can’t go to sleep until they’ve had that last cigarette of the night. Nicotine addiction is the reason. The physiological effects of nicotine combine with the effects of your morning coffee to give you the extra stimulation you need to get going. Similarly, the negative feelings that nicotine counteracts (feeling sad, anxious, stressed out) all evoke strong urges for a cigarette. So you have a cigarette at bedtime, you feel more relaxed, and you’re able to fall asleep.
The Three Big Reasons for Smoking
1. Nicotine is a powerful reinforcer.
2. The act of smoking offers many positive reinforcements.
3. The reinforcement becomes associated with many cues and activities in daily life.
So, smoking becomes tied to many satisfactions each day.
As you can see, triggers tend to expand and make new connections. By the time most smokers have bought this book, they may feel that almost everything they do has become a trigger for smoking. This may be true, but as you will see later, an important part of getting ready to quit is breaking up some of your strongest smoking triggers.
Smoking Is More Than Just Puffing
The process of smoking also involves buying cigarettes, removing each cigarette from the pack, lighting it, locating and handling an ashtray, blowing the smoke out of your mouth and nose, watching the smoke rise in the air, feeling the cigarette in your hand, flicking off the ashes, stubbing it out when you’re finished, among many other things. In a sense, these too become triggers—the sight of the ashtray, for example.
The steps in smoking—from pouring the cup of coffee to lighting up, to stubbing it out when done—all of these become woven into a highly organized pattern that’s repeated each time you smoke. Each individual action becomes reinfored through its connection to the others in the pattern, and the eventual nicotine to which they lead. The entire array of behaviors soon takes its place as an integral part of your daily life.
Just as a person who’s recently retired from a job complains that “I don’t know what to do with myself,” it’s no wonder that people who try to quit smoking complain that “Smoking is almost constantly on my mind,” and worry that they’ll be unable to do without it. The cues and triggers are everywhere!
Your own personal smoking triggers—how often they occur and how strong they are—are what determine your smoking habit pattern.
Numerous research studies indicate that the single most helpful thing you can do to break the smoking habit is to take it off automatic pilot—to stop and notice your smoking triggers.
