Thursday, April 21, 2011

Smoking: The Addiction Psychology


If you've ever been around someone, or known someone who has had cancer and gone through the process of chemotherapy, you will know that it is probably one of the most painful and uncomfortable of all of the medical procedures out there. Basically the Doctor is pumping toxic chemicals into the patient's body to kill the cancer cells. The problem is that the chemicals don't distinguish between cancerous and healthy cells; it kills everything in its path. This leaves the cancer patient with horrible bouts of nausea and vomiting, hair loss, lack of energy, pain and fatigue, mouth sores, infections, and diarrhea just to name a few problems. It is definitely not something you would wish on even your worst enemy. So why is it that smokers who know that their chances of cancer, and thus the chance of someday experiencing chemotherapy for themselves, are greatly increased continue to smoke?
The answer is quite simple; smoking is a psychological and chemical dependency. Smokers are drug addicts plain and simple. Studies now show that the addiction to cigarettes is actually much more addictive that both cocaine and heroin. As a matter of fact, the CDC has it at the top of its list of most addictive substances. (Heroin, by the way, is down at number 5)1 The crazy thing about the human mind is that regardless of the consequences to a person who is a drug addict, be it monetarily, physically, or socially, the dependence is just too strong. We all know the old stories about the drug addicts on the streets that steal, beg, and many other unmentionables, just for their next fix; Smoking is no different.
Need proof of this? Think of those you may know, who have said over and over, "if the price of a pack of cigarettes goes up any more, I'm quitting!" Well on February 9, 2009 the United States government imposed it's largest ever tax increase on a pack of cigarettes. Overnight the federal tax went from thirty nine cents to over a dollar per pack. Because the states also followed suite, the average price of a pack of cigarettes doubled overnight. Did those who complained about the price quit? Chances are they did not. What makes a person so addicted that they refuse the obvious, will chance illness, and steal from their family?
Smoking is an interesting addiction in that it holds both the psychological and physical addiction properties. On the physical side, nicotine causes the brain to produce the chemical dopamine which in turn gives the smoker the calm feeling of ease. Over time the brain begins to need nicotine to function at normal levels. When the smoker does not get their "fix" of nicotine, they may experience side effects such as nervousness, trembling, sweating, etc. But the nicotine addiction does not appear to be the hardest part of the addiction to overcome, that honor is held by the psychological effects of smoking.
To understand the psychological effects of smoking, we must go back to the famous Russian psychologist from the early 1900's, Ivan Pavlov. You may know Pavlov for his work with behavior in dogs that famously are called Pavlov's dogs. What Pavlov found in his research is that much of the response to different stimulus, whether it be in dogs or humans, is conditioned.
During his research he found that dogs would begin to salivate when presented with food. Going a little further, Pavlov would ring a bell right before feeding his dogs, until after some time, they would begin to salivate when the bell was rung even without the food being present. Interestingly, this behavior works with humans as well. Most of the way we feel about, or react to certain situations, is part of this conditioning that we are subjected to over time.
As every smoker will tell you, smoking is very much triggered by events, situations, or scenarios. When a smoker is used to always smoking a cigarette while driving, the moment they get into the car, they will immediately begin to have the urge for a cigarette. The same would be true for having a cup of coffee, drinking a beer, or right after lunch, just to name some of the more common "triggers."
Over time, what researchers have found is that often time, it's this Pavlovian response that is much harder for a smoker to deal with than the actual physical addiction. As a matter of fact, it is said that it takes roughly three days to a week for the human body to ‘kick' the physical dependency on the chemical nicotine, but the psychological addiction can last for years.
So what is the smoker who would like to quit, to do? Here is a small sampling of the most popular suggestion from Physicians around the world.
  • Replacement Therapy  
    • Replacement therapy most often involves replacing the nicotine a user receives from a cigarette by way of a patch, gum, or lozenge. This allows the smoker to focus on breaking that Pavlovian response without the physical feelings one would get from nicotine withdrawal.
    • Replace the Pavlovian response with something that provides a simulation of the cigarette. Many times this would be chewing a pen, gum, or the new electronic cigarettes on the market.
    • Medication
      • Many physicians are now prescribing any number of ‘quit smoking' drugs that have hit the market. From Welbutrin to Chantix, they all essentially help calm the obsessive nature of the smoking habit. (the Pavlovian response) These medications are also many times used for depression and obsessive compulsive disorder.
      • Cold Turkey
        • Basically with the "cold turkey" method, the user relies on will power to combat both the physical and psychological effects the addiction to smoking.
However the smoker decides to deal with their addiction to nicotine and the act of smoking, you can see that the effects on their health, pocket book, and those around them would be greatly enhanced by doing so. This would also take the burden off of society for the estimated 440, 000 smoking related deaths each year, or the $150 million in health care costs.



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