The psychology of cigarette addiction
Robert West, Professor of Health Psychology and Director of Tobacco Studies, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, UK
Psychology is the study of the behaviour of individuals and explanations in terms of mental processes. Cigarette addiction involves powerful motivation to smoke which undermines and overwhelms motivation not to. This presentation argues that there is evidence for multiple mechanisms underlying it. First, nicotine from a cigarette sets up a learned association between the act and sensations of smoking in the presence of certain cues and the impulse to smoke. This leads smokers to feel an automatic urge to smoke in the presence of smoking cues. Second, nicotine makes smoking enjoyable. Enjoyment of smoking makes smokers ‘want’ to smoke. Thirdly, chronic nicotine intake changes the functioning of the brain to create a kind of ‘nicotine hunger’ and unpleasant mood and physical symptoms when CNS concentrations are depleted. This creates a ‘need’ to smoke. Finally, smokers form beliefs about the benefits of smoking (e.g. for stress relief) and these also generate the ‘want’ and ‘need’ to smoke.
Helping smokers to stop involves finding ways of reducing the strength and frequency of as many of these sources of motivation as possible and bolstering resolve not to smoke through every means possible. As abstinence continues, many of the motivations to smoke decrease and the momentary risk of relapse is reduced. However, the risk is not eliminated and long-term protection from relapse requires an absolute personal rule that smoking is not allowed under any circumstances.
About the presenter
Robert West, PhD, is a Professor of Health Psychology and Director of Tobacco Studies at the Cancer Research UK Health Behaviour Research Centre of University College London. Professor West
is the Editor-in-Chief of Addiction. He has published more than 250 scientific works and is coauthor of the English and Scottish National Smoking Cessation Guidelines that provided the blueprint for the UK-wide network of NHS smoking-cessation services.
He has developed a new theory of motivation (PRIME Theory) intended as a basis for development of behaviour change interventions (www.primetheory.com).