Why People Smoke Cigarettes

Summary of "Why People Smoke Cigarettes" part two, based on the statement on cigarette smoking developed from testimony delivered before the U.S. Congress by William Pollin, M.D., Director of the National Institute on Drug Abuse on March 16, 1982 (DHHS, 1983).

Read part one: Why Do People Smoke?

The Way People Smoke

What at first appears to be a casual, unordered routine, in short, turns out to be not casual at all, but a controlled behavior.

  • A typical pattern of dependent smoking (if there were such a thing) would begin with the first cigarette, in the morning.
  • This sends a burst of nicotine to the brain which produces an almost immediate feeling of euphoria and satisfaction.
  • The smoker tries to maintain this feeling for the rest of the day by manipulating his or her intake of tobacco smoke (by inhaling more or less deeply, taking more or fewer puffs, and smoking at different intervals).
  • When fewer than a minimum number of cigarettes are smoked, which appears for many people to be about ten cigarettes a day, blood levels satisfactory to the dependent smoker cannot be maintained.
  • Nicotine can affect the body in different ways . In stressful situations, it can act as an anti-anxiety agent like a tranquilizing drug, while in serene situations it can act as a stimulant like the amphetamines.
  • Some effects of smoking are psychological. Some people enjoy handling cigarettes and fussing with matches and ash trays; others smoke out of habit, sometimes unaware even that they are smoking.

Quitting Smoking

What happens when a person tries to quit smoking?

  • With some smokers, nothing at all happens; they simply quit. Many of these, but by no means all of them, will be light or casual smokers.
  • Young people who have not yet become dependent on cigarettes may find it easy to quit.
  • For those who have become dependent on cigarettes, the first few days of withdrawal are likely to bring about a number of physiological and psychological reactions.

    This may include decreases in heart rate and blood pressure, decreases in the excretion of some of the hormones which affect the nervous system, occasional headaches, and gastrointestinal discomfort.

  • For some people, a weight gain may take place; it is uncertain whether this is caused-by increased appetite or a changed metabolism or both.
  • Behavioral and mood changes may also occur, usually peaking within a few days after quitting. Common symptoms are irritability, aggressiveness, and difficulty in sleeping.
  • For the dependent smoker, these first few days of quitting are only, the beginning; the real challenge comes later. The temptation to go back to smoking can be very strong and can continue for a long time.

    Any number of events and situations can trigger relapse, including, paradoxically, both moments of stress and unhappiness and moments of relaxation and pleasure.

Lessons

There are lessons learned in the treatment of other dependencies however, which can be applied to cigarette smoking. Here are some of them:

1. It helps to recognize from the outset that a drug dependence may exist. As noted earlier, drug dependence is a state in which a person's freedom of choice has been compromised by the physical effects of the drug on the brain and the nervous system.

To discover that quitting can be difficult is not a sign of a weak will.

2. Quitting is a long-term process; some former smokers report an occasional craving for cigarettes years after they have quit smoking. With tobacco, as with all dependence-producing drugs, relapse is common: 'If one fails on the first try, the only thing to do is to go back and try again.

3. In some cases, it may be useful to attend a clinic on join a cessation group. Such services can be found in every large community, some privately sponsored and others operated by church or health agencies; some are listed in the telephone directory yellow pages under "Smokers Information and Treatment Centers."

Help can also be obtained from local offices of the American Cancer Society, the American Heart Association and the American Lung Association.

4. Whether one joins a group or not, one should seek the support and help of other people. The most important single influence in determining whether one uses or does not use a drug is the behavior and attitudes of one's family and friends.

This is just as true of cigarette smoking as it is of alcohol and heroin and, the other drugs of abuse.

5. And friends and family should provide support and help. They too, need to recognize that smoking can be more than just a "bad habit", that it can be a drug dependence, an addictive behavior.

"Why People Smoke Cigarettes" is a highly recommeded read if you can get ahold of a copy.

References

U.S. Dept. of Health and Human Services, Public Health Service (DHHS). Why people smoke cigarettes. U.S. Dept. of Health and Human Services, Public Health Service. DHHS Publication No. (PHS) 83-50195, 1983.

Further Reading

The Behavioral Aspects of Smoking, NIDA Research Monograph 26, DHEW Pub No. (ADM) 79-882, U.S. Government Printing Office, Washington D.C., 1979.

Cigarette Smoking as a Dependence Process. NIDA Research Monograph 23. DHEW Pub No. (ADM) 79-800, U.S. Government Printing Office, Washington, D.C., 1979.

Substance Use Disorders. IN: Diagnostic and Statistical Manual of Mental Disorders. (Third Edition). American Psychiatric Association, Washington, D.C., 1980, p 176.

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