Understanding Why Smoking Is So Addictive

Why smoking is so addictive, the part you don't know

Smoking is bad. Smoking is addictive. Tens of thousands of people try to quit smoking and fail every year. Smoking kills over 400,000 people annually in the United States alone. Smoking gives you bad breath that can limit your dating options. Most people know these facts. Most people do not understand the deeper, underlying reasons for why cigarettes are so addictive, though. This addiction is very complex and goes beyond just nicotine dependence.

The effect of nicotine on the body historically gets most of the attention. This effect is simple. Nicotine initially creates an elevation of mood, a reduction of anxiety, and improvement in concentration, among other pleasurable effects. Tolerance starts to develop to this, and more is required to replicate the same effect. Over time, the body gets used to it and then does not feel well if you take it away. That is the first layer of this addiction that often triggers a smoking relapse. This layer can be addressed with direct nicotine replacement in any number of different forms. People use nicotine gum, patches, nasal sprays, and lately even electric cigarettes, all with mixed results. Partial nicotine replacement with the prescription medication Chantix also has mixed results, as well as problematic side effects such as depression. The limited success of these forms of treatment underscores the fact that there are other major contributing factors to this form of addiction.

The behavioral elements of smoking encompass the next layer of smoking addiction. The act of pulling out the pack, then the cig, and then the lighter is the first step. Any number of gestures may blend into the sequence that eventually yields a lit cigarette. The hands and the mouth then remain occupied until most or all of the usable tobacco has been burned and inhaled. At that point, the entire ritual often repeats, along with a reinforcement of all of the related behaviors. This is why smokers who try to quit often struggle with finding ways to keep their hands and mouths busy. Here is where chewing gum, brushing teeth, singing, whistling, and even gargling can help occupy the mouth. Holding a pencil, drawing, writing, sewing, and even learning sign language can help keep the hands busy. To a non-smoker, this may all seem trivial, but to the smoker whose oral and hand movements have been repeatedly reinforced by the addictive behavior, it all makes perfect sense. As obvious as the behavioral elements often are, they are still not the most powerful contributors to smoking addiction.

The most powerful, most dangerous, and least known contributor to smoking addiction is the psychological trap. People do know that cigarettes are psychologically addictive, but they do not entirely understand why. The critical aspect here is that of delayed consequence. Delayed consequence refers to how most of the major problems that result from smoking take many years to develop. Smoker's breath, bad skin, and tooth discoloration happen much more quickly, but do not do much to scare anyone other than the more vain sectors of the population. Most worry more about cancer, cardiovascular disease, and emphysema about the bigger risks that carry higher levels of public awareness. People routinely smoke for 5 to 10 years before heart disease and cancer start to manifest with significantly greater frequency. Many smoke for much longer before developing breathing problems such as emphysema. Even the financial consequences are typically overlooked. The high total financial costs are spread into small, frequent payments that make this type of consequence much less apparent. It is these delays and oversights that allow smokers to procrastinate when they feel they would have to worry, which usually delays the development of any real desire to quit.

When someone develops a more conventional drug problem, such as with a hard street drug, they experience major problems quickly. Being forced to deal with the consequences makes the addiction "real" to them and can motivate them to stop. Not having to deal with anything major because it has just not manifested yet enables a certain degree of denial to fester. The individual in denial believes nothing is wrong. It is only human nature for many of us to delay doing something until we really have to do it. When the cancer, heart disease, or breathing problems actually appear, it is often too late to survive without permanent damage, if the individual can survive at all. That is the critical psychological trap of the cigarette. This is the biggest barrier to smoking cessation that most people are not aware of.

Dr Rodriguez is the founder and Medical Director of the Delray Center for Healing, as well as the director of the Delray Center smoking cessation program. He is board-certified in both Adult Psychiatry and Addiction Medicine, with a clinical focus in the treatment of addiction, eating disorders, mood disorders, and trauma. The Delray Center for Healing is a comprehensive outpatient treatment center that incorporates the most advanced psychotherapeutic and psychopharmacological modalities in the treatment of complex multiple diagnosis cases.