Why Do People Smoke?

Exactly why do people smoke? It was a question I sought the answer to for several years when I first began writing stop smoking articles.

Eventually, I came across "Why People Smoke Cigarettes", a 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).

The statement, based upon robust scientific knowledge, conveys a profound level of understanding of why people smoke and the reasons cigarettes are hard to quit from the viewpoint of smoking as a drug dependency.

This article summarises the key points as the document is no longer freely available.

Background

Bearing in mind that the statement was written in 1982, the following facts help put the scale of cigarette smoking in America, at that time, into context.

"Four drugs stand out among all drugs and substances of abuse":

  • Fewer than 500,000 persons used heroin
  • Alcohol affected 10 million problem drinkers and their families
  • Marijuana was the most widely used illicit drug and
  • Tobacco, in the form of cigarettes was smoked by 56 million Americans

Smoking is more than just a "nasty" habit (Mark Twain), "it is, in fact, the most widespread example of drug dependence in our country".

"All drugs that produce dependence have at least these four characteristics in common":

  • Psychoactive (affecting the chemistry of the brain and nervous system).
  • By definition, they create dependence and lead to compulsive use
  • When one gives up the drug abruptly, one may experience physiological and psychological distress
  • There is a strong tendency among former users to relapse, sometimes months or even years after quitting.

The Role of Nicotine

The most important role of nicotine is its action on the brain and nervous system in helping to create dependence.

  • Nicotine reinforces and strengthens the desire to smoke and causes users to keep on smoking.
  • Cigarette smokers absorb nicotine more quickly than pipe and cigar smokers or those who chew tobacco or use snuff because most cigarette smokers inhale.
  • Inhalation is the fastest and most efficient way of getting nicotine to the brain.
  • Nicotine acts through specialized cell formations located in the human brain and muscle tissues. These receptors have the capacity to recognize and react to nicotine when it is present in the body.
  • Nicotine and the opium derivatives are the only other drugs of dependence for which specialized receptors of this kind have been identitied and studied in detail.
  • When the receptors signal the presence of nicotine, a wide range of physical reactions occur. Changes occur in heart rate and skin temperature, blood pressure rises, peripheral blood circulation slows, changes occur in brain waves, and hormones affecting the central nervous system are released.

This articles continues in Part Two: Why People Smoke Cigarettes which considers: 'the way people Smoke', 'what happens when a person tries to quit smoking' and 'lessons learned in the treatment of other dependencies that can be applied to cigarette smoking'.

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.

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