An addiction is a health problem that usually appears as the result of a process, which may be more or less accelerated over time. Normally, addiction develops over time, linking different types of use, rather than arising suddenly.
Psychopathology and medical manuals classify it as an illness, although it is not solely an impairment of the body or the brain; it also has psychological and social causes and consequences. That is why we say it is a biopsychosocial condition:
1. Biological
First, nicotine addiction, and the use of tobacco or other products that contain it, is a problem that affects the body and biology, because it has serious consequences for health. For example, it predisposes you to respiratory diseases, cardiovascular diseases, cancers, and many others.
Addiction is also sustained and reinforced through the so-called reward circuit. This structure is in your brain and is responsible for releasing the neurotransmitter dopamine so that you seek out stimuli and rewards in your environment that help you survive. In this way, this circuit serves to guide the search towards finding and accumulating food or maintaining sexual relationships.
In the evolution of our species, accumulating resources even when they were not necessary at that precise moment has been a very valuable strategy, since it was necessary to anticipate days or periods of food scarcity.
When addiction to tobacco develops, this structure is altered, because it asks you to reward it with nicotine. In this way, it drives you to seek more and more of the substance, under the premise that if you accumulate something valuable, such as food, you will have a better chance of surviving. However, addiction disrupts this mechanism, which begins to activate so that you consume and accumulate nicotine in your body.
2. Psychological
Second, addiction has psychological roots and consequences. Many people describe feeling that their need to use is not so much physical as mental, because they notice that when they cannot access cigarettes (long journeys, periods of illness, hospitalisations) they do not feel as strong a need to smoke, but when that possibility becomes more feasible, the urge suddenly awakens.
Thus, smoking is also a psychological experience and is grounded in the association of stimuli (you may fancy it less on a plane; more on a terrace), but also in more complex aspects such as a person’s identity: being outgoing, interesting, adult, attractive, intellectual, daring, etc., or in needs associated with use: rest, switching off, reward, rebellion, standing out, connecting with other people, etc.
It is very beneficial for you to be aware of the psychological implications of nicotine addiction because this places you as an active part of the change, allows you to ask yourself what your particular way of dealing with the situation will be, and to feel that you have agency over your life.
If you view it solely as a physical illness, you may tend to approach the process of change as merely a passive patient. Although this is beginning to change, bodily illnesses are often treated without much need for patient involvement: patients are given medication or undergo an intervention, but they do not decide on or design the treatment.
If it is accepted that smoking also has a subjective basis—that is, the unique way in which each person has built and developed it, and the psychological aspects that accompany it—then the recovery process can also be guided by drawing on personal resources, gaining self-knowledge and self-efficacy. This personal process can help you answer for yourself why, when, and in what way you are going to begin abstinence.
In that sense, it is important that you can acknowledge to yourself the difficulty with nicotine and the resulting health problem it entails, and, on the other hand, that you can build your own motivation (not only that of your family or doctors) to stop. At the same time, doubts, moments of weakness, or ambivalence are normal and are allowed throughout the process.
3. Social
Finally, smoking is also a social issue: it is a socially accepted behaviour, promoted in advertising, social media, cinema and other public spaces, and you may even feel that it gives you a good reputation, the feeling of being part of the community of smokers, and, moreover, it is a substance that is easy to obtain.
Smoking is a social epidemic because it has not been consumed in the same way in all cultures and at all points in history. Just as there are parts of the world where use is decreasing, there are others where it is growing, and this is not explained by many people starting or stopping smoking simultaneously by chance, but because it is a social dynamic.
Although social acceptance of smoking may contribute to maintaining use, abstinence can also be a social experience in which you receive support and external reinforcement, through a network that accompanies and sustains you.
That is why we recommend involving your environment to make nicotine addiction a shared difficulty and abstinence a collaborative commitment. Shared problems are resolved sooner than problems that are hidden or kept secret. Later on, we will suggest at what point in the process you can involve the people around you.