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, chaining together different types of use, rather than suddenly.
Psychopathology and medical manuals classify it as an illness, although it is not only an impact on 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 of all, nicotine addiction and the use of tobacco or other products containing it is a problem that affects the body, because these are biological substances whose consumption has serious consequences for the health of the organism. For example, it predisposes you to respiratory and 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 for and accumulation of food or the maintenance of sexual relationships.
In the evolution of the species, accumulating resources even when they were not needed at that exact moment has been a very valuable strategy, because it was necessary to anticipate days or phases of food scarcity.
When tobacco addiction develops, this structure is altered, since 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 much need to smoke, but when that possibility becomes more feasible, the urge arises abruptly. The psychological has to do with the fact that all people are individuals, capable of experiencing their reality in a singular way.
Thus, smoking is also a psychological experience and is based on the association of stimuli (you may feel less like it on a plane; more so on a terrace), but also on more complex aspects such as the person’s identity: being outgoing, interesting, adult, attractive, intellectual, daring, etc., or on needs associated with smoking: rest, switching off, reward, rebellion, differentiation, 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 change, allows you to ask yourself what your particular way of facing the situation will be, and feel that you have agency over your life.
If you view it only as a physical illness, you may tend to approach the change process as a merely passive patient. Although this is beginning to change, bodily illnesses are often treated without much need for patient involvement: patients receive medication or undergo an intervention, but do not decide on or design the treatment.
If it is accepted that smoking also has a subjective basis — that is, the singular way each person has built and developed it, and the psychological aspects that accompany it — it will also be possible to guide the recovery process 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 consequent health problem it entails and, on the other hand, that you can build your own motivation (not only your family’s or doctors’) to stop. At the same time, doubts, moments of weakness, or ambivalence are normal and allowed throughout the process.
Change is a process that involves awareness, learning, and the development or recovery of skills, and it can happen at different paces, depending on each person and their situation and context. Just like learning a new language, change at the beginning requires a lot of awareness, but with practice it becomes a skill that no longer needs as much attention.
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. You may even feel that smoking gives you a good reputation or the feeling of being part of the community of smokers. In addition, tobacco is a substance that is easy to access.
Smoking is a social epidemic because it has not been consumed in the same way in all cultures or throughout all historical periods. In the same way that there are areas of the world where consumption decreases, there are others where it grows, and this is not explained by many people starting or quitting 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 relying on your surroundings to make nicotine addiction a shared difficulty and abstinence a collaborative commitment. Shared problems are resolved sooner than hidden or secret problems. Later on, we will propose at what point in the process you can involve the people around you.
Smoking is a biological phenomenon, because it has to do with substances; psychological, because it is carried out by individuals who can feel in different ways and give a different meaning to that experience; and social, because there is a situation and a context around this fact. Focusing on only one of the three aspects would be like trying to sit on a one-legged stool.
Congratulations on getting this far. Quitting smoking is possible!