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 appearing suddenly.
Psychopathology and medical manuals classify it as an illness, although it is not only an effect 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, nicotine addiction and the use of tobacco or other products that contain it is a problem that affects the body, because these are biological substances whose use has serious consequences for the body’s health. For example, it predisposes you to respiratory and cardiovascular diseases, cancers, and many others.
Also, addiction is sustained and reinforced by 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. Thus, this circuit serves to guide the search toward finding and stockpiling food or maintaining sexual relationships.
In the evolution of the 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 tobacco addiction develops, this structure is altered, since it asks you to reward it with nicotine. In this way, it directs you to seek more and more of the substance, under the premise that if you stockpile 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 can’t access a cigarette (long trips, periods of illness, hospitalizations), they don’t feel as much need to smoke, but when that possibility becomes more feasible, the craving awakens abruptly. The psychological aspect has to do with the fact that all people are individuals, capable of living their reality in a unique way.
Thus, smoking is also a psychological experience and is grounded in the association of stimuli (on a plane you may feel less like it; on a patio, more), but also in more complex aspects such as a person’s identity: being outgoing, interesting, grown-up, attractive, intellectual, daring, etc., or else in needs associated with use: rest, disconnecting, 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 it positions you as an active part of change, allows you to ask yourself what your particular way of facing the situation will be, and to 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 mere passive patient. Although this is beginning to change, bodily illnesses are frequently treated without much need for patients’ involvement: they receive 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 each person has built and developed it, and the psychological aspects that accompany it—you will also be able to guide the recovery process by relying 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 recognize 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 from your family or doctors) to quit. At the same time, doubts, moments of weakness, or ambivalence are normal and are allowed throughout the process.
Change is a process that involves awareness, learning, and developing or recovering skills, and it can happen at different paces, depending on each person and their situation and context. Just like when learning a new language, a change at first requires a lot of awareness, but with practice it becomes a skill that no longer needs as much attention.
3. Social
Lastly, smoking is also a social problem: it is a socially accepted behavior, promoted in advertising, social media, movies, 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 equally in all cultures and at all points in history. In the same way that there are regions of the world where use decreases, there are others where it increases, and that is not explained by many people starting or quitting smoking simultaneously by chance, but because it is a social dynamic.
Although the 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 environment to make nicotine addiction a shared difficulty and abstinence a collaborative commitment. Shared problems are solved sooner than hidden or secret problems. Later on, we will suggest 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 may feel different ways and give that experience a different meaning; and social, because there is a situation and a context around this fact. Focusing only on one of the three aspects would be like trying to sit on a one-legged stool.
Congratulations on making it this far. Quitting smoking is possible!