Nicotine is one of the most addictive substances with 13 percent of Americans dependent on its use, despite sharp declines in smoking rates during the last 30 years.
While most adults have tried nicotine, not all become addicted. A new book by a University of Toledo researcher explores why some people are more likely to begin smoking and have a more difficult time giving up the nicotine habit.“Everyone has a different reason to smoke,” said Dr. F. Scott Hall, assistant professor of pharmacology. “The key to helping someone quit is exploring why they begin smoking and continue to use nicotine.”
Negative Affective States and Cognitive Impairments in Nicotine Dependence explores the idea that there could be more to nicotine addiction than its “feel good” effects and the avoidance of nicotine withdrawal symptoms.
When a smoker inhales nicotine, the body reacts within seconds and the brain releases dopamine, which regulates behavior and mood and gives smokers a pleasant feeling. Getting that happy nicotine rush is a major part of the attraction of smoking. However, other effects of nicotine on other brain systems, particularly those involved in attention and cognition, could be as important in some people.
“This positive reinforcement response tapers with time as a smoker builds tolerance to nicotine,” Hall said. “Eventually, a smoker needs nicotine not to feel good, but to feel normal.”
Once nicotine and dopamine levels drop, smokers may react with a depressed mood, greater appetite, slower heart rate and problems focusing.
“That’s why it can be so difficult for smokers to quit,” Hall said. “They continue to use nicotine to avoid the negative effects of nicotine withdrawal.”
Hall’s book is the first of its kind to examine other contributing factors to nicotine addiction such as an underlying psychiatric disorder.
“Nearly 80 percent of schizophrenia patients are smokers, and individuals with ADHD are two times more likely to use nicotine,” Hall said. “Patients with other disorders such as depression, anxiety and post-traumatic stress disorder may be using nicotine as a way to self-treat these conditions.”
This correlation also could explain why some individuals find it so hard to quit smoking or begin smoking again after stopping.
“It’s important for smokers to do a little self-examination about why they smoke and to talk with their doctor about what their triggers are for smoking,” Hall said. “If an underlying condition is treated, it may be much easier to kick the nicotine habit for good.”
The book, aimed at doctors and researchers, provides the psychological perspective on nicotine addiction and paves the way for improved psychiatric and addictive medications and tailored treatment programs. It is scheduled to be published by Elsevier Science Publishing Co. Inc. in September.
“There is no one-size-fits-all answer for stopping smoking,” Hall said. “The treatment plan for nicotine addiction should be just as individualized as the reason someone begins smoking in the first place.”