By Linda M. Guhe, MSW, LCSW
 

	Introduction – Nicotine Addiction
	At What Age Does Tobacco Use and Addiction Usually Begin?

Introduction – Nicotine Addiction

You may wonder, “If it is so damaging to health, why do so many people continue or even begin to smoke or chew tobacco?” Although many understand tobacco use as a “habit,” the nicotine in tobacco products is actually a strong addictive drug. Nicotine produces changes in brain chemistry that lead to changes in mood and behavior. The idea that tobacco use is a “habit” stems from the fact that the behaviors associated with tobacco become “habitual.”

After entering the lungs, nicotine from inhaled smoke enters into the blood stream and quickly travels to the brain. Nicotine from smokeless tobacco enters the bloodstream through the mucus lining of the mouth.

There are two ways in which tobacco use leads to physiological nicotine addiction and dependency:

1. Nicotine produces a relaxing effect, increases mental alertness, and lifts a person’s mood. In order to maintain these positive feelings (rewards) the brain begins to rely on nicotine. Over time, however, more and more nicotine is needed to produce the same level of pleasurable effects.Nicotine is a “positive reinforcement” in that consumption leads to positive feelings and mood. The tobacco user becomes dependent on nicotine to get the desired positive effects.
2. If a person decreases his or her use of cigarettes, nicotine levels in the blood stream drop. Lower levels of nicotine cause negative withdrawal symptoms like anxiety, irritability, and difficulty concentrating.When a person is undergoing withdrawal symptoms due to a drop in the nicotine level in their blood, smoking becomes a “negative reinforcement” because it temporarily relieves or removes the painful uncomfortable symptoms of withdrawal. Tobacco users become dependent on nicotine to avoid unpleasant withdrawal symptoms.

Tobacco dependence is complex and affects the user psychologically, emotionally, socially, and behaviorally.

Psychological: Tobacco is often used to cope with emotions and conflict. The pleasurable feelings induced by tobacco can cover and numb feelings and emotions associated with grief, loss, and mourning. Stressful situations or emotionally upsetting events can act as triggers to use tobacco. Nicotine also increases concentration.

Social: Tobacco is often used to cope with uncertainty and/or awkwardness in social situations. People who smoke usually feel comfortable with others who smoke. For example, employees often gather during work breaks. It provides a time for social interaction and acceptance. Tobacco users also share asocial stigma from non-smokers. A social culture of rituals and shared experience in tobacco users develops that centers on tobacco.

Behavior: Once addicted, a belief develops that tobacco is needed in order to function effectively. The belief can become so strong that the reality of the harm tobacco has on the body is denied or ignored. A compulsive pattern of unhealthy behaviors centered on tobacco use develops in response to stress and strong emotions, and as a way to avoid symptoms of nicotine withdrawal.

Certain behaviors become “associated” with the effects of nicotine in the brain, creating a strong connection between specific behaviors and the physiological addiction. For example, after quitting, the automatic behavior of reaching for a pack of cigarettes or can of chewing tobacco in reaction to stress can trigger the brain to “crave” nicotine.

Over time, tobacco users rely more and more on nicotine to regulate mood and concentration. Healthy and even invigorating approaches to lift mood, cope with stress, and anger are abandoned or never learned. Tobacco users are cheated of opportunities to learn creative ways to cope.

At What Age Does Tobacco Use and Addiction Usually Begin?

Most tobacco use begins during adolescence. In fact, tobacco addiction specialists call smoking a “pediatric disease” because most tobacco use begins in childhood and adolescence. About 5,000 adolescents a day experiment with smoking. Of that number, approximately 2,000 will go on to become addicted to tobacco.

One-third of adolescents who become addicted to tobacco will eventually die from a smoking-related disease. Smoking at a young age also leads to serious impairments in physical health. Cigarette smoking in adolescence leads to increased lung-related illnesses, decreases in physical fitness, and decreased levels of lung function.

Teenagers are often eager to be adults. Tobacco use may be a way to rebel against dependence on parents and other adults. Smoking may be a result of internalized sports and movie star celebrity role models. For example, smoking and other forms of tobacco use may be connected for males with strength and masculinity. For females, smoking may be associated with being sexy and strong.

Other reasons teenagers take up smoking include peer pressure and wanting to belong. Adolescence can be a time of uncertainty and ambivalence because of no longer being a dependent child, yet not quite an independent adult either. The rituals involved with tobacco use are sometimes used by adolescents to guide them about what to do and how to act in social situations.

For many adolescents, mainly females, weight control plays a large role in tobacco use. Girls feel cultural and societal pressure to be slim and sleek. Often, the addiction to tobacco becomes tied to eating disorders and frantic attempts to maintain alarmingly low body weight.

Low self-esteem and depression can also lead to vulnerability to tobacco use. Strong emotions and identify confusion add to a sense of susceptibility. Tobacco becomes a way to cope with stress and can become a very part of a person’s identity. While the reasons adolescents begin tobacco use vary, the reason they become dependent on tobacco is directly tied to nicotine addiction.

Today, there are committed and dedicated advocates fighting to protect children and adolescents from the dangers of tobacco and tobacco smoke. There are also tobacco addiction specialists promoting and encouraging tobacco cessation. Concerned parents, loved ones, educators and others interested in the well-being of children, adolescents, and others they care about, can find local and national resources and help.

References:

• Database & Educational Resource for Treatment of Tobacco Dependence: www.treatobacco.net/home/home.cfm
• National Cancer Institute: www.cancer.gov/cancertopics/tobacco
• National Center for Tobacco-Free Kids: www.tobaccofreekids.org
• National Institute on Drug Abuse: www.nida.nih.gov/DrugPages/Nicotine.html
• Office on Smoking and Health at the Centers for Disease Control and Prevention: www.cdc.gov/tobacco

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