Causes of Smoking Addiction

What Causes Smoking Addiction in the Brain?

Like all tobacco products, Nicotine—the addictive substance in tobacco—affects the dopamine levels in the brain.

Dopamine is a type of brain neurotransmitter that causes us to feel good and belongs to our brain’s reward center.

That rush of dopamine while smoking can make someone feel euphoric, relaxed, and less stressed. Nicotine also works quickly, but it also doesn’t last long, which can cause someone to go back for another cigarette, then another, and so on.

This recurring desire to feel the effects of nicotine again and again can quickly cause the body to become used to having a regular amount of nicotine, leading to dependence and eventually nicotine addiction (aka tobacco addiction).

Understanding Smoking Addiction and Dependence

While smoking dependence and smoking addiction are similar, they are not the same.

Dependence happens when your brain becomes used to having a regular amount of nicotine in your system. A common sign of smoking dependence is experiencing withdrawal symptoms (anxiety, irritability, and cravings) when it’s been a while since your last cigarette.

On the other hand, addiction is about an uncontrollable urge to keep smoking, often despite health risks or other negative consequences.

When a smoker develops that tobacco addiction, not only has their brain become dependent on the regular level of nicotine, they have usually created a positive association with behaviors around cigarette smoking.

The dependence and addiction process is very similar to other tobacco use, from smokeless tobacco products like chewing tobacco to trendy e-cigarettes (electronic cigarettes)—especially when the tobacco user creates positive associations with use.

How Smoking Addiction Can Cause Health Risks

One of the key issues of smoking addiction is that it causes a compulsory need to keep smoking despite negative consequences—including the problematic health effects that smoking can have on the body.

Some of the more common health problems behind smoking include:

• High blood pressure
• Risk of stroke
• Risk of diabetes
• Constipation, upset stomach
• Respiratory issues like COPD
• Heart disease
• Lung cancer

Additionally, someone addicted to smoking may also ignore the potential risks that tobacco smoke can have on those around them. The health problems caused by secondhand smoke are dangerous and well-documented.

What Other Factors Can Influence Smoking Addiction?

There’s more to understanding the causes of smoking addiction besides knowing how the effects of nicotine can influence a person’s behavior.

Many other factors can put someone more at risk for developing a smoking addiction or increase their likelihood of becoming a smoker, from genetics to the environment they grow up in.

By exploring these different risk factors, we can potentially offer more effective smoking prevention strategies and continue to offer more effective treatment options if someone does become addicted.

The following categories are some of the most common factors that might influence a smoking addiction.

Biological Factors

Biological factors can strongly influence the likelihood of someone developing an addiction to smoking.

By understanding these biological influences, people who meet one or more of these potential risk factors may decide they won’t even experiment with tobacco use just to play it safe.

Some biological examples include:

• Genetic predispositions, like having other family members with smoking addiction (or other substance use disorders)
• How nicotine affects your unique brain chemistry
• How quickly your body metabolizes nicotine

It’s also worth noting that over time, long-term smoking can cause changes to your brain’s chemistry, thus making smoking addiction even tougher to quit because of how normal it feels to your body.

Psychological Factors

Several psychological factors can play a big role in both developing a smoking addiction and how difficult it is for that person to quit.

Some research suggests that the psychological factors behind smoking addiction are what differentiates smoking addiction from just nicotine or tobacco addiction alone.

These psychological factors affect how someone might think about cigarette smoking as well as why they smoke to begin with. For some, the behavioral and emotional patterns of smoking make it not just a physical addiction but also a deeply embedded psychological habit.

For example, someone may become addicted to smoking partly as a result of these psychological influences:

Coping with Stress

Nicotine can provide a temporary sense of relief, which can create a strong psychological dependence.

People who start smoking to manage stress and anxiety will often find themselves reaching for a cigarette as a coping strategy, which can also make it much harder for them to quit.

Habits and Rituals

For many people, smoking has become part of their daily lives. They start their day and might have a cigarette with their coffee. Perhaps they enjoy a cigarette after meals or during breaks at work.

Over time, these positive rituals around smoking create triggers where the presence of other things—like morning coffee, for instance—makes the person want to smoke even if they aren’t craving a cigarette beforehand.

Mental Health Conditions

Smoking can act as a form of self-medication, temporarily alleviating symptoms of mental health disorders like anxiety or depression.

This creates a cycle where the psychological dependence on nicotine becomes intertwined with managing psychiatric symptoms, complicating efforts to quit.

Emotional Triggers

Similarly, negative emotions like sadness, anger, or boredom can lead people to smoke as a way to self-soothe or escape from uncomfortable feelings.

Over time, smoking can become a habitual way of managing these uncomfortable emotions, leading to a cycle of emotional and physical dependence.

Beliefs and Perspectives

The way a person views smoking in general can strongly influence whether or not they feel compelled to start or keep smoking.

For instance, if someone believes that smoking helps them stay thin, improves their concentration, or is a type of reward, they are more likely to try it out and stick with it.

These distorted beliefs can also create a barrier to quitting, as the imagined “benefits” of smoking overshadow their desire to quit.

Addictive Personality Traits

Some personality traits can also lend themselves to becoming addicted to smoking. For instance, impulsivity, sensation-seeking, and compulsive behavior can make a person more susceptible to developing a smoking addiction.

People with these traits may also find it more difficult to resist cravings or have a higher likelihood of experimenting with smoking in the first place.

Social and Environmental Influence

A person’s environment often plays a crucial role in smoking behavior, from the way they were raised to the peers they surround themselves with. Being around friends or colleagues who smoke can normalize the behavior and make it more difficult to quit.

Additionally, social smoking—where individuals only smoke with friends or peers—can still lead to addiction due to the way nicotine creates that cycle of dependence.

Examples of some environmental factors that can influence smoking addiction:

Peers and Social Circles

The people we spend time with can greatly influence our habits, even on a passive level. When people think of peer pressure, they often picture one person verbally encouraging another to try something, like having a cigarette.

Passive peer pressure is more likely to influence someone to pick up a habit like smoking simply by seeing friends and peers engaging in the activity. They don’t want to feel like the odd one out, so they may try smoking cigarettes to feel more “part of the group” and end up becoming addicted to smoking.

Cultural Norms

Societal attitudes towards smoking vary between cultures. In some cultures where smoking is normalized or even glamorized, people raised with those attitudes may not question whether or not smoking is harmful. They are also likely to engage in what is considered normal in their culture and may also be less likely to consider smoking to be a problematic habit.

Accessibility

Having easy access to cigarettes increases the likelihood of experimentation and then continuing to fuel their habit. If cigarettes and other tobacco products are readily available in local stores, vending machines, or even in the home (where they can be snuck out of a parent’s stash or borrowed from a roommate), people are more likely to purchase and use them.

Advertisements and Social Media

Media representations of smoking in movies, TV shows, advertisements, and even through celebrities or influencers can glamorize smoking. By making smoking look cool, interesting, fun, or some other element of intrigue, this kind of exposure to smoking can encourage a person—especially someone young—to try smoking.

School and Education

Whether or not a person understands the health risks of smoking or knows just how addictive nicotine can be are topics covered in a lot of school programs.

Lack of funding can lead to poor outreach and a lack of these important programs, leading adolescents and young people to miss out on critical information about smoking.

Economic Factors Causing Smoking Addiction

Economic factors can significantly impact smoking addiction, influencing both the likelihood of starting smoking and the ability to quit. These factors encompass the cost of tobacco products, socioeconomic status, and access to resources.

Here’s how economic factors can affect smoking addiction:

• Socioeconomic status: Research shows that socioeconomic status (aka social class) is closely tied to smoking addiction. People with a “lower” class status typically have higher smoking rates, a disparity that can be attributed to factors like increased stress, limited healthcare access, and lower education.
• Access to resources: People with limited financial resources may not have access to treatment options to help them quit. Tools like counseling, nicotine replacement therapies, or medications may not be affordable, making it even more difficult to stop smoking.
• Marketing: Economic factors also influence how tobacco companies market their products. In lower-income communities, tobacco companies often use strategies to make smoking appear more appealing or affordable to these populations, increasing the risk of smoking addiction.
• Financial worry: Economic pressures like job insecurity or financial instability can lead people to turn to smoking as a coping strategy. Nicotine can provide immediate relief and a temporary escape.

Age and Developmental Factors

A person’s age and the stage of brain development can also influence whether or not someone is more likely to develop an addiction to cigarette smoking.

Research shows that someone who experimented with cigarette smoking in adolescence is more likely to develop a smoking addiction than someone who started smoking as a young adult or even later.

In addition, adolescents may be more susceptible to peer pressure than their older counterparts. On top of that, their age and lack of maturity prevent them from fully considering the health risks of smoking.

As a result, a kid or teenager can more easily fall into an addiction just by experimenting with cigarettes and not thinking about the consequences.

Comorbid Substance Use

Combining smoking with other substances, such as alcohol or recreational drugs, can create a complicated cycle of dependence and addiction. The interaction between smoking and other substances can increase certain properties of each and the way they affect how you feel.

For example, smoking can increase some of the pleasurable side effects of alcohol (e.g., relaxation, euphoria), making the combination of smoking and drinking seem more fun.

The combination of smoking and alcohol can make the user more dependent on both substances and the way they interact.

It can also turn alcohol into a trigger, where future drinking can make the person crave a cigarette because they have created an association between drinking alcohol and smoking cigarettes. The same is true for combining smoking and other substance use.

How Can We Prevent Smoking Addiction?

The best way to prevent smoking addiction is through a combination of public health initiatives, education, policies, and support systems.

Through these different strategies, we can reduce the likelihood of people experimenting with smoking to begin with, especially among adolescents. In addition, we can better support those who are ready to quit.

Some examples of ways we can approach smoking addiction prevention:

• Implement school-based education programs to educate students about the risks of smoking
• Develop and support community programs that educate about the dangers of smoking and provide resources for quitting
• Increase taxes on tobacco products, which makes them more expensive and less accessible
• Enforce strict age restrictions, making sure retailers aren’t selling to anyone underage (i.e., limiting access)
• Regulate tobacco marketing and advertising—especially ads intended to target impressionable young people
• Create smoke-free public spaces, from parks and transport to housing
• Promote healthy alternatives, like physical activities, hobbies, and other healthy options besides smoking
• Provide better access to smoking cessation tools (free or subsidized)
• Support legislation that aims to reduce tobacco use and exposure

How Is Smoking Addiction Treated?

Smoking addiction is complex because it is influenced by biological, psychological, environmental, and social factors. Someone who wants to quit will usually need a comprehensive approach.

By understanding the causes of smoking addiction, we can create and improve treatment methods that will help more people quit smoking for good.

Some of the most common types of smoking addiction treatment methods are:

• Nicotine replacement therapy (NRT): This FDA-approved nicotine treatment includes gum, patches, lozenges, inhalers, and nasal spray. NRTs work by delivering a tapered level of nicotine to the body over a set period, allowing a person to slowly wean off cigarette use while avoiding the harsh chemicals found in cigarettes and other tobacco products.
• Smoking Cessation Pills: Also called stop-smoking pills, these medications include bupropion (an antidepressant) and varenicline. Bupropion helps the brain regulate dopamine, which in turn can reduce cravings and withdrawal symptoms. Varenicline is specifically designed to block your nicotine receptors, reducing cravings and making it so that smoking no longer has a positive effect (therefore reducing relapse rates).
• Support Groups: A highly effective tool in maintaining abstinence from smoking by providing support and accountability, support groups include 12-step programs like Nicotine Anonymous) and other types of meetings. Many support groups offer online meetings as well as traditional in-person meetings.
• Counseling or Therapy: For many, smoking addiction is multifaceted, and a huge part of it happens as a result of creating routines or coping mechanisms around smoking. Individual or group therapy, which typically utilizes cognitive behavioral therapy (CBT) strategies, helps people rewire their brains. By identifying their smoking triggers and examining other reasons why they may have started smoking, people can work with a therapist to create more positive coping mechanisms and healthier routines outside of using cigarettes.

Effectiveness of Smoking Addiction Treatment

Research shows that smoking addiction treatment leads to much higher success rates in quitting. The degree of success will vary based on the individual, type of treatment, and other variables.

Nicotine replacement therapy (NRT) can increase the likelihood of quitting by 50-70% compared to not using any type of treatment.

Similarly, prescription pills (i.e., varenicline and bupropion) can also improve quit rates. Varenicline has been shown to double or triple the chances of quitting, and bupropion increases the chances of success by 19%.

Meanwhile, behavioral therapies—usually in combination with medication or NRT—increase the chances of quitting even further. Individual or group counseling can improve success rates by another 14%.

While there is no singular “best method,” having any kind of support or additional treatment dramatically increases your chances for success when you decide you’re ready to stop smoking once and for all.

Take the First Step Toward Quitting Smoking

If you’re ready to live a smoke- and tobacco-free life, you can talk to your primary doctor or make an appointment with a local healthcare provider to discuss your options.

Additionally, the following are just a few examples of resources that provide counseling, support, and additional information to help you quit:

• Nicotine Anonymous
• National Cancer Institute Quitline (877-448-7848)
• Freedom From Smoking®
• Smokefree.gov
• Smartphone apps like quitSTART

These can help you assess your situation and figure out what treatment methods might work best based on how long you’ve been smoking, how often you smoke, what additional health issues you may have, and more.