Explain factors related to the development of substance abuse or addictive behavior
· Substance abuse refers to the continued use of the substance despite knowing problems associated with the substance such as persistent desire to use it and/or unsuccessful efforts to control substance use. Smoking could be an example of substance abuse when smokers want to quit but find they are unable to.
· Substance dependence This is demonstrated in craving (i.e. a strong desire to get the substance or engage in a behavior) and in withdrawal symptoms (i.e. the unpleasant physiological and psychological symptoms when people don’t get the substance on which they are dependent).
· Addiction (or addictive behavior) occurs when people become physically or biologically dependent on a substance because of repeated use over time.
· The psychoactive drug in tobacco is nicotine. Nicotine alters levels of neurotransmitters (e.g. acetylcholine, dopamine, adrenaline, vasopressin). Secretion of adrenaline results in temporarily increased heart rate and blood pressure. Secretion of dopamine is involved in the alteration of mood. Secretion of acetylcholine appears to enhance memory. Nicotine is also associated with relaxation and changes in mood.
· Nicotine is a highly addictive substance. A habitual smoker will experience withdrawal symptoms if the level of nicotine is not constant in the body. This could explain why up to 80% of smokers in the USA who would like to quit are not able to do it (Benowitz, 2009).
· Marks et al. (2005) report that although teenagers’ initial reaction to tobacco smoke is generally negative, they quickly develop a taste for it. Young smokers report that smoking has a calming effect and that they experience craving if they cannot smoke. This is confirmed in measurement of nicotine levels in the saliva. Within a couple of years, teenagers report that they find it difficult to stop.
DiFranza et al. (2006) Research on adolescents’ smoking history and addiction
· The aim of the study was to investigate the relationship between attitudes to smoking and smoking habits.
· The design was longitudinal and used questionnaires and interviews for data collection. In Massachusetts 217 adolescents (mean age 12) answered questionnaires on their smoking history, social environment (e.g. family and peers) as well as beliefs and attitudes towards smoking. All participants reported having smoked a cigarette at least once.
· Eleven of the participants were interviewed. Tobacco dependence was assessed based on reported cravings, and inability to quit.
· The results showed that of those adolescents who recalled a relaxation effect after their first inhale, 67% became dependent compared to 29% of those who did not experience such an effect.
· Feelings of relaxation after inhalation were the main risk factor for addiction. Of the participants who the experienced relaxation effect, 91% reported that it was not possible for them to quit smoking even though they wanted to and 60% said they felt they had lost control.
· The conclusion was that for some people addiction to smoking seems to start almost after the first puff but it is unknown why some are more vulnerable to nicotine addiction than others. It could be genetic but smoking is a complex behavior where both genes and environmental factors interact.
According to social learning theory (SLT) smoking is learned through modeling (remember Bandura). This could apply to the role of parents and peers in the initiation of smoking.
Bauman et al. (1990) found that 80% of a sample of American adolescents aged 12–14 whose parents did not smoke had never tried to smoke themselves. If the parents smoked, half of the children had tried smoking. Murray et al. (1984) found that in families where the parents were strongly against smoking, the children were up to seven times less likely to smoke.
Is it peer pressure (conformity…Asch)?
According to the UN Department of Health and Human Services (2001) peer smoking appear to be the most important factor in smoking initiation. More than 70% of all cigarettes smoked by adolescents are smoked in the presence of a peer according to Biglan et al. (1984).
Unger et al. (2001) Cross-cultural survey on adolescent smoking
· The aim of the study was to investigate smoking habits in relation to peers and cultural background.
· The sample consisted of adolescents from California (N=5,143, mean age 13).
· The results showed that white students with close friends who smoked were much more likely to smoke than non-white students (e.g. Asian American and Hispanic students).
· The researchers explained that in individualistic cultures, adolescents typically create their own youth culture characterized by rebellion in order to set themselves apart from their parents. In collectivistic cultures, the bond between the teen and the parents is considered important. Rebellion is not tolerated so adolescents are more likely to conform to the roles and norms that parents prescribe for them.
Role of advertising and marketing
· Consumer research shows that tobacco advertising has a powerful effect on smoking attitudes and behavior of young people. The use of imagery and positive association in combination with brand consciousness in young people influences the young to smoke the most popular and well-advertised product.
· Advertising functions as a “cue” to smoking (e.g. associating pleasure and fun with smoking may activate craving in smokers but it could also motivate young people to start smoking).
· Tobacco sponsorships promote brand association and makes it easier to start smoking. Charlton et al. (1997) found that boys who showed a preference for Formula One motor racing that was sponsored by cigarette manufacturers were more likely to start smoking.