Why is tobacco so addictive?
Tobacco is an incredibly addictive substance. Studies have found that smoking tobacco can be as addictive as heroin and cocaine (opens in new tab), but what makes people crave a cigarette? And why do many people find it difficult to quit smoking even though they are aware of the dangers?
As it turns out, the answer has to do with the fact that tobacco alters the way our brains work, making us want more of it US Food and Drug Administration (opens in new tab) (FDA).
“Addiction is primarily defined as losing control over the use of a substance and continuing to use it despite the consequences,” Bernard Le Foll, chair of addiction psychiatry at the University of Toronto Department of Psychiatry, told Live Science in an email.
“Once an addiction to a substance has developed, people will experience cravings and/or withdrawal symptoms if they don’t use it for a period of time. Tobacco is addictive because it contains nicotine, a highly addictive psychoactive substance,” said Le Foll.
Related: How does cannabis get you high?
A psychoactive substance is a substance that affects the way the brain works and is noisy National Cancer Institute (opens in new tab) (NCI), “causes changes in mood, consciousness, thoughts, feelings, or behavior.” Other examples of psychoactive substances include LSD, alcohol, and caffeine.
Nicotine is particularly addictive when smoked or otherwise ingested lung because “the onset of stimulant-like effects is very rapid by this route of administration,” David Ledgerwood, a clinical psychologist in the Substance Abuse Research Department at Wayne State University in Detroit, Michigan, told Live Science in an email.
While the initial pleasure of smoking a cigarette is felt almost immediately, it also wears off quickly, leading smokers to frequently turn to tobacco products to achieve “the same stimulating experience,” according to Ledgerwood.
When tobacco is consumed, nicotine blood levels rise (opens in new tab) and enter the brain. Once in the cerebrum, nicotine attaches to and activates receptors that release the “happy” brain chemical dopamine, which they say makes people feel good Mayo Clinic (opens in new tab). As a result, nicotine quickly becomes a “feel good” in smokers’ brains and is craved for in the breaks between cigarettes.
Chronic smoking increases the number of nicotinic receptors in the brain, which explains why addicted smokers “have billions more of these receptors than nonsmokers,” the Mayo Clinic reported.
When someone smokes regularly for months and years, their brain becomes so used to nicotine that they eventually “need nicotine to function well,” Ledgerwood said. During times when the addicted person is not smoking, physical withdrawal symptoms may occur as their brain adjusts to the absence of nicotine. These symptoms include poor concentration, insomnia, depression and loss of appetite, according to NCI (opens in new tab).
This, among other factors, explains why so many smokers have trouble quitting the habit, Ledgerwood said.
“Besides this physiological effect, that cigarettes are legal, can be bought at any gas station or corner shop, and can still be smoked in many different places, it becomes incredibly difficult for someone who wants to quit smoking to do this to do,” Ledgerwood added.
People who start using tobacco products as children or teenagers may find it particularly difficult to quit because exposure to nicotine can disrupt brain development, according to the FDA. And it’s easy for young smokers to become addicted; Brain imaging studies have shown that while reward systems mature early in the brain, the control center in the prefrontal cortex matures slowly, according to a 2012 report originally published in Cold Spring Harbor perspectives in medicine (opens in new tab). “Compared to adults, adolescents are generally more motivated by rewards, less risk-averse, and more easily influenced by their peers,” says the report.
Are some people at risk of addiction?
But are some people more prone to addiction than others? Does everyone face similar difficulties when it comes to quitting smoking, or do some find it relatively easy to quit?
“I don’t think people are immune to addiction,” Ledgerwood said. “Some people may be more susceptible to addiction than others, and it certainly appears that exposure to addictive substances at an earlier age puts you at greater risk of developing an addiction.”
The Fagerstrom test for nicotine dependence (opens in new tab), developed by Swedish psychologist Karl-Olov Fagerström in 1978, is a questionnaire used to determine a person’s degree of nicotine dependence related to cigarette smoking. The test has gone through several iterations since its inception, but is still used today and is still one of the most important methods for assessing addiction. Questions on the test include when a person smokes their first cigarette of the day, how many cigarettes they smoke each day, and whether they would smoke even if they were so ill that they were bedridden.
If someone does particularly well on this test, Ledgerwood explains, it’s probably because of more than just the body wanting frequent nicotine hits. “For many people who smoke, there are powerful factors that contribute to smoking,” Ledgerwood said. “These individuals often grow up in families where their parents smoke, and their behavior has been modeled on them.
“Cigarettes are still readily available in many places and while there are restrictions on where people can smoke, there are still plenty of opportunities for people to smoke in public. There are also still many depictions of smoking in popular culture (movies, TV shows) that can contribute to the feeling that smoking is normal and possibly even glamorous behaviour,” he added.
Additionally, studies have found that genetic factors play a role in nicotine addiction, meaning addiction can run in families, according to a 2010 review in the journal Current cardiovascular risk reports (opens in new tab). The Mayo Clinic states that genetics “may affect how receptors on the surface of your brain’s nerve cells respond to high doses of nicotine delivered by cigarettes,” which could mean that due to genetic inheritance, some people may not more likely once they start smoking than others to continue the habit later. After 2008 from the conducted research American Psychological Association (opens in new tab)“At least half of a person’s susceptibility to drug addiction can be linked to genetic factors.”
Despite the many risks associated with smoking and although it is believed to contribute to the deaths of people 8 million people (opens in new tab) worldwide every year – including 1.2 million who die from secondhand smoke – tobacco remains widely available and easily accessible.
However, while addiction comes on quickly, so do the health benefits once a person quits. According to the Mayo Clinic, within 20 minutes of smoking a cigarette, heartbeat sinks; within 12 hours the concentration of the toxic gas carbon monoxide normalizes in the blood; within three months lung function and blood circulation improve; and after one year the risk a heart Attack falls by half.
Originally published on Live Science.
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