Addiction: nicotine

Question 1

Explain genetic explanation for smoking initiation

Answer 1

One explanation is that some people inherit a genetic
vulnerability to start smoking and ultimately develop an addiction.
One candidate gene for smoking (and other addictions) is the
A1DRD2 variation. This seems to code for defective and
insufficient dopamine receptors in the brain’s reward circuitry,
meaning some individuals cannot produce pleasure naturally and
may engage in smoking behaviours to raise dopamine to optimal
levels

Question 2

Action of nictotine

Explain in detail the role of dopamine and behaviour repetition

Answer 2

1- Nicotine stimulates specific acetylcholine (nicotinic acetylcholine receptors - NAcR) receptors which increases alertness, memory function and learning.

2- This action causes a rise in dopamine activity in the ventral tegmental area (VTA): a critical area in the brain’s reward circuitry which is highly populated with NAcR. This gives nicotine a rewarding sensation.

3- The VTA activity caused by nicotine is then projected to the nucleus accumbens, a producer of dopamine that is located deep in the mesolimbic dopamine pathway.

4- The nucleus accumbens is a primary reward centre in the brain and with increased activity: dopamine rises causing users to evaluate ‘smoking’ as very pleasurable, compelling further use.

5- At the same time, the nucleus accumbens is encouraged to release more dopamine as nicotine also stimulates endorphins that reduce GABA activity.
A decrease in GABA correlates with further rises in dopamine (as GABA usually suppresses dopamine).
More and more dopamine forces smokers to engage with further use.

Question 3

Describe smoking relapse and downregulation

Answer 3

Nicotine triggers the firing of dopamine in the mesolimbic dopamine pathway, and this acts like a reward, or a ‘kick’ to the smoker. The smoker will want this reward again, but tolerance develops.

With long term use, the Nicotine Regulation Model (Shachter, 1977) suggests that the smokers ‘reward system’ becomes temporarily less active/sensitive (downregulation) i.e., specific acetylcholine receptors become unavailable and inactive. This can create anxiety, lethargy and sadness.

To avoid this, smokers continue to smoke more to maintain a certain level of nicotine in their bodies to avoid these unpleasant side effects (negative reinforcement).

Hence, with the downregulation (tolerance) in the mesolimbic pathway, an increased amount of nicotine is needed to achieve the same initial ‘kick’ as the rewarding receptors have been ground down.

Question 4

Describe upregulation and smoking

Answer 4

As long as the individual is smoking, nicotinic receptors are desensitised and cravings and withdrawal symptoms held off. However, when smokers go without nicotine for a prolonged period of time, nicotine disappears from the body. This allows more nicotine receptors to become functional again (upregulation).

Question 5

EVALUATING Brain chemistry and dopamine in NICOTINE ADDICTION: evidence

paterson

Answer 5

Paterson et al. (2002) found support for the role of nicotine and dopamine through research with epilepsy drug (Gamma-vinyl GABA).
This drug reduces the surge of dopamine in the nucleus accumbens that occurs after nicotine. This effectively reduces the addictive properties of nicotine, without major side effects.

Question 6

EVALUATING Brain chemistry and dopamine in NICOTINE ADDICTION: beta bias

Answer 6

Nerin and Jane (2007) argue the onset of smoking addiction is significantly different between the sexes - i.e., women typically start smoking much later than men.
The biological reasoning for this is ignored.

Question 7

EVALUATING Brain chemistry and dopamine in NICOTINE ADDICTION: neglects to consider nurture

Answer 7

Neglects to consider the role of nurture.
Perhaps the rewarding qualities of nicotine are also gained through the environment - for example the peer acceptance and approval that have been shown to be positively reinforcing.
Research has shown that nicotine activates dopamine - but studies have also shown peer approval activates dopamine as well.

Question 8

EVALUATING Brain chemistry and dopamine in NICOTINE ADDICTION: scientific

Answer 8

The dopamine account uses both empirical and falsifiable methods to help identify the biochemical action of nicotine.
For instance, dopamine and NAcR can be objectively measured through cerebrospinal fluid (CSF), sophisticated PET scans as well as carefully examining urine for waste products.

Question 9

EVALUATING Brain chemistry and dopamine in NICOTINE ADDICTION: practical applications

Answer 9

Delivering therapeutic doses of nicotine (without the undesirable parts of tobacco) in the early stages of stopping smoking. This release of nicotine is absorbed much more slowly and steadily than in tobacco.
For instance, there are _____________________ currently available to purchase. The use of inhalers has been shown to keep 28% of the treatment group off cigarettes for 12 months.
- Davison, 2004

Question 10

What are the 3 parts of learning theory for smoking addiction?

Answer 10

Smoking initiation - Social Learning Theory

Smoking maintenance - Consequential learning and peer acceptance

Smoking maintenance and relapse - Cue reactivity

Question 11

Outline smoking maintenance (SLT)

Answer 11

Nicotine addiction could be picked up easily through vicarious reinforcement and learning from equal status (peers) and higher status (parent) role models.
E.g., individuals may see mum being particularly stressed out and then smoke a cigarette which appears to remove her stress (and example of vicarious (negative) reinforcement).
If this pattern of behaviour is repeated several times, not only is this legitimising smoking as acceptable, but we are likely to remember this event and be motivated to repeat the behaviour ourselves - chasing this negative reinforcement (stress reduction).

Question 12

Outline smoking maintenance

Answer 12

Consequential Learning
Skinner: Immediate reinforcers take precedence over the long term consequences.
I.e., short term benefits of smoking (reduced stress) outwight long term costs of smoking (addiction - health risks etc). 25% of inhaled nicotine reaches the brain in less than 10 seconds.

Peer Acceptance
Milton et al. (2008): Young smokers identified peer influence as an important factor in smoking, and the rejection from a peer group as key.
Hence, through social modelling and interaction, peer acceptance acts like reinforcement that helps maintain smoking behaviour.

Question 14

Outline cue reactivity

Answer 14

Carter and Tiffany (1999)
CC claims smoking addictions are often maintained and relapsed due to triggers or cues in the environment that we have learnt to associate with smoking addiction.
These cues (CS) will elicit a conditioned response even in the absence of the actual smoking behaviour.

MAINTENANCE: As the effects of tobacco start to wear off with repeated exposure users can experience
unpleasant withdrawal symptoms (e.g. nausea, insomnia, cravings). Taking
more nicotine stops these negative experiences occurring. As this further use removes the
negative states and provides more pleasure, this is likely to increase the
frequency of smoking and subsequent addiction. Hence, maintaining pleasurable effects
from tobacco acts as a negative reinforcer.

RELAPSE= Classical conditioning claims smoking (and other addictions) are often maintained and
relapsed due to triggers or CUES in the environment that we have learnt to associate with
smoking addiction. These triggers are referred to as a Conditioned Stimulus (CS). Through CC
these cues (or CS) will elicit C__________________ R____________ even in the absence of
the actual smoking behaviour.

Question 15

list some of the cues or CS that may reignite smoking and /or create cravings

Answer 15

• PUB
• LIGHTERS
• PEERS
• ALCOHOL
• LOCAL SHOP

Question 16

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: practical application

Answer 16

This theory has led to useful practical applications to help treat those who suffer from smoking addiction.
Cue exposure therapy involves presenting the cue (e.g., lighter or alcohol) to the individual and helping them control their reaction to it (i.e., to develop coping strategies). In this way, the response of ‘smoking’ in the presence of alcohol, lighters and/or their peers fades away or extinguishes. This is thought to be more effective than simply trying to avoid the cues, for example never drinking.
This implies… that the learning theory of smoking addiction and ideas around cue reactivity can help the 14% of the UK population to quit smoking for good.

Question 17

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: individual differences

Answer 17

However, a weakness of the explanation is that the theory neglects to consider individual differences.
Robinson & Berridge (1993) argue that many people try smoking yet do not become addicted despite the rewarding experiences on offer.
This suggests other factors must also be at work, that allow some yet not others to become full blown smoking addicts.
For example… what other factors could cause nicotine addictions?
This implies that a more holistic approach may be needed to fully explain nicotine addiction.

Question 18

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: environmentally deterministic

Answer 18

The approach takes an environmental deterministic approach to explaining smoking, that although
creates general laws, creates a dilemma for psychologists.
The approach suggests that if your environment and role models are addicted to smoking it’s
inevitable that you will face the same fate. This does not consider the role of personal autonomy and
suggests we are ‘mere puppets of circumstance’.
In contrast, society at large promotes personal responsibility. This is a theoretical problem for the
learning explanation

Question 19

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: nature and nurture

Answer 19

The explanation is consistent with neurological findings that drugs have rewarding properties, and how nature and nurture may both contribute to drug abuse.
This theory is compatible with the neural explanation of nicotine as well as it focuses on the idea of nicotine being positively reinforced in the form of peer approval (learning theory) and in the form Dopamine activation (neural explanation). This would imply to remove this addiction you should tackle both the biochemical action (e.g., through NRT), and the environmental features (e.g., through desensitising individuals to cues that may activate smoking).
This means that OC provides a more comprehensive account of substance misuse than other theories focusing purely on Nature OR nurture alone.

Question 20

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: evidence

Answer 20

There is experimental support that illustrates the role of vicarious reinforcement in smoking behaviour.
HARAKEH et al (2007) investigated the role of peers and siblings in smoking behaviour with 428 families with two adolescent kids through surveys. Results showed Non-smoking adolescents with older siblings that smoked and those with a smoking best friend were more likely to have started smoking 1 year later, showing how vicarious learning from friends and older siblings influence the initiation of smoking addiction.
This illustrates that vicarious reinforcement plays apart in smoking addiction, making the theory more credible.

Question 21

EVALUATING the LEARNING APPROACH TO SMOKING ADDICTION: scientific

Answer 21

A final strength of the learning explanation of nicotine addiction is the explicit focus on observable behaviour, creating a falsifiable scientific account of smoking.
The behavioural account only focuses on observable behaviors of nicotine addiction - e.g. the observation and learning from other addicted role models, rather than the emotional / cognitive aspects of smoking addiction (e.g. psychological dependency) that are more difficult to measure objectively.
This implies the explanation of nicotine addiction is more credible and trustworthy.