Nicotine Addiction - including reference to cue reactivity

Question 1

Operant conditioning assumes that

Answer 1

behaviour is learnt through consequence i.e. rewards, punishments

Question 2

Reinforcement

Answer 2

anything in the environment that strengthens a behaviour, increasing the probability that it will reoccur in the future

Question 3

Positive Reinforcement

Answer 3

is the provision of a desirable/positive consequence/reward that strengthens the preceding behaviour

Question 4

Operant conditioning can be used to explain the

Answer 4

initiation and maintenance of addictive behaviour, in that a behaviour will become more frequent if it has been reinforced in the past

Question 5

Smoking may be addictive because of:

Answer 5

Physiological rewards
e.g. increase dopamine produced in the nucleus accumbens (part of the reward pathway in the brain), resulting in feelings of pleasure

Psychological rewards
e.g. perceived relaxation and stress relief

Social rewards
e.g. popularity amongst peers; praise from peers

Question 6

Negative Reinforcement can explain why individuals continue to smoke

Answer 6

(maintenance) and why many relapse, as they seek to reduce or avoid the unpleasant withdrawal symptoms (a negative stimulus), that appear once the effects of nicotine wear off, by smoking again and reintroducing nicotine into their system.

Question 7

Withdrawal symptoms:

Answer 7

irritability, shaking, anxiety, difficulty concentrating, headaches, coughing, intense cravings

Question 8

Can you think of anything else a smoker might want to avoid?

Answer 8

Stress or any other negative emotional state

Question 9

What is a ‘conditioned cue’?

Answer 9

Stimuli (objects or environments) that occur immediately before or at the same time as the smoking behaviour and become heavily associated with the primary reinforcer (nicotine). They are also known as secondary reinforcers or conditioned stimuli.

Question 10

Cues previously associated with receiving nicotine e.g.

Answer 10

cigarette packets or the smell of cigarette smoke, increase the likelihood that the smoker will respond by smoking, because they are associated with the rewarding effects of nicotine.
These conditioned cues therefore often trigger relapse.

Question 11

Cue Reactivity:

Answer 11

When a smoker comes into contact with objects or environments (conditioned cues) heavily associated with the nicotine, they experience cravings and physiological arousal, as they anticipate the effects of nicotine.

Question 12

Although the effects of nicotine on the brain are important when an individual first starts to smoke

Answer 12

smoking-related cues rapidly become conditioned stimuli (cues) and activate the same brain areas as nicotine, making cessation more difficult (Franklin,2007).

Question 13

The ‘nicotine effect:’

Answer 13

nicotine activates brain reward pathways, increasing the release of dopamine (unconditioned stimulus).
In response to this change in dopamine levels, the brain attempts to restore equilibrium by lowering dopamine levels back to normal (unconditioned response).
Any stimulus that is present when the individual smokes is the neutral stimulus, but over time, after repeated associations, becomes strongly associated with the nicotine effect, thus becoming a conditioned stimulus (conditioned cue).

Question 14

NICOTINE ADDICTION: SOCIAL LEARNING THEORY

Answer 14

Assumes that the learning of smoking behaviour occurs through observation, particularly of role models e.g. parents, peers, whom an individual identifies with and therefore pay more attention to.

Rewards are experienced indirectly, which is known as vicarious reinforcement (through the observation of positive consequences).

If smoking is seen to have positive outcomes, then this may lead to an increased likelihood of imitation and repetition of the behaviour in future.

Question 15

As a result, ‘outcome expectancies’ (an understanding of the potential rewards/negative consequences) are formed and

Answer 15

therefore affect future behaviour i.e. if the rewards of smoking outweigh the costs, then the behaviour will continue to be displayed.
A young person may form a positive association between smoking and receiving praise from peers. Having observed this, the individual may take up smoking, with the expectancy that s/he will receive this same praise.

Question 16

P: There is research support for operant conditioning as an explanation for nicotine addiction.

Answer 16

E: In research with rats, Levin et al. (1981) gave them the choice of self-administering doses of nicotine, by licking one of two waterspouts (one of which contained nicotine).
The rats licked the nicotine waterspout significantly more often.

C: This suggests that nicotine is physiologically rewarding and that its effects positively reinforce self-administration in rats, pointing towards the operation of a similar mechanism in humans.

Question 17

P: There is research support for the role of cue reactivity in nicotine addiction

Answer 17

E: Carter and Tiffany (1999) conducted a meta-analysis of 41 studies into the effects of cue reactivity.
Such studies present dependent and non-dependent smokers (and non-smokers) with images of smoking-related cues, such as lighters, ashtrays and cigarette packets.
Self-reported desire or craving is measured, along with several physiological indicators of arousal (heart rate, activation in the nucleus accumbens, etc.).
They found that dependent smokers reacted strongly to cues presented to them, reporting high levels of craving and increased physiological arousal.

C: This suggests a neural basis for cue reactivity, as well as demonstrating how smokers have a powerful tendency to experience the arousing effects of nicotine in response to cues associated with smoking, even when no nicotine is present.

Question 18

P: There is research support for the role of social learning influences in the development of addictive behaviours.

Answer 18

E: DiBlasio and Benda (1993) found peer group influences to be the primary influence for adolescents who experiment with smoking. Adolescents who smoked were more likely to ‘hang out’ with other adolescents who also smoked.
This is perhaps due to conforming to the norms of their reference group and imitating the behaviour of admired peers, thus demonstrating the influence of vicarious reinforcement.

C: However, there is an issue of causality. Choice of peer group may be influenced by addiction i.e. an addict might choose a peer group that allows them easy access to the focus of their addiction.
DeVries et al. (2006) argued that smokers befriend other smokers, rather than smokers influencing non-smokers to take up the habit.

Question 19

Karcher and Finn (2005) found that:

Answer 19

Youths whose parents smoked were 1.88x more likely to take up smoking.
They were 2.64x more likely to smoke if their siblings smoked.
If close friends smoked, they were 8x more likely to smoke than if their parents, siblings and friends did not smoke.
This adds further support to the social learning explanation.

Question 20

Evaluation of the Learning Theory of Nicotine Addiction

Answer 20

There is extensive research support for the role of social learning in initiation of smoking behaviour, which cannot be explained so well by other learning theories.

However, there are issues with generalising findings from animal research to explain addiction to nicotine in humans, as it might simplify the causes – human behaviour is arguably far more complex in terms of the factors it is influenced by.

Implications for treatment: Cue Exposure Therapy (Drummond et al., 1990) This involves presenting the cues without the opportunity to engage in smoking. This leads to stimulus discrimination - without the reinforcement provided by the nicotine, the association between the cue and smoking behaviour is extinguished, thus reducing the cravings for nicotine that arise when exposed to that particular cue.

Question 21

Research suggests that there are gender differences in patterns of nicotine addiction, which cannot be explained by the learning theory explanations. For example:

Answer 21

• Women start smoking later than men (Lopez et al., 1994)
• Women are more likely to smoke in stressful situations and their nicotine dependence grows more rapidly (Baewert et al., 2014)
• Women experience withdrawal effects sooner and find it more difficult to quit smoking.

Question 22

The learning theory for smoking behaviour is reductionist as it

Answer 22

reduces the complex nature of smoking addiction down to simple stimulus-response units - there is very little consideration of the cognitive and emotional influences. The theory also overlooks the role that genetics might play i.e. genetic vulnerability.
The fact that not everyone who tries smoking and enjoys it becomes addicted suggests that there are other (psychological and/or biological) factors involved in the transition from consumption to addiction.
- The Diathesis-Stress Model may provide a better explanation for smoking addiction –