Psychology - Tobacco dependence and withdrawal

Question 1

Criteria for tobacco use disorder

Answer 1

• higher level of use than intended
• Unsuccessful efforts to quit and reduce
• Inordinate amount of time acquiring or using
• Tolerance for nicotine
• Withdrawal symptoms/cravings
• Smoking prioritised over other responsibilities
• Uses despite knowing harmful physical and social effects
• Smoking in hazardous situations

Question 2

Mechanism of dependence

Answer 2

Operant conditioning - positive reinforcement due to nicotine high, negative reinforcement due to alleviation of withdrawal discomfort

Classical conditioning - result of places, situations or objects being associated with smoking, e.g. social smoking with a coffee

Question 3

Withdrawal symptoms

Answer 3

Transient or permanent physical and psychological changes following temporary or long term smoking cessation

• Irritability/aggression; depression
• Decreased concentration, restlessness, increased appetite, anxiety, sleep disturbance, constipation

Question 4

Methods of smoking cessation

Answer 4

• Taxation has been the most effective way to reduce smoking rates
• NHS Stop smoking services - behavioural support (group or 1 to 1) + medication (nicotine replacement therapy, bupropion)
• Opportunistic advice from healthcare professionals (additional 1-3% stop long term)
• Pregnant women offered financial incentive to quit
• Swap to stop E-cigs, sometimes in combo with NRT