Smoking and Alcohol

• Initiation (biological approach) - a person may start smoking due to the biological factors related to nicotine. This can be becuase of a genetic predisposition or dopamine receptors.
• Genes may be a risk factor for a nicotine addiction. if a person has a genetic predisposition, we would expect to find smoking running in their family. ‘Predisposition’ means a person‘s inherited genes make them more vulnerable to smoking, however this does not mean they will inevitably smoke as non genetic factors are important.
• carmelli et al found that genetic influences contribute 53% to the risk of taking up smoking.
• The influence of nicotine receptors can be a factor to the initiation of smoking. A nicotine addiction involves neurons in the Ventral Tegmenal Area (VTA). these neurons have receptors which are activated by molecules of dopamine. Nicotine molecules are able to attach to the same dopamine receptors. When a smoker takes their first hit, nicotine molecules reach the receptors in seconds, and this triggers a release of dopamine in the Nucleus Accumbens (NA) . The feeling of pleasure is rewarding because of the dopamine release
• Maintenance and relapse (biological approach) -a person may keep smoking or relapse due to the factors of dopamine, tolerance and nicotine regulation and withdrawal.
• The role of dopamine may be a factor to why someone maintains/relapse smoking. Nicotine dependence develops as nicotine molecules continue to attach to receptors in the VTA, and dopamine is released in the NA, producing more pleasure and reward. Smokers continue to smoke as the pleasure from the dopamine release positively reinforces their behaviour, making it more likely to happen again
• Nicotine regulation and withdrawal symptoms may be a factor to the maintenance and relapse of smoking. If a smoker goes too long without smoking, they experience withdrawal symptoms such as a headache. dependent smokers smoking throughout the day means nicotine molecules are continually attaching to dopamine receptors and activating dopamine neurons. This keeps nicotine in the bloodstream, and maintaining a sufficient level to avoid withdrawals is nicotine regulation.
• Tolerance may be a factor to the maintenance and relapse of smoking. Over time, the constant stimulation of dopamine receptors reduces their sensitivity. The person has to smoke more to restimulate these receptors to the previous levels to achieve the sensations they used to get, so their tolerance has increased.
• A strength of using the biological approach to explain a smoking addiction is that there are clear practical benefits using the biological approach in helping stopping smoking. Using nicotine replacements such as gum replaces the source of nicotine in a less harmful way as they don’t have the other harmful chemicals that are present in cigarettes. This shows how the biological approach can reduce the damage caused by smoking
• A weakness of the biological approach in explaining a smoking addiction is that it can be seen as reductionalist, as they only consider certain aspects such a genetics and so is oversimplified. Situation, personality or cultural differences need to be considered. And so it is too narrow and doesn’t consider non biological treatments
• Initiation of smoking (learning approach) - a person may start smoking due to factors such as parental and peer role models, and positive reinforcement.
• Parental and peer role models may be a factor to the imitation of smoking. The smoking model gets satisfaction and pleasure from smoking, and so this gets observed by the young person as vicarious reinforcement. They makes it more likely they will imitate this behaviour as they expect the same rewards
• Positive reinforcement may be a factor as to why someone initially starts smoking. Nicotine is a powerful reinforcement via its physiological effects on the dopamine reward system. The enjoyable sensations reward the smoking behaviour and so they are more likely to carry on smoking.
• Factors that influence the maintenance of smoking (learning approach) include negative reinforcement and classical conditioning.
• Negative reinforcement may be a factor to maintain smoking. When people smoke, they experience withdrawal symptoms which are unpleasant. By having another cigarette, these symptoms disappear and so the smoker feels better. So the act of smoking reduces the discomfort and so becomes reinforced. This can explain a nicotine dependence.
• Classical conditioning is a factor in the maintenance of smoking. The smoker learns an association between the sensations of smoking and its pleasurable effects. These sensations (smell of smoke, feel of cigarette) go from being a neutral stimulus to a conditioned stimulus after being paired with the pleasure of smoking. They are then able to trigger a response on their own
• Conditioned cues and self-efficacy are factors that influence relapse of smoking.
• Conditioned cues is a factor in the relapse of smoking. The stimuli associated with smoking can become rewarding without the need to smoke. When an ex-smoker encounters an object, person or place associated with smoking, they experience the pleasure they would get from smoking and this triggers a craving
• Self efficacy is a factor in relapse in smoking. Self efficacy refers to a persons confidence in their ability to stop smoking, and continue to stay sober. Low self efficacy is key to relapse as it had an impact on someone’s attitudes, beliefs and behaviours. They will make less effort to quit, and if they do, turn to smoking at the first sign of difficulty.
• A strength of the learning approach in understanding smoking is that it has practical uses. There are several treatment programmes e.g. aversion therapy which counter conditions nicotine addiction by associating the pleasure of smoking with an unpleasant stimulus e.g. electric shock. This are cost effective
• A weakness of the learning approach is thst it cannot explain all nicotine addictions. The approach claims vicarious reinforcement and observation is a strong reinforcer, and are powerful initiators of smoking, however many you people observe role models e.g. parents smoking and do not take this up themselves . This shows there must be several causes of smoking initiation and maintenance
• The cognitive approach can help explain alcohol addiction. This explanation focuses on how a person perceives past traumatic experiences and current feelings of distresses.
• The self medication model may be an influence why someone starts drinking. The person uses alcohol to manage their anxiety and psychological pain and to become emotionally stable.
• The initiation of choosing to drink alcohol may be to relieve stress or anxiety. If they persist drinking alcohol, they may be under the impression that the drug is working. The alcohol will alleviate nervousness as it stops the unpleasant symptoms of increased breathing and anxiety they would be experiencing. People often become reliant on alcohol, and is used as a coping mechanism. The initial decision to start is conscious and deliberate.
• The self-medication model can explain the maintenance of an alcohol addiction. There is an expectation that drinking alcohol will lead to positive outcomes, however once they started drinking, this assumption becomes part of their thinking. Early traumas and current stress means they can’t look after themself and have low-self esteem. They self medicate to be more sociable. They assume drinking is a stress reliever but this encourages them to drink more but then gained an alcohol dependency.
• The self-medication model can explain relapse of alcohol addiction. If someone has had a period of quitting drinking, the withdrawal symptoms will be significant as they have built up a tolerance over a long period of time. these withdrawal symptoms mean they face higher levels of stress to continue drinking than they had during drinking. Using alcohol to self medicate is counterproductive and self defeating as alcohol relieves stress but the stressor is still present when the effects of alcohol have worn off. The withdrawal effects make them drink again
• A strength of the cognitive approach to understanding alcohol addiction is that it has practical uses. There are several treatments for alcohol dependency, such as cognitive behavioural therapy (CBT) . This tackles irrational cognitions through therapy by reflecting and accepting their choices to drink have been irrational and harmful and so this suggests that addiction must have some cognitive element.
• Initiation of alcohol addiction can be explained by the learning approach, via positive reinforcement and vicarious reinforcement.
• Positive reinforcement can explain the initiation of alcohol. Alcohol makes you feel good and relaxed and reduces stress. It stimulates the release of dopamine which provides stress release and activates the reward pathway in the brain and so keep drinking. Also, they may feel more confident when drinking and so this reinforces the behaviour and keep drinking
• Vicarious reinforcement can explain the initiation of alcohol addiction. If someone sees a role model drinking and them getting pleasurable effects, they are likely to imitate the behaviour and drink themselves to gain the same rewards.
• Negative reinforcement can explain maintenance of an alcohol addiction. Drinking is maintained overtime to avoid or reduce withdrawal symptoms. When someone stops drinking they experience disturbing withdrawal symptoms with both psychological and physiological symptoms such as heart palpitations and irritation. These symptoms can be avoided by drinking again and so this reinforces the drinking.
• Relapse can explain an alcohol addiction. Negative reinforcement can cause relapse when a drinker has stopped. The withdrawal symptoms associated with stopping drinking acts as a punishment and so this can prevent someone from giving up drinking. Therefore, drinking alcohol again will immediately remove these symptoms by acting as negative reinforcer. Even when withdrawal is over, and negative reinforcement is no longer a motivator alcohol still provides a powerful escape from reality if they experience further trauma.
• A strength of the learning approach in understanding alcohol addiction is that there is practical uses. There are several possible treatments for alcohol dependency such as Cue Exposure with Response Prevention. Cue exposure is when a therapist presents the drinker with alcohol related cues. The drinker experiences the physiological and psychological effects associated with their addiction. Response Prevention is when the drinker isn’t allowed to drink to relieve these symptoms. This shows how understanding the processes that create addiction can lead to successful treatment.
• A weakness of the learning approach in explaining alcohol addiction is that is a narrow explanation. Reinforcement may not be an effective explanation of alcohol addiction. Reinforcement doesn’t explain the transition from just using alcohol to abuse of alcohol. Most people use alcohol but only a few people becomes dependent on alcohol. This suggests there are non-conditioning factors are crucial in alcohol addiction such as genes.