Thursday, November 3, 2011

Do You Think You Are Addicted to Nicotine? Part 1

All right, it's a trick question. What is your definition of addition?
Here’s one:
Addiction is a persistent, compulsive dependence on a behavior or substance. The term has been partially replaced by the word dependence for substance abuse. Addiction has been extended, however, to include mood-altering behaviors or activities.
Some researchers speak of two types of addictions: substance addictions (for example, alcoholism, drug abuse, and smoking); and process addictions (for example, gambling, spending, shopping, eating, and sexual activity). There is a growing recognition that many addicts, such as polydrug abusers, are addicted to more than one substance or process.
(From the Medical Dictionary: The Free Dictionary)

Is smoking a substance or a behavior?
Answer: Nicotine is a substance. Smoking is a behavior.

Nicotine is an addictive substance and I am not going to try to convince you otherwise.
So is heroin. So is caffeine. I know what you’ve read and heard, “Oh, nicotine is one of the most addictive substances in the world. More than heroin!” But really, is it?
Ask yourself: If you had to go to the depths of the Bronx at two o’clock in the morning, walk up stairs reeking of urine, to a rat-infested lair to score your cigarettes, would you still do it? I ask my clients that question and very few say yes.
For most of you reading this blog, you must admit, if you had to score your cigarettes that way, you would have quit a long time ago.
When I hear that “more addictive than heroin” quotation from a physician, I press him/her on the issue. What do you mean? After a few minutes of quoting the headlines of medical journals and popular media, the doctor says that it’s hard to quit smoking because cigarettes are legal, cheap and everywhere.
Tobacco is, most certainly, one of the most widely-used addictive substances in the world.
So, how addictive is it?
Lots of people, including me, are addicted to caffeine. When I get up in the morning, I look forward to my one daily cup of coffee. It smells so good and it helps me wake up. If I don’t have my caffeine fix, I get a headache and I am an absolute bitch until I do get it. I admit it; I have a caffeine addiction. When I quit drinking coffee, which I have done several times for various reasons, I progressively cut down for 5-6 days and then I’m off caffeine. No more headache; no other withdrawal symptoms -- Just a feeling of nostalgia whenever I walk past Starbuck’s. (I’m originally from Seattle, people!)
Is nicotine addictive? Sure. But I think that for most people, it is more like a caffeine addiction than a heroine addiction. I can't imagine the reaction of the doctor if I'd asked to be admitted to an addiction program when she recommended I stop drinking coffee. (and don't worry about me now, I'm drinking coffee with my doctor's approval) I’ve had too many clients who came in absolutely convinced that they had a terrible addiction, and they walked out of my office smoke free, with no withdrawal symptoms.
How can that be if smoking is so addictive?

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