4/18/2013

Many current young smokers feel they are invincible. This perception may give rise to them taking on the risk of smoking, because they can enjoy it now and quit later before they get the lung or cardiovascular disease. Sadly, the behavioral conditioning and the chemical addiction is forming, literally, right under their noses. Because of the powerful effects of nicotine on the brain, 85% of all smokers are addicted. This may explain why some people can seemingly quit cold turkey without any problems, while others struggle to quit and suffer multiple relapses.



Is it important to diagnose someone as addicted to nicotine if such a large percentage of smokers already seem to be in that category? The answer seems to be yes, as studies show that formally diagnosing a smoker as nicotine dependent triggers some smokers to quit.



What defines a person as being clinically addicted to nicotine? Is it a requirement that they smoke like a freight train or can't quit on the first attempt? Not entirely. The answer lies within a set of clinical guidelines. It would take too long to go into all of them here, so let's look at a few which are most relevant to people trying to stop smoking.



First of all, the definition for nicotine addiction (or dependence) requires a pattern of nicotine use, that causes distress in multiple areas of their life during a 12 month period of time. This means the smoker compromises a normal pattern of behavior or suffers physical need because of nicotine (or smoking in our example). Now remember, this doesn't just happen in one part of the smoker's life; it manifests some kind of impairment in at least 3 different ways in a person's life. So in this abbreviated list, a smoker is addicted if they display at least 3 of these characteristics within 12 months.



#1 - The smoker develops a tolerance to nicotine requiring a need for markedly increased amounts of nicotine to get the desired feeling. Another way to say this is they don't get the same "buzz" from the same amount of nicotine as they used to.



#2 - The smoker suffers withdrawal symptoms when nicotine is stopped or the smoker takes a nicotine replacement product to reduce the withdrawal symptoms.



#3 - The smoker spends a lot of their time in attempts to get nicotine.



#4 - The smoker is willing to give up work-related or social activities in order to use nicotine.



#5 - The smoker continues to smoke even when faced with a health problem that is directly caused by and/or worsened by smoking.



This partial lists describes many smokers who claim they can quit whenever they want. Once again, they underestimate the chemical and behavioral link between nicotine and their brain. The following story is a great example of what's described above.



Many hospitals are now non-smoking facilities. This means smokers who are admitted must find some place off campus to smoke. Any respiratory therapist can tell you the same story of how one of their patients left their room after a breathing treatment to get a smoke. You watch them grab their IV pole with one hand and their pack of smokes with the other as they walk to the elevators to get outside. It's very sad, but very true. Unfortunately, this occurs all too often and points out the powerful addictive properties that nicotine possesses.
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