Lately, when I've been interviewed about smoking cessation, the host will usually ask, "Isn't nicotine addiction the reason most people are not able to successfully quit smoking?" They are surprised when I tell them nicotine is not a real addictive substance because it doesn't have the characteristics of an addictive substance. The drive or compulsion to smoke cigarettes is strictly psychological.

The interviewers are surprised because addiction to cigarettes (nicotine) has been used as a rationalization as to why it is so hard to quit smoking. The truth is, nicotine does not present the characteristics of a physical addiction. The real cause of the difficulty to simply quit smoking cigarettes is the Psychological Smoking Mechanism. If you stop cigarettes and don't remove this mechanism, you will continue to be a smoker who isn't smoking right now. It is the real reason why the smoker, after being off cigarettes for weeks or months, is compelled to start again.

In this article, I will discuss the dynamics of true physical addiction. You will see that nicotine doesn't fit in this category. In part 2 of this article, I will discuss more specifics that demonstrate how nicotine is not a true addictive substance and how the Psychological Smoking Mechanism is the real power behind smoking.

What is Addiction?

Any substance that alters the physiology of the body is capable of being addictive. Many people accidentally become addicted to pain medicine so we will use that as an example.

In our example, we have a person who has been severely injured and is in a great deal of pain. Pain is the body signal to our conscious selves that we have a problem that needs to be immediately corrected.

With modern medicine today, injuries are quickly and effectively treated. However, although the mechanical damage has been repaired, the healing process, which only the body can do, has not yet taken place. To make things easier on ourselves, we take pain medicine. After all, we know we are injured and it's been treated, we don't need to be reminded with unpleasant pain.

The chemicals in the medicine interfere with the pain signals reducing them so we are more comfortable. If we take the pain medication as directed, there is little chance of addiction. If the body heals in a timely manner, the pain medicine continues to help because the healing process is reducing the need for pain.

What the patient doesn't realize is that each day on the pain medicine, it becomes less and less effective! Why? Because the body is trying to do it's natural process of pain generation. When it is artificially suppressed, the body boosts the pain signal.

As long as healing is taking place and reducing the pain intensity, this signal boost isn't noticed by the patient. It's only when the healing process lags, e.g. takes an extended period of time, that the patient notices the pain medication isn't working as well.

To achieve the same level of pain control requires more medicine. The patient's doctor will not allow this because of the problem with addiction. You should listen to your doctor. However, some people won't listen. They're hurting, what they were taking had helped and they want the same level of relief. Perhaps they have a friend that had left over pain medicine and persuades them to give it to them because they need it. Not a good idea but people do it.

So on their own, they boost the dosage. They have the pain relief they were getting initially. But the body doesn't like this at all. It again boosts the pain signal weakening the effects of the medicine. If the patient managed to get a large amount of extra pain medication, they continue to increase the dosage to get the same amount of relief. The body, seeking balance, continues to boost the pain signal.

At this point the person is in a hazardous situation. They cannot simply stop the pain medication because if they've taken it too long and increased the dosage too much, the physical backlash might be life threatening!

The Potentially Deadly Tug-of-war: Body vs. Pain Medication

Look at it like the game tug-of-war. The pain medicine is on one side and the body is on the other. The pain medicine side adds a member (increased dosage), the body side adds a member (puts out more pressure), not to win the tug-of-war, but to get the marker back in the middle. To the body, the pain medicine has gotten it out of balance and it uses it's biochemical and physiological resources to bring itself back into balance. This is why the pain medicine loses effectiveness over time. This is technically called habituation -Physiological tolerance to a drug resulting from repeated use.

What happens if you stop taking the pain medicine cold-turkey? In our tug-of-war analogy, stopping cold-turkey is like one side, the pain medication, letting go of the rope. The side still applying force, the body, backlashes into a jumbled pile. In real tug-of-war, the people on the side still pulling slam into each other, possibly being injured if they were pulling hard enough. In our example, it is your body that's going to be the jumbled pile with possible injuries!

Solution to the Problem

You can't safely stop taking excessive pain medication cold-turkey. This requires a stay in rehab where the addicted person is medically monitored and the pain medication reduced slowly over time. As the pain medication is reduced, the body counter reaction to it is also reduced. The body is happy because it keeps itself in balance which is all it was trying to do anyway. You are happy because your body doesn't end up in a jumbled pile!

Chemical Addiction Pattern

Remember, the body always works to keep balance. The technical term is homeostasis. Whenever the body is confronted with a chemical that pushes it out of balance, it applies a counter force to get back to balance. The stronger the chemical, e.g. high dosage of pain medication, the stronger the body pushes back.

You cannot safely stop after overusing pain medicine without giving the body time to adjust slowly.

Nicotine

As you can see, nicotine simply doesn't fit this pattern. No one ever had a life threatening experience being deprived of cigarettes. Granted, there have been many smokers tell you, "I'm dying for a cigarette." However, it's a certain physiological fact that a smoker will not die if they don't get a cigarette!

In part 2 of this article, we will discuss specifics that demonstrate why nicotine is not chemically addictive and why the Psychological Smoking Mechanism is the real factor that makes quitting smoking difficult.

© Copyright 2009, R. Michael Stone