Tobacco 101: A Guide to Working with Nicotine Addicted Patients
Psychological Addiction

The psychological component of nicotine addiction can be viewed as a series of habits that are reinforced with rewards. As proposed by Charles Duhigg in his excellent book, “The Power of Habit,” habits involve three processes, an environmental cue, a behavioral routine, and a reward. Some of the environmental cues in smoking and tobacco use may be a cup of coffee, an alcoholic drink, smoking with friends, playing a sport, driving in a car, or stressors created by work, family or other social situations.

The behavioral routine would be to light up a tobacco or nicotine containing product, and the reward would be a release of dopamine or endogenous opioids, creating the beneficial feelings stated above.

It is clear that in order to break a dependence on nicotine, a patient will need to have to address both their physical as well as psychological addictions.