Michael J Kuhar Therapeutic Communities

Treatment Types: Theraputic Communities

TOBACCO: DEPENDENCE In the United States as of 1999, there were about 57 million cigarette smokers-representing 25 percent of the adult population. Another 5 percent (men) use smokeless tobacco (chewing tobacco or snuff). Most (70-80%) say they would like to quit. Unfortunately, they are dependent on (addicted to) nicotine, an alkaloid that makes it difficult to stop using tobacco. Most of them will have to try to quit several times before they are successful. Both the direct effects of nicotine on the body and behavioral associations with those effects learned over the years of tobacco use keep people going back for more even when they want to quit.

The role of nicotine in tobacco use is complex. Nicotine acts on the body directly to produce effects such as pleasure, arousal, enhanced vigilance, relief of anxiety, reduced hunger, and body-weight reduction. It may also reverse the withdrawal who is symptoms that occur in a nicotine-dependent person trying to quit, when nicotine levels in the body fall. These symptoms include anxiety, irritability, difficulty concentrating, restlessness, hunger, depression, sleep disturbance, and craving for tobacco. When this happens, the use of nicotine (whether tobacco or nicotine-containing medications) usually makes people feel better by reversing the unpleasant withdrawal symptoms.

Nicotine also acts indirectly, through a learning process that occurs when the direct effects of nicotine occur repeatedly in the presence of certain features of the environment. As a result of the learning process, called conditioning, formerly insignificant environmental factors become cues for the direct actions of nicotine. These factors can become either pleasurable in themselves or they can serve as a triggering mechanism for lighting up a cigarette. For example, the taste, smell, and feel of tobacco often evoke a neutral response and sometimes repugnance in a nonsmoker. After years of experiencing the direct effects of nicotine in the presence of tobacco, however, a smoker finds the sensory aspects of tobacco pleasurable.

The indirect or conditioned effects of nicotine are responsible for much more complicated learning than the learning associated with nicotine's direct effects. Conditioning is also the process whereby the situations in which people often smoke such as after a meal, with a cup of coffee, with an alcoholic beverage, while doing a task at work, while talking on the phone, or with friends who also smoke become in themselves powerful cues for the urge to smoke. When people stop using tobacco, therefore, the direct effects of nicotine are not the only pleasures they must give up. They must also learn to forgo the indirect effects of nicotine: those experiences that, through learning, have become either pleasurable in themselves or a cue to smoke.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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