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Ask people why they can’t stop smoking and some will say it’s because they’re addicted to the nicotine. Others would say that smoking helps reduce the stress in their lives, while still others might say that it’s nothing but a bad habit they picked up along the way. The stop smoking program at the Loma Linda VA Medical Center teaches that all of these people are correct. This is because smoking addictions are actually the result of three powerful causes that are Physical, Psychological, and Habitual in nature.

While the distinction between these causes is often difficult to distinguish, everyone who is addicted to smoking is affected in varying degrees by all three of them. This is what makes smoking such a difficult addiction to stop. As you learn about the three addictive causes below, consider to what degree each one of them affects your own smoking addiction. Once you’ve familiarized yourself with them, scroll to the bottom of the page to watch a video that further illustrates the various contributing factors that can exacerbate one’s smoking addiction.


Tobacco is a plant grown for its leaves which are smoked, chewed, or sniffed for a variety of effects. It is considered physically addictive because of certain chemicals it contains; particularly nicotine. In addition to the nicotine, tobacco products also contain more than 19 known cancer-causing chemicals (most of which are referred to as “tar”,) along with more than 4,000 other chemicals. These additional chemicals include acetone, ammonia, carbon monoxide, cyanide, methane, propane, and butane.

After tobacco smoke is inhaled into the lungs it moves into the bloodstream and up to the smoker’s brain within 7 to 10 seconds. Once there, nicotine triggers a number of chemical reactions which the brain normally triggers on its own. These nicotine-induced chemical reactions produce temporary feelings of comfort and enhanced pleasure that usually subside within just a few short minutes. As a person smokes more and more, the brain begins to let the nicotine do the job of triggering feelings of comfort and pleasure rather than triggering them on its own. In effect, nicotine sends some parts of the brain on an extended “vacation” while it (the nicotine) takes over some of the jobs that the brain used to do on its own. Eventually if a person tries to smoke less than what he or she has grown accustomed to, those feelings of comfort and enhanced pleasure are replaced by feelings of discomfort and agitation because those parts of the brain are still “on vacation.” This is a sign of nicotine withdrawal. In order to relieve the agitation and bring back those feelings of comfort and enhanced pleasure, smokers must light up again and again. This is what the “physical” addiction to smoking is all about.

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Video: Nicotine’s Effect On Our Smoking Addiction

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Although the psychological causes of smoking addiction usually take more time to develop than the physical causes, they can eventually become just as powerful. Beginning smokers don’t normally start out by having a psychological attachment to cigarettes. At first they just happen to light up with no regard for whether they’re feeling happy or sad, good or bad, etc. It might take many repetitions of lighting up before smokers begin to attach the act of smoking to certain emotions (such as happiness or sadness,) personal situations (like being alone or bored,) or events (when attending family or other social gatherings) that they experience on a day to day basis. Eventually those emotions, personal situations, and events become psychological catalysts or triggers that spark people into wanting to smoke. To take this even further, for many smokers cigarettes become a form of self-medication that they use to deal with their depression, anxiety, loneliness, sadness, and a host of other psychological conditions. These concepts are easier to understand when considering some of the reasons smokers give for lighting up:

  • “I have to smoke when I’m under stress (or when I’m sad, or when I’m happy, or when I’m lonely, or…)”
  • “It gives my hands something to do when I’m nervous.”
  • “I’m more relaxed and talkative when I smoke, so it’s easier for me to meet new people when I go out.”
  • “Most of the people I hang out with smoke and I’m afraid they won’t accept me if I quit.”
  • Cigarettes are my best friends. They’ve always been there for me.”

Sometimes it can be difficult to determine if someone is smoking due to a physical or psychological cause. Just saying that a smoker lit a cigarette because of stress, for example, isn’t enough. Was the stress caused because the person hadn’t smoked in awhile and his nicotine level was low enough to cause agitation and stress? That would be nicotine withdrawal which is a physical cause. Or, was the stress brought about from the break-up with a significant other? That would be a psychological cause. In both cases of stress, whether it’s caused physically or psychologically, a smoker’s reaction is likely to be the same: to light up another cigarette. That’s the important thing to understand.

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“Habitual” is just another word to describe the activities that we repeat over and over again without even thinking about them. Otherwise known simply as “habits,” everyone acquires both good ones and bad ones over the course of their lives. When people talk about “habit” as part of the smoking addiction, they’re referring to the times when people light up their cigarettes automatically, without even thinking about it. These are the cigarettes that people smoke when they aren’t necessarily craving a nicotine fix (physical cause,) nor are they facing any kind of stress or emotional crisis (psychological cause.) Here are some classic examples of smoking out of pure habit:

  • Automatically lighting a cigarette after pouring a cup of coffee
  • Feeling the need to smoke whenever you drink your favorite alcoholic beverage
  • Starting one cigarette while an unfinished cigarette is still burning in the ashtray
  • Always smoking immediately following a meal, just before bed, after sex, or some other regular activity
  • Lighting up every time you get into your car or every time you get out of it
  • Note: Most smoking cessation programs only separate the addiction by its physical and psychological causes. They either include the habitual cause in with the psychological cause or they pay little attention to it. The reason the VA’s smoking cessation program smartly separates the habitual cause from the psychological cause is that they’ve developed proven techniques and therapies that are unique to treating each cause, thus more thoroughly attacking the entire addiction.

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    Here’s a fun exercise for those of you who have 5 or 6 minutes to spare. Watch the following Disney cartoon from 1951 and see if you can identify which parts of Goofy’s addiction are a result of the three causes listed above:

    Video: Goofy starring in “No Smoking”

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