Understanding Psychology (10th Ed)

488 Chapter 
14 
Health Psychology: Stress, Coping, and Well-Being
Ultimately, smoking becomes a habit. And it’s an easy habit to pick up: Smok-
ing even a single cigarette leads to a loss of autonomy, when a smoker fi nds that 
not smoking requires an effort or involves discomfort. Subsequently, people begin 
to label themselves smokers, and smoking becomes part of their self-concept. More-
over, they become dependent physiologically as a result of smoking because nico-
tine, a primary ingredient of tobacco, is highly addictive. A complex relationship 
develops among smoking, nicotine levels, and a smoker’s emotions in which a cer-
tain nicotine level becomes associated with a positive emotional state. As a result, 
people smoke in an effort to regulate both emotional states and nicotine levels in the 
blood (Amos, Wiltshire, & Haw, 2006; Kassel et al., 2007; Ursprung, Sanouri, & 
DiFranza, 2009).
 QUITTING SMOKING 
Because smoking has both psychological and biological components, few habits are 
as diffi cult to break. Long-term successful treatment typically occurs in just 15% of 
those who try to stop smoking; once smoking becomes a habit, it is as hard to stop 
as an addiction to cocaine or heroin. In fact, some of the biochemical reactions to 
nicotine are similar to those to cocaine, amphetamines, and morphine. Furthermore, 
changes in brain chemistry brought about by smoking may make smokers more 
resistant to antismoking messages see also Figure 1; (Vanasse, Niyonsenga, & 
Courteau, 2004; Foulds et al., 2006; Dani & Montague, 2007). 
Many people try to quit smoking but fail. The average smoker tries to quit 8 
to 10 times before being successful, and even then many relapse. Even long-time 
Neuroscience in Your Life: 
Smoking—
Why It’s So Diffi
cult to Quit
FIGURE 1 
Even with the use of treatments such as nicotine replacement therapies, relapse 
for exsmokers is common. One potential reason smokers relapse is that media, such as 
cigarette ads, can trigger cravings in exsmokers even when they are no longer addicted to 
nicotine. These MRI scans show the brain of a person after quitting smoking. Some areas 
of the brain, shown in red, relate to habit learning, action planning, and craving. These 
areas show greater activation when viewing smoking-related images after quitting as 
compared to before quitting smoking. In addition, some areas of the brain, shown in blue, 
relate to memory formation and show reduced activity while viewing smoking-related 
images after quitting. Diff erences in how an exsmoker’s brain responds to these images 
may explain why the desire to smoke persists long after quitting smoking.
(Source: Janes 
et al., 2009, Figure 1.)
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