Reinforcement: reasons why smoking cessation might be difficult to sustain
Positive and negative reinforcement
Positive and negative reinforcement both produce a wanted state.
One of the positive reinforcement strategies that people adopt when using substances like cigarettes is reliance on them to regulate their cognitive and emotional states (e.g., feel better, think clearer, have more confidence, feel more relaxed, etc). These strategies also help to create an escape from reality and give people a good reason to have a break at work or from the kids.
Many become dependent on substances because they’ve been conditioned to use them at certain times and events e.g., when having a coffee or alcohol, or being around certain people e.g., family, friends or colleagues.
Negative reinforcement is another powerful strategy that keeps habits going, for example, by avoiding withdrawal from substances like nicotine in cigarettes which can cause psychological dependence. Even people who have never stopped or when they have, haven't had cravings before, may read in the literature how highly likely they are to have them this time, which exacerbates their fear so much that they prefer to continue the habit despite not liking it and really wanting to stop.
Cravings are often viewed as a sign of loss of enjoyment, not coping and a sign to continue use, rather than a natural process of the body returning to its pre-smoking normality. As smokers, we often forget that our bodies fared pretty well by themselves before we started our smoking careers and were introduced to nicotine!
Like most habits, cravings from smoking typically happen more in relation to substance-related cues, i.e., items, events, people, or emotional states such as stress or loneliness, which we’ve associated with times we usually have a cigarette.
For a smoker it could be passing the tobacco kiosk, having a beer with a bestie, alongside the first cup of coffee in the morning, watching the game in the pub, or when they get stressed or anxious about a situation they’re not confident about. Seeing items such as ashtrays, or passively smoking nearby smokers’ fumes will also potentially trigger a smoker into restarting their habit despite the best of intentions to quit.
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