A psychopharmacological and psychophysiological evaluation of smoking motives.

Compared to alcohol or opiate dependence, the physical withdrawal symptoms which occur with the cessation of the tobacco smoking habit are relatively weak, although they can produce discomfort. Long-term abstinence rates, however, remain similarly low. This raises the question about the nature of the strength of this habit. When evaluating the complex mechanisms of cigarette smoking behavior and its determinants, a surprisingly large variety of pharmacological and nonpharmacological motives emerges. These appear to outweigh the health-related arguments for abstinence in the majority of smokers. An attempt has been made to categorize classes of motives according to their positive or negative reinforcing impacts on the habit. The acute tobacco withdrawal syndrome, problems with weight gain after cessation and the phenomenon of craving are classified as primarily negative reinforcers. Effects of smoking on cognitive functions and on "pleasure" are seen as primarily positive reinforcers. In conjunction with stress, the tranquillizing effects of smoking seem to have negative reinforcing properties in situations involving passive coping and anxiety, whereas smoking may have positive reinforcing effects in situations involving active coping. It is suggested that the memory of these reinforcing effects of smoking can contribute to the phenomenon of craving. Although substantially reduced after discontinuation of the smoking habit, craving may exacerbate and contribute significantly to late relapse.