Surveys find that 80% of smokers claim they smoke more when worried, 75% say they light up when angry, and 60% feel that smoking cheers them up (e.g., Russell et al. Reference Russell, Peto and Patel1974; reviewed Warburton Reference Warburton, Wonnacott, Russell and Stolerman1990). As the Surgeon General's Report stated:
The conclusion from this literature is that in the general population, persons perceive that smoking has functions that are relevant for mood regulation. Persons report that they smoke more in situations involving negative mood, and they perceive that smoking makes them feel better in such situations (US DHHS 1988; p. 399).
In other words, smokers are using nicotine as a form of drug utilization as described by M&S.
Nevertheless, it has been argued that these mood effects represent only relief of withdrawal symptoms (NWH) and not a motive for smoking as in the NUH (functional model, Warburton Reference Warburton, Martin, Loon, Iwamoto and Davis1987). Both NWH and NUH predict that abstaining smokers will experience dysphoria after abstinence, but NWH predicts that there will be a stereotyped syndrome, so that ex-smokers will eventually return to their non-smoking state.
Numerous studies do not show a stereotyped syndrome, or an invariable cluster of symptoms for every quitter. For example, Hughes et al. (Reference Hughes, Gust, Skoog, Keenan and Fenwick1991) found that anxiety was the commonest sign after two days (49%) then restlessness (46%). Irritability was 38% whereas depression was 31%. As well as over half of quitters having no mood changes, the percentage of participants having a specific sign vary remarkably across studies. This is not what one would expect from the NWH.
NWH also predicts that ex-smokers will not differ in mental health from non-smokers after prolonged abstinence. Warburton (Reference Warburton1994) examined the incidence of depression or nervous illness in smokers. Women, current and ex-smokers, were more likely to have experienced depression or nervous illness than those who had never been smokers. But, male ex-smokers were intermediate between never-smokers and current smokers and not significantly different from either group.
Ex-smokers were subdivided into number of years since quitting. Those who had quit 20 or more years or fewer than 10 years before had a significantly greater incidence than those who had stopped 10 to 19 years before, but the latter did not differ significantly from never-smokers. Clearly, there was no simple relationship between duration of abstinence and mental health, unless nicotine exposure had damaged the brain permanently.
A comparison of cigar smokers, pipe smokers, and never-smokers was made because they absorb significant doses of nicotine. There was no relation between nicotine exposure and the incidence of depression or nervous illness in these groups and so no support for the idea that exposure to nicotine has adverse effects on mental health and that ex-smokers return to “normalcy” after cessation.
More evidence for NUH is factors that predict initiation, and so predate nicotine exposure – for example, personality. Gilbert (Reference Gilbert1995) found an association of smoking with neuroticism and depression. Twin designs have evaluated whether the association between smoking and depression was causal or non-causal (Kendler et al. Reference Kendler, Neale, MacLean, Heath, Eaves and Kessler1993). The best-fitting model suggested that the relationship between smoking and depression resulted solely from genes that predispose to both smoking and major depression.
These data fit the hypothesis that genes predispose to anxiety and depression. In the teenage years, susceptible individuals find that smoking enhances their mood. Consequently, some adopt smoking as a form of nicotine utilization, and not surprisingly, ex-smokers miss these effects when they quit.
A second result from smoking surveys is that smokers claim that smoking helps them think and concentrate (Russell et al. Reference Russell, Peto and Patel1974). Despite many studies (see Warburton Reference Warburton, Wonnacott, Russell and Stolerman1990), the NWH doubts whether nicotine influences cognition. But, nicotine improved attentional performance in animals not in withdrawal (see M&S). Positive effects of nicotine on the performance of non-smokers have been found (Wesnes & Warburton Reference Wesnes and Warburton1984), and smoking improves minimally deprived smokers (e.g., Warburton & Arnall Reference Warburton and Arnall1994). Other studies (e.g., Warburton & Mancuso Reference Warburton and Mancuso1998; Mancuso et al. Reference Mancuso, Warburton, Sherwood and Tirelli1999) have applied a transdermal nicotine patch for 6 hours so testing is done after any tolerance would have developed. In these studies, attentional performance was improved over the baseline in comparison with placebo at 3 hours and at 6 hours, indicating clearly that nicotine deprivation is not necessary for enhancing performance, contradicting the NWH.
Mancuso et al. (Reference Mancuso, Warburton, Sherwood and Tirelli1999) found that transdermal nicotine patches improved speed of verbally producing a sequence of 100 letters in a random fashion (random letter generation) but did not affect the occurrence of stereotypical errors significantly, which is consistent with nicotine modulating an intensity system. Hence, for tasks requiring mental effort, nicotine “locks” the brain in the attentional mode.
It has been claimed that only simple tasks are improved and certainly not creativity. However, nicotine improved performance of non-smokers in a flight simulator (Mumenthaler et al. Reference Mumenthaler, Taylor, O'Hara and Yesavage1998). And the fallacy of the creativity statement can be demonstrated by looking at a list of creative people. Notable smokers were Charles Darwin, Albert Einstein, Isaac Newton, James Watson, Bertrand Russell, Jean-Paul Sartre, Ludwig Wittgenstein, Vincent van Gogh, and Pablo Picasso.
Early evidence on memory improvements in humans and animals was summarized in Warburton (Reference Warburton, Wonnacott, Russell and Stolerman1990). Later studies confirmed that attentional resources are important for the associative processing and demonstrated that nicotine improves verbal memory only for the semantically processed information (Rusted et al. Reference Rusted, Graupner and Warburton1995; Warburton et al. Reference Warburton, Rusted and Müller1992; Reference Warburton, Skinner and Martin2001). Semantic processing requires more effort and produces a more richly encoded memory trace with more associations. Nicotine facilitates these associations and enhanced storage, which raises the possibility that nicotine facilitates the formation of the drug memories, described by M&S.
These data support the NUH, the functional model (Warburton Reference Warburton, Martin, Loon, Iwamoto and Davis1987), which is a version of M&S's drug utilization hypothesis. The NUH views nicotine use as a purposive activity by which the smoker improves mood and performance. It can be seen as adopted for coping with problems, as well as for enhancing function. Motives are both exogenous (situational) and endogenous (genetic). The NUH predicts that abstinence experiences will vary, because functions differ for the individual. Hence, cessation programs must be individually tailored.
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Surveys find that 80% of smokers claim they smoke more when worried, 75% say they light up when angry, and 60% feel that smoking cheers them up (e.g., Russell et al. Reference Russell, Peto and Patel1974; reviewed Warburton Reference Warburton, Wonnacott, Russell and Stolerman1990). As the Surgeon General's Report stated:
The conclusion from this literature is that in the general population, persons perceive that smoking has functions that are relevant for mood regulation. Persons report that they smoke more in situations involving negative mood, and they perceive that smoking makes them feel better in such situations (US DHHS 1988; p. 399).
In other words, smokers are using nicotine as a form of drug utilization as described by M&S.
Nevertheless, it has been argued that these mood effects represent only relief of withdrawal symptoms (NWH) and not a motive for smoking as in the NUH (functional model, Warburton Reference Warburton, Martin, Loon, Iwamoto and Davis1987). Both NWH and NUH predict that abstaining smokers will experience dysphoria after abstinence, but NWH predicts that there will be a stereotyped syndrome, so that ex-smokers will eventually return to their non-smoking state.
Numerous studies do not show a stereotyped syndrome, or an invariable cluster of symptoms for every quitter. For example, Hughes et al. (Reference Hughes, Gust, Skoog, Keenan and Fenwick1991) found that anxiety was the commonest sign after two days (49%) then restlessness (46%). Irritability was 38% whereas depression was 31%. As well as over half of quitters having no mood changes, the percentage of participants having a specific sign vary remarkably across studies. This is not what one would expect from the NWH.
NWH also predicts that ex-smokers will not differ in mental health from non-smokers after prolonged abstinence. Warburton (Reference Warburton1994) examined the incidence of depression or nervous illness in smokers. Women, current and ex-smokers, were more likely to have experienced depression or nervous illness than those who had never been smokers. But, male ex-smokers were intermediate between never-smokers and current smokers and not significantly different from either group.
Ex-smokers were subdivided into number of years since quitting. Those who had quit 20 or more years or fewer than 10 years before had a significantly greater incidence than those who had stopped 10 to 19 years before, but the latter did not differ significantly from never-smokers. Clearly, there was no simple relationship between duration of abstinence and mental health, unless nicotine exposure had damaged the brain permanently.
A comparison of cigar smokers, pipe smokers, and never-smokers was made because they absorb significant doses of nicotine. There was no relation between nicotine exposure and the incidence of depression or nervous illness in these groups and so no support for the idea that exposure to nicotine has adverse effects on mental health and that ex-smokers return to “normalcy” after cessation.
More evidence for NUH is factors that predict initiation, and so predate nicotine exposure – for example, personality. Gilbert (Reference Gilbert1995) found an association of smoking with neuroticism and depression. Twin designs have evaluated whether the association between smoking and depression was causal or non-causal (Kendler et al. Reference Kendler, Neale, MacLean, Heath, Eaves and Kessler1993). The best-fitting model suggested that the relationship between smoking and depression resulted solely from genes that predispose to both smoking and major depression.
These data fit the hypothesis that genes predispose to anxiety and depression. In the teenage years, susceptible individuals find that smoking enhances their mood. Consequently, some adopt smoking as a form of nicotine utilization, and not surprisingly, ex-smokers miss these effects when they quit.
A second result from smoking surveys is that smokers claim that smoking helps them think and concentrate (Russell et al. Reference Russell, Peto and Patel1974). Despite many studies (see Warburton Reference Warburton, Wonnacott, Russell and Stolerman1990), the NWH doubts whether nicotine influences cognition. But, nicotine improved attentional performance in animals not in withdrawal (see M&S). Positive effects of nicotine on the performance of non-smokers have been found (Wesnes & Warburton Reference Wesnes and Warburton1984), and smoking improves minimally deprived smokers (e.g., Warburton & Arnall Reference Warburton and Arnall1994). Other studies (e.g., Warburton & Mancuso Reference Warburton and Mancuso1998; Mancuso et al. Reference Mancuso, Warburton, Sherwood and Tirelli1999) have applied a transdermal nicotine patch for 6 hours so testing is done after any tolerance would have developed. In these studies, attentional performance was improved over the baseline in comparison with placebo at 3 hours and at 6 hours, indicating clearly that nicotine deprivation is not necessary for enhancing performance, contradicting the NWH.
Mancuso et al. (Reference Mancuso, Warburton, Sherwood and Tirelli1999) found that transdermal nicotine patches improved speed of verbally producing a sequence of 100 letters in a random fashion (random letter generation) but did not affect the occurrence of stereotypical errors significantly, which is consistent with nicotine modulating an intensity system. Hence, for tasks requiring mental effort, nicotine “locks” the brain in the attentional mode.
It has been claimed that only simple tasks are improved and certainly not creativity. However, nicotine improved performance of non-smokers in a flight simulator (Mumenthaler et al. Reference Mumenthaler, Taylor, O'Hara and Yesavage1998). And the fallacy of the creativity statement can be demonstrated by looking at a list of creative people. Notable smokers were Charles Darwin, Albert Einstein, Isaac Newton, James Watson, Bertrand Russell, Jean-Paul Sartre, Ludwig Wittgenstein, Vincent van Gogh, and Pablo Picasso.
Early evidence on memory improvements in humans and animals was summarized in Warburton (Reference Warburton, Wonnacott, Russell and Stolerman1990). Later studies confirmed that attentional resources are important for the associative processing and demonstrated that nicotine improves verbal memory only for the semantically processed information (Rusted et al. Reference Rusted, Graupner and Warburton1995; Warburton et al. Reference Warburton, Rusted and Müller1992; Reference Warburton, Skinner and Martin2001). Semantic processing requires more effort and produces a more richly encoded memory trace with more associations. Nicotine facilitates these associations and enhanced storage, which raises the possibility that nicotine facilitates the formation of the drug memories, described by M&S.
These data support the NUH, the functional model (Warburton Reference Warburton, Martin, Loon, Iwamoto and Davis1987), which is a version of M&S's drug utilization hypothesis. The NUH views nicotine use as a purposive activity by which the smoker improves mood and performance. It can be seen as adopted for coping with problems, as well as for enhancing function. Motives are both exogenous (situational) and endogenous (genetic). The NUH predicts that abstinence experiences will vary, because functions differ for the individual. Hence, cessation programs must be individually tailored.