thesis
Neurocognitive Insights in Nicotine Addiction
- Publication date
- 1 January 2012
- Publisher
- In the Netherlands, 27% of the population is currently smoking. Nicotine is
among the most addictive substances of abuse. Thirty-two percent of the people
who tried smoking develop nicotine dependence within ten year. This percentage
is higher for nicotine than for other substances of abuse (e.g., 23 for heroin:
Anthony, et al. 1994). Eighty percent of the smokers intend to quit smoking in the
future while only 25% actually attempt to quit every year. Most of these quit
attempts fail as 88-95% of the quitters smoke again in the year following the quit
attempt (International Tobacco Control Policy Evaluation Project 2011). Although
smoking rates are decreasing since 1970, the decline in smoking rates is less
distinct in populations with a lower social economic status. Youngsters with lower
educational levels start smoking more often and it could be that those with lower
social economic status have more difficulties giving up smoking. Nicotine
dependence is currently included in the Diagnostic and Statistical Manual of
Mental Disorders fourth edition (DSM-IV-TR) as a ‘substance use disorder’.
Examples of diagnostic criteria are tolerance, withdrawal, smoking more than
one intended, and the continuation of smoking despite knowledge of adverse
consequences. Although nicotine dependence is included in the DSM-IV, nicotine
dependence is rarely diagnosed. In addition, many smokers do not meet the
diagnostic criteria, although they do experience problems giving up smoking
(Schmitz, et al. 2003) and have increased risks for serious health problems. All
these characteristics of smoking imply that smoking is a serious and chronic
condition that occurs in a substantial part of the population.