Risk Factors

Risk Factors

1. Age

   • Most people start smoking between the ages of 14-16.
     • There's a positive correlation between early smoking initiation and likely continued maintenance/relapse.
   • Biology
     • The prefrontal cortex isn't fully matured until we're about 20.
     • The prefrontal cortex is involved in decision making and risk taking
     • Shram (2008)
       • Nicotine activated the brain more in teens than adults
       • Teens were more receptive to the rewarding qualities of nicotine and less sensitive to the adverse effects.
   • Peers
     • Social learning theory
       • Key terms: observation, modelling, vicarious reinforcement, imitation, direct reinforcement, self-efficacy.
       • Bandura
         • Young people are likely to imitate the behaviour of those whom they have the most social contact with.
         • Once they've started smoking experiences with the new behaviour determine whether it persists.
     • Normative social influence
       • You're doing it to fit in.
       • You comply with the group during initiation but eventually become addicted and internalise the group view.
     • Social identity theory
       • About taking on the behaviours of the group you want to belong to.
       • You want to make the similarities between yourself and your in-group high and the similarities between yourself an an out-group low.
       • Explains why people continue to smoke outside of the group.
       • Key terms: status, social approval, social norms
     • Karcher and Finn (2005)
       • Youths whose parents smoked were 1.88xs as likely to take up smoking. If siblings smoked it was 2.64, if close friends smoked it was up to 8xs more likely, even if their parents, siblings and friends didn't smoke.
       • Family conflict, modelling within the family, tolerance of drugs use from parents and deviant peer group association show that these explanations are quite deterministic
         • People can resist it. It's only 1 influence.
     • Do peers create the behaviour or do dependent peers select others to smoke with them to fit their own identity (cause or correlation)?
     • Are teens impervious to the demands of their social group when they conflict with their own concerns to maintain a healthy lifestyle?

2. Stress

   • Everyday stress
     • People report that they drink, smoke use drugs, gamble etc. to cope with daily hassles such as money worries, relationship problems and workplace stress
       • Such stressors may contribute to initiation, maintenance and relapse.
         • NIDA study
   • Traumatic stress
     • People exposed to severe stress are more vulnerable to addiction, especially children.
   • Despite smokers smoking because it supposedly reduces stress, smoking increases stress levels.
     • Stress may be a risk factor but the addiction (formed through self-medication) doesn't have the desired effect.
   • Hajek et al (2010)
     • Once a smoker has taken up smoking it may become stress reducing because the desire to have another cigarette is stressful so having one can relieve this somewhat.

3. Media influences

   • Public health ads
   • Gambling ads
   • Does the media glamourise addictive behaviour or portray it's issues?
     • Deterministic - we may not react by taking up smoking.
     • Smoking isn't always portrayed positively in the media
   • Celebrity role models
   • Social learning theory
   • Waylen et al (2011)
     • Teens who watched films where there was smoking were more likely to start smoking even when peer and parental influence was controlled for.
     • There was a significant relationship between smoking and the number of films predicting smoking seen.
   • Individual differences in how we react to media influences.
   • Sulkunen (2007)
     • Choice of TV and programmes is subjective
     • Depends on a subjective interpretation because it's qualitative data
     • In some films drugs were also used as self-medication.
     • Films about drug use presented scenes of drug competence and enjoyment of the effects contrasted with dull ordinary life.
     • Content analysis of 140 scenes from 47 films depicting use of alcohol, drugs, smoking, gambling and sex.
       • Only 61 scenes were about addiction and were analysed.

4. Personality

   • EPI (Eysenck's Personality Inventory
     • Measures emotional stability vs neuroticism and extraversion vs introversion
       • Later he included a section to look at psychoticism
       • Research has shown a link between high scores in neuroticism and psychoticism and addictive behaviours (Francis 1996).
   • Cloniger (1987) proposed 3 personality traits that predispose individuals towards substance dependence
     • Novelty-seeking
     • Harm avoidance (includes worry and pessimism)
     • Reward dependence - the extent to which you learn quickly from rewarding experiences and repeat rewarded behaviours.
   • Belin et al (2008)
     • Placed rats in a device where they could self-administer cocaine doses.
     • One group were sensation-seekers and immediately started taking large doses.
     • Another group were high in impulsiveness and started with lower doses. However they were the ones that got addicted.
     • How do you measure a rat's personality?
     • Is animal research generalisable to humans?
   • Personality traits may be common amongst addicts but this doesn't mean that they predict addiction.