Psychological Theories and Models on Smoking Cessation - Essay Example

? Psychology: Smoking Cessation By of Learning: Psychology: Smoking Cessation Introduction Health issues can be viewed from different perspective depending on the heath conditions and the causative agents. Most of the health issues are normally looked at from the medical perspective yet they can be best dealt with from other easier and convenient perspectives. In most cases, it is best to consider all the possible perspective while dealing with any health issue. Smoking habit is one of the health conditions that can be best dealt with from the physiological perspective yet many people prefer other ways. Smoking cessation can be looked at in terms of both physiological, biological and social factors and not purely biological terms. This can be achieved through looking at some of the psychological models that help explain how psychological factors such as emotions, behavior and thoughts, biological factors and social factors all play a big role in human beings function in the smoking cessation context. As medical experts view medical conditions in terms of the most suitable treatment and the body malfunction leading to the health condition, the psychological component on the other hand looks at the condition for possible psychological causes like emotional turmoil, lack of self-control and negative thinking. A good number of people who engage in smoking normally do this out of psychological causes more than other causes. This implies that the condition can be best dealt with using psychological approaches than any other means (Kobasa, 1979, p. 9) Some of the psychological models include the social part and other psychosocial models which try to explain how smoking is influenced by social factors like poverty, status, religion and technology. This shows that health care officials have to address smoking cessation in terms of the biological, social and psychological influence on the patients functioning. This paper is out to show how different psychological theories and models can be applied on smoking cessation, looks at the broader psychological and social impact of smoking cessation on the health of the patients and tries to suggest possible strategies that can be employed to address the smoking cessation issue (Long, 2003. P. 50) Psychological Theories and Models on Smoking Cessation Different people have different perception about diseases and health conditions. The same is seen in smoking with some people looking at this health issue as a disease while others consider it as a habit. For any health condition, the perspective of the situations and events leading to the conditions are normally influenced by several factors like cognitive and personality factors. Symptoms and signs of a disease may at times fail to be accurate thus not that helpful in trying to seek appropriate medication. This is evident in smoking cessation as some of the symptoms and signs characteristic of the smokers do not have any prescribed medicine. Most of the signs such as depression need more of a psychological approach than biological treatment. Smokers may also have psychological concerns like anxiety which may end up affecting their health perception. The self-regulatory model of illness cognition and behavior states that stimuli within a patient results in a perception of the symptoms and influences the way the patients interprets what such symptoms mean (Curry and McBride, 1994.p. 350). The patients always try to make some sense out of their body reaction. This model can be applied in the case of smoking cessation where a patient feels anxious or stressed; the feeling might be resulting from other factors but most of the smokers will interpret the situation as lack on nicotine in their body hence they will settle on smoking. Patients may be fully aware of the risks associated with their health condition but still find themselves ignoring and fail to do anything that might check on the possible consequences. This is common in smokers as most of them are aware of the adverse effects associated with the habit but are unable to control or stop their smoking. Such conditions can only be resolved by changing certain behaviors. The attribution theory states that human beings view their life as being controllable and predictable (Chapman and MacKenzie, 2010, p. 2). This makes people to believe in the effects and causes of the things happening in their lives. The notion is also applied when it comes to beliefs related to different health conditions. Different illnesses have been considered with different representations, perceptions and cognitions. This has led to different beliefs related to health conditions behaviors and experiences. Some go to the extent of defining some health conditions on the basis of what caused the conditions, how the conditions runs its course, how it can be cured and its effects on the body. Different people have different beliefs when it comes to smoking cessation. Some direct their beliefs to what made them to start the smoking habit, others on reasons why they cannot stop, others believe the habit has no side effects on them, other smokers have the notion that it is just a stage in life and that they will stop when the right time comes while others believe the condition cannot be managed. Such beliefs influence their smoking habits in great ways as some of the beliefs make it almost impossible for the victims to stop or control the behavior. Smoking is more of a habit than a disease following its psychological association. Habits are basically formed through repetition over time; and the older a habit is, the harder it is to break. This is the same case with smoking; once an individual starts smoking, the habit worsens with time to the extent that it is almost impossible to stop it. Similarly, new habits are hard to develop. Individuals who have never smoked will find it very hard to start smoking as compared to those who were smokers in the past even if they are fully aware of the addictive and the side effects. Any activity or behavior, when repeated over a period of time in a consistent manner, induces habit. Habits are capable of making familiar neural pathways. Once formed, these pathways make patterns of behaviour which are hard to break. An activity like smoking is a habit which is hard to break because it has been created through specific neural pathways. However, it is possible to alter or change these neural patterns, but when there is a strong stimulus, it is hard to resist and people fall into the old habits. Smoking can be viewed as being a unique habit following both its psychological and biological factors. The presence of nicotine in cigarettes makes the habit addictive. With time, the smoking habit moves from being a habit to an addiction. This implies that there are issues other than the mere biological addiction to be addressed to make the de-addiction efforts effective. The smoking addiction is greatly affected by socio-economic factors as grief processing, identity issues, plain-old classically conditioned triggers, coping strategies, and operant conditioning. The Eysenck’s Trait Theory introduces two distinct categories of human traits; extraversion-introversion, and neuroticism-stability (Drach-Zahavy and Somech, 1989, p. 969). Individuals who possess extraversion traits are marked by sociability and adventurous nature; and neuroticism exhibits moodiness, anxiety, and low willpower. This implies that people with different personality traits are likely to be stressed in different degrees. Individuals with high negative affect and neuroticism find events more stressful than other people do. That means for such people, symptoms associated with smoking cessation can be unbearable. Psycho-Social Impacts of Smoking Cessation on Health Smoking cessation does not just have physical impacts like kidney destruction on the health of smokers as most people believe. There are several psycho-social impacts that have been associated with smoking cessation. Most smokers have been observed to be have a lower self esteem than other individuals. These may be as a result of the way they are looked at by the society or the way they have failed to control the addiction after endless efforts. Such a low esteem may greatly affect the normal functions of an individual. This can be best explained using the cognitive competence theory which states that the self esteem of a person affects his or her perception when it comes to being able to solve issues (Fiske and Taylor, 1991, p. 67). The perception is mostly related to one’s knowledge or intelligence. With reference to the theory, smokers tend to have a lower self esteem thus will always consider themselves as being unable to carry out some responsibilities in the society. Some smokers believe they have to first smoke for them to think or act normally. The social competence theory also suggests self esteem determines the perception of individuals with regards to their social skills and how they adopt to social situations. Most heavy smokers believe that they cannot do heavy chaos or strenuous activities like running long distances even before trying it out. Smoking cessation also impacts the social identity of individuals. This includes their social competence as well the respect they receive from their peers. In some societies, smoking is considered as a vice hence smokers tend to feel that they are not respected. Low self esteem normally results from individual’s perceptions on their inadequacy with their physical competence, appearance, social competence and cognitive competence. Smoking addition being associated with both biological and psychological roots; it means that those involved in smoking have to struggle to cope with the effects of smoking cessation. Coping can be viewed as the process of continuously altering their cognitive and behavioral tendency in an effort to control specific external or internal demands. Most of these demands are normally psychological or social. There are various symptoms associated with nicotine usage and withdrawal. They include; cravings to smoke, irritability, fatigue, inability to concentrate, headache, cough, sore throat, constipation, dry mouth, postnasal drip, and tightness in the chest. Smoking cessation has also been found to affect the personality of an individual in a number of ways. The personality individual theory states that every individual is unique and that each individual reacts in his or her own ways when faced with challenging situations (Heyman, 2009, p. 34). Each individual is believed to have particular characteristics that are subjective and can carry value judgment or on the other hand be objective. Most smokers will run to the next shop when subjected to stress or pressure. This leaves the individuals subjective to the nicotine demands in their bodies. This is also closely associated with the attribution theory which states that the personality of an individual maybe attributed wrongly to a given personality label without putting into consideration the prevailing situation factors surrounding their behaviors when faced with given situations (House, Landis and Umberson, 1988, p. 542). The behavior of depending on smoking every time an individual is subjected to pressure even when the situations is caused by other factors rather than the need to smoke can be explained by this theory. The theory goes ahead to state that such differences are witnessed due to several factors like biological, genetic, environmental and social. This implies that different personality types prefer to use different coping strategies. While the mentally healthy ones adopt adaptive strategies which enable them to react soberly with the prevailing situation, the neurotic, or the mentally unhealthy ones, adopt maladaptive techniques, or the techniques which are inappropriate in relation to the situation. Neurotic individual differ from the normal ones in that they have 10 neurotic needs (compulsive attachments) which are more important for the neurotics than for the normal ones. They are; the need for affection, the need for a partner, the need to simplify ones life, the need for power, the need to exploit others, the need for social recognition, the need for personal admiration, the need for personal achievement, the need for self-sufficiency, and the need for perfection. Thus, while the normal ones do not get seriously affected by the lack of these things, the neurotic ones are seriously affected by these needs (Kobasa, 1979, p. 9). This health situation also affects the emotional response of the victims. This interferes with the way they react to emotions. Emotions are normally expressed through feelings, thoughts and behavior. The cognitive process leads to behavioral responses resulting to external situations or events that are not normal (Lazarus and Folkman, 1984, p 23). Emotions are seen to not only affect smokers psychologically but also lead to physiological changes which in turn affect their behavior and thinking. Their behavioral responses such as withdrawal from the public are physical actions that are suitable to the stimuli coming from their body or the events leading to them. Smoking cessation has also been associated with depression and stress in such a way that when the smokers are experiencing hard times in their lives, they tend to keep the issues within them instead of sharing and rely on smoking to keep them going. Such emotions are negative and if negative emotions get suppressed for a long time then they may lead to ill-health. The way people respond to emotions also affect their decision making process as well as the way they reach out for help or the way they support ill health. Fear has been seen to result in avoidance behavior which may stop an individual from reaching out to health services. Some smokers tend to fear the way the society will react to their habits while some have tried several ways of stopping the habit until they fear that no matter what is done, nothing can turn out as being helpful to them. Anxiety is also one of the results of smoking cessation. Anxiety is considered as being a negative emotion and high levels of anxiety have been linked with detrimental health effects. Depression on the other hand has been associated poor health as well as high mortality rates (Lally, 2010, p. 1000). Social support has been heavily linked to stress and is normally considered as part of biological component because it is deeply linked to the biological environment of the individual. In fact, there are various aspects of this social support. They come in many forms including emotional, tangible, and informational aspects which are vitally linked to physiological processes. Another area of biological component is the personality. As already seen, people with Type A personality are more competitive, impatient, and hostile in life. Probably as a result, these individuals have been observed to have higher levels of coronary heart diseases due to the high levels of stress associated with this personality. The repressors smokers are prone to cancer. There is also the issue of hardiness which is considerably linked to how an individual handles stress. Hardiness relates to the sense of control, commitment, and challenge towards everything in life. Patients with hard personalities are mentally and emotionally better off than other people. Amidst all these issues, the point that offers some opportunity for a psychological approach is the fact that these personality types are modifiable, though to some extent. Health Strategies on Smoking Cessation In Relation to Psychological Wellbeing Social and economic factors play a big role in shaping the social choices of smokers in relation to social regulations and policies. Policies on smoking and smoking cessation exist everywhere. What matters is the health choices that are available to the patients. The Locus control theory demands that the extent at which a patient attributes to his or her health condition depends mostly to them and not the measures put in place (Long, 2003.p. 50). This means that for smokers to be helped, the first step has to come from within them. The health belief model on the other hand states that the health behavior following a given belief pattern can be used to control or prevent some health conditions. Locus of control and self-efficacy theories are associated with the coping strategies smokers adopt and how they perceive their situation. This makes most smokers to possess internal locus of control, in which they tend to look into themselves for reasons and some possess external locus of control in which they believe in the existence of powerful external factors like fate. Similarly, self-efficacy too can influence positive health behaviors. Self-efficacy can be defined as the belief in ones own ability to carry out ones plan successfully. Self-efficacy enables people to adopt positive and cognitive coping strategies. This means that smokers should be made to believe that they have the ability to overcome their smoking habit if they accept to undergo the recovery measures available to them. Optimism and high self-esteem has been strongly associated with well-being and good health while depression and negative characteristics like pessimism are associated with poor health. Negative characteristics are also linked with conditions that may have both psycho-social and physical causations. Smokers, mainly through therapy and counseling, have to be encouraged to be positive with their condition and given hope that their habit is curable. The health behavior theory has it that there has been an increasing trend which links illness and personality to health behavior (McMahon and Jason, 1998). The theory concerns itself mainly with the causes of behavior change as well as its effects. In order to promote the health of patients, there has to be a broad intervention range that should be available to them. Smokers should not just be subjected to a specific strategy in an effort to control or stop their habit. This may end up being monotonous and discouraging especially when it takes longer than expected. There are several models that have come up on change of behavior including Cognitive Behavioral Therapy, Health belief Model and the Transtheoretical Model of Change. The Transtheoretical Model of Change has been widely used especially in areas like Alcohol and Drug addiction as well as smoking cessation. The models are out to help the patients understand the motivations behind change and ways of maintaining change. These efforts will have the smokers understand the importance of the motivations that have been put in place by the families, government, friends and physicians towards their recovery and guide the same patients on ways of maintaining their changed behavior to prevent them from getting back to smoking as the habit is so addictive. The Transtheoretical Model of Change also emphasizes on the responsibility of individuals when it comes to their own condition. Smokers have to be responsible for their habit and should come up with their own efforts to control the habit or support the efforts of the interested parties. One of the main working strategies in helping to control and prevent smoking cessation is smoking cessation therapy. This seems workable in relation to the cognitive-behavioral therapy theory which insists that the best medication is the collaboration between the therapist and the client (Sheier, 1989, p. 1035). During therapy, both the therapist and the client are expected to concentrate more in identifying specific behavioral and thinking patterns that may be resulting to the smoking problem. Now that ingrained contributing behaviors and beliefs can be easily revealed through therapy, new ways of feelings, acting and perceiving can start to take shape. The therapy involves uncovering negative smoking behavior patterns, having the perceptions of the smokers discussed and trying out new behaviors that will keep the victims away from their smoking habits. Most families and physicians are out to encourage smokers and support them in every way they can. The government has also come up with policies and broad frame works to address tobacco dependence and have progressively expanded its treatment measures, strengthen its resources allocation and intensify laws on public smoking. Despite all these efforts, the decision to change mainly depends on the smoker in question. Still referring to the Transtheoretical model that has its focus mainly on individual’s decision making, it is the patient to decide if the measures in place can help him or her to stop or control the situation. Smoking cessation can also be dealt with by taking into consideration social influence explained by the peer influence models and policy change models. The case can also be viewed from its biological influence by introducing the nicotine regulation models as well as replacement therapy. In the Transtheoretical Model context, the above measures can be looked at as external influences which are impacting through the patient. The model preaches self-support reliance thus the cognitions, emotions and behavior of the smokers play a crucial role in their recovery (Uchino, 1996, p. 490). The emotions of the smokers also have to be considered during the healing process. The emotions of an individual include psychological changes thus affect their behavior and thinking. The cognitive theory suggests that people are consciously aware of their emotions (Weiten, 2007, p. 14). Following the consciousness factor, it means that the smokers have the ability to have control over their emotions and behaviors, or may learn how to suppress them. Conclusion Smoking cessation just like most of the health issues can be better looked at from the psychological perspective. This is because most causes of smoking cessation and the possible measures that control the health condition are psychological. Psychological models and theories have tried to explain the psychological impacts of smoking cessation as well as the socio-economic factors leading to the condition. The same models have come up with suggestion for possible preventive measures such as therapy. Thus, in total, it becomes evident that coping is a process that takes place at various levels; physiological, cognitive, and social level. It also becomes evident that these various factors are interrelated and influencing each other. To illustrate, the physiological factors can influence the cognitive and social learning perspectives, and the learning aspect is powerful enough to influence the physiological and cognitive aspects. Thus, it becomes evident that in the case of smoking cessation too, the coping strategy one adopts will be dependent on ones own hereditary factors, cognition, and social and cultural environment. Now that the condition is entirely psychological, it is evident that in order to control and manage it, the strategies that are workable are psychological. References List Barbosa, E., 2012. ‘Bandura’s Social Learning/Cognitive Theory’. Chapter III: Theoretical Framework. Florida Braisil.com. Accessed 30 May 2012 Curry, S., & McBride, M., 1994. ‘Relapse Prevention for Smoking Cessation: Review and Evaluation of Concepts and Interventions’, Annual Review of Public Health, (15): 345-66. Chapman, S & R. MacKenzie, 2010. ‘The Global Research Neglect of Unassisted Smoking Cessation: Causes and Consequences’, PLOS Medicine. Accessed 30 May 2012 Drach-Zahavy, A & Somech, A., 1989. ‘Constructive Thinking: A Complex Coping Variable that Distinctively Influences the Effectiveness of Specific Difficult Goals’. Personality and Individual Difference, 27 (5): 969. Fiske, S & Taylor, E., 1991. Social Cognition: From Brains to Culture (2nd edn.). US: McGraw-Hill Higher Education. Grohol, J., 2000. “The truth about quitting smoking”. World of Psychology. Accessed 30 May 2012 Grohol, J. 2000. MIT Explains Why Bad Habits are hard to Break. World of Psychology. Accessed 30 May 2012 Heyman, G. 2009. Addiction: A Disorder of Choice. Harvard University Press: New York Heffner, C., 2002. ‘Personality Synopsis: Chapter 3: Biological Components of Personality. Section 2: Hans Eysenck's Structure of Personality. AllPsychOnline. Accessed 30 May 2012 House, J & Landis, K & Umberson, E., 1988. ‘Social Relationships and Health’, Science July 29, p. 542. Kobasa, S., 1979. ‘Stressful Life Events, Personality, and Health: An Inquiry into Hardiness, Journal of Personality and Social Psychology 37(1): 9. Kober, H., et al. 2009. ‘Regulation of Craving by Cognitive Strategies in Cigarette Smokers, Drug Alcohol Depend. Elsevier Ireland Ltd. 1-3. Accessed 30 May 2012 Lazarus, R & Folkman. S., 1984. Stress, Appraisal, and Coping. Springer Publishing Company: New York Langenderfer, G., 1999. Karen Horney (1885-1952). Accessed 30 May 2012 Lally, P. et al., 2010. ‘How are Habits Formed: Modelling Habit Formation in the Real World’. Eur. J. Soc. Psychol (40): 998–1009.  Long, D., 2003. ‘Smoking As a Coping Strategy, Nursing Times 19 August, 99 (33), p. 50. McMahon, S & Jason, A., 1998. ‘Stress ad Coping in Smoking Cessation: A Longitudinal Examination’, Anxiety, Stress & Coping: An international Journal 11 (4): 327-43. Psychology Today (n. d.) ‘Habit Formation’. Accessed 30 May 2012 ‘Psychoanalytic Social Theory- Karen Horney’ (n. d.) Accessed 30 May 2012 Perking, K., Conklin, C & Levine, 2007. Cognitive-behavioral Therapy for Smoking Cessation: A Practical Guide Book to the Most Effective Treatments. US: CRC Press. Rosenman, R., 1993. ‘Relationships of Type A Behaviour Patter with Coronary Heart Disease. In J. Goldberger and S. Brezenitz (eds.) Handbook of Stress- Theoretical and Clinical Aspects, p. 190. US: Free Press. Sheier, M. et al., 1989. ‘Dispositional Optimism and Recovery from Coronary Artery Bypass Surgery: The Beneficial Effects on Physical and Psychological Well-being’, Journal of Personality and Social Psychology 57(6): 1035. Uchino, B., 1996. ‘The Relationship between Social Support and Physiological Processes: A review with Emphasis on Underlying Mechanisms and Implications for Health’, Psychological Bulletin 119 (3): 488-525. Weiten, W., 2007. Psychology: Themes & Variations. 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