- Mental Health
Motivation & The Brain
In a published study found in the Archives of Pediatric and Adolescent Medicine, researchers show that 10 percent of youths that develop an addiction to cigarettes are actually addicted within the first two days after the first initial inhalation and another 25 percent are addicted within a month (Duffy, 2007). Current studies have shown that the quantity of nicotine in one cigarette is capable of flooding the nicotine receptors located in the human brain and this flooding can generate an addiction within the initial inhalation. These addiction-related modifications are everlasting and can stay for years even in smokers that have quit. This shows why that only one cigarette can elicit an instantaneous relapse in an ex-smoker (Duffy, 2007). With quitting smoking, not only does one need motivation to overcome the physical withdrawals, but there are also to make the mental changes that need to take place.
Parts of the Brain Involved in Quitting Smoking
Many areas of the human brain are wired for the reinforcement of nicotine smoking and because of this wiring quitting smoking is one of the hardest things to do. According to Dr. Noonan, “Nicotine, the main active component of cigarettes, acts on nicotinic acetylcholine receptors in the brain” (Noonan, 2010). Nicotine withdrawal symptoms include sleep problems, increased appetite, irritability, inattention, and intense cravings for cigarettes. These withdrawal symptoms can all be linked to mental changes that happen in the brain, after the nicotine is withheld. There are many areas of the human brain that are linked to the process of quitting smoking. These are the ventral tegmental area (VTA), the nucleus accumbens (NAc), the frontal lobe, the hippocampus and the amygdala (Noonan, 2010).
Ventral Tegmental Area & Nucleus Accumbens
The VTA contains neurons whose cell bodies are located in the VTA but have projections that venture into the nucleus accumbens. These neurons also release neurotransmitters including dopamine into the NAc. This VTA-NAc association is known as the mesolimbic dopamine pathway and it is also considered the "reward pathway" (Noonan, 2010). The VTA also releases dopamine into the hippocampus, the frontal cortex and the amygdala. The neurons in the VTA contain nicotinic acetylcholine receptors and when triggered cause the VTA to release dopamine. Therefore when a person smokes, they cause an excess amount of dopamine to be released by the VTA. According to Dr. Noonan, “this increased dopamine release causes the reinforcement of smoking. When smokers try to quit, the decrease in the dopamine release leads to cigarette cravings and hampers the ability to not relapse” (Noonan, 2010).
The frontal cortex is an area in the brain involved in planning, strategy and "free will." The VTA releases dopamine into the frontal cortex. Because smoking can increase dopamine release in the frontal cortex, when a person quits smoking and the nicotine is no longer in the system, the withdrawal leads to less dopamine in the frontal cortex, which leads to poor attention. This lesser amount of dopamine in the frontal cortex hampers with the brain’s “free will” which causes issues with making the decision to stay quit, or to pick up a cigarette (Noonan, 2010).
As stated before, the VTA also releases dopamine into the hippocampus. Learning and memory are two actions that the hippocampus is involved with. This is important, because it controls the contextual cues that can trigger a relapse (Noonan, 2010). Nicotine withdrawal in this area of the brain leads to associations to certain environments and smoking which produce strong cravings.
The final area that the VTA releases dopamine is the amygdala. The amygdala is the area of the brain that manages emotional responses and the lack of nicotine can produce irritability because of the lower amount of dopamine that is released from the VTA to the amygdala. Also, there are brain cells that release opioids into the amygdala. These opioid releasing brain cells also have nicotinic receptors on them. Therefore, the lack of nicotine in the body can decrease the opioid release into the amygdala which triggers cravings (Noonan, 2010).
The Factors that Motivate Quitting Smoking
When thinking about the reasons that inspire an individual to quit smoking one needs to think about motivation. There are two kinds of motivation that can aid a person when they decide to quit smoking; they are intrinsic and extrinsic motivations. Intrinsic motivation comes from within a person while extrinsic motivations are the outside factors.
Two main extrinsic motivations are the price of smoking and the presence of other smokers (Foulds, 2011). In today’s society there is a less than favorable to opinion about smoking. There are procedures and polices that prevent people from smoking in public places and the percentage of smokers is declining. This in turn means for the person who is trying to stop smoking, there are fewer prompts or triggers in their surroundings. The temptations are becoming fewer. There are strict laws regarding second hand smoke, smoking in public places such as bars and restaurants. In the past one could see a smoker siting in a bar or in a restaurant and lighting up one smoke after another at the table, now one sees the smoker outside, inside a designated smoking area. Sometimes the extrinsic factor of being the odd person out is enough to make a person quit. With the lower percentage of smokers in society, the active smokers are becoming a smaller group of individuals who stand out in a crowd. Because of the new regulations of having designated smoking areas, smokers are now required to segregate themselves from the general population.
Also in these hard economic times, the growing price of cigarettes makes the decision to quit a little easier (Foulds, 2011). In the past, when a pack was around $1.50 they seemed like a good deal considering the other things one could spend their money on and the information regarding long term health problems due to smoking was slim. But now that it’s as high as $7.50 per pack and there is a multitude of health studies regarding long term cigarette smoking, it seems even crazier to be spending at least $50 per week on something that is going to harm your health so much (Foulds, 2011).
Intrinsic motivation is the kind of motivation that originates from inside an individual and that individual will quit smoking because that is what they want to do. Intrinsic motivation is a better motivator because the individual is motivated internally and not by any type of reward or incentive. The issue with this kind of motivation is that it is tougher to boost intrinsic motivation in people. It also much more likely that an intrinsically motivated person will get discouraged (Intrinsic and Extrinsic). According to Dr. Foulds:
“Nowadays we also have better tools to help you deal with the intrinsic factors….with addiction to tobacco being the biggest barrier to quitting. Years ago you could get a pamphlet from your doctor and maybe some 2mg nicotine gum to help you quit. Today there are at least 7 different smoking cessation medicines, and new evidence showing that some of them can be combined to improve your chances a bit more. I sometimes see patients who tell me they tried nicotine gum years before and "it didn’t work". Very often when I ask for more details they tell me they didn’t like the taste, and so only used a few pieces and then stopped using it and went back to smoking. Nowadays, as well as having more smoking cessation medicines we have improved versions of the original formulations. So for example, nicotine gum is now available in a variety of flavors that smokers find much more acceptable to use, and medicines like bupropion are now available in formulations that release the drug more evenly across the day to reduce side effects.”
Although there is a myriad of health issues, such as cancer and asthma that would make a person want to quit smoking, there are other issues that one has to consider before quitting. One has to be motivated in order to quit smoking. The nicotine’s effect on the brain creates physical withdrawals as well as mental withdrawals. And in order to fight these mental and physical withdrawals a person needs to have motivation. In order to quit a person needs to rearrange their thinking, such as keeping away from places or people that trigger them to smoke, they need to squelch their cravings through using medications or other quit-smoking devices. And the person’s motivation needs to be a combination of both intrinsic and extrinsic motivations. Although according to Dr. Foulds “Nowadays we also have better tools to help you deal with the intrinsic factors” it is the intrinsic motivation that needs to be inside a person in order for them to tackle the great task of quitting smoking. Combining the extrinsic motivations with the intrinsic motivations only enhance the person’s ability to quit smoking.
Duffy, A. (2007, July ). Just One Dose Of Nicotine Affects Brain Structure And Function - Kids Can Become Addicted Within 2 Days Of First Inhaling From A Cigarette. Medical News Today, Retrieved from (1/22/10): http://www.medicalnewstoday.com/articles/75953.php
Foulds, J. (2011). Healthline. Healthline Networks Inc. Retrieved from http://www.healthline.com/blogs/smoking_cessation/2009/10/you-can-quit-smoking.html
Intrinsic and Extrinsic. Retrieved from http://intranet.micds.org/upper/health/Health-Web/smahmood/intext.html
Noonan, M. (2010). Livestrong.com. Retrieved from http://www.livestrong.com/article/195790-parts-of-the-brain-that-control-motivation-to-quit-smoking/
Sweeney, M. (2008). Smoking and Tobacco. newWellness. Retrieved electronically
March 10, 2008. http://www.netwellness.org/question.cfm/1229.htm