Smoking Cravings and Potential Addiction in Friends

Hello, doctor, may I ask you..?

Hello Dr.
Chou: Last week, I went out with a friend, a classmate I hadn't seen in years.
Unexpectedly, he started shaking and frantically grabbed my wheelchair.
Later, he asked me to buy him cigarettes.
After smoking three cigarettes, he seemed fine.
I asked him if he had taken any "substances," and he said he didn't know, just that someone offered him a cigarette and he reacted this way.
He smoked two packs of that kind of cigarette.
Is this a sign of drug addiction, or is it just a nicotine addiction? He told me that he experiences this situation every night, but smoking alleviates it.

shucai, 20~29 year old female. Ask Date: 2008/05/27

Dr. Zhou Sunyuan reply Psychiatry

The situation you described raises concerns about potential drug use.
However, this information alone is insufficient to determine whether drugs were used.
Moreover, since the cigarettes your friend later used were purchased by you, they should not have been laced with drugs, which lowers the likelihood of drug involvement.
To confirm, it would be advisable for your friend to seek further evaluation at a hospital.

Reply Date: 2008/05/27

More Info

Understanding smoking cravings and potential addiction can be quite complex, especially when observing the behavior of friends or acquaintances. From your description, it seems that your friend exhibits signs of nicotine dependence, which is a common issue among smokers. Nicotine addiction can manifest in various ways, including physical withdrawal symptoms and psychological cravings.

When someone who is dependent on nicotine goes without smoking for a period, they may experience withdrawal symptoms. These can include irritability, anxiety, restlessness, and physical symptoms like shaking or sweating, which your friend seems to have displayed when he was craving a cigarette. The fact that he felt an urgent need to smoke and that smoking alleviated his discomfort suggests that he is likely experiencing nicotine withdrawal.

Nicotine is a highly addictive substance found in tobacco products. It stimulates the release of neurotransmitters in the brain, particularly dopamine, which is associated with pleasure and reward. Over time, the brain becomes accustomed to the presence of nicotine, and when it is absent, withdrawal symptoms can occur. This cycle of craving and relief can lead to a strong psychological dependence on smoking.

Your friend's experience of feeling "normal" again after smoking a few cigarettes indicates that he may be using nicotine to self-medicate his withdrawal symptoms. This is not uncommon; many smokers report that they feel more relaxed or focused after smoking, which reinforces the habit. The fact that he experiences these cravings specifically at night could suggest a pattern of use that is tied to his daily routine or stress levels.

It's important to note that while smoking can provide temporary relief from withdrawal symptoms, it ultimately perpetuates the cycle of addiction. The more he smokes, the more his body becomes reliant on nicotine, making it increasingly difficult to quit. If he is smoking two packs a day, as you mentioned, he is likely experiencing significant physical dependence.

In terms of addressing this situation, it may be beneficial for your friend to seek professional help. Many resources are available for individuals looking to quit smoking, including counseling, support groups, and medications that can help manage withdrawal symptoms and cravings. Encouraging him to talk to a healthcare provider about his smoking habits could be a positive step toward understanding his addiction and exploring options for quitting.

Additionally, as a friend, you can provide support by being understanding and non-judgmental. Encourage him to consider the long-term health risks associated with smoking, such as lung cancer, heart disease, and respiratory issues. Highlighting the benefits of quitting, such as improved health, better quality of life, and financial savings, may also motivate him to seek help.

In summary, your friend's behavior suggests a strong likelihood of nicotine addiction, characterized by withdrawal symptoms and a reliance on smoking to feel "normal." Supporting him in seeking professional assistance and understanding the nature of his cravings can be crucial steps in helping him address his smoking habit.

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