Lesson 9.2 Understanding Tobacco Use

Learning Outcomes

After studying this lesson, you will be able to

• what is a substance use disorder.

• the stages of substance use disorder in relation to tobacco use.

• of withdrawal symptoms people with a nicotine addiction may experience.

• individual factors that cause teens to try tobacco products.

• how family members, peers, and the media are factors that cause tobacco use among adolescents.

You learned about health issues and , , and associated with use in the previous lesson. You also learned that and thirdhand smoke and aerosol puts family members and friends at risk for health conditions. Given these facts, you may wonder why anyone would start to use tobacco products. Despite the health risks, the number of youths who used vaping devices in 2018.

In this lesson, you will learn about how using tobacco products can lead to a substance use disorder. This lesson also discusses several factors that may cause someone to try tobacco products.

Substance Use Disorder

Most people cannot use tobacco products in a . It is much more likely that a person will develop a from using . A substance use disorder occurs when a person a substance, such as nicotine, regardless of its negative effects on the body and areas of a person’s life. It involves a person’s recurrent use of substances, repetition of behaviors that lead to health issues, and an inability to meet responsibilities at home, school, or work.

When a person has a substance use disorder, this is a mental illness that requires professional treatment to break. It sometimes occurs with other mental illnesses, such as major depressive disorder and anxiety disorders. Two or more mental illnesses that occur together are called co-occurring disorders.

Stages of Substance Use

Substances such as cause - and -term changes in the brain and body that a person’s health. People with substance use disorders often feel like they a substance, even if they want to. The stages of substance use lead to addiction and a substance use disorder (Figure 9.12).

Experimentation

People often choose to use a tobacco product “.” This is the stage of . In this stage, a person is trying a substance. Most substances that lead to substance use disorders cause , such as and . These feelings cause a person to want to use more of the substance, which often leads to the regular use of a substance.

Regular Use

After experimentation, people usually their substance use. Over time, people may slowly increase the number of times they use a tobacco product per week. They are then likely to develop a of products, as the pleasant feelings associated with the substance reinforce behavior. For example, people may at a certain time of day or while performing a certain activity.

Tolerance

As a person a substance like , the body develops a tolerance for that substance. describes an increase in how much of a substance the body needs to certain effects. The body can quickly develop a tolerance to nicotine and of it to achieve the original effect of pleasurable feelings.

For example, during experimentation, a person may smoke a week. This may increase to one cigarette each day with regular use. Once a tolerance develops, a person may need to smoke each day to feel the original effects of nicotine (Figure 9.13).

Figure 9.13 Young people are extra vulnerable to many unhealthy habits, including an addiction to nicotine.

A to nicotine is dangerous because it causes people to use tobacco products more as they pursue the pleasant feelings associated with the substance. This increases the done to the body. Even if someone is not feeling the effect of the nicotine, the substance is still entering the body. The more a person uses tobacco, the more damage that person causes.

Dependence

After repeated use, the body becomes on the way nicotine makes it feel. This means the body to the feelings that nicotine causes. occurs when the body needs an in its system to function normally or avoid cravings and anxiety. There are two types of dependence— and .

A occurs when the body adjusts to a substance and requires it to function normally. For example, nicotine causes the release of , which causes feelings of . Long-term, the brain produces less of these chemicals on its own. This means the body requires nicotine or other substances to reach normal levels of these chemicals. Without the substance in the body, a person feels uncomfortable and even sick.

People can also develop a . Short-term, this causes cravings and anxiety that a person feels when not using or trying to quit the substance. Psychological dependence relates to factors. If a person is unable to use a tobacco product, this person may feel irritable. For example, a person who regularly vapes may feel if a vape pen is not available when a craving occurs.

People may develop for using a substance, such as every day. Patterns such as this can connect a substance with certain triggers (Figure 9.14). Triggers are like reminders that cause people to feel a for a substance. In this case, the end of the meal becomes the trigger to vape. When people who use tobacco encounter triggers that they connect with tobacco use, they feel a strong psychological need to use a tobacco product.

Figure 9.14 People can connect tobacco use mentally with a certain feeling, habit, person, or situation that can increase their desire to smoke, vape, or chew tobacco. Which type of dependence is related to mental and emotional factors such as stress?

Addiction

develops when a person continues using a substance despite on health. Addiction is the physical and psychological need for a given substance or behavior. For example, people may continue , even if they experience social isolation or have to turn to other measures to afford the substance. At this point, a person has developed a substance use disorder.

Withdrawal Symptoms

occurs when someone with an to a substance tries to stop using that substance. The term withdrawal describes . These symptoms vary based on the . In the short-term, people with an addiction to nicotine may experience , difficulty concentrating, , nausea, and weight gain during withdrawal. They also experience intense cravings for nicotine. This occurs because the body is physically dependent on this substance.

Withdrawal is one of the reasons people who use tobacco have such difficulty quitting. The withdrawal symptoms for tobacco or even months. Some people who quit tobacco use have occasional tobacco cravings for years after quitting.

Factors Affecting Tobacco Use and Addiction

Most young people who begin to smoke, , or use smokeless tobacco do plan to quit. They believe that quitting will be easy. They soon find out, however, that tobacco use is very . The majority of young people who use tobacco become adults who regularly use tobacco products (Figure 9.15).

Various factors may cause a young person to try tobacco or develop a substance use disorder. These include individual factors and external factors such as family, , and the media.

Individual Factors

are the factors related to your and . These factors include genetic makeup, mental health, and stage of development. Genetic makeup influences how likely a person is to develop an addiction to nicotine. For example, having a of nicotine addiction increases a person’s risk for developing an addiction to nicotine.

Some young people use and in an attempt to manage their mental health. They may feel stressed and turn to tobacco use as a way to relax. People may try tobacco to cope with a condition. They may be trying out a new identity. Young people may associate using tobacco with maturity, glamour, rebellion, or toughness. They may believe that tobacco use will make them seem . Mental health conditions can increase the risk of nicotine addiction in young people. Rather than turning to tobacco products, people with mental health conditions need to seek professional treatment.

Another individual factor that influences risk is stage of development. Young people are especially sensitive to the effects of nicotine because their developing. If a young person uses tobacco at an , this person is more likely to develop an addiction to nicotine.

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Figure 9.15 Using vaping devices increases the risk of also using cigarettes.

Family

Family members’ attitudes and about tobacco use influence whether young people use tobacco. Young people are much less likely to start using tobacco products or develop a substance use disorder if their families set , discuss their views on tobacco products, and follow through on consequences for using tobacco (Figure 9.16).

Families' attitudes toward tobacco use create an environment that young people’s behavior. Some families are strongly against the use of tobacco products. These family members do not use tobacco products and may tell guests not to use cigarettes, , and smokeless tobacco in the house. In this environment, young people are less likely to use tobacco. Other families are more accepting of tobacco use and may even use tobacco products in the home environment. in this environment are more likely to try using cigarettes, vaping devices, or smokeless tobacco and develop a substance use disorder.

Peer Pressure

During the school-age years, the influence of friends can be strong. This may lead young people to make to be accepted. The people you spend your time with have a on whether you try tobacco products and develop a substance use disorder.

Many young people use their first tobacco product with a friend. Young people with friends who use and misuse tobacco are also much more likely to choose to use tobacco products and use disorders themselves. Young people whose friends smoke or vape are offered a tobacco product much more often than those whose friends do not smoke or vape. It is important to learn how to say “no” when someone offers you tobacco.

Young people may experience to use or misuse a tobacco product. Peer pressure is the influence that people your age or status have on your actions. Peer pressure is if used to encourage an individual to do something unsafe, , or uncomfortable. Peer pressure is positive if it is respectful and encourages healthy behaviors (Figure 9.17).

Figure 9.17 There are many ways peer pressure can be used to inspire healthy behaviors. Encouraging your friends not to vape is one example.

Young people may worry that not using or misusing tobacco products means others will not like or accept them. If someone you to try a cigarette, , or smokeless tobacco, that person is not really your friend. Real friends do not want their friends to engage in unhealthy behaviors. You can use to encourage your friends to practice healthy behaviors.

Media Messages

The media is a factor affecting tobacco use. Originally, tobacco companies their products on , the radio, and in magazines and newspapers. After scientific data demonstrated the consequences of tobacco use, bans forced tobacco companies to stop these types of advertising.

Today, still cannot advertise on , or in print publications. Instead, they try to avoid these laws by using social media. Some tobacco companies pay ambassadors and to post content and to tobacco products. Sometimes, posts by influencers do not even mention tobacco, but advertise upcoming events where people promote or give away tobacco products. Young people may see these posts and not even recognize they are at getting people to try tobacco products (Figure 9.18).

People often look to on social media for ideas about new hairstyles, fashionable clothing, and , such as using tobacco. Young people also imitate the behaviors of their peers on social media. Social media only tells a small portion of a person's story, however. It may not capture the serious health consequences of tobacco use immediately and in the future. Young people are more likely to after seeing ads or their role models using them.

Television shows and also many young people to tobacco products. In fact, 26 percent of movies rated G, PG, or PG-13 use. It may seem harmless to see smoking or vaping in a TV show or movie. Research shows, however, that young people who in movies are more likely to .