Positive effects
Alcohol may also have a positive effect on health. In a longitudinal study, Friedman and
Kimball (1986) reported that light and moderate drinkers had lower morbidity and
mortality rates than both non-drinkers and heavy drinkers. They argued that alcohol
consumption reduces coronary heart disease via the following mechanisms: (1) a
reduction in the production of catecholamines when stressed; (2) the protection of blood
vessels from cholesterol; (3) a reduction in blood pressure; (4) self-therapy; and (5) a
short-term coping strategy. The results from the General Household Survey (1992) also
showed some benefits of alcohol consumption with the reported prevalence of ill-
health being higher among non-drinkers than among drinkers. However, it has been
suggested that the apparent positive effects of alcohol on health may be an artefact of
poor health in the non-drinkers who have stopped drinking due to health problems.
In an attempt to understand why people smoke and drink, much health psychology
research has drawn upon the social cognition models described in Chapter 2. However,
there is a vast addiction literature which has also been applied to smoking and drinking.
Addiction theories will now be explored.
WHAT IS AN ADDICTION?
Many theories have been developed to explain addictions and addictive behaviours,
including moral models, which regard an addiction as the result of weakness and a
lack of moral fibre; biomedical models, which see an addiction as a disease; and social
learning theories, which regard addictive behaviours as behaviours that are learned
according to the rules of learning theory. The multitude of terms that exist and are
used with respect to behaviours such as smoking and alcohol are indicative of these
different theoretical perspectives and in addition illustrate the tautological nature of the
definitions. For example:
An addict: someone who ‘has no control over their behaviour’, ‘lacks moral fibre’,
‘uses a maladaptive coping mechanism’, ‘has an addictive behaviour’.
An addiction: ‘a need for a drug’, ‘the use of a substance that is psychologically and
physiologically addictive’, ‘showing tolerance and withdrawal’.
Dependency: ‘showing psychological and physiological withdrawal’.
Drug: ‘an addictive substance’, ‘a substance that causes dependency’, ‘any medical
substance’.
These different definitions indicate the relationship between terminology and theory. For
example, concepts of ‘control’, ‘withdrawal’, ‘tolerance’ are indicative of a biomedical
view of addictions. Concepts such as ‘lacking moral fibre’ suggest a moral model of
addictions, and ‘maladaptive coping mechanism’ suggests a social learning perspective.
In addition, the terms illustrate how difficult it is to define one term without using
another with the risk that the definitions become tautologies.
Many questions have been asked about different addictive behaviours, including:
SMOKING AND ALCOHOL USE 103