A CROSS-ADDICTIVE BEHAVIOUR PERSPECTIVE
According to the disease models of addiction, each behaviour is examined separately.
Therefore, an addiction to cigarettes is seen as separate and different to an addiction to
alcohol. However, from a social learning perspective, it is possible to examine similarities
between behaviours and to apply similar processes to the initiation, maintenance,
cessation and relapse of behaviours such as exercise, sex, gambling and eating (e.g.
Orford 1985). Research has examined these behaviours independently of each other
and, in addition, has also assessed the associations between them. In particular, recent
research has examined the interrelationship between smoking and eating behaviour.Smoking and eating behaviour
Research into the interrelationship between smoking and eating has examined (1)
gender differences in smoking; (2) smoking cessation and changes in food intake; and
(3) substitution between substances.Gender differences in smoking
Research has highlighted gender differences in tobacco use (Grunberg et al. 1991) with
the suggestion being that whilst male smoking has remained stable, or even declined
over the past 20 years in the USA and UK, female smoking has increased. This increase is
reflected by reports of gender differences in cancer with lung cancer now being the
leading cause of death in American women. To explain increases in female smoking,
research has focused on the perceived benefits of smoking, suggesting that smokers
of both genders continue to smoke for fear of weight gain. Consequently, the present
cultural obsession with thinness in women may account for increased female smoking.
Smokers generally weigh about 7 lb less than comparably-aged non-smokers, and
abstinent smokers tend to show weight gains of about 6 lb (US Department of Health
and Human Services 1990). As a result, research suggests that female dieters may use
cigarette smoking as a weight loss/maintenance strategy (Klesges and Klesges 1988;
Ogden and Fox 1994). For example, in a recent study dieters showed greater agreement
with statements relating to smoking initiation and smoking maintenance for weight
control, the role of weight gain in previous experiences of smoking relapse, intentions to
quit following weight loss and intentions to quit in five years (Ogden and Fox 1994).Smoking and changes in food intake
How cigarette smoking influences weight is unclear with different possible mechanisms
predicting either a change or no change in food intake. For example, it has been proposed
that weight gain could be a result of decreased energy use due to withdrawal or fatigue,
or that nicotine may increase metabolic rate; both mechanisms suggest no post-cessation
changes in eating behaviour. However, Grunberg (1986) suggests that nicotine may
increase blood sugar levels and that post-cessation weight gain could be explained by
an increase in sweet food consumption, which has been supported by both animal and128 HEALTH PSYCHOLOGY