further drinking behaviour. However, it has been suggested that it is not the actual
effects of alcohol use that promote drinking but the expected effects (George and Marlatt
1983). Therefore, because a small amount of alcohol may have positive effects people
assume that these positive effects will continue with increased use. This perspective is in
line with the social learning model of addictive behaviours and emphasizes the role of
reinforcement and cognitions.
Social predictors of alcohol initiation and maintenance
Many of the social factors that relate to smoking behaviour are also predictive of alcohol
consumption. For example, parental drinking is predictive of problem drinking in
children. According to a disease model of addictions it could be argued that this reflects
the genetic predisposition to develop an addictive behaviour. However, parental drinking
may be influential through ‘social hereditary factors’, with children being exposed to
drinking behaviour and learning this behaviour from their parents (Orford and Velleman
1991). In addition, peer group alcohol use and abuse also predicts drinking behaviour as
does being someone who is sensation seeking, with a tendency to be aggressive and
having a history of getting into trouble with authority. Johnston and White (2003) used
the theory of planned behaviour (see Chapter 2) to predict binge drinking in students.
However, given the social nature of binge drinking they focused on the role of norms.
Using a longitudinal design, 289 undergraduate students completed a questionnaire
concerning their beliefs with follow-up collected about reported binge drinking. The
results showed an important role for norms particularly if the norms were of a
behaviourally relevant reference group that the student reported a strong identification
with.
STAGE 3: THE CESSATION OF AN ADDICTIVE BEHAVIOUR
Because of the potential health consequences of both smoking and alcohol consump-
tion, research has examined different means to help smokers and drinkers quit their
behaviour. Cessation of an addictive behaviour can be examined in terms of the processes
involved in cessation and the interventions designed to motivate individuals to quit their
behaviour.
The process of cessation
Traditionally, smoking cessation was viewed as a dichotomy: an individual either smoked
or did not. Individuals were categorized as either smokers, ex-smokers or non-smokers.
This perspective was in line with a biomedical model of addictions and emphasized the
‘all or nothing nature’ of smoking behaviour. In addition, alcoholics were encouraged
to abstain and to become non-drinkers. However, early attempts at promoting total
abstinence were relatively unsuccessful and research now often emphasizes cessation as
a process. In particular, Prochaska and DiClemente (1984; see Chapter 2) adapted their
stages of change model to examine cessation of addictive behaviours. This model
SMOKING AND ALCOHOL USE 113