human research. Further research suggests that smoking cessation may result in
increases in consumption of calories, increases in sucrose, fats and carbohydrate
intake (see Ogden 1994 for an overview). Theories to explain the changes in food intake
following smoking cessation have focused on physiological factors such as a release of
brain serotonin following nicotine withdrawal (Benwell et al. 1988), which may be
compensated for by carbohydrates. However, an alternative explanation of the relation-
ship focuses on the subjective experience of craving for a substance.
The subjective experience of craving
The desire to eat and the response to food deprivation is characterized by the experience
of ‘emptiness’, ‘tension’, ‘agitation’, ‘light-headedness’ as well as more specific feelings
such as a ‘rumbling stomach’. Smoking abstainers also describe their desire for a
cigarette in similar ways, again using language such as ‘emptiness’, ‘agitation’ and
‘light-headedness’. A possible explanation of the interaction between smoking and
eating is that sensations of deprivation may be interchangeable. Alcohol research
suggests that craving for alcohol may be a form of misattribution of internal states, with
the alcoholic labelling internal states as a desire for alcohol (Ludwig and Stark 1974;
Marlatt 1978). With reference to eating and smoking, the desire to smoke may be
labelled as hunger and therefore satiated by food intake. In a recent experimental study,
smokers were asked either to abstain for 24 hours or to continue smoking as usual, and
their craving for food and cigarettes and food intake was compared with each other
and with a group of non-smokers (Ogden 1994). The results showed that smoking
abstinence resulted in an increased craving for food and increased food intake. In
addition, the results showed that an increased craving for cigarettes resulted in increased
food intake. Furthermore, the results showed that this association between craving for
cigarettes and food was greater in women than men, and particularly apparent in dieting
women.
These studies support a cross-behavioural perspective of addictions and suggest an
interrelationship between different behaviours. It is possible that because women
dieters may use smoking as a means to reduce their eating they develop an association
between these behaviours. It is also possible that the substitution between addictive
behaviours may also exist between other behaviours such as alcohol and smoking
(stopping smoking increases drinking), or gambling and eating (stopping gambling
increases eating).
TO CONCLUDE
Smoking and alcohol consumption both have negative effects on health and yet are
common behaviours. There are many different theories to explain why people smoke
or drink and how they can be encouraged to adopt healthy behaviours. This chapter
examined the different models of addiction, including the moral model, the disease
models and the social learning perspective. It then examined the stages of substance use
from initiation and maintenance (involving psychological factors, such as beliefs and
SMOKING AND ALCOHOL USE 129