Griffiths, M.D. (1996). Nicotine, tobacco and addiction. Nature, 384, 18. more

Nicotine, tobacco and addiction Sir — For many people, the concept of addiction involves taking of drugs1; most official definitions of addiction include drug ingestion. Despite such definitions, there are many potentially addictive behav- iours that do not involve drug ingestion, for example gambling, overeating, sex, exer- cise, computer-game playing, the Internet, pair bonding and work". Such diversity has led to all-encompassing definitions of what constitutes addictive behaviour. Trying to define 'addiction' is rather like defining a 'mountain' or 'tree' in that there is no sin- gle set of criteria that can ever be necessary or suffiqient to define all instances. In essence, the whole is easier to recognize than the parts. Here I suggest six compo- nents that in my view need to be fulfilled if a behaviour is to be defined as 'addictive'. Salience: when the particular activity becomes the most important activity in people's lives and dominates their thinking (preoccupations and cognitive distortions), feelings (cravings) and behaviour (deterio- ration of socialized behaviour). For in- stance, even if they are not actually engaged in the behaviour, they will be thinking about the next time they will be. Mood modification: subjective experiences that people report as a consequence of engaging in the particular activity and can be seen as a coping strategy (they experi- ence an arousing 'buzz' or a 'high' or a paradoxically tranquillizing feel of 'escape' or 'numbing'). Tolerance: a process whereby increasing amounts of the particular activity are required to achieve the former effects. For instance, a gambler may have gradually to increase the size of the bet to experience a euphoric effect that was initially obtained by a much smaller bet. , Withdrawal symptoms: unpleasant feeling states and/or physical effects that occur when the particular activity is discontinued or suddenly reduced, for example 'the shakes', moodiness or irritability. Conflict: conflicts between addicts and those around them (interpersonal conflict) or from within the individual (intrapsychic conflict) that are concerned with the partic- ular activity. Relapse: the tendency for repeated rever- sions to earlier patterns of the particular activity to recur and for even the most extreme patterns typical of the height of the addiction to be quickly restored after many years of abstinence or control. I believe that explanations for addiction must come from a biopsychosocial approach, in that 'addiction' arises from a combination of biological predisposition, social environment and psychological con- stitution. To many, this goes without saying, but others present oversimplistic and parsi- monious explanations. Behaviorial addic- tions do exist, and should be treated no differently from the better-known chemi- cally based addictions. Mark Griffiths Psychology Division, Nottingham Trent University, Nottingham NG1 ABU, UK £ Rachlln. H. Psychol. Scl. 1. 294-297 (1990). 2. Miller. W. R. The Addictive Behaviors (Pergamon, Oxford, 1980). 3. Orford, J. Excessive Appetites: A Psychological View of the Addictions (Wiley, Chichester, 1985).