Age

  Wider influence of peers on smoking and drug abuse seems to reduce with age.

 Social crowds might have a greater impact in younger adolescence, but in later adolescence the role of best friends or romantic partners become the most important influence in attitudes and behaviours, especially those health related.

  There is also an increased vulnerability to addiction with age.

 Research has found that around 1/3 of alcoholics develop their dependancy after retirement, suggesting that a change in lifestyle can link to the behaviour.

  The increased stresses of age can also lead to addictive behaviours, such as boredom or the death of a loved one.

  Support for age being a vulnerability to addiction comes from SHRAM, who found that nicotine had a greater activating effect on the brains of adolescent rats. They were also more sensitive to the rewarding effects of nicotine, but less to the adverse effects of withdrawal.

These results therefore suggest that the rewarding effects of nicotine are highest in adolescents, demonstrating how this is the primetime for the initiation of addiction.

Peers

  Peer Pressure can significantly affect an individual's behaviour, especially in childhood and adolescence . If the individual has positive attitudes towards addictive behaviour and experimentation, this makes them more vulnerable to dependency.
 Many people with addiction problems blame the initiation and maintenance of their behaviour on peer pressure. Many conform in order to be liked or gain acceptance; when a peer group develop an addictive behaviour, such as smoking, it can become a part of an individual's 'in-group identity'.

  The role of peers can also be explained through operant conditioning. The group reinforces participation and positive attitudes towards addictive habits, such as praise and status.

  In terms of social learning, individuals may observe and imitate their peer's behaviour as a form of vicarious reinforcement.

  Research has found that friend and peer use of drugs is a strong predictor of drug use among teenagers, therefore when peers groups are offering and modelling drugs, it increases the likelihood of the individual to also take drugs. This demonstrates the influences of social groups in determining individual vulnerability.

Stress

 Addiction is associated with relieving anxiety. People may drink, smoke, gamble or do drugs in order to cope with daily hassles, such as relationship problems, workplace stress and financial difficulties. This may contribute to the initiation and continuation of addictive behaviour. 

 Research has found that people who are exposed to severe stress are more vulnerable to addiction, especially adolescents who have experienced parental loss or child abuse. Furthermore, a study also found that 30% of drug addicts and 15% of Alcoholics suffered from Post-Dramatic Stress Disorder, and that experience to more trauma was sufficient to lead to addiction.
 Additionally, Kosten found that baby rats subject to isolation stress on their 2nd to 9th day of life had a greater tendency to self-administer cocaine when adults than rats who didn't suffer isolation stress.
These results have important implications for the role of early childhood stress in the vulnerability to addiction in later life.

Media Influences on Addiction

Films 

  In terms of the Social Learning Theory, we learn new behaviours through observing and imitating through 'vicarious reinforcement'. It is therefore likely that characters on TV might act as powerful role models, who either positively or negatively reinforce addiction.

  In support of this, Sulkunen looked at 61 scenes from nearly 47 films that portrayed nearly every type of addictive behaviour. It was found that most of these films tended to focus on the more positive effect of drugs.
 A psychologist also found, through studying over 80 of the most popular films in the past 20 years, that:
- Weed featured in                            8%
- Nicotine in                                   68% 
- And alcohol consumption in          32%
The portrayal tended to be positive with negative consequences.
 These studies have shown that the more adolescents are exposed to smoking in films, the more likely they are to start.


Media Advertising 

  This can be a method to either promote or discourage addiction. It can be used to promote the sales of tobacco, alcohol, lottery cards or online poker. On the other hand it can be used to promote government health campaigns such as 'Anti-Smoking' or 'Talk to Frank'.

  In support of this Chapman and Fitzgerald studied underage smokers and found a preference to heavily advertised brands. This shows that the advertisement of addictive products does seem to increase people's awareness of them.
 Due to the 'Health of the Nation Strategy' in 1992, The British Psychological Society called for a ban  on advertising all tobacco products, which was passed. Government research has suggested a relationship between advertisement and sales, and in 4 countries that have banned advertising smoking, there has been a significant drop in tobacco consumption.

 An issue underlying media influences on addiction is that much of the research remains inconclusive, therefore more research is needed in order to investigate the effects of media portrayal in addictive behaviour. It also does not take into account individual differences, suggesting we are all influenced by the media in the same way.
 Furthermore, the findings in advertisement and addiction have mainly been focused on correlational research. It is therefore hard to show whether advertisement caused a direct effect on the consumption of addictive products; the effects are often hard to measure due to the influence of extraneous and confounding variables. 

Reducing Addictive Behaviour - Behavioural Interventions

  Aversion Therapy focuses on punishment rather than reward. Early therapies involved electrical shocks for punishment every time an addict wanted to drink, smoke or gamble, however this proved to be unsuccessful.
 Antabuse is now widely used; a drug that makes people sick when taking alcohol. It was hoped that this would cause alcoholics to associate alcohol with the punishing effect of being sick.

  Research has found this to be very effective, however it does not come without it's limitations, for one the therapy requires the alcoholic to take the drug in the first place. It is also reductionist, as it ignores the reasons which lead an individual to developing an addiction to alcohol in the first place. Most importantly, there are several ethical issues underlying the appropriateness of the use of Antabuse. The client has no protection from harm, which they may severely experience both physically and mentally during therapy. Additionally, if Antabuse is administered in a clinical setting, the client has no informed consent or right to withdraw.


  Cue Exposure is based around the cues that trigger addiction. For instance, many smokers drinking alcohol is a cue. The therapy helps addicts to control cravings through coping strategies. 
 Through this, the responses to the cues in the environment that may cause smoking will eventually fade away. Through relapse triggers in the absence of addiction, the addict learns to stay addiction free in these situations.
 This method of therapy is thought to be much more effective than simply avoiding cues.


  Contingency Contracting is relatively similar to cue exposure. It requires the individual to identify the environmental factors that are associated with smoking/drinking. For example, smokers may smoke in a smokers shed at college, and thus this environmental cue can trigger smoking.
 The therapist aims to gradually expose the client with different cues, and helps them to develop coping strategies in order to deal with them.

 Contingency Contracting has been found to be a much more effective method than Cue Avoidance, as although this intervention reduces the physical addiction, it doesn't teach coping strategies to deal with environmental triggers or associations that are around the addict in everyday life.


Overall, all these behaviour interventions share on thing in common; they all target environmental cues that are associated with addiction. On the other hand, they do not target why individuals become addicted to the addiction in the first place, which therefore reduces their long-term effectiveness.
 A further disadvantage with these interventions is that they only focus on smoking and alcohol addiction, therefore causing problems when trying to relate them to gambling (most of the research conducted to support their effectiveness has focused on smoking and drinking).
 Nonetheless, these interventions have proven to be more effective in a multicomponent programme, which often incorporates both biological methods and psychological therapies. 

Reducing Addictive Behaviour - Theory of Planned Behaviour (TBP)

  The theory aims to predict an individual's intentions; whether they are to initiate or end the addictive behaviour, through measuring 3 things:

1. Attitudes Towards The Behaviour - these can either be positive or negative attitudes, as well as beliefs about the outcome.

2. Subjective Norms - The individual's perception of social norms and pressures to perform the behaviour, and whether or not they are able to comply to the pressures.

3. Perceived Behaviour Control - Whether or not the individual can carry out the behaviour when taking internal factors into consideration (skills, abilities and information) as well as external factors (obstacles and opportunities). This perceived control is then weighed up in the light of past behaviour.

(I have a fantastic acrostic for this but I'm not prepared to publicise it)


  Support for this comes from Conner et al, who investigated the role of planned behaviour in smoking initiation in 11-12 year olds by testing 675 adolescents through various measures, including TPB, and 9 months later checking to see if any of them took up smoking. It was found that behavioural intentions were generally a good predictor for later smoking behaviour. 
 Furthermore, research from Guo, who tested 14 thousand Chinese adolescents, also found that TPB to be a useful predictor for later smoking behaviour. 
 Both studies highlight the theory to be very effective, even in non-western cultures.

  Overall, TPB has proven to be a much suited and influential model, which is currently the most popular and widely used social condition model in health psychology. It also takes a variety of variables into account, as it considers past behaviour and addresses social and environmental factors.
 TPB also has substantial empirical support, and has proven very successful with smoking behaviours. However, it does not take into account them emotional disappointment that may occur if the planned behaviour does not work for an individual.

Learning Model of Addiction - Applied to Smoking

 ▲ Initiation   ▲ Maintenance   ▲ Relapse

According to this model, smoking is initiated through classical conditioning.
 An individual may have grown up in a family of smokers and seen how they respond to smoking; the craving and satisfaction. They may therefore be conditioned to respond to a cigarette in the same way, through associating it with pleasure, thus making them more likely to start smoking.
  According to the Social Learning Theory, smoking is initiated through 'vicarious reinforcement'. The person may have observed significant role models and seen how they respond to the pleasures of smoking, which may cause them to imitate the behaviour and therefore start smoking.
  Peer pressure might also influence someone to start smoking.
 Colleagues and friends might encourage a person to smoke, and wont stop until they finally do. Taking up smoking allows and individual to access a social network, which reduces the teasing they may have experienced when refusing a cigarette, therefore making them much happier.
  Bandura also proposed that observing a role model experiencing the pleasures of smoking may be enough for an adolescent to take up the habit.

  This idea has been supported by research from the NIDA, who completed a survey and showed that 90% of American smokers started as adolescents, and  this was mainly due to the observation and imitation of peers. This therefore supports the basic predictions of the social learning theory.
 Further supporting research comes from Winnett et al, who found that role models with higher social status are more likely to influence the observer's behaviour.
 Bryner also found that media images of smoking created a perception of it being attractive and 'ard, again supporting the role of the Social Learning Theory on the initiation of smoking.


  The maintenance of smoking can also be explained in terms of classical conditioning.
 The 'cue reactivity theory' suggests that addicts react to cues which make them want to smoke a cigarette, including lighters, matches, ashtrays and cigarette packets. 
 The pressure that people feel to take up and carry on smoking remains dominant throughout their smoking life; the people they mix with are often themselves smokers, which makes giving up even more difficult.
  In support of this, Ogden found a relationship between peer group identity and tobacco use in the USA, suggesting it is an important factor in the maintenance of smoking.


  The 'cue reactivity theory' is also important in the relapse of smoking behaviour.
 The pressures to return to the addictive behaviour are around smokers everyday. It may be that just seeing someone smoking a cigarette or even hearing the spark of a lighter to be enough to bring back familiar cravings for a cigarette. 

  In support of this, Shiffman gave a questionnaire to ex-smokers who had relapsed. It was reported that smokers were more likely to relapse if they were in the presence of other smokers or if cigarettes were readily available, supporting the basic predictions of the cue reactivity theory in relation to the relapse of smoking addiction.