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Empirical, logical and philosophical arguments against cigarette smoking as a pharmacologically compelled act

Russell, C. and Davies, J.B. (2009) Empirical, logical and philosophical arguments against cigarette smoking as a pharmacologically compelled act. Current Psychology, 28 (3). pp. 147-168. ISSN 1046-1310

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The fundamental hypothesis of the disease model of nicotine addiction states that, following a regime of chronic smoking, further smoking becomes a pharmacologically compelled rather than a chosen act. Despite it's public and professional popularity as an explanation for why people continue to smoke in spite of a deteriorating quality of life, the validity of this hypothesis has been critically undermined by the state of evidence in four domains: inconclusive empirical evidence of withdrawal severity as a potent predictor of quit outcome; methodological problems concerning the measurement of factors which maintain smoking; logical problems with the interpretation of factors which maintain smoking, in particular, failures to discriminate reflexive and mediated actions in explanations of why people smoke; and philosophical problems with conceptualisations of human action as determined rather than willed. In light of these problems, it is argued that evidence on the nature of nicotine addiction is not well explained by the disease model, but rather, posits smoking primarily as a decision-making process influenced peripherally by the pharmacologic effects of nicotine on the brain and body.