We all know smoking is highly physically and psychologically addictive. Now, research into why smokers relapse has shown that as well as nicotine, ex-smokers crave their old social identities.
Around three quarters of attempts to quit fail within four weeks, the researchers based in the U.K. noted. They believe former smokers are vulnerable to relapse because lighting up becomes tied in with who they are, often at a young age. Smoking again recaptures what they perceive as their lost social identity as a “smoker.”
To investigate the potential psychological and social factors of ex-smokers reverting back to their former ways, researchers at the University of East Anglia interviewed 43 people who had quit and relapsed.
The individuals detailed their history of smoking, their attempts at quitting, and why past and recent efforts had failed.
The researchers then focused on 23 participants, who went into further detail about their experiences.
The authors concluded that well as physical addiction, smoking causes emotional, behavioral and social dependencies, too. The study was published in the Journal of Substance Use.
Dr. Caitlin Notley, study author and senior lecturer in mental health and fellow of the U.K. Society for the Study of Addiction, explained the study indicates relapse is associated with a range of emotional triggers.
Notley acknowledged the study was a small-scale qualitative study, and the new theory requires further testing. However, she told Newsweek the findings are still significant as they offer new insight into a behavior that is not rational in terms of an individual’s health.
“Understanding the process of relapse may help to inform evidence-based relapse prevention interventions to support people to stay smoke-free long term,” said Notley. “At present in the U.K. there are no recommended approaches to relapse prevention support due to a lack of underpinning evidence. This study is the first step in providing the necessary evidence.”
“People want to feel part of a social group, and recover a sense of who they are—with smoking having been part of their identity, for most, since their teenage years,” she explained in a statement. Identifying a smoker offers membership to what feels like an exclusive group, she said.
“When people attempt to quit smoking, what they are really doing is attempting to bury part of their old identity and reconfigure a new one,” said Notley. “That can be hard. Particularly when it’s something that has been ‘part of them’ for most of their adult life.”
For some, quitting smoking can also mean letting go of old friends, she added. In addition, people who relied on smoking as a form of stress relief saw slipping back as inevitable.
“They [the participants] also talked about a sense of relief at regaining their identity as a smoker—so there are a lot of emotional reactions related to relapse such as pleasure, but also guilt and shame,” she said.
Notley told Newsweek creating a new identity can be an important tool for successfully quitting smoking. “For example, ex-smokers may take up new sports of hobbies that give them a sense of belonging to a group that does not involve harmful health behaviors.
“Vaping may be a suitable alternative, and offers a social identity, to ex-smokers who find it difficult to give up nicotine completely.”
According to the latest figures cited by the Centers for Disease Control and Prevention (CDC), 36.5 million adults in the U.S. smoked in 2015. But many of those want to quit, the agency said.
Almost one in five deaths in the U.S. are caused by cigarette smoking, amounting to over 480,000 casualties a year.
Smokers are more likely to develop heart disease, lung cancer and experience strokes. Even those who smoke fewer than five cigarettes a day can show signs of cardiovascular disease, the CDC warned.