Cited by 145Smoking Behavior and CessationBehavioral Health and InterventionsSubstance Abuse Treatment and Outcomes

The DOI matches its Crossref record; 41 of the 41 references it cites were found in a registry or an index; 1 of the 43 sources its claims cite were checked for support.

The Multiple Facets of Cigarette Addiction and What They Mean for Encouraging and Helping Smokers to Stop

Open access
West, Robert·2009·COPD: Journal of Chronic Obstructive Pulmonary Disease

Abstract

Addiction involves powerful motivation to engage in an activity repeatedly to an extent that is harmful often accompanied by impaired capacity for self-control. To effectively combat addiction to cigarettes requires an understanding that there are several mechanisms underlying it. The PRIME Theory of motivation aims to provide a model that can encapsulate these mechanisms. It recognises that evolution has led to multiple levels of motivation from basic impulses and inhibitions, through 'motives' (feelings of want and need), to 'evaluations' (beliefs about what is good or bad), and plans (intentions regarding future actions). Self-control involves self-consciously generating motives from evaluations or plans; it requires and depletes mental energy. Nicotine from cigarettes generates the motivation to smoke and undermines self-control by interacting with all of the level of motivation. It: creates stimulus-impulse associations resulting in cue-driven urges; impairs inhibitory control; gives enjoyment resulting in 'wanting' to smoke; it leads to 'nicotine hunger', withdrawal symptoms and beliefs about benefits of smoking (e.g. stress relief) all of which can result in a 'need' to smoke. Evidence is emerging that wanting to smoke (because of enjoyment) is a major deterrent to making quit attempts but does not influence success, while cue-driven impulses to smoke, nicotine hunger and adverse mood and beliefs about the benefits of smoking are important in relapse. Combating cigarette addiction requires attention to all of these factors.

Overview

AI snapshot

Written from the paper’s full text.

TL;DR

West argues that cigarette addiction arises from multiple motivational mechanisms in PRIME Theory—impulses and inhibitions, motives, evaluations, plans, and self-control—and that cessation requires addressing all of them. It distinguishes wanting to smoke for enjoyment, which deters quit attempts, from cue-driven urges, nicotine hunger, withdrawal, and beliefs about smoking benefits, which drive relapse.

Key findings

  • PRIME Theory proposes multiple levels of motivation: responses, impulses and inhibitions, motives, evaluations, and plans; higher levels must operate through lower ones, and self-control requires and depletes mental energy.
  • Nicotine acts at all levels: it creates stimulus-impulse associations and cue-driven urges, impairs inhibitory control during withdrawal, produces enjoyment and “wanting” to smoke, and causes “nicotine hunger,” withdrawal symptoms, and beliefs about benefits such as stress relief that can generate a “need” to smoke.
  • Evidence is emerging that wanting to smoke because of enjoyment is a major deterrent to making quit attempts but does not influence success, while cue-driven impulses, nicotine hunger, adverse mood, and beliefs about the benefits of smoking are important in relapse.
  • In approximately half of cases where smokers form a rule to stop, there is no pre-planning; using nicotine patches for 2 weeks prior to the quit date appears to improve long-term abstinence rates.

Methods

  • Conceptual/theoretical paper presenting the PRIME Theory of motivation and applying it to cigarette addiction and smoking cessation; no primary empirical study is reported.
  • Draws on cited literature and clinical experience to propose principles for clinical interventions, including a 4-state model of smoking cessation and the SNAP model.
  • No sample, data collection, or statistical analysis is reported.

Limitations

  • The paper states no limitations. Evident: it is a narrative theoretical synthesis, not a systematic review or empirical test, and some cited evidence is described as emerging or anecdotal.
  • Evident: the author reports receiving funds for research and consultancy from companies that develop and manufacture smoking cessation medications, a potential conflict of interest.
  • Evident: “mental energy” is acknowledged as lacking a known physiological basis and can currently be defined only in terms of subjective experience and behavioral correlates.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1080/15412550903049181

Cites

41 of 41 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Verification

Claims the paper makes

35 Not checked yet · 23 Own interpretation · 2 No basis given · 1 Partly supported · accuracy not yet measured

Verify all 42 references — free account

Show all 42 claims

  • It may state two separate claims as one. 12
  • Probably not a substantial claim. 7
19 of 19
  • The authors state this as an assumption.

    The brain recovers its normal functioning during abstinence, leading to decline in cue-driven impulses, nicotine hunger and withdrawal symptoms.

    “presumably as the brain recovers its normal functioning.”
1 of 1

Claims other papers make about this one

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Citations

Cites

Show all 41 references

Research works printed but not linked: 6

  1. RCP, 2000, Nicotine Addiction in Britain
  2. Ferguson S G, 2008, J Subst Abuse Treat
  3. Pisinger C, 2005, Prev Med, 40, 278
  4. Cahill K, 2008, Cochrane Database Syst Rev
  5. Stead L F, 2008, Cochrane Database Syst Rev
  6. Hughes J R, 2007, Cochrane Database Syst Rev

Cited by

Sorted by citations

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Metadata

Authors
West, R.
Affiliations
University College London (GB)
Corresponding author
West, Robert
Venue
COPD: Journal of Chronic Obstructive Pulmonary Disease
Published
2009-01
Volume
6
Issue
4
Pages
277-283
ISSN
  • 1541-2555 (ISSN-L)
  • 1541-2563
OpenAlex
W2158717404
Cited by
145
References
41
Citations by year
2026: 4 · 2025: 2 · 2024: 3 · 2023: 2 · 2022: 10 · 2021: 10 · 2020: 9 · 2019: 13 · 2018: 8 · 2017: 12 · 2016: 5 · 2015: 10 · 2014: 9 · 2013: 16 · 2012: 10
FWCI
1.17
Type
journal article
Language
en
Open access
Locations
  • COPD Journal of Chronic Obstructive Pulmonary Disease (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Smoking Behavior and Cessation
  • Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
tobacco dependence, smoking cessation, nicotine, self-control, inhibitory control, nicotine withdrawal, relapse
MeSH terms
Smoking Prevention, Humans, Motivation, Smoking, Tobacco Use Disorder, Smoking Cessation, Behavior, Addictive

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