293 Copyright Goodheart-Willcox Co., Inc. Chapter 9 Tobacco and Vaping feeling the effect of the nicotine, the substance is still entering the body. The more a person uses tobacco, the more damage that person causes. Dependence After repeated use, the body becomes dependent on the way nicotine makes it feel. This means the body adjusts to the feelings that nicotine causes. Dependence occurs when the body needs an addictive substance in its system to function normally or avoid cravings and anxiety. There are two types of dependence—physical and psychological. A physical dependence occurs when the body adjusts to a substance and requires it to function normally. For example, nicotine causes the release of dopamine, which causes feelings of happiness. Eventually, the brain produces less of these chemicals on its own. This means the body requires nicotine or other substances to reach normal levels of these chemicals. Without the substance in the body, a person feels uncomfortable and even sick. People can also develop a psychological dependence. This causes cravings and anxiety that a person feels when not using or trying to quit the substance. Psychological dependence relates to mental and emotional factors. If a person is unable to use a tobacco product, this person may feel irritable. For example, a person who regularly vapes may feel anxious and irritable if a vape pen is not available when a craving occurs. People may develop patterns for using a substance, such as vaping after dinner every day. Patterns such as this can connect a substance with certain triggers (Figure 9.18). Triggers are like reminders that cause people to feel a strong desire for a substance. In this case, the end of the meal becomes the trigger to vape. When people who use tobacco encounter triggers that they connect with tobacco use, they feel a strong psychological need to use a tobacco product. Figure 9.18 People can connect tobacco use mentally with a certain feeling, habit, person, or situation that can increase their desire to smoke, vape, or chew tobacco. Which type of dependence is related to mental and emotional factors such as stress? Triggers That Can Lead to a Desire to Use a Tobacco Product Emotional Experiencing stress, anxiety, excitement, boredom, loneliness, satisfaction Pattern Connecting a nicotine habit with an activity such as talking on the phone or watching TV Social Going to a party or social event and seeing or spending time with people who smoke, vape, or chew tobacco Withdrawal Smelling smoke, handling vaping devices or lighters, feeling like you need to do something with your hands Triggers