title: Smoking addiction in chronic obstructive pulmonary disease: Integrating neurobiology and phenomenology through a review of the literature.
abstract: The aim of this review is to extend professional understanding of the various mechanisms that make smoking cessation difficult for patients with chronic obstructive pulmonary disease (COPD). Smoking in people with COPD is a major challenge for health care today. In spite of significant advances in knowledge about the processes of nicotine addiction, current interventions to support smoking cessation in patients with COPD are less successful than hoped for. A wealth of literature has confirmed that nicotine addiction is a powerful force and that smoking is not simply an unhealthy lifestyle or destructive behavior. However, research based on this realization is still in its infancy. To increase understanding and to develop ways of enhancing smoking cessation in patients with COPD, we review and synthesize knowledge found in neurobiology and phenomenology. We use neurobiology to explain the neurochemical changes that take place in addiction in order to substantiate phenomenological perspectives of smoking in patients with COPD. We relate the smoking experience to the concept of "affordances"-in this context "smoking affordances"-to analyze how smoking affects action possibilities in individuals with COPD. Combining these perspectives helps to illuminate the manifold and unique issues related to smoking addiction in patients with COPD.
authors.affiliation: Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Reykjavik, Iceland klinke@simnet.is.
authors.forename: Marianne E
authors.initials: ME
authors.lastname: Klinke
authors.affiliation: Faculty of Nursing, School of Health Sciences, University of Iceland, Eirberg, Reykjavik, Iceland.
authors.forename: Helga
authors.initials: H
authors.lastname: Jónsdóttir
mesh_terms: D016739:Behavior, Addictive / Q000378:metabolism / Q000523:psychology*; D001921:Brain / Q000378:metabolism; D006801:Humans; D009446:Neurobiology; D009538:Nicotine / Q000378:metabolism*; D029424:Pulmonary Disease, Chronic Obstructive / Q000523:psychology*; D012907:Smoking / Q000378:metabolism* / Q000523:psychology*; D016540:Smoking Cessation; D014029:Tobacco Use Disorder / Q000378:metabolism / Q000523:psychology*
chemical_list: D009538:Nicotine
keywords: Affordances; COPD; experience; neurology; phenomenology; smoking addiction