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Why do you smoke? The Biopsychosocial Explanation

Samstag, 29. September 2012 - 14:20

The Biopsychosocial Model in regard to Smoking

Contemporary psychologists approach research, diagnosis, and treatment of mental disorders from a holistic point of view by using the biopsychosocial model (Clinical Psychology, 2010). Thus, this artice analysis the importance of the biopsychosocial approach and why it is necessary to use such a perspective in regard to the health related behavior of smoking. Next, the health related behavior smoking is dismantled using the biopsychosocial model and an explanation about the consequences of failing to examine the behavior from all those three perspectives of the biopsychosocial model is given (Schindler, 2012).

The Biopsychosocial Model

Humans are like onions. Layer per layer you may find a different perspective or plural explanations about human behaviour along the life span development (Interactive Media, n.d.). Thus, human behaviour is multicausal, multidimensional, and multifactorial. How may something as complex as human behaviour be explained using a reductionist perspective solely? It would not work and would not meet the requirements necessary in order to assess, diagnose, and treat an individual who suffers from a health related behaviour (Engel, 1977). To understand such a complex behaviour like smoking, one needs to disassemble it by using the biopsychosocial model like following:

The Biological Perspective

The biological cause for the addiction of smoking lies within the drug itself. Tobacco is containing about 4000 ingredients. The main substance nicotine is with a very high probability responsible for the extreme addiction that comes with smoking. For a non-smoker the rate of decomposition takes 120 minutes, for a strong smoker it takes only 30 minutes. If the substance is not consumed, then, severe deprivation symptoms like a low frustration level, aggressiveness, anxiety, depressive moods, concentration problems, and insomnia arise that leads the addicted smoker to the next cigarette (Unland, 1995).

The Psychological Perspective

The above-mentioned criteria are only those related to the physiological part of addiction. The smoker himself realizes as a consequence of the nicotine intake a feeling of relaxation and power, an increase of concentration and memory, leverage of pain and hunger, and even some wished-for changes in their social environment like easier contact with people, stress and aggression mastering. Those psychological factors tie in with the physiology of a smoker and will subsequently lead to addiction (Plante, 2005).

Moreover, to explain smoking from the behavioral point of view means to look at the two foundational principals of learning – classical and operant conditioning (Glassman & Hadad, 2005). Nobody is born as a smoker, thus the behavior of smoking is learnt during the course of life. For example, if smoking after dinner produces the feeling of relaxation, then dinner produces a response. The more often those responses are paired the stronger they will be and the behavior is reinforced by the stimulus-response-reaction. The smoker is not consciously realizing when the stimulus is in action (Kowalski & Westen, 2005).

Both forms of conditioning lead to the addiction of smoking, where nicotine is the addictive substance. Next, cognitive processes are also responsible for this stimuli-response-chains that are: expectation of the favorable effect of smoking and extreme anxiety in the case of smoking cessation (Unland, 1995). The rational-emotive therapy founded by Ellis helps to untie the knot of expectancies by the way of the “Socratic dialog” (Plante, 2005).

The Social Perspective

Since human behaviour does not take place in a vacuum, social influences like modeling, peer pressure, and family members who smoke are also part of the whole picture. The social perspective is as much important as the other two approaches are because assessment and treatment may not work if that factor is left behind. According to Bowen, social systems like family and peer groups affect each other’s behaviours, cognitions, and emotions  (2000).


40 to 45% of all death due to cancer is nicotine related (Unland, 1995). As a consequence, the biopsychosocial model that includes demographic factors like gender, culture, and age is the best that contemporary clinical psychology has to offer to help smokers to quit. To use the biopsychosocial model means to satisfy the multicausal, multifactorial, and multidimensional aspect of human health related behaviours like smoking. To neglect one of those biopsychosocial factors would mean to miss the opportunity to most effectively treat an individual who smokes.

Beate Landgraf


Bowen, M. (2000). The Bowen Theory. Retrieved on February 18, 2010, from http://www.thebowencenter.org/pages/theory.html.

Clinical psychology. (2010). In Encyclopædia Britannica. Retrieved January from

Engel, G. L.  (1977). The need for a new medical model: A challenge for biomedicine. Science, 196(4286), 129–136. Retrieved from             http://www.sciencemag.org.ezproxy.liv.ac.uk/content/196/4286.toc.

Glassman, W. E., & Hadad, M. (2009). Approaches to psychology (5th ed.). Maidenhead: Open University Press.

Interactive Media, (n. d.). The Onion Diagram of Biopsychosocial Model. Retrieved from University of Liverpool Week 1 Learning Resources.

Kowalski, R., & Westen, D. (2005). Psychology (4th ed.). Hoboken, NJ: John Wiley & Sons, Inc.

Plante, T. (2005). Contemporary clinical psychology (2nd ed.). Hoboken, NJ: Wiley & Sons, Inc.

Schindler, L. (2012). Week 1 Assignments – The Biopsychosocial Model. Retrieved from University of Liverpool online Master’s Program of Applied Psychology.

Unland, H. (1995). Wir gewöhnen uns das Rauchen ab. Tübingen, Germany: Deutsche Gesellschaft für Verhaltenstherapie e.V.

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Beate Landgraf

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