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Hypothesis for temporal displacement of metabolic and neuronal accommodation in smoking addiction.

Using the overlapping criteria of (1) current smoking status and (2) homeostatic accommodation of smoking, the categories of nonsmoker, beginning smoker, smoker, and quitting smoker are structured into a cyclic representation of smoking addiction. This cyclic representation reveals that elimination of homeostatic accommodation of smoking is a critical success factor to the process of becoming a nonsmoker, while the act of stopping smoking is necessary yet insufficient to the success of that process. Homeostatic accommodation is described as having two components: metabolic and neuronal. A hypothesis for temporal displacement of metabolic and neuronal accommodation is presented to explain the behavior of "chippers" (occasional smokers) and adolescent smokers. Recommendations are made for research on the rates of development and dissipation of metabolic and neuronal accommodation of smoking, and for the development of a bimodal therapy that addresses both metabolic and neuronal accommodation and reduces relapse for quitting smokers.