Types of Addiction

What is Addiction?

The Addictive Behaviors Core of Women's Health Research at Yale studies several types of addictive behaviors that are relevant to women. These include smoking (and nicotine dependence), overeating, gambling, drinking and other substance use.  Addictive disorders share a number of key features, such as continued behavior despite adverse consequences, diminished behavioral control, compulsive engagement in the addictive behavior, and cravings or urges associated with engagement in the behavior.

Smoking

  • Tobacco use is the leading preventable cause of death in the United States, responsible for about 1 of every 5 deaths. Illnesses from cigarette smoking kill an estimated 178,000 women in the United States each year.
  • Although there are fewer adult women who smoke than men, the gender gap is decreasing as the number of male smokers declines at a rate faster than the number of female smokers.
  • Women may be more adversely affected by smoking then men. Women may be at higher risk for developing smoking-related cancer, heart disease, and lung disease than their male counterparts.
  • Women may be more responsive than men to non-nicotine stimuli associated with smoking, such as social and behavioral cues.
  • Women may be less successful than men in quitting smoking, although they join smoking cessation groups more often than men.
  • Women who quit smoking may relapse to smoking for different reasons than men. Stress, weight control, and negative emotions are reasons cited by women for relapse.

What is Nicotine Dependence?

A physical or psychological reliance on tobacco products, including cigarettes, cigars, pipes, chewing tobacco, and smokeless tobacco. These all contain nicotine, the drug which is considered responsible for addiction to these products. Nicotine-containing products can produce physical and mood-altering effects in one’s brain which are perceived as pleasurable and may lead to dependence. Attempting to quit or cut back use of nicotine-containing products can lead to withdrawal symptoms, which are often different for women and men. 

Resources

Alcohol

  • An estimated 5.3 million women in the United States drink in a way that threatens their health, safety, and general well-being.
  • Alcohol appears to have different physiological effects on women and men. Females generally experience higher levels of intoxication with the same amounts of alcohol, and have variations in response to alcohol during the course of their menstrual cycle.
  • Women appear more susceptible to alcohol-related illness than men and can develop alcohol-related illnesses from exposure to lower levels of alcohol and from shorter periods of heavy drinking than men.
  • Females with problematic alcohol use may report significantly greater depression, anxiety, neuroticism, and health-related stressful events compared to their male counterparts.
  • Women who drink excessively appear more likely to be a target of violence and sexual assault. On college campuses, assaults, unwanted sexual advances, and unplanned and unsafe sex appear more likely among females who drink 4 or more drinks in a row.
  • Women who drink alcohol may also pose a serious risk for their children. Drinking during pregnancy can cause fetal alcohol syndrome, which is characterized by growth and mental impairment. Drinking while taking care of children can also expose children to injuries and/or neglect.

What is Alcohol Abuse and Alcohol Dependence?

A pattern of alcohol use that is unhealthy or dangerous.  Excessive use of alcohol can also lead to alcohol dependence, often referred to as alcoholism. Alcohol dependence can make it difficult to quit drinking or control how much drinking is involved. Physical problems such as tolerance (needing to drink more to obtain the same effect), withdrawal, and alcohol-related health complications (e.g. cirrhosis) may develop. A person with alcohol dependence may spend a significant amount of time in activities necessary to obtain alcohol, drinking alcohol, or recovering from its effects. Some behaviors associated with alcohol abuse include:

  • drinking too much, 
  • drinking when it is dangerous to do so (e.g. while driving or taking care of children),
  • missing work, school or other obligations due to drinking or being hung over, 
  • getting in trouble with the law,
  • recurrent social or interpersonal problems (e.g. arguments about alcohol use, physical fights while intoxicated), 
  • and continued alcohol consumption despite the problems it has caused or made worse. 

Resources

Click here for publications by the National Institute on Alcohol Abuse and Alcoholism.

Gambling

Pathological gambling is more predominant in men than in women. However, females show a disproportionately increasing rate of gambling, which may eventually decrease the gender gap. A number of studies have shown gender differences in gambling, including both behavioral and biological differences. These include:

  • Male gamblers are more likely than female gamblers to report a longer duration of gambling. However, women develop problems with gambling more rapidly than men once they begin gambling. This phenomenon is described as "telescoping" and is also associated with alcohol and drug use problems.
  • Women and men differ in the types of gambling they engage in and the location of their gambling. For example, women are more likely to report problems with nonstrategic gambling, such as casino slot machine gambling, while men report more problems with non-casino gambling, such as sports betting.
  • High rates of depression and anxiety perceived to be caused by gambling are found for both genders. However, female gamblers are more likely than male gamblers to report anxiety and suicide attempts attributed to gambling.
  • At-risk gambling in women may be associated with more severe psychiatric symptoms than in men.
  • There appears to be a stronger association between nicotine dependence and gambling symptomatology in women compared to men.
  • Gender differences in motivation to gamble are also apparent. Women more often report gambling as a means of escape from problems in their lives, while men who gamble may do so more often for the thrill or for ego enhancement.


What is Pathological Gambling?

A pattern of excessive and/or destructive gambling behavior. It is classified as an impulse control disorder. Pathological gambling has been shown to share features with substance use disorders. Similarities may include its features (e.g., urges/cravings, high rates in adolescence and young adults, and a “telescoping” phenomenon in women in which the time course between initial engagement and develop of a problem is foreshortened in women as compared to men), co-occurrence with substance abuse/dependence, tolerance, withdrawal, similar responses to behavioral and pharmacological treatments, and shared biological features such as genetics and neurobiology with other addictive behaviors. This has led some researchers to describe pathological gambling as a non-substance addiction.