A positive feedback loop of smoking risk

Recent research has suggested that certain personality traits and experiences predict and help maintain smoking behavior, thus leading to dependence and negative health consequences. A crucial challenge is to understand how people's early engagement in smoking behavior develops into problematic levels of use, despite their knowledge of the harms associated with smoking. In this chapter, we describe evidence indicating that there appears to be a positive feedback loop of increasing smoking and increasing risk for future smoking due to transactional processes involving high-risk personality traits, high-risk psychosocial learning, and early adolescent smoking behavior. A striking aspect of the findings supporting this model is that there is no evidence of a corrective process, whereby early smoking experiences lead to reduced risk. The opposite appears to be the case: early smoking leads to greater personality-based and learning-based risk. Remarkably, this process occurs in a climate in which virtually everyone knows about the health risks of smoking.