Hey @bluewaterlily! Thanks for following the thread, and thanks for the question Sorry for the delay in getting back to you, I started, then I was on many planes for many hours, and I forgot to finish.
Ah. Smoking.
First of all to answer your easiest question - yes, 10 cigarettes is about half a pack xD
Then onto the stickier stuff.
The thing about addiction comes down to this: are you addicted? Do you fulfil the criteria for addiction - or dependence, as we more politely call it? So if some of these apply to him, then he's addicted. And a month seems a reasonable amount of time to me for these to develop.
There are criteria, and these can be applied to any substance- alcohol, cigarettes, heroin, whatever. I'm going to go through them not just for the sake of it but also because they can actually inform us a lot about addiction even if we've never experienced it. I'm nursing quite a considerable caffeine addiction - I know because I tick a number of these boxes xD.
1. Craving - you want it, you need it, you crave it.
2. Withdrawal - you experience withdrawal without it. This depends on the substance - for caffeine it's dreadful headaches, for alcohol it's tremors, agitation, hallucinations, seizures. For nicotine, it's agitation and restlessness, insomnia, sometimes a tremor.
3. Loss of control - you don't feel in control of the habit. There's a drink or cigarette in your hand before you've really noticed.
4. Tolerance - you need more and more of it to achieve the same effect. When one cigarette might have done him before bed, now he needs ten a day.
5. Continued use despite harm- this can be harm to a relationship, your finances, your health. Maybe he feels short of breath going up the stairs and knows it's because of the cigarettes. Maybe he knows he's spending too much money on them.
6. Primacy - this one is hard to explain but basically: it takes precedence over everything else. It's the most important thing. If you have a tenner in your pocket and you can buy lunch or a pack of cigarettes, you buy the cigarettes.
7. Inability to stop- fairly self explanatory.
So if he ticks enough of those boxes then he's addicted. And the thing is that you can still feel those things even when you're not using the substance. You can still think, Boy, I need a cigarette. You can still exhibit some of those symptoms (even if you have, in fact, stopped). So I guess that that also answers your question about psychological withdrawal!
With regards to physical withdrawal - as I said, agitation, restlessness, headaches, tremors. We would offer short term nicotine replacement therapy, usually in the form of patches but it depends. In theory, patches are supposed to be a short term solution. It depends on local guidelines but for someone who smokes ten cigarettes a day he would probably be on a low-dose patch for maybe two to four weeks. Buuuuut many people are reluctant to give up the patches after four weeks and mightn't feel ready to, so may well still be using them to help fight the cravings. And otherwise, you would just treat his symptoms, maybe a paracetamol for the headache, and some people might give him a sleeping tablet if he's got insomnia.
Psychological withdrawal... I've never really dealt with smoking in this way, but I know that there are smoking cessation counsellors and hotlines and stuff where there are people to talk you through it and try to keep you on the straight and narrow.
Hope that was helpful, sorry if I'm a bit disjointed!
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