Tobacco Documents Online

"ADDICTION ARGUMENTS" Argumentation: The "addiction" label, as applied to tobacco, is often not based on scientific criteria. 1) In everyday language, the word "addiction" has been applied to any activity to which people have strong attachment (such as playing tennis or eating sweets) and the removal of which can cause lsymptoms such as sleeplessness, irritation and depression. 2) In 1964, WHO recommended that the ter~ "drug addiction" be replaced by the term "drug dependence". Subsequently, a WHC Expert Committee on Drug Dependence classified tobacco as a "dependence-producing drug" the definition of which is so broad that it can include substances present in tea and coffee. However, tobacco was not given specific attention because it was not cons3idered to be "capable of exerting major psychotic effects". 3) Even the American Psychiatric Association (APA) has qualified its definition of Tobacco Dependence so that dysphoria or illness in connection with the behavior was a necessary criterion: "In practice, this diagnosis will be given only when the individual is seeking professional help to stop smoking, or, in the judgment of the diagnostician, the use of tobacco is seriously affecting the individual's physical health. It should also be noted that a heavy smoker who has never tried to stop smoking, who has never developed Tobacco Withdrawal, and who has not tobacco-related serious disorder, according to the criteria in this manual, does not have the disorder of Tobacco Dependence ••• (1, pp. 176-177)." In other words, the APA says if a smoker is not trying to quit, he cannot be diagnosed as "addicted". Argumentation: Nicotine has frequently been alleged to be the "addictive" substance in tobacco. Despite intensive research, there is no scientific agreement to support this allegation. 1) In his 1981 report on smoking, the US Surgeon General recogniz~s research inadequacy regarding "addiction" and smoking: "A great amount of preliminary data already exists on the role of nicotine in human smoking behavior..., but

the influence of tolerance and dependence on nicotine on the initiation, maintenance, and cessation of smoking behavior are still not resolved." 2) Even the 1983 Royal College of Physicians' Report concedes that the evidence on the use of nicotine-based products in smoking cessation experiments "indicate(ed) again that there is more tF the smoking habit than simply nicotine dependence". Argumentation: It is an oversimplification and inappropriate to describe a person who continues to smoke as "addicted" to cigarettes. 1) An American psychologist states:b "The behavior and responses of cigarette smokers are quite different than those observed in individuals who are addicted to heroin and other substances that are demonstrably addictive. 2) An "It has been reported that many smokers are able to refrain from smoking for relatively long periods of time for practical, safety or religious reasons and to do so without apparent discomfort. Some examples are coal miners who may not smoke at the pitface, Orthodox Jews who give up smoking at sundown on Friday and cease smoking until sundown on Saturday, and so forth. Such behavior does not fit conventional views of addiction. "Whereas the effects of use and withdrawal are consistent and predictable with known addictive substances despite a wide range of uses, descriptions of tobacco effects are extremely varied and inconsistent. In this regard, tobacco use is more like the use of caffeine rather than alcohol or opiates. "It has been reported ... that the continuance of smoking appears more related to a wide range of psychosocial motives such as pleasure, stimulation, sensory motor manipulation, and reduction of negative effect than an addiction factor." American researcher states:7 "Most of us who do research on smoking have at some time championed the hypothesis that cigarette smoking, with nicotine as the active agent, is an addiction. Sometimes, however, it is difficult to figure out why that conviction is so strong. The data supporting the proposition are not particularly good; in fact, looked at with a ruthless eye, they are rather flimsy." - 2 -

Argumentation: If cigarette smoking is "addictive", how does one explain: 1) The finding that some 95% of the 35 million Americans who quit smoking do so w~thout the aid of an organized smoking cessation programmer? 2) The finding of some studies that there are no changes at all in cigaret~e consumption after decreases in nicotine yield of 20 to 30%? 3) The observation that there are "heavy" smokers who will not light up 1~heir first cigarette of the day until the afternoon? 4) The observation that there are smokers who smoke only at parties or while they are working and otherwise not at all, or those who smoke less than 10 cigarettes a day? 5) No one has been hospitalized or died from nicotine "withdrawal" -- a not uncommon outcome in withdrawal from heroin and other illicit drugs. 6) Use of addictive drugs impairs performance in regular life activities such as work and recreation, tobacco use has no corresponding effect.

REFERENCES 1 BLAU, T., Statement, U.S. Congress, House, Committee on Energy• and Commerce, Subcommittee on Health and the Environment, Comprehensive Smoking Prevention Education Act, Hearings, 97th Congress, 2nd. Session, (March 5, 11 and 12, 1982) pp. 486-488 2 WHO Expert Committee on Addiction-Producing Drugs, Thirteenth Report, Technical Report Series No. 273 (Geneva, 1964) pp. 9-10 3 WHO Expert Committee on Drug Dependence, Twentieth Report, Technical Report Series No. 551 (Geneva, 1974) pp. 14-16 4 US SURGEON GENERAL, The Health Consequences of Smoking: The Changing Cigarette, (1981), p. 179 5 ROYAL COLLEGE OF PHYSICIANS, Health or Smoking?, (1983) p. 16 (United Kingdom) 6 BLAU, T., op. cit., p. 487 7 SCHACHTER, S., "Regulatio n, withdrawal, and nicotine addiction", Chapter 10, Kr asnegor, N.A. (ed.) Cigarette Smoking as a Dependence Process, National Institute on Drug Abuse, Research Monograph No. 23 (January, 1979) 8 US SURGEON GENERAL, The Health Consequences of Smoking: Cancer, (1982), p. 257 9 ROYAL COLLEGE OF PHYSICIANS, Health or Smoking?, (1983) p. 14 10 (United Kingdom) SCHACHTER, S., op. cit. ADDICT 4