Winsten, J.A. "Research status report: Nicotine dependency and compulsive tobacco use." Boston: Center for Health Communication, Harvard School of Public Education.

OVERVIEW

The U.S. Public Health Service and Surgeon General blame 350,000 premature deaths in U.S. each year on tobacco use. Although 45,000 studies point to the hazards of smoking and smokeless tobacco, tobacco companies still deny the link between smoking and cancer, heart disease, and other health problems.

The tobacco industry has been fighting off suits claiming damage to health for 30 years. Rose Cipollone smoked since the age of sixteen and sued three tobacco companies before she died of lung cancer in 1984. She claimed that the warnings on cigarette packets are not adequate for a product so defective and dangerous. Advertisements linking smoking with youth, health, and glamour, her lawyers claimed, powerfully contradict the package warning.

Judges have historically dismissed such cases. Recently, courts are showing more readiness to hold manufacturers liable, as with makers of asbestos and contraceptive pills.

The study notes the controversy over tobacco lawsuits:

An important issue in pending tobacco product liability suits is whether tobacco users are exercising free choice and should, therefore, be held personally responsible for continuing to use the substance—or whether they have succumbed to an addiction that was not disclosed by the manufacturer. Public ignorance or confusion regarding the ‘addiction’ issue also impinges on decisions by young people to begin using tobacco. To help clarify this issue, the Center for Health Communication has prepared [this Report].

DESIGN

The research is a compilation of many studies:

The Report is based on a 6-month examination of the research literature, and has been reviewed by leading experts in the field.

FINDINGS

• Nicotine, inhaled in smoking or ingested as snuff or chewing tobacco, is addictive.
• This addiction resembles the pattern of opium-based drugs such as heroin.
• There are several similarities between tobacco and opium (heroin) use:
  • Both create physiological dependence.
  • Cessation of both causes withdrawal symptoms.
  • The use of both substances leads to tolerance and increased need.
  • Relapse rates among those who quit are the same for both drugs—70% in the first 3 months, 75% by the end of first year.
  • Both drugs are psychoactive, producing mood changes.
  • Both substances serve as reinforcers. For example, nicotine’s effect on the central nervous system, the touch and feel of a cigarette, and the smell of smoke all reinforce drug-seeking behavior.

CONCLUSIONS

Department of Health and Human Services (Youth Use of Smokeless Tobacco, 1986) encapsulates the findings:

In sum, nicotine has a profile of behavioral and physiologic effects typical of other drugs of abuse and, like the heroin derived from opium, meets rigorous experimental criteria as a drug with considerable potential to cause dependence...Surveys indicate that 90% of smokers would like to quit, but only a small minority succeed because of the difficulty of overcoming dependence on nicotine.

Likewise, 70% of junior and senior high school users of smokeless tobacco say that they have tried to quit, often many times, yet most fail and cite ‘addiction’ or ‘craving’ as the main reason why they cannot kick the habit.

CRITIQUE AND EVALUATION

Scott Staph of the Tobacco Institute describes the comparison of nicotine use to heroin as "ludicrous...The American Cancer Society says 35 million have quit smoking over the last 20 years...The surgeon general says 95 percent quit smoking on their own." Still, Winsten’s report found that 75% of those who quit nicotine and heroin resume use.

IMPLICATIONS

• Suits against tobacco companies may significantly battle nicotine addiction. Reports such as this may help change the legal perspective in such claims.
• Very few young people or adults know the facts contained in this Report. Such evidence will help many young people make life-improving decisions.
• Self-image, peer influence, and lifestyle are important factors in choosing to be free from, or enslaved to, a chemical substance.
• Adult friends and youth groups can affect the important decisions of young people.