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hallucinations, the doses used in cigarettes produce only a very
mild high.
But researchers now know, says Dr. Jack Henningfield, chief of
clinical pharmacology at the Addiction Research Center of the
Government's National Institute on Drug Abuse, that many qualities
are related to a drug's addictiveness, and the level of intoxication
it produces may be one of the least important.
If one merely asks how much pleasure the drugs produce, as
researchers used to do and tobacco companies still do, then heroin
or cocaine and nicotine do not seem to be in the same category. Dr.
Kozlowski said, "It's not that cigarettes are without pleasure, but
the pleasure is not in the same ball park with heroin."
But now, he said, there are more questions to ask. "If the question
is, How hard is it to stop? then nicotine is a very impressive drug,"
he said. "Its urges are very similar to heroin."
Among the properties of a psychoactive drug - how much craving it can
cause, how severe is the withdrawal, how intense a high it brings -
each addicting drug has its own profile.
Heroin has a painful, powerful withdrawal, as does alcohol. But
cocaine has little or no withdrawal. On the other hand, cocaine is
more habit-forming in some respects. It is more reinforcing in the
scientific terminology, meaning that animals and humans will seek to
use it frequently in short periods of time, even over food and water.
Drugs rank differently on the scale of how difficult they are to quit
as well, with nicotine rated by most experts as the most difficult to
quit.
Moreover, it is not merely the drug that determines addiction, says
Dr. John R. Hughes, an addiction expert at the University of Vermont.
It is also the person, and the circumstances in the person's life. A
user may be able to resist dependence at one time and not at another.
A central property of addiction is the user's control over the
substance. With all drugs, including heroin, many are occasional users.
The addictive property of the substance can be measured by how many
users maintain a casual habit and how many are persistent, regular
users.
According to large Government surveys of alcohol users, only about
15 percent are regular, dependent drinkers. Among cocaine users,
about 8 percent become dependent.
For cigarettes, the percentage is reversed. About 90 percent of
smokers are persistent daily users, and 55 percent become dependent
by official American Psychiatric Association criteria, according to
a study by Dr. Naomi Breslau of the Henry Ford Health Sciences Center
in Detroit. Only 10 percent are occasional users.
Surveys also indicate that two-thirds to four-fifths of smokers want
to quit but cannot, even after a number of attempts.
Dr. John Robinson, a psychologist who works for the R.J. Reynolds
Tobacco Company, contests the consensus view of nicotine as addictive.
Using the current standard definition of addiction, he said at a
recent meeting on nicotine addiction, he could not distinguish "crack
smoking from coffee drinking, glue sniffing from jogging, heroin from
carrots and cocaine from colas."
It is not that Dr. Robinson and other scientists supported by tobacco
companies disagree with the main points made by mainstream scientists,
but that they define addiction differently.
Dr. Robinson says intoxication that is psychologically debilitating is
the major defining trait of an addicting substance. It is a feature
that was part of standard definitions of the 1950's, and is still
linked to popular ideas about addiction, but which experts now say is
too simplistic and has been left behind as scientific evidence
accumulates.
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