Hooked on the Myth of Instantly Addictive Cigarettes
Jacob Sullum | February 13, 2008, 2:02pm
Digging through a pile of medical journals, New York Times health reporter Jane Brody discovers that cigarettes are instantly addictive:
Dire warning to all adolescents: You can get "hooked from the first cigarette."
Brody is quoting an article (available for $10) from the December Journal of Family Practice in which tobacco researcher Joseph R. DiFranza warns that "one cigarette may be all it takes to get hooked." But DiFranza immediately back-pedals:
Hooked from the first cigarette?
You bet.
Very soon after that first cigarette, adolescents can experience a loss of autonomy over tobacco, and recent research indicates that this loss of autonomy may play a key role in nicotine addiction.
Notice how the claim of instant addiction quickly becomes a claim that some time after the first cigarette (possibly after the 10th or 100th?) smokers may begin to experience "loss of autonomy," which ultimately could play a role in addiction. And how is this "loss of autonomy" measured? With a 10-point checklist:
| 1. | Have you ever tried to quit smoking, but couldn't? | | |
| 2. | Do you smoke now because it is really hard to quit? | | |
| 3. | Have you ever felt like you were addicted to tobacco? | | |
| 4. | Do you ever have strong cravings to smoke? | | |
| 5. | Have you ever felt like you really needed a cigarette? | | |
| 6. | Is it hard to keep from smoking in places where you are not supposed to, like school? | | |
When you tried to stop smoking (or, when you haven't used tobacco for a while):
| 7. | Did you find it hard to concentrate because you couldn't smoke? | | |
| 8. | Did you feel more irritable because you couldn't smoke? | | |
| 9. | Did you feel a strong need or urge to smoke? | | |
| 10. | Did you feel nervous, restless, or anxious because you couldn't smoke? |
If you answer yes to one or more of these questions, according to DiFranza, you have experienced "loss of autonomy" and are well on your way to a cigarette habit that will give you lung cancer when you're 65. In a sentence that Brody quotes, DiFranza says "three New Zealand national surveys involving 25,722 adolescent smokers who used this checklist revealed a loss of autonomy in 25% to 30% of young people who had smoked their one and only cigarette during the preceding month." How plausible is it that someone who has smoked exactly one cigarette in his life has tried to quit smoking but couldn't, or feels strong cravings for a cigarette, or gets irritable and has trouble concentrating when he can't smoke? Maybe teenagers who have tried cigarettes sometimes say such things because they believe that's what a smoker would say, and they are experimenting with that identity. Or maybe they are just screwing with the people conducting the survey.
Neither DiFranza nor Brody considers these possibilities. Brody is so eager to believe in the overwhelming power of nicotine that she does not even notice how she contradicts herself. After quoting a tobacco researcher who notes that "the vast majority of teenagers who try one or two cigarettes don't go on to become smokers," Brody blithely asserts that "smoking by youngsters...typically leads to a lifetime of smoking."
This sort of misrepresentation reinforces the myth that nicotine is irresistible and inescapable, which is counterproductive for at least two reasons that DiFranza and Brody should be able to appreciate. Teenagers who experiment with tobacco or observe peers who do so will quickly discover that addiction takes more than a single cigarette. Having seen through the scare tactics aimed at stopping them from taking that first puff, they may be inclined to dismiss better-grounded concerns about, say, the long-term health consequences of a pack-a-day habit or the difficulty of giving up cigarettes once you've come to depend on them as a way of relieving stress. And if they do eventually become regular smokers, exaggerating the enslaving power of nicotine will discourage them from trying to quit and from persisting in the attempt.
I commented on earlier attempts to portray cigarettes as instantly addictive here and here.
James Anderson Merritt | February 13, 2008, 2:36pm | #
I have had one cigarette, smoked during my teen years and causing reactions similar to Cesar's above. I smoked my only cigar -- a Cuban -- a few years ago, and enjoyed it very much. But I wasn't inspired to pick up the habit, and an opportunity to smoke another hasn't come up since then.
My mother, on the other hand, started smoking early and never quit. She died at 64, of complications of emphysema and lung cancer that spread to her brain. One of the last memories I have of her is when she practically begged me for cigarettes that the healthcare facility had denied her.
As far as I know, my Dad never smoked anything, and preached abstinence for tobacco, booze, and illicit drugs. His lifetime of "clean living" and hard work got him to 82 with all of his own teeth, but he died well short of his 100-year goal.
So, in my own life, I have seen:
1) Tobacco can be addictive
2) Tobacco isn't necessarily addictive, and certainly not after just one cigarette or cigar
3) Many other things are addictive, but never overwhelmingly, irresistibly so
4) People who are never addicted to anything still die
Unfortunately, the government has elected to pursue my Dad's position of zero-tolerance abstinence, which has always seemed like counterproductive overkill to me. I believe in "inoculation": facing down and learning to master things that otherwise might control or afflict us. So far, that policy has worked pretty well, but it is a hard road to travel in the land of a authoritarian, therapeutic, nanny state. Can someone point me to the land of the free and the home of the brave? I seem to have lost directions...
AlfromAlberta | February 13, 2008, 6:46pm | #
Abstract:
Journal of Drug Issues 31(2), 325-394, 2001
Nicotine as an Addictive Substance: A Critical Examination of the Basic Concepts and Empirical Evidence
Dale M. Atrens
__________
Dale Atrens received a B.A. from the University of Windsor, an A.M. from Hollins College, and a Ph.D. from Rutgers University. He has held
appointments at universities in North America, Europe, Asia, and Australia. He is currently a Reader in psychobiology at the University of Sydney.
He is the author of several neuroscience textbooks and a number of popular books on diet and lifestyle.
_____________
The present review is a critical analysis of the concepts behind and the empirical data supporting the view that tobacco use represents an addiction to nicotine. It deals with general aspects of the notion of addiction, while concentrating on specific problems associated with incorporating nicotine into current frameworks. The notion of addiction suffers from unprecedented definitional difficulties. The definitions offered by various authorities are very different, even contradictory.
Definitions that reasonably include nicotine are so broad and vague that they allow many trivial things, such as salt, sugar, and watching television, to be considered addictive. Definitions that exclude the trivia also exclude nicotine. The addiction hypothesis, in general, is strongly shaped by views that certain drugs bring about a molecular level subversion of rationality. The main human evidence for this is verbal reports of smokers who say that they can't quit. On the other
hand, the existence of many millions of successful quitters suggests that most people can quit. Some smokers don't quit, but whether they can't is another matter. The addiction hypothesis would be greatly strengthened by the demonstration that any drug of abuse produces special changes in the brain. It has yet to be shown that any drug produces changes in the brain different from those produced by many innocuous substances and events. The effects of nicotine on the brain are similar to those of sugar, salt, exercise, and other harmless substances and events. Apart from numerous conceptual and definitional inadequacies with the addiction concept in general, the notion that nicotine is addictive lacks reasonable empirical support. Nicotine does not have the properties of reference drugs of abuse. There are so many findings that conflict so starkly with the view that nicotine is addictive that it increasingly appears that adhering to the nicotine addiction thesis is only defensible on extra-scientific grounds.
Whole thing here:http://www.forces.org/evidence/download/nicotine_addiction.pdf