Depending on nicotine?
The US Food and Drug Administration has led a move
to have nicotine classified as a
drug under the FDA statutory definition and
therefore to have tobacco products
regulated by the FDA- The FDA!s contention is that
smokers smoke primarily for
nicotine and that tobacco manufacturers,
recognising this, manipulate levels of nicotine
in order to keep smokers addicted.
The evidence relating to these issues is complex -
in particular, the allegation that
nicotine is addictive. This has been widely
challenged by some scientists working in the
field. Those working with drug addicts in the USA,
for example, complained that the
US Surgeon General's claim back in 1988 that
smoking was as addictive as heroin and
cocaine trivialised the whole problem of drug
addiction.
It is easy to see why. Tobacco is not
intoxicating, unlike other substances that have
been claimed to be addictive - from heroin and
cocaine through to alcohol. Smoking
doesn't impair judgement, or interfere with
people's ability to think clearly or perform
tasks. Smokers are perfectly capable of continuing
a normal family life and holding
down a job - whereas there is little evidence of
this with regular users of drugs of
dependence.
Nicotine does not induce physical dependence
(usually measured by the presence of a
distinct and consistent pattern of 'withdrawal
symptoms' when attempting to quit) or
tolerance (the need to increase the dose of a
substance continually over time in order
to maintain the initial effect of the substance).
Also, as even the US Surgeon General
has acknowledged, millions of smokers around the
world have given up smoking
without any professional help. In Australia, it is
claimed that there are more ex-
smokers than smokers. Clearly, this contradicts
the implications ofthe FDA and others
that the addictive nature ofnicotine deprives
smokers ofthe choice to quit.
Is this the picture of a drug addict? Are a third
or more of many adult populations
around the world -who smoke tobacco really no
different from heroin addicts? - No
more than the much higher percentage of the
population who drink tea and coffee
(which contain substances like caffeine - similar
to nicotine in many ways) can be said
to be drug addicts.
U-1
Part of the problem centres around the definition
of what constitutes in addictive drug C:)
- in everyday usage, the term 'addiction' is
applied to many activities that people enjoy
ON
BATCo document for Province of BritiSh Columbia 29
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and therefore find difficult to give up. For
example, people claim to be addicted to
certain foods, such as chocolate, or to work -
hence the term 'workaholic' - or even to
shopping. Addiction is commonly applied to any
regular behaviour that people feel is
important or enjoyable to them, and which they are
reluctant for these reasons to stop.
Equally, there are many different scientific
definitions of addiction, but nicotine
typically has not fined well into those
definitions that rely on traditional criteria such
as
those discussed above of intoxication, physical
dependence and tolerance. The US
Surgeon General in his 1988 report redefined
'addiction' to incoporate nicotine,
adopting a set of criteria that were so broad that
virtually any often-repeated
behaviour, as well as a huge number of psychiatric
drugs, could fall, within the
definition.
He adopted two concepts that were quite new to
definitions of addiction as his primary
crite4 relegating the traditionally important
concepts such as tolerance and physical
dependence to the bottom of his list. Those two
new concepts were 'psychoactive
effects' and 'drug-reinforced behaviour.' The
former refers to the ability of a substance
to alter mood (in any direction - either
pleasurable or not) by an effect on the brain.
This can, however, be said of a wide range of
substances in everyday use with an
equally wide range of effects, most of which are
not regarded as being addictive.
Theophylline in tea, theobromine in cocao products
and caffeine in coffee and soft
drinks are all 'psychoactive! and are consumed
every day by millions of people. This
would arguably apply even to a bedtime glass of
milk which alters levels of the
chemicals in the brain that are believed to affect
mood.
The second new criterion, 'drug-reinforced
behaviour', describes a situation in which
the activity of the substance is so rewarding that
animals will work hard to obtain it.
Laboratory animals can be trained to press levers
in specially-designed boxes in order
to obtainn a particular substance. Rats will
indeed press levers hundreds, or even
thousands, of times to obtain a dose of heroin.
Some studies report that rats will also
press levers to obtain nicotine, but only under
certain conditions, where they do not
have to work so hard and with nothing like the
same degree of deterrnination, and
where the delivery of nicotine is predictable.
Equally, rats will press levers in order to obtain
novel food, drink, chocolate and
access to a female rat. These may be rewarding and
pleasurable experiences, but are
they really evidence of addiction? Scientists
agree that reward and addiction are two C:)
different things.
CO
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It can be seen that these two new criteria can be
applied to most enjoyable daily habits,
becoming so broad in scope as to be meaningless.
In short, the attept of anti-smoking groups and
individuals to label cigarette smoking
as addictive behaviour runs contrary not just to
most of the scientific data, but to
common sense. It is ludicrous to put substances
such as caffeine and nicotine, enjoyed
by large numbers of the population, into the same
category as drugs of dependence
such as heroin and cocaine.
It has also to be remembered that tobacco is not
the only substance containing
nicotine. Many common vegetables such as tomatoes,
potato skins and aubergines
contain nicotine. If one Mows the logic of many
activists in the US and elsewhere,
arguing that smoking must be addictive because it
contains nicotine, perhaps it is time
to consider vegetable eaters as drug users -
physically depndent on their ratatouille,
perhaps, in the same way that heroin addicts are
dependent on their heroin?
Un
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BATCo document for Province of BritiSh Columbia 29
October 1999