Definitions

Henningfield (1986) compared tobacco dependence to other forms of drug dependence and concluded that there are more similarities than differences. He noted that (1) tobacco dependence, like other forms of drug dependence, is a complex process, involving interactions between drug and nondrug factors; (2) tobacco dependence is an orderly and lawful process governed by the same factors that control other forms of drug self-administration; (3) tobacco use, like other forms of drug use, is sensitive to dose manipulation; (4) development of tolerance (diminished response to repeated doses of a drug or the requirement for increasing the dose to have the same effect) and physiological dependence (termination of nicotine followed by a syndrome of withdrawal phenomena) when nicotine is repeatedly administered is similar to the development of tolerance and dependence of other drugs of abuse; and (5) tobacco, like many other substances of abuse, produces effects often considered a utility or benefit to the user (e.g., relief of anxiety or stress, avoidance of weight gain, alteration in mood).

Although the similarities between tobacco or nicotine dependence and other forms of drug dependence are noteworthy, there are features of tobacco use that make it unique. In contrast to many other drugs of abuse, tobacco products are legal and readily available. When used as intended, tobacco products lead to disease and death. Unlike alcohol, a legal drug that can be consumed socially and in moderation without ill effects, all levels of tobacco use are harmful (U.S. Department of Health and Human Services, 1988).

Large sums of money are spent each year to advertise and market tobacco products, particularly cigarettes. This adds an important dimension to tobacco dependence not present to the same degree with other substances, with the possible exception of alcohol. Few children in our society grow up free of Big Tobacco's reach, which provides unique opportunities for the tobacco companies to teach them about the virtues of tobacco, the manner in which it should be used, and the role it should play in their daily lives. So pervasive is the positive imagery associated with cigarette smoking that it is almost impossible to distinguish between the reinforcing qualities of cigarettes that derive from past conditioning and learning and those that derive solely from nicotine.

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