Nicotine as an Addictive Substance: A Critical Examination of the Basic Concepts and Empirical Evidence

By Atrens, Dale M. | Journal of Drug Issues, Spring 2001 | Go to article overview

Nicotine as an Addictive Substance: A Critical Examination of the Basic Concepts and Empirical Evidence


Atrens, Dale M., Journal of Drug Issues


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 extrascientific grounds.

INTRODUCTION

The addiction model has dominated smoking research for over a generation (Benowitz, 1988; Benowitz, 1996; Henningfield & Heishman, 1995; Peele, 1990a; Rose, 1996; Russell, 1990a; Stolerman & Jarvis, 1995). Tobacco smoke is said to contain numerous agents that cause ill health (Gupta, Murti, & Bhonsle, 1996; Trichopoulos, Li, & Hunter 1996) as well as a powerful addictive drug, nicotine (Altman et al., 1996; Anonymous, 1996; Benowitz, 1996; Busto, Bendayan, & Sellers, 1989; Dewey et al., 1999; Griffiths, 1996; Grunberg, 1994; Henningfield, 1984; Henningfield, Cohen, & Slade, 1991; Rose, 1996; Shytle, Silver, & Sanberg, 1996; Stephenson, 1996; Waldum, Nilsen, Nilsen, Rorvik, Syversen, Sandvik, Haugen, Torp, & Brenna, 1996; Altman et al., 1996). According to the dominant model, as the nicotine addiction develops, the smoker becomes progressively less able to stop (Anonymous, 1995; Foulds & Ghodse, 1995; Frantzen, 1996; Henningfield, 1983). The essence of the nicotine addiction hypothesis is that smokers are unable to stop because nicotine changes the brain in such a way as to perpetuate its use. More broadly, drug addictions are seen as representing brain dysfunctions. It is this hypothesis and related issues that are examined in the present work.

The 1988 Surgeon General's Report on Smoking and Health states the nicotine addiction viewpoint succinctly:

Cigarettes and other forms of tobacco are addicting. Nicotine is the drug in tobacco that causes addiction. The pharmacologic and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. (United States Department of Health and Human Services, 1988, p. 4)

The addiction model continues to generate strong views. This is reflected in titles such as: "The nicotine addiction trap: A 40-year sentence for four cigarettes" (Russell, 1990b, p. 293). Goldstein refers to smoking as "addictive suicide" (Goldstein, 1994, p. …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Nicotine as an Addictive Substance: A Critical Examination of the Basic Concepts and Empirical Evidence
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Full screen

matching results for page

Cited passage

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

"Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited passage

Thanks for trying Questia!

Please continue trying out our research tools, but please note, full functionality is available only to our active members.

Your work will be lost once you leave this Web page.

For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

Already a member? Log in now.