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Anyone who has ever tried to give up smoking cigarettes knows the meaning of being hooked. Even those who succeed in quitting for the first time suffer the same 75% relapse rate as recovering alcoholics and heroin addicts. Last week the U.S. Surgeon General made official what everyone has recognized for a long time: tobacco, like cocaine or heroin, is addictive. In a no-holds-barred, 618-page report, the forthright C. Everett Koop not only proclaimed that "cigarettes and other forms of tobacco are addicting" but also urged that they should be treated with the same caution as illegal...
...common sense and contradict the fact that people quit smoking every day," said Brennan Moran, a spokeswoman for the Tobacco Institute. "The Surgeon General has mistaken the enemy," declared Democratic Senator Terry Sanford of North Carolina. "In comparing tobacco -- a legitimate and legal substance -- to insidious narcotics such as heroin and cocaine, he has directed 'friendly fire' at American farmers and businessmen...
Koop's retort was devastating. "I haven't mistaken the enemy," he countered. "My enemy kills 350,000 people a year." In the U.S. in 1986, smoking-related lung ailments accounted for 108,000 deaths; heart disease, 200,000 more. By comparison, Koop continued, cocaine and opiates such as heroin dispatch about 6,000 people a year and alcohol about 125,000. Said he: "I think we're way ahead on deaths." As for nicotine's addictive qualities, the Surgeon General cited several national surveys that reveal 75% to 85% of the nation's 51 million smokers would like...
...panic of a heavy smoker bereft of cigarettes speaks alarmingly of a physiological force at work that is more powerful than mere desire. Not long after taking up the habit, smokers become tolerant of nicotine's effects; as with heroin and cocaine, dependence quickly follows. Tobacco only seems safer because it is not immediately dangerous. Nicotine is not likely, for example, to fatally overstimulate a healthy heart, cause disorienting hallucinations or pack anywhere near the same euphoric punch as many other drugs. "People die with crack immediately," explains Alexander Glassman, a psychopharmacologist at the New York State Psychiatric Institute...
Despite all this, smoking can be conquered. Although ex-heroin users have reported that tobacco's grip was harder to break than their illicit drug habit, 43 million Americans have managed to quit smoking, mostly succeeding on their own. Increasingly, though, the one-third of all Americans who still smoke are seeking help in antismoking programs, which generally stress that the tobacco habit is a treatable addiction. The best stop-smoking programs, says Thomas Kottke, a senior consultant at the Mayo Clinic in Rochester, Minn., combine several approaches with plenty of long-term support for the struggling nonsmoker...