Perverting the Dictionary

by Martha Perske
29 October 1996

In 1964, the Surgeon General's Report (SGR) clearly stated that smoking was not an addiction.

"In medical and scientific terminology the practice (smoking) should be labeled habituation to distinguish it clearly from addiction, since the biological effects of tobacco, like coffee and other caffeine-containing beverages, betel morsel chewing and the like, are not comparable to those produced by morphine, alcohol, barbiturates, and many other potent addicting drugs."
(1964 Surgeon General's Report: Smoking and Health - Report of the Advisory Committee to the Surgeon General of the Public Health Service. U.S. DHEW 1964 p. 350. emphasis in original)

The 1964 SGR's conclusion was based on the World Health Organization's (WHO) definition, which stated that "Drug addiction is a state of periodic or chronic intoxication produced by the repeated consumption of a drug (natural or synthetic)." (1964 SGR, p. 351)

In other words, "intoxication" was a crucial component in defining addiction. This was further emphasized in 1978:

"In 1978 the WHO reiterated the importance of the concept of intoxication, stating that 'psychotropic' substances considered for control by the international community must be capable of producing both a state of 'dependence' and 'central nervous system stimulation or depression, resulting in hallucinations or disturbances in motor function or thinking or behavior or perception or mood' (WHO, Technical Report Series. No. 618. 1978. p.8)." ¹

All of this changed when the 1988 SGR re-defined addiction and dropped the criterion of intoxication (obviously, smokers do not become "intoxicated"). The "new" criteria for defining addiction (appearing for the first time in the 1988 SGR) are:

1. Highly controlled or compulsive use
2. Psychoactive effects
3. Drug-reinforced behavior

The 1988 SGR says these three primary criteria "are sufficient to define drug dependence." (The 1988 SGR considers the terms "drug addiction" and "drug dependence" to be scientifically equivalent.)

Based on these new criteria (which ignore "intoxication"), the 1988 SGR concludes that (1) cigarettes and other forms of tobacco are addicting. (2) nicotine is the drug in tobacco that causes addiction, and (3) the pharmacologic and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine. (1988 SGR: The Health Consequences of Smoking - Nicotine Addiction - A Report of the Surgeon General 1988, U.S. DHHS, p.9)

As for "psychoactive effects" (now a criterion for addiction), among the things are are psychoactive (in addition to nicotine) are theophylline in tea, theobromine in cocoa products, and the most widely consumed drug in the world, caffeine. ¹

In August (1996) President Clinton approved FDA plans to classify nicotine as an addictive drug "thereby giving the agency authority to regulate cigarettes and smokeless tobacco." (AP Wire, 10-15-96). However, it appears that Clinton and Kessler are relying on a politically expedient "new" set of criteria for defining addiction that cannot distinguish the effects of crack smoking from coffee drinking.

"...common sense tells us that nicotine is not like heroin, cocaine or any other 'classic' addicting drug in its physiological and behavioral effects. One does not have to be a trained behavioral scientist to come to this conclusion. Simply ask and honestly answer the question as to how many people would board a plane piloted by someone who has just consumed an addicting drug (alcohol, heroin, cocaine, barbiturates) versus a plane piloted by someone who had just had a cup of coffee and smoked a cigarette." ¹

Footnote:
[¹] Robinson, John H. and Pritchard, Walter S., The Role of Nicotine in Tobacco Use Pschyopharmacology (1992) 108:397-407