View Single Post
Old August 20th, 2007, 12:34 AM
Hajo Flettner
Status: Offline
Hookah Legend
Join Date: May 2007
Posts: 4,746
Default Nicotine as an addictive substance

Those of you with access to a well stocked library really should check this reference out as it utter destroys the whole notion of nicotine as being like a narcotic. I've put some highlights I found on my hard drive and the citation below.
__________________________________________________ _________________

Nicotine as an addictive substance: A critical examination of the basic concepts and empirical evidence

Journal of Drug Issues
Publication date: 2001-04-01

Alarmist views of cannabis are now considered quaint, whereas tobacco use is currently portrayed as a deadly addiction.
The fact that no momentous new evidence or theoretical developments have appeared suggests that political and legal considerations have taken precedence over scientific considerations considerations (Davies, 1997; Epstein, 1990; Kutchins & Kirk, 1997; Pandina & Huber, 1990; Peele, 1991; Sullum, 1998).
As long as smoking is portrayed as an inexorable addictive process, the success of cessation programs will be limited by a self-fulfilling prophecy (Coleman, 1976; Drew, 1986; Fingarette, 1979; Fingarette, 1981; Fingarette, 1990; Jensen & Coambs, 1994; Schwartz, 1992).
Addiction is used to describe behaviors ranging from injecting heroin and cocaine, to smoking or chewing tobacco, drinking coffee, eating chocolate, shopping, watching television soap operas (Jaffe, 1992), and falling in love (Griffin- Shelley, 1993). There are reports of addiction to water (Kaplan, 1998), cardiac defibrillators (Fricchione, Olson, & Vlay, 1989), carrots (Cerny & Cerny, 1992; Kaplan 1996), hormone replacement therapy (Bewley & Bewley, 1992), and numerous other unusual entities (Glatt & Cook, 1987; Griffin-Shelley, 1993; Hodge, 1992; Robinson, 1997; Solursh, 1989). The clinical literature is replete with examples of people who develop unfortunate, even destructive, relationships with a great many substances, objects, events, and people ( American Psychiatric Association, 1994).
It has yet to be demonstrated that nicotine can exert more control over behavior than that exerted by any of scores of innocuous substances and events. Moreover, smoking is almost always done along with something else. The fact that smoking enhances a broad range of abilities (Pritchard & Robinson, 1994) suggests that the user's behavior is not controlled by the substance.
Certain religions prohibit smoking on the Sabbath, and even the heaviest smokers report no difficulty in observing this rule (Shiffman, 1991). It is difficult to imagine a molecular dysfunction of the brain that respects the Sabbath.
Under certain circumstances, nearly every substance taken by man is psychoactive. Merely being detectable could mean psychoactive (Goudie, 1991). This is another part of the definition that is so over-inclusive as to be meaningless.
In the 1964 report on smoking and health, the Surgeon General stated unequivocally that nicotine was not addictive (Ruxton & Kirk, 1997). In 1988 he reversed this view (US Department of Health and Human Services, 1988). There were no scientific or clinical breakthroughs in this interval, but there was a great deal of legal and political activity (Jones, 1992; Peele, 1992; Seltzer, 1997; Taylor, 1984; Vallin, 1984; Warburton, 1994b).
The fact that the combined efforts of thousands of scientists and legislators for fifty-odd years have not produced a single rigorous definition suggests that they may be trying to define an undefinable.
Nicotine meets some of the criteria for being psychoactive, although even here there is a good deal of definitional uncertainty.
However, being psychoactive is a necessary, but not sufficient, condition for abuse potential. A large number of psychoactive substances have no abuse potential.
Nicotine does not produce anything like intoxication. Indeed, nicotine facilitates many cognitive and motor functions (Damon et al., 1997; Levin, Briggs, Christopher, & Rose, 1992; Rusted, Graupner, & Warburton, 1995; Rusted & Warburton, 1995; Warburton 1994c, 1994d; Warburton & Arnall, 1994). According to the National Institute of Drug Abuse criteria, nicotine is not psychoactive. ... Thus nicotine self- administration is a poor model of even the alkaloid aspects of smoking.

... Thus, the primate dose is 15150 times higher than humans typically self-administer while smoking.
The most common nicotine dose used in rodent self-administration studies is 30 (mu)g/kg (Chiamulera, Borgo, Falchetto, Valerio, & Tessari, 1996; Corrigall & Coen, 1991 a), which is over 40 times higher than typical human self-dosage. Studies in which nicotine is given as a pre-treatment use even higher doses. In one such study, rats were given 400 (mu)g/kg, which is over 500 times higher than humans selfadminister in a single puff and more than twice as much as even very heavy smokers self-administer nasally over the course of an entire day (Tonnesen, Mikkelsen, Norregaard, & Jorgensen, 1996).
If laboratory species will voluntarily take a drug, it is assumed that humans will too.
...However, in marked contrast to humans, smoking in infrahuman primates can only be established by coercive procedures (Ando, Hironaka, & Yanagita, 1986). Moreover, once established, smoking in primates does not produce any evidence of a habit; they stop at the first opportunity (Swedberg, Henningfield, & Goldberg, 1990; Wood, 1990).
...Smoking does not appear to be reinforcing for laboratory primates.
For example, Singer and Wallace (1984) show maximum nicotine self-administration rates that are scarcely greater than those supported by saline. This is far from being compulsive drug use. Animals will quickly learn to press a lever thousands of times per hour to get cocaine (Iwamoto & Martin, 1988; Ward et al., 1996). With nicotine, the highest self- administration rates ever reported in rats are around 25 per hour (Corrigall & Coen, 1989). ... . Woolverton (1992) has shown that monkeys respond at rates greater than 20 per hour for saline.
There are two notable exceptions to the normally sluggish performance seen in nicotine self-administration experiments. Monkeys pressed a lever for a brief visual stimulus occasionally accompanied by an intravenous injection of nicotine (Goldberg, Spealman, & Goldberg, 1981). This second-order schedule produced lever-press rates much higher than anyone has ever reported for nicotine. However, there are a number of points that temper the usefulness of these data. First, three of the four monkeys had been previously trained on a similar schedule for cocaine. Additionally, in the absence of the signal, the monkeys performed as vigorously when the drug was no longer available. This suggests an extremely strange phenomenon. The peculiarity of these findings is further indicated by the fact that they have never been replicated. A single, well- controlled and replicable instance of vigorous nicotine self- administration would greatly strengthen the reinforcement thesis, yet no such instance exists.
Monkeys are capable of extraordinarily vigorous operant behavior. However, this vigor can also lead to interpretational difficulties. Monkeys may respond at extremely high rates for almost anything. They may make hundreds of thousands of responses to self-administer painful electric shocks (McKearney, 1968). This paradoxical behavior illustrates the problems in interpreting operant behavior. To infer reinforcement processes, let alone hedonic experience or addiction, from operant behavior requires numerous and tenuous assumptions.
Animals self-administer aspirin (Hoffmeister & Wuttke, 1973) and caffeine (Atkinson & Enslen, 1976; Deneau, Yangita, & Seevers, 1969; Sekita et al., 1992) As with nicotine, aspirin and caffeine self- administration is not very vigorous and sometimes it may not occur a\t all (Heishman & Henningfield, 1992). Since adverse effects on health have been associated with both aspirin and caffeine (Bednar & Gross, 1999; Kiyohara et al., 1999) as with nicotine, their use could be seen as meeting the principle criteria for addiction.
"Studies do not provide unequivocal evidence for nicotine producing reward either via euphoric actions or through reduction of pain, anxiety, or negative affect" (p. 20).

Humans reported that intravenous injections of nicotine felt similar to cocaine. The face appeal of these findings is reduced by methodological problems. First, all of the subjects were hospitalized with unspecified histories of substance abuse. Additionally, some of the subjects who reported that nicotine was like cocaine had never experienced cocaine (Clark, 1990). Additionally, some subjects thought nicotine was like cannabis, morphine, or Valium(R). Such gross errors suggest that the subjects were fairly confused. Some subjects reported a "rush" from the nicotine injection. Considering that they were given the nicotine content of three cigarettes in one bolus, such an effect is not surprising. High doses of nicotine often produce dizziness (Perkins et al., 1994) .
Another study in a similar group of patients reported that intravenous caffeine produced subjective effects similar to those of cocaine (Rush, Sullivan, & Griffiths, 1995). These subjects identified caffeine as cocaine more often than they identified cocaine as cocaine! The subjective reports of intravenous drug users are influenced by many processes with little relevance to human drug taking (Iwamoto & Martin, 1988).
The fact that humans engage in many behaviors in spite of numerous warnings of the attendant harms is not evidence of addictive processes. It is testimony to human frailty and the ineffectiveness of fear in controlling behavior.
Addiction is commonly portrayed as a brain disease (Anonymous, 1997; Batter, 1996; Brautbar, 1995; Dani & Heinemann, 1996; Leshner, 1996; Nash, 1997; Nutt, 1996; Rose, 1996) In spite of such claims, there is no brain pathology or even special brain state uniquely associated with the use of any drug in any species. Drugs of abuse change brain function (Di Chiara, 1995; Joseph, Young, & Gray, 1996; Peele, 1990c). However, similar changes are also produced by relatively innocuous substances and everyday events (Hernandez & Hoebel, 1988a, 1988b; Pfaus, Damsma, Wenkstern, & Fibiger, 1995; Wilson, Nomikos, Collu, & Fibiger, 1995; Yoshida, Yokoo, Mizoguchi, Kawahara, Tsuda, Nishikawa, & Tanaka, 1992; Young, Joseph, & Gray, 1992). Such changes cannot reasonably be said to represent the neural substrate of addiction.
__________________________________________________ ______________

Smoking: addiction or habit?

USING the modern sense of the word 'addiction', it is now widely accepted (even by some tobacco companies) that nicotine is 'addictive'. Unfortunately the word is now used so often - in relation, for example, to sex or chocolate or even television - that it is largely meaningless.

The late Professor Hans Eysenck, one of world's leading psychologists, argued that 'Smoking is not an addiction because the term 'addiction' really has no scientific meaning ... You can call anything addictive which a person does routinely and which he would be sorry to stop doing and which might have all sorts of repercussions on his mental and physical life.'

Using the more traditional definition ('a habit that has become impossible to break', Chambers Dictionary, 1992) it is even easier to argue that smoking is not addictive.

Professor John Davis (University of Strathclyde) put things in perspective when he said, 'What I don't agree with is the idea that people who use nicotine become ... helpless addicts who have no say in the choice of this activity - that the nicotine compels them to smoke. The evidence is simply not there. People give up smoking all the time ...'

Smoking and common sense

Dr Tage Voss, author of Smoking and Common Sense (1992), agrees. According to Voss, tobacco consumption is a habit not an addiction because it doesn't conform to the criteria of addiction that consumers exhibit 'social collapse, mental dissolution and require an escalation of dosage'. In other words - and unlike alcohol or drugs such as heroin or cocaine - nicotine does not dramatically change people's behaviour patterns.

Unlike those who are addicted to heroin, for example, there is no evidence that consumers of tobacco are so desperate for their next 'fix' that they have ever mugged anyone for the money to pay for it. Likewise, on an average Friday or Saturday night, it is alcohol not nicotine that is responsible for hospital casualty departments being rather busier than usual.

Interestingly, in 1996 Dr Sandy Macara, the then chairman of the British Medical Association and a former smoker, wrote (Western Daily Press), 'I don't accept that smokers are truly addicted to tobacco. I think they have a habit ... I believe the majority of smokers could stop tomorrow - no, today - if they really wanted to.'

Language of addiction

Dr Macara was possibly influenced by his own experience of giving up and by a BMA handbook, 'Help Your Patient Stop', which stated that 'A balance needs to be struck, acknowledging the potential difficulties of stopping as well as the ease with which many smokers manage to stop.' That was published in 1988 when 2,000 people a day were said to be giving up.

For once the evidence is in the statistics. In the 1950s 80% of all men smoked. Since then the figure has dropped to just 28% of men and 26% of women. In total eleven million people have given up smoking in Britain alone, hardly the sign of a nation addicted to nicotine.

For most people smoking is simply a habit, a difficult one for some people to break should they choose to, but a habit nonetheless. In fact, describing it as an addiction is often counter-productive because it gives people the perfect excuse not to give up. After all, they reason, it's not their fault they smoke. They're addicted and there's nothing they can do about it.

The language of addiction is hopelessly self-defeating. A couple of years ago health campaigners spoke of a cigarette being the equivalent of a 'dirty syringe used by heroin addicts'. Ordinary smokers switched off in droves when they heard this because few (if any) tobacco smokers would ever dream of comparing themselves to a heroin addict. FOREST spokesmen pointed this out at every opportunity and the comparison appears, for the moment, to have been dropped.

Why the addiction argument is so popular

There's a great deal of hypocrisy surrounding the addiction argument. After all, if smoking is so addictive why does the anti-smoking lobby try so hard to ban smoking in all public places? Surely, if smokers are as addicted as they say, prohibition is simply going to increase their suffering.

No, the reason the addiction argument is so popular among anti-smokers is because it takes away the important concepts of free choice and personal responsibility. By arguing so vociferously that smokers are 'slaves to the ****', the anti-smokers are trying to undermine the idea (held by FOREST and by many other people) that by choosing to smoke adult smokers are old enough to decide their own lifestyle and are merely exercising their own free will.

This in turn gives anti-smokers the excuse to insist that the state must apply the tightest restrictions on smokers 'for their own good'. What the killjoys cannot accept is that a great many people enjoy smoking and take pleasure from it. The fact that they smoke has nothing to do with addiction.

The truth is that although smoking, like many other habits, can be a difficult one to break, millions of smokers have successfully quit and the vast majority do so without the need for drugs, patches, acupuncture or hypnotherapy. Ultimately, it all comes down to willpower. You've either got it - or you haven't.

Reply With Quote