Understanding Addiction to Tobacco

“I thought I had more time.”

Jesse, a productive 56-year-old health care manager was recently diagnosed with lung cancer. Like most smokers, he was fully aware of the health risks and promised himself, his family and his doctor that he would quit smoking—one day, when he had more time. The sad irony is that now he will spend most of his remaining time battling cancer instead of enjoying his work, family and loved ones.

Smoking prevalence

Tobacco use is the leading preventable cause of disease and death in the United States, causing approximately 440,000 deaths each year and costing approximately $157 billion in annual health-related economic losses.

Major gains have been made in reducing smoking prevalence over the past three decades. Overall, smoking has dropped from 51 percent of the United States population in the late 1940s to 24 percent in 2001. In spite of these gains, nicotine, the psychoactive ingredient in tobacco, remains the most widely used and abused drug in the United States and the world. There are approximately 1 billion cigarette smokers in the world today, and approximately 3 million people die each year from smoking-related illnesses.

Although the rates of smoking continue to decline, an estimated 46.2 million adults in the United States were smoking in 2001, and about 6 million people (mostly men and teens) use smokeless tobacco on a daily basis.

Tobacco is not glamorous

The dramatic decline in smoking prevalence in recent years is primarily due to increased public awareness and education regarding the dangers of tobacco and the more recent and widespread antismoking sentiment that has resulted in social and political intervention. Adult smokers are ostracized and relegated to the hinterlands of restaurants and airports.

Because it is no longer fashionable, sophisticated or socially rewarding for an adult to be a smoker, this change in public perception and attitude has made the case for addictive disease more compelling. Bottom line: Tobacco users continue to smoke and chew in spite of harmful physical and social consequences because they are addicted.

If quitting were easy, everyone would do it

Most tobacco-dependent persons never successfully quit and half die prematurely of tobacco-related disease. In the United States less than 10 percent of the nearly 20 million people who quit smoking for a day remain abstinent one year later. Moreover, 70 percent of smokers want to quit but only 2 percent to 3 percent will succeed. This is why tobacco is considered among the most addicting drugs.

The good news is that educational and political efforts have had a positive impact on adult perception and attitudes about smoking. The bad news is that until recently doctors have lacked the medical and psychological expertise and commitment to intervene effectively and aggressively treat those who want to quit—until now.

Reason for hope

In recent years medical science has made major breakthroughs in understanding addictive disease, particularly tobacco. New pharmacological treatments and tobacco cessation programs are readily available. Learning more about tobacco and the process of quitting is important, but not as important as making the decision to quit. A good place to start: Ask yourself how much more time and health you are willing to lose to tobacco.

Sources: Gold, M.S., Edwards, D.W. (2000). Treating cigarette smokers in 2000. Your Patient & Fitness, 14(4) 6-11; “The Health Benefits of Smoking Cessation: A Report of the Surgeon General,” 1990.

By Drew Edwards, EdD MS
© 2005 Achieve Solutions