11.1 Nicotine as a drug of addiction

Based on criteria for drug dependence developed by the World Health Organization, the US Surgeon General has concluded that tobacco delivered nicotine is addictive.(1)

These criteria include:

Primary criteria:

ð highly controlled or compulsive use

ð psychoactive (mood altering) effects

ð drug-reinforced behaviour (the drug acting as a reinforcer that can directly strengthen behaviour leading to further drug ingestion)

Additional criteria:

Addictive behaviour often involves:

ð stereotypic patterns of use

ð use despite harmful effects

ð relapse following abstinence

ð recurrent drug cravings

Dependence producing drugs often produce:

ð tolerance

ð physical dependence

ð pleasant (euphoric) effects

Judging by the above criteria, the US Surgeon General has reached the following major conclusions:(1)

1. Cigarettes and other forms of tobacco are addicting.

2. Nicotine is the drug in tobacco that causes addiction.

3. The pharmacologic and behavioural processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin or cocaine.


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