Nicotine Is More Addictive Than Heroin

Date: Thu, 11 Jul 1996 16:37:50 EDT
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From: Neil Johnson <njj>
Subject: Re: Dole And Tobacco -Reply by Jack Heningfield
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I would like to thank this nations leading expert on addiction, Jack Henningfield for pointing out that nicotine is more addictive than heroin, alcohol, or cocaine. A true voice uncorrupted by tobacco money. I would also add that tobacco has a far higher death rate (33%?) than either heroin, alcohol, or cocaine. Yet, addiction criteria alone does not determine the nicotine (or illicit drug) health threat.

The body of scientific evidence now indicates that harm associated with both heroin & nicotine is the result of contaminates in the drug delivery devices. Other than addiction itself neither nicotine nor heroin pose significant behavioral or toxicological threats (given the use of safe/effective drug delivery devices).

The result of this scientific understanding, in the interest of public health, has led to the current over the counter sales of safe high purity nicotine chewing gum and soon to be OTC nicotine patches. On the European front, heroin prescription programs are having great success in both England & Switzerland.

The issue of alcohol/cocaine addiction, use, and harm is a little more complex than posed by nicotine/heroin addiction. Alcohol and cocaine addiction are causative of both behavioral & biological problems. However most daily users of either alcohol or cocaine have no problem regulating usage at levels that do not cause behavioral or biological harm. The effect of daily light/moderate alcohol consumption being relaxation & lowered risk of heart disease. The effect of light/moderate cocaine consumption being the equivalent of prescription ritalin (increased levels of dopamine), ie increased attention span, less impulsive behavior, and better ability to focus on desired tasks.

Neil Johnson


Jed Rose,

Wish you luck with the up comming "ECLIPSE AND THE HARM REDUCTION STRATEGY FOR SMOKING" conference. Advocating safety improvements for non-medical nicotine devices is quite a controversial area of science. Yet, I see no reason that nicotine users should not be afforded the same level of safety afforded to todays coffee drinkers.

---Begin Jack Heningfields post---

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Date: Thu, 11 Jul 1996 10:20:35 -0500
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From: Jack Henningfield <JHENNING@IRP.NIDA.NIH.GOV>
Subject: Re: Dole And Tobacco -Reply
To: Multiple recipients of list DIV28 <>

(July 11, 1996)

Nicotine, cocaine, heroin, and alcohol all meet criteria as addictive or dependence producing drugs, though none of these drugs causes addiction in all who are exposed (cf., APA, APA, WHO, Sur. Gen., FDA, NIDA, etc.). The risk of addiction following any use, the prevalence of frequent use among current users, and the occurance of APA, DSM-defined dependence among current users ranges from about 2 to 10 times greater for cigarettes than for these other drugs (Anthony et al. 1994, Exp.Clin. Psychopharm.; NIDA's Monitoring the Future Survey, FDA in Fed Register, Aug. 11, 1995; Surg. Gen. 1988). Thus, Dole' s comment, in which he specifically challenged the conclusion that nicotine is appropriately considered an addictive drug, is even more applicable to cocaine, heroin, and alcohol; yet it would generally be considered ludicrous to not consider these drugs appropriately categorized as addicting. In fact, Bob Dole has made many statements over the past few weeks, repeatedly challenging the general categorization of nicotine as an addictive drug, and whether there is adequate consensus among experts to warrant such categorization. He has not backed off that contention though given several opportunities. If the Director of NIDA (or even Bob Dole) used the data summarized above to imply that we wasn't sure NIDA should take youth access to cocaine and heroin so seriously because these drugs weren't addictive for everybody he would be out of his position very quickly.

The criteria for categorizing drugs as addictive has never required that all individuals exposed become addicted but if you were going to challenge the appropriateness of categorization of drugs as addictive or dependence producing based on the relative risk of becoming addicted, cigarettes would be the last on the list to go. Pharmacologists subscribing to the Dole system for drug classification would have to give up categories such as "psychomotor stimulants," "CNS depressants," "hallucinogens," "antidepressants," "anxiolytics," etc., because the drugs so categorized do not always produce the effects implied by their categorization. We know that the risk of developing dependence to dependence producing drugs, in humans, as well as laboratory animals, depends on a wide range of factors including form of administration, availability and cost (Henningfield et al., 1991, Brit. J. Add.). There is presently active study of the factors that affect the risk of developing addiction to addictive drugs as well as how to best translate such findings into public policy. This is a legitimate and very important area of study for both its basic science and public health implications. But does anyone think Bob Dole understands these issues or is prepared to go to the public saying that what he said is also true, only more so, for cocaine and heroin and that perhaps we should not be as concerned about access to these drugs by youth?