Smoking Is "Gateway" To Other Addictions

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Smoking Is "Gateway" To Other Addictions

Teenagers' cigarette smoking often leads to alcoholism, and addiction to cocaine, heroin and other illicit drugs, three experts conclude from a new survey Of scientific findings on drug dependence. They call smoking and the nicotine addiction it engenders the "gateway" to the other addictions.

"The vast majority of people who have ever used illicit drugs, such as marijuana and cocaine, had previously used cigarettes and alcohol," the experts say. "Conversely," they add, "people who have never smoked only rarely abuse illicit drugs or alcohol." Although the reasons for the high degree of involvement of tobacco use in other drug abuses are not well understood, it is clear that cigarette smoking is a major preventable risk factor in the spread of illicit drug and alcohol abuse among the young of this nation.

This cautionary finding is issued by Baltimore psychologist Jack E. Henningfield, Ph. D., at the Addiction Research Center of the National Institute on Drug Abuse (NIDA), that agency's former director, psychiatrist William Pollin, M.D., of Bethesda, MD, and their colleague, sociologist Richard Clayton, Ph.D., at the University of Kentucky, in Lexington. Their report on tobacco's "involvement" in alcoholism and illicit drug use appears in the February issue of the British Journal of Addictions.

The three experts, cautiously, are not ready to say that nicotine addiction causes the other addictions that often follow in its wake. They do say:

"Although not necessarily a causal determinant of illicit drug use, tobacco use is highly associated with such use." They add:

"Tobacco is involved in the development of other drug dependencies."

They cite these pieces of evidence from the vast literature they surveyed:

- Among people who had smoked both tobacco and marijuana 10 or more times, two-thirds of the males and three-quarters of the females said they had used tobacco first

- Tobacco use -- and also alcohol use -- are higher than the average in users of illicit drugs

- Precocious smokers (ages 12 to 17) are highly likely to use and abuse other drugs. Specifically, federal data show that threequarters of smokers in this age group drink; half use marijuana; and almost one in ten uses cocaine.

- The more young people smoke, the more often they get "drunk" and the more likely they are to use marijuana or cocaine ten or more times.

Dr. Henningfield and his colleagues identify tobacco as a "gateway substance" to the other addictions both because it precedes use of the other drugs, and also because nicotine is in its own right a highly deadly and addictive substance.

Only 10% to 15% of alcohol users abuse alcohol, they note. But close to 90% of cigarette smokers smoke in a regular, daily fashion despite the knowledge of the harm it is doing.

At the least, the researchers suggest, dependence on tobacco seems to soften smokers up -- render them more vulnerable -- to other addictions. They say:

"Development of dependence to tobacco appears to generally precede development of dependence to alcohol and illicit drugs. These observations have led growing numbers of researchers and policy-makers...to consider the role of tobacco in programs aimed at preventing other forms of drug abuse."

PNG Publications.

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