204 



m. STATENfFNT OF FACT! AL GROfNDS 



A. TOBACCO PRODUCTS ARE A VIAFOR CAUSE OF DISEASE IN THE 

 LOTTED STATES A.\D ARE ADDICTPVE. >aCOTINE IS THE DRUG Dv 

 TOBACCO THAT CAUSES ADDICTION. 



It is now well established and accepted that tobacco products are a major cause of 



cancer, heart disease, emphysema, stroke, and many other diseases. It is also well 



established that tobacco products are addictive. Tobacco products contain 



nicotine which is readily absorbed into the body both in the form of tobacco 



smoke, as in the case for cigarettes, as well as through the mouth and nose as in 



the case for smokeless tobacco products. 



The 1988 Report of the Surgeon General, "Nicotine Addiction," provides the most 

 in depth and extensive review of the scientific literature on the powerful role that 

 nicotine plays in causing and maintaining addiction. Prior to this report, however, 

 numerous other reports and studies had made similar fmdings and conclusions. 

 As the report notes: 



For example, numerous monographs prepared in the 1970s by the 

 National Institute on Drug Abuse (NDDA) considered tobacco use as a 

 form of drug dependence. In 1980, the American Psychiatric Association, 

 in its Diagnostic and Sutistical Manual of Mental Disorders, included 

 tobacco dependence as a substance abuse disorder and tobacco 

 withdrawal as an organic mental disorder (APA 1980). The 1987 revised 

 edition of this manial (APA 1987), in recognition of the role of nicotine, 

 changed "tobacco withdrawal" to "nicotine withdrawal." In 1982, the 

 Director of NIDA testified to Congress that the position of NEDA was 

 that tobacco use could lead to dependence and that nicotine was a 

 prototypic dependence-producing drug. In a 1983 publication, "Why 

 People Smoke Cigarettes," the U.S. Public Health Service supported this 

 position of NIDA regarding tobacco and nicotine (XFS DHHS 1983b). In 

 the 1984 NIDA Triennial Repoit to Congress, nicotme was labeled a 

 prototypic dependence-producing drug and the role of nicotine in tobacco 

 use was considered to be analogous to the roles of morphine, cocaine, 

 and ethanol, in the use of opium, coca-derived products, and alcoholic 

 beverages, respectively (US DHHS 1984b). In 1986, a consensus 

 conference of the National Institutes of Health and the Report of the 

 Advisory Committee to the Surgeon General on the health consequences 

 of using smokeless tobacco concluded that smokeless tobacco can be 

 addicting and that nicotine is a dependence-producing (i.e., addicting) 

 drug (US DHHS 1986b). 



