207 



2. Environmental factors including drug-associated stimuli and social 

 pressure are important mtluences ot mitiation. patterns ot use. 

 quitting, and relapse to use of opioids, alcohol, mcotine. and other 

 addictmg drugs. 



3. Many persons dependent upon opioids, alcohol, mcotine. or other 

 drugs are able to give up their drug use outside the context of 

 treatment programs; other persons, however, require the assistance of 

 formal cessation programs to achieve lasting drug abstinence. 



4. Relapse to drug use often occurs among persons who have achieved 

 abstinence from opioids, alcohol, nicotine, or other drugs. 



5. Behavioral and pharmacologic intervention techniques with 

 demonstrated efficacy are available for the treatment of addiction to 

 opioids, alcohol, nicotine, and other drugs. 



5. Effects of Nicotine That May Promote Tobacco Dependence 



1. After smoking cigarettes or receiving mcotine. smoken perform 

 better on some cognitive tasks (including sustained attention and 

 selective anention) than they do when deprived of cigarettes or 

 nicotine. However, smoking and nicotine do not improve general 

 leanung. 



2. Stress increases cigarette consumption among smokers. Funher, 

 stress has been identified as a risk factor for initiation of smoking in 

 adolescence. 



3. In general, cigarette smokers weigh less (approximately 7 lb less on 

 average) than nonsmokers. Many smokers who quit smoking gam 

 weight. 



4. Foc^ intake and probably metabolic factors are involved in the 

 inverse relationship between smoking and body weight. There is 

 evidence that nicotine plays an important role in the relationship 

 between smoking and body weight. 



6. Treatment of Tobacco Dependence 



1 . Tobacco dependence can be treated successfully. 



2. Effective interventions include behavioral approaches alone and 

 behavioral approaches with adjunctive phannacologic treatment. 



3. Behavioral interventions are most effective when they include 

 multiple components (procedures such as aversive smoking, skills 

 training, group support, and self-reward). Inclusion of too many 

 treatment procedures can lead to less successful outcome. 



4. Nicotine replacement can reduce tobacco withdrawal symptoms and 

 may enhance the efficacy of behavioral treatment. 



Source: The Health Consequences of Smoking: Nicotine .Addiction. A 

 Report of the Surgeon General, 1988, pp. 13-15. 



