385 



dangerous changes in body temperature, seizures, mood changes often accompanied by paranoia, and 

 suicidal ideation and attempts. Death may ensue even if the patient is hospitalized and properly 

 medically managed. Withdrawal with hard drugs is so severe as to render the addict incapable of 

 making or carrying out reasoned decisions. In fact, mentation and judgment are impaired for months 

 and even years following resolution of the acute withdrawal phase. 



Cigarettes and nicotine cessation is not really withdrawal because it produces none of these 

 signs or symptoms. It is impossible to predict whether or not a smoker will have any tobacco 

 abstinence discomfort based on the number of cigarettes smoked per day or the duration of smoking. 

 The clinical complaints associated with cigarette abstinence are a far cry from hard drug withdrawal. 

 The most uncomfortable, complaining cigarette abstainer does not remotely resemble a person who 

 is withdrawing from hard drugs. But they do resemble those of a dieter or other person giving up 

 a well-liked habit or close relationship. The symptoms and complainu experienced by people 

 changing these other well-liked habits are of the same magnitude and degree, and include mild 

 apprehension, restlessness, periodic recurrent thoughts about the lost object or person and a repeated 

 wish to reunite or resume the habit. But people changing common habits like cigarette smoking 

 continue working while "withdrawing" and continue to meet their responsibilities without significant 

 disruption of reasoning, judgment, concentration or efficiency. 



In addition to the acute organic brain effects of intoxication, chronic administration of hard 

 drugs may cause irreversible brain changes before or after the offending drug is withdrawn. The 

 person may be left demented or psychotic. Long-term cigarette use does not produce this result. 



