584 



the associated symptoms were identified in the 1964 Surgeon General's Report: restlessness, 

 anxiety, trouble concentrating, and other "mild and variable symptoms".^ That report 

 stated that these symptoms were the same as those seen when any well-liked behavior was 

 suddenly stopped. Nothing new has been established in this area. Caffeine withdrawal is 

 much more well-established and well-defined, including the physical symptom of the 

 "caffeine headache." Under Dr. Kessler's definition, caffeine and heroin should be treated 

 equally. 



Smoking cessation never involves any of the severe physical and behavioral 

 disruptions involved in withdrawal from truly addicting drugs such as heroin, cocaine, and 

 amphetamines. In fact, the symptoms of hard drug withdrawal normally require medical 

 treatment. With many drugs (e.g.. barbiturates and alcohol), the addict can die fi-om 

 withdrawal if not medically treated. An addict undergoing withdrawal from hard drugs is 

 unable to think clearly or control his actions while in the throes of withdrawal. This is never 

 the case with cigarette smokers who quit. They continue to attend to their responsibilities 

 and lead normal lives. The symptoms reported by cigarette smokers when they stop are of 

 the same kind and magnitude reported by dieters and people changing sleep patterns (s^, 

 changing from the first to third shift at work )." 



" 1964 Surgeon General's Report, supra, at 352. 



" It should be noted that DSM-III-R states that there is no evidence that, even at its 

 most severe level, tobacco withdrawal prevents a person from successfully stopping. 

 The same can not be said for barbiturates, alcohol or crack cocaine. Diagnostic and 

 Statistical Manual of Mental Disorders (Third Edition - Revised ) American 

 Psychiatric Association, (1987), 151. 



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