629 



Exhibit 1 



THE HEALTH CONSEQUENCES OF SMOKING: NICOTINE ADDICTION 

 (A Report of the Surgeon General) 



FOREWORD 



This 20th Report of the Surgeon General on the health conse- 

 quences of tobacco use provides an additional important piece of 

 evidence concerning the serious health risks associated with using 

 tobacco. 



The subject of this Report, nicotine addiction, was first mentioned 

 in the 1964 Report of the Advisory Committee to the Surgeon 

 General, which referred to tobacco use as "habituating." In the 

 landmark 1979 Report of the Surgeon General, by which time 

 considerably more research had been conducted, smoking was called 

 "the prototypical substance-abuse dependency." Scientists in the 

 field of drug addiction now agree that nicotine, the principal 

 pharmacologic agent that is common to all forms of tobacco, is a 

 powerfully addicting drug. 



Recognizing tobacco use as an addiction is critical both for treating 

 the tobacco user and for understanding why people continue to use 

 tobacco despite the known health risks. Nicotine is a psychoactive 

 drug with actions that reinforce the use of tobacco. Efforts to reduce 

 tobacco use in our society must address all the major influences that 

 encourage continued use, including social, f)sychological, and phar- 

 macologic factors. 



After carefully examining the available evidence, this Report 

 concludes that: 



• Cigarettes and other forms of tobacco are addicting. 



• Nicotine is the drug in tobacco that causes addiction. 



• The pharmacologic and behavioral processes that determine 

 tobacco addiction are similar to those that determine addiction 

 to drugs such as heroin and cocaine. 



We must recognize both the potential for behavioral and pharma- 

 cologic treatment of the addicted tobacco user and the problems of 

 withdrawal. Tobacco use is a disorder which can be remedied 

 through medical attention; therefore, it should be approached by 

 health care providers just as other substance-use disorders are 

 approached: with knowledge, understanding, and persistence. E^ch 

 health care provider should use every available clinical opportunity 

 to encourage or assist smokers to quit and to help former smokers to 

 maintain abstinence. 



