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determine tobacco addiction are similar to those that determine 

 addiction to other drugs, including illegal drugs. 



In addition, some smokers may not believe that tobacco is 

 addicting because of a reluctance to admit that one's behavior is 

 largely controlled by a drug. On the other hand, most smokers admit 

 that they would like to quit but have been unable to do so. Smokers 

 who have repeatedly failed in their attempts to quit probably realize 

 that smoking is more than just a simple habit. 



Many smokers have quit on their own ("spontaneous remission") 

 and some smokers smoke only occasionally. However, spontaneous 

 remission and occasional use also occur with the illicit drugs of 

 addiction, and in no way disqualify a drug from being classified as 

 addicting. Most narcotics users, for example, never progress beyond 

 occasional use, and of those who do, approximately 30 percent 

 spontaneously remit. Moreover, it seems plausible that spontaneous 

 remitters are largely those who have either learned to deliver 

 effective treatments to themselves or for whom environmental 

 circumstances have fortuitously changed in such a way as to support 

 drug cessation and abstinence. 



Treatment 



Like other addictions, tobacco use can be effectively treated. A 

 wide variety of behavioral interventions have been used for many 

 years, including aversion procedures (e.g., satiation, rapid smoking), 

 relaxation training, coping skills trsdning, stimulus control, and 

 nicotine fading. In recognition of the important role that nicotine 

 plays in maintaining tobacco use, nicotine replacement therapy is 

 now available. Nicotine polacrilex gum has been shown in controlled 

 trials to relieve withdrawal symptoms. In addition, some (but not all) 

 studies have shown that nicotine gum, as an adjunct to behavioral 

 interventions, increases smoking abstinence rates. In recent years, 

 multicompwnent interventions have been applied successfully to the 

 treatment of tobacco addiction. 



Public Health Strateglea 



The conclusion that cigarettes and other forms of tobacco are 

 addicting has important implications for health professionals, educa- 

 tors, and policy-makers. In treating the tobacco user, health profes- 

 sionals must address the tenacious hold that nicotine has on the 

 body. More effective interventions must be developed to counteract 

 both the psychological and pharmacologic addictions that accompa- 

 ny tobacco use. More research is needed to evaluate how best to treat 

 those with the strongest dependence on the drug. Treatment of 

 tobacco addiction should be more widely available and should be 



