Comparing Tobacco Cigarette Dependence With Other Drug Dependencies

About 1000 persons seeking treatment for alcohol or drug dependence were asked, relative to cigarettes, about the difficulty of quitting the use of the substance for which they were seeking treatment, the strength of their strongest urges to use, and the pleasure they derived from use. Fifty-seven percent said that cigarettes would be harder to quit using than their problem substance. These ratings were related to the level of cigarette dependence and the perceived difficulty of quitting the use of the problem substance. The alcohol-dependent persons were about four times more likely than the drug-dependent persons to say that their strongest urges for cigarettes were at least as great as their strongest urges for their problem substance. Cigarettes were generally rated as less pleasurable than alcohol or other drugs. Thus, experiential experts on dependence judge cigarette dependence as at least as "addictive" as other drug use, but not as pleasurable, indicating important similarities and differences between cigarette dependence and other forms of dependence on psychoactive substances. (JAMA1989;261:898-901)