Nicotine indicted as an addictive drug

Abstract

Catalyzed by a report issued last week by Surgeon General C. Everett Koop indicting nicotine as an addictive drug, health groups and their supporters in Congress have launched a new assault on the tobacco industry, linking the war on cigarettes to the war on illegal drugs. The 639-page study focuses on the pharmacologic basis of addiction to tobacco. It asks why people smoke and use other tobacco products despite the known health hazards. Koop gives three simple answers: 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. All tobacco products contain substantial amounts of nicotine—a tertiary amine composed of a pyridine and a pyrrolidine ring—and other alkaloids. The report reviews nicotine's pharmacokinetics, metabolism, pharmacodynamics, sites and mechanisms of action, toxicity, and its ad...