Saturday, November 04, 2006

Is Smoking a Choice or an Addiction?

Just thought I'd wax lyrical about whether smoking tobacco is a choice or an addiction. I think it is both in different amounts in different people. In no small measure dependent on some genetic material. However, I refute the widely held belief that nicotine addiction is as rife a problem as we are led to believe. Primarily it only matters if you choose to stop smoking and even then its importance is over stated.

Tobacco use becomes a choice because it exists. Put another way a legal choice because it is legal (different but similar statement). If it was illegal it would be a different choice dependent on the same and some additional genes, which influence our tendency towards illegal behaviour.
No doubt the tendancy towards liking smoke or smokers has some genetic basis as well as indeed being an anti-smoking lobbyist must have some flawed genetic trait. Also the likelihood of being harmed by tobacco has some genetic basis whereas the likelihood of being harmed by passive smoke has no genetic basis other than the genes governing gullibility and unfavourable personality traits.

It would appear that something within those prone to depression and other forms of mental illness are more likely to chose to smoke..genes again. This is rewarded by the relief of the symptoms of mental illness, particularly anxiety. Arguably it becomes less of a choice in these individuals. So the choice angle is complicated enough and not easy to simplify for the case of legal arguments.

It would apear that a substance in tobacco can produce a state of craving that substance..Nicotine. So smoking is labelled as addictive. The habit of putting something in one's mouth is thought to have some psychological addiction. I would rather explain this simply by habitual behaviour.

Addiction perse is not a problem unless the addict wishes or must stop the habit so can only be used as a relevancy in those people. Morphine, which I prescribe on a very regular basis, is said not to be addictive when used to treat pain. The proof for that is easily available. It does however cause withdrawal symptoms in these people when the drug is no longer necessary. Withdrawal symptoms are a physical reaction by the body to the absence of the substance and occur in addicts but are not synonymous with addiction.

So nicotine withdrawal causes cravings and withdrawal symptoms but that does not mean the individual is addicted to nicotine.

Addiction is usually diagnosed on the presence of addictive behaviour and it is diffficult to apply this thinking to tobacco users in my opinion. Perhaps when it is illegal to smoke it will be easier as addictive behaviour will be easier to recognise. Going on the game to fund your tobacco habit for example.

Smoking for me is a choice and I do it because I enjoy it. I don't see myself as addicted to it because it isn't a problem to me. I do so in full knowledge of its potential to harm me and not to harm others.

Oh and by the way, I have just read something in New Scientist. This is only tenuously connected but worthy of note...

Professor of Medicine of the University of California, Drummond Rennie has coined the term "Astroturf" rather than "Grassroots" to describe organistions that practice the business of "Disguising an orchestrated campaign as a spontaneous upwelling of public opinion".
This term fits well with ASH. Is "Astroturfing" an illegal activity?