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Tobacco has long been a problem in our society. The detrimental health effects of smoking have been known for some time in the medical community (Centers for Disease Control and Prevention, 1997). And the general public has been made aware of these conclusions since the government mandated warning labels on cigarettes and advertisements in 1965.
Many parents would breath a sigh of relief to find that their kids were only smoking cigarettes and not using illegal drugs or alcohol. They might think that tobacco is not as harmful as illegal drugs and not immoral. What parents may not know is that tobacco is more often than not the first step toward illicit drug addiction and alcohol abuse, and also a first sign that their child may be headed toward heroine or cocaine use.
In a study reported by the National Institute on Drug Abuse (NIDA) daily use of marijuana is found to be twenty times higher among high school seniors who smoke, and the daily use of other illicit drugs is thirteen times higher among tobacco users. Conversely a study published in the Journal of Pediatrics claims that subjects in their study who had never used marijuana were likely to never use heroin at all in the future. Therefore many argue that there seems to be a progression of drugs with tobacco being the first in a sad sequence of addictions.
Several studies have linked tobacco and the use of illicit drugs. Classifying nicotine as a gateway drug means that scientists believe people who use tobacco are more likely to experiment with other drugs. In order to consider nicotine a gateway drug, one must first consider it a drug. While the tobacco industry publicly denounces using the word drug to specifically describe their product, their internal documents often use language consistent with the classical definition of drug (any chemical agent that affects living processes). Cigarettes have also been referred to as ‘drug delivery devices’ by the government in an effort to bring cigarettes under the control of the Food and Drug Administration’s control.
Tobacco companies often referred to smoking as a habit people can voluntarily adopt rather than an addiction. Reducing this addiction to a ‘habit’ has a way of giving smoking an illusion of harmlessness as if people were simply biting their nails. The problem is that nicotine is an addictive substance. In 1989, the Surgeon General's Report on the Health Consequences of Smoking concentrated on smoking as an addiction. This report established nicotine's addictive properties and its role in reinforcing smoking behavior. The eighty five percent of teenager tobacco users who have unsuccessfully tried to quit smoking can confirm the difficulty in kicking the nicotine ‘habit’.
Drug dependence develops slowly, not suddenly overnight. The average path to addiction involves that first puff on a cigarette at age twelve, a drink of alcohol at around twelve and a half, and then at age fourteen an introduction to illegal substances with marijuana. Many claim that there are no drug addicts that do not also smoke. In What You Should Know About Tobacco, Frank L. Wood, M.D. claims that there would not be any marijuana addicts at all if people did not first learn to smoke cigarettes. Other studies establish a relationship between marijuana use and the use of cocaine and heroin.
Studies published in the International Journal of Addiction and the British Journal of Addiction indicate that tobacco is a special kind of gateway drug not only preceding the use of other drugs, but also more likely to increase in use. Studies of college students found that students who smoke were more likely to have used both legal and illegal substances abusively. In addition, tobacco is found to have similar features affecting initiation, abstinence, addiction, and relapse as opioids and alcohol. The National Household Survey on Drug Abuse (1985) reported twelve to seventeen year olds who smoked cigarettes daily were thirty two times as likely to use cocaine compared to nonsmokers. Even more concerning is that these same young smokers were over one hundred times more likely to use marijuana.
While all this research is fairly conclusive indicating a connection between drug use and tobacco use, it is important to note that there is not yet a lot of evidence indicating a causal effect. This means that researchers can say that drug abusers are likely to use tobacco before they turn to other drugs. However, these same researchers may not conclude that tobacco use caused the drug abuse.
It is important not to lose sight of the harm tobacco causes in terms of death and disease before it even acts as a gateway drug to other dangerous substances. The Centers for Disease Control and Prevention estimate the death toll to be about 450,000 a year in the United States due to preventable tobacco-related illnesses. The estimated death toll worldwide is over one million. Perhaps an even more stunning statistic is that each year 50,000 people die from the effects of secondhand smoke (Centers for Disease Control and Prevention, 1997). The average smoker starts smoking before the age of eighteen and loses twelve years of their life.
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