The tobacco companies have always maintained that when smokers want to quit, they quit. Next Monday, C. Everett Koop, the Surgeon General, will release a major report that says some smokers can't quit because they are addicted to nicotine, a derivative of the dried tobacco leaves.
The Surgeon General's report will show the seriousness of nicotine as a drug compared to such illicit drugs as cocaine or heroin. According to sources familiar with the report, it will include statistical information that has never been made public on nicotine addiction. Antismoking specialists believe it will not break new ground, however.
Yet the report has wide-ranging implications, including the possibility that it might result in new laws and regulations. The Surgeon General's report in 1986 on passive smoking is widely credited as the catalyst for much of the antismoking legislation on a state and local level as well as the federal airline smoking ban on flights of two hours or less.
Antismoking activists would most like to see nicotine declared a controlled substance, meaning it would be regulated by the Food and Drug Administration (FDA). Only two weeks ago, the Coalition on Smoking or Health, asked that the FDA regulate low tar and nicotine cigarettes. Such cigarettes have chemical additives in them to replace the tar, ``and could be more dangerous,'' maintains Scott Ballin, chairman of the coalition. Mr. Ballin thinks this report will show that ``nicotine is a dangerous addictive substance that needs to be addressed.''
The report may help Rep. Bob Whittaker (R) of Kansas, who is sponsoring federal legislation that would put tobacco producers under the aegis of the FDA. Representative Whittaker decided to sponsor the legislation after the Federal Trade Commission (FTC) closed its cigarette testing lab a year ago. So far, the legislation has only 19 co-sponsors. ``There has been no action on the bill, but we're hoping the Surgeon General's report assists in that,'' says an aide.
Some legislators from tobacco states seem resigned to such legislation. Sen. Strom Thurmond (R) of South Carolina says, ``I feel truth through research should be known and the public has a right to this information. I regret the damage that may be done to the economy, i.e., the loss of revenues through cigarette sales, but it can't be helped.''
The report may also become evidence in the scores of liability lawsuits brought against the tobacco companies. The industry has long maintained that smoking is just a habit and smokers can quit if they want to. They point out that 40 million people have stopped smoking.
Finally, antismoking groups hope that the report will be a catalyst to get yet another warning on the cigarette packages themselves. ``They have agreed to cancer and emphysema, but not addiction,'' says John Banzhaf III, director of Action on Smoking and Health.
The Tobacco Institute, which represents the industry, adamantly disagrees with any comparison of nicotine to cocaine or heroin. ``It is apparent that anti-tobacco zeal has overtaken common sense and good judgement,'' the institute said in a statement last week. ``To imply that 55 million American tobacco users are drug abusers is to subvert and divert attention from the nation's war on illicit drugs.''
But to some smokers, getting off nicotine does seem like a battle against a powerful drug. At a Smokenders Inc. graduation ceremony in New York City, Ruth Stowe, after three weeks without a cigarette says, ``It's a harder addiction to kick than marijuana.'' A man complains that he has slept only an hour per night since he stopped smoking. Another tells the Smokenders instructor he can't concentrate on anything. Almost 80 percent of the class of 30 has tried to quit before.
This powerful hold on the smokers comes from the drug nicotine, researchers say. In liquid form, it is colorless to amber, with a bitter, burning taste. Cigarette companies often add menthol, which numbs the taste buds, eliminating the bitter flavor. In larger amounts and mixed with mineral salts, nicotine is used as an insecticide.
But in the smaller amounts in cigarettes, it has a different effect on users. It can be a sedative for chain smokers and a stimulant for people who smoke less frequently.
An article in the New York Times Magazine quotes Dr. Jack Henningfield, one of the authors of the Surgeon General's report, as finding nicotine ``5 to 10 times more potent in producing a euphoric effect than cocaine.''
If those past findings are incorporated into the report, says Angela Mickel, coordinator of the Tobacco-Free America Project, ``it will be one more nail in the tobacco industry's coffin.''
Hillary Chura and Roberta Schur contributed to this report.