S E R I E S
Tobacco use kills nearly half a million Americans each year, with one in every six U.S. deaths the result of smoking. Smoking harms nearly every organ of the body, causing many diseases and compromising smokers’ health in general. Nicotine, a component of tobacco, is the primary reason that tobacco is addictive, although cigarette smoke contains many other dangerous chemicals, including tar, carbon monoxide, acetaldehyde, nitrosamines, and more. An improved overall understanding of addiction and of nicotine as an addictive drug has been instrumental in developing medications and behavioral treatments for tobacco addiction. For example, the nicotine patch and gum, now readily available at drugstores and supermarkets nationwide, have proven effective for smoking cessation when combined with behavioral therapy. Advanced neuroimaging technologies further assist this mission by allowing researchers to observe changes in brain function that result from smoking tobacco. Researchers have also identified new roles for genes that predispose people to tobacco addiction and predict their response to smoking cessation treatments. These findings—and many other recent research accomplishments—are affording us unique opportunities to discover, develop, and disseminate new treatments for tobacco addiction, as well as scientifically based prevention programs to help curtail the public health burden that tobacco use represents. We hope this Research Report, summarizing the latest scientific information about tobacco addiction, will help readers understand its harmful effects as well as identify best practices for its prevention and treatment.
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What is the extent and impact of tobacco use?
from the director
ccording to the 2004 National Survey on Drug Use and Health, an estimated 70.3 million Americans age 12 or older reported current use of tobacco—59.9 million (24.9 percent of the population) were current cigarette smokers, 13.7 million (5.7 percent) smoked cigars, 1.8 million (0.8 percent) smoked pipes, and 7.2 million (3.0 percent) used smokeless tobacco, confirming that tobacco is one of the most widely abused substances in the United States. While these numbers are still
unacceptably high, they represent a decrease of almost 50 percent since peak use in 1965. NIDA’s 2005 Monitoring the Future Survey of 8th-, 10th-, and 12th-graders, used to track drug use patterns and attitudes, has also shown a striking decrease in smoking trends among the Nation’s youth. The latest results indicate that about 9 percent of 8th-graders, 15 percent of 10thgraders, and 23 percent of 12thgraders had used cigarettes in the 30 days prior to the survey. Despite cigarette use being at the lowest levels of the survey since a peak in the mid-1990s, the past few years indicate a clear slowing of this decline. And while perceived risk and disapproval of
Current* Cigarette Use by 8th-, 10th-, and 12th-Graders
35% 30 25 20 15 10 5 0
33.5 27.9 23.9 19.1 14.6 9.3 14.9 23.2 31.4
Nora D.Volkow, M.D.
Director National Institute on Drug Abuse
Percent of Adolescents
1995 2000 2005
Source: 2005 Monitoring the Future Survey.
* Reported cigarette use in past 30 days.
U.S. Department of Health and Human Services
NIDA RESEARCH REPORT SERIES
smoking had been on the rise, recent years have shown the rate of change to be dwindling. In fact, current use, perceived risk, and disapproval leveled off among 8th-graders in 2005, suggesting that renewed efforts are needed to ensure that teens understand the harmful consequences of smoking. Moreover, the declining prevalence of cigarette smoking among the general U.S. population is not