
Not smoking was apparently just a matter of willpower. When the first warnings about tobacco were published more than 20 years ago, many experts thought that smoking was ''no different than compulsive potato chip eating,'' says Dr. Jack Henningfield, who specializes in the biology of dependence and abuse potential at the Addiction Research Center of the National Institute on Drug Abuse in Baltimore.

''The known enemy is more easily overcome,'' says Dr.

New strategies for quitting, based on a deeper understanding of the addiction, are in the wings. Those still addicted tend to smoke more cigarettes, but they should not lose hope. Since the first Surgeon General's report on smoking in 1964, about 37 million Americans have quit. The medical bill for individuals with fatal illnesses related to smoking has been estimated at $60 million a day, according to a 1985 study by the Congressional Office of Technology Assessment. Tobacco use is the number one preventable cause of illness and death in the United States. Its hooks go deep, involving complex physiological and psychological mechanisms that drive and maintain smoking behavior and that even produce some ''good'' effects, such as improved performance on intellectual, computational and stressful tasks. Scientists have found, for instance, that nicotine is as addictive as heroin, cocaine or amphetamines, and for most people more addictive than alcohol. Interdisciplinary research in pharmacology, psychology, physiology and neurobiology is just beginning to shed light on the incredible hold that tobacco has on people. Are smokers more weak-willed than nonsmokers or former smokers? Or do millions of people continue to smoke for reasons more powerful than previously imagined? What, for example, could possess a heart attack victim to light up a cigarette the moment he is wheeled out of the coronary care unit? Yet, after repeated attempts to give up smoking, they find that they cannot control this one, seemingly uncomplicated, aspect of their behavior. Many smokers are highly intelligent people with impressive levels of control over institutions, budgets, employees and political affairs. Increasingly aware that their addiction is also harmful to their children and co-workers, they continue to puff away on 570 billion cigarettes a year. SS-5):1–29.DESPITE OVERWHELMING EVIDENCE that tobacco is destroying their health and shortening their lives, 53 million Americans continue to smoke. Morbidity and Mortality Weekly Report, 2022 71(No. Tobacco Product Use and Associated Factors Among Middle and High School Students – National Youth Tobacco Survey, United States, 2021.
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More than half of adult cigarette smokers report having made a quit attempt in the past year. In 2015, 68.0% of adult smokers (22.7 million) said that they wanted to quit smoking.Most adult cigarette smokers want to quit.
