Annals of Health Law
STRATEGY AGAINST SMOKING
named strategies have to be complemented by providing treatment against
tobacco addiction. Combating nicotine’s addictive nature often demands
access to professional advice and, in more serious cases, to pharmacological
and behavioral treatment. While nicotine addiction is commonly
underestimated with regard to its level of dependence and the difficulties of
cessation, particularly by non- or social smokers, in scientific terms,
nicotine addiction is put into the same category of addiction caused by
drugs like heroin or cocaine. 62 When nicotine is inhaled and enters the
lungs, it moves to the heart and immediately passes to the brain. 63 The
rapid absorption and the high amounts of nicotine reaching the brain
contribute to developing and sustaining nicotine addiction. 64 Adolescents
are particularly susceptible and often appear to be in denial of nicotine’s
health risk, its addictive nature, and the difficulty of cessation. 65 Nowadays
in the United States, smokers can resort to a broad range of information
providing strategies for smoking cessation, 66 amongst others given by
health-care providers, as well as to individual, group, and telephone
counseling, 67 or to pharmacotherapies. 68
The significant decline in tobacco use from 42.4% to 19.3% of the
United States adult population from 1965 to 201069 due to the array of
tobacco control strategies can certainly be described as one of the great
public health success stories. Nevertheless, the number of smokers is still
far from comforting, and the decline has been almost stalled over the last
62. Dorothy K. Hatsukami, Lindsay F. Stead & Prakash C. Gupta, Tobacco Addiction,
371 LANCET 2027, 2027-28 (2008). See also Min Sohn et al., Tobacco Use and Dependence,
19( 4) SEMINARS IN ONCOLOG Y NURSING 250, 251 (2003).
63. Benowitz, supra note 47, at 2295; Neal L. Benowitz, Clinical Pharmacology of
Nicotine: Implications for Understanding, Preventing, and Treating Tobacco Addiction, 83
CLINICAL PHARMACOLOGY & THERAPEU TICS 531, 532 (2008).
64. Cf. Benowitz, supra note 47, at 2295; Hatsukami, supra note 62, at 2028; Jack E.
Henningfield & Robert M. Keenan, Nicotine Delivery Kinetics and Abuse Liability, 61 J.
CONSULT. CLIN. PSYCHOL. 743, 744 (1993).
65. SeeCOMMITTEE ONREDUCINGTOBACCOUSE:STRATEGIES,BARRIERS, AND
CONSEQUENCES, supra note 40, at 89-93.
66. See, e.g., Michael C. Fiore, Dorothy K. Hatsukami & Timothy B. Baker, Effective
Tobacco Dependence Treatment, 288 J. AM. MED. ASS’N 1768, 1769 (2002); Michael C.
Fiore et al.,TREATING TOBACCO USE AND DEPENDENCE: 2008 UPDATE, i, 2 (2008);
Hatsukami, supra note 62, at 2030-31; U.S. DEP’T OF HEALTH AND HUMAN SERV., HOW
TOBACCO SMOKE CAUSES DISEASE: THE BIOLOGY AND BEHAVIORAL BASIS FOR SMOKING-
ATTRIBUTABLE DISEASE: A REP. OF THE SURGEON GENERAL 395-402 (2010).
67. See Lindsay F. Stead, Rafael Perera & Tim Lancaster, Telephone Counselling for
Smoking Cessation, 3 THE COCHRANE LIBRARY 1, 2 (2009).
68. See Hatsukami et al., supra note 62, at 2031-34; Richard D. Hurt & Jon O. Ebbert,
Preventing Lung Cancer by Stopping Smoking, 23( 1) CLINICS IN CHEST MED. 27, 30-34