Now for the Biggest Drug Pushers
President Clinton has recently let the Food and Drug Administration (FDA) declare what the tobacco industry has known for more than 30 years: Nicotine is an addictive drug and cigarettes are drug delivery devices.
Not surprisingly, the tobacco industry and its political allies are disputing this conclusion. But such objections ring hollow when compared to thousands of pages of previously secret tobacco industry documents that were anonymously sent to me two years ago. These secret documents, which report extensive and sophisticated scientific research into nicotine pharmacology and the health dangers of smoking, contrast starkly with the tobacco industry's public positions that nicotine is a "flavoring agent" and that there is no evidence that smoking is dangerous.
In 1963 Addison Yeaman, vice president and general counsel of Brown and Williamson Tobacco (the company that recently lost a $750,000 case to a Florida smoker with lung cancer), observed that "nicotine is addictive. We are, then in the business of selling nicotine, an addictive drug effective in the release of stress mechanisms."
Even more remarkable is the 1962 statement of Sir Charles Ellis, an executive and scientist for British American Tobacco. He said members of the tobacco industry should "examine whether smoking is just a habit of addiction" and cited benefits of cigarettes as a way to deliver nicotine: "Nicotine is not only a very fine drug, but the technique of administration by smoking has considerable psychological advantages and a built-in control against excessive absorption. It is almost impossible to take an overdose of nicotine in the way it is only too easy to do with sleeping pills."
The latest tactic of the tobacco industry and its political allies, including Republican House Speaker Newt Gingrich and presidential candidate Robert Dole, has been to attack the Clinton administration for wasting time on beating up the tobacco industry while ignoring "drugs." But nicotine addiction is America's biggest drug problem.
Illegal drugs are a problem for America; they kill about 10,000 people a year. But this toll pales in comparison to nicotine. Cigarettes kill 424,000 smokers and 53,000 nonsmokers every year, nearly 50 times the fatalities from illegal drugs.
Moreover, nicotine is the "gateway drug." Virtually all users of illegal drugs begin with nicotine, move on to alcohol, then graduate to "hard" drugs. The tobacco industry understands this connection. For example, to attract "starters" market researchers for one cigarette company recommended, "To the best of your ability, (considering some legal considerations), relate the cigarette to 'pot,' wine, beer, sex, etc."
Nicotine addiction affects more people and holds them in a tighter grip than other drugs. Of the 146 million Americans who have ever smoked, 54 million - 37 percent - are still hooked. Of the 23 million who have ever used cocaine, 1 million - 6 percent - are current users.
Given this information and the role of tobacco as a gateway drug, why hasn't the antidrug lobby, which has been so vocal for so many years, forced nicotine addiction to the top of the agenda? Look at who helps finance anti drug organizations such as the Partnership for a Drug Free America. It is the tobacco industry and its multi-billion-dollar advertising agencies. By providing money for the antidrug lobby, the tobacco industry has ensured that the lobby stayed away from our biggest drug problem - nicotine - while providing a convenient diversion away from big tobacco.
Up until Mr. Clinton and the FDA recognized that nicotine was a drug, efforts to curb the use of illegal drugs were hampered by the fact that dealing with the "gateway drug" was off limits because of a fear of antagonizing the powerful tobacco industry. By limiting their focus to illegal drugs, Clinton's Republican opponents and the Democrats allied with the tobacco industry are not only showing a willingness to see the tobacco industry continue its predatory marketing practices, but are also remaining committed to an approach to illegal drugs that ignores the crucial first drug: nicotine.
Clinton has opened the way for an effective attack on the biggest, most aggressive drug pushers in the world, the tobacco companies. In doing so, he also makes it easier to reduce the toll of illegal drugs.
*Stanton A. Glantz is a professor of medicine at the University of California, San Francisco, and author of "The Cigarette Papers" (University of California Press).