Two Tales of Addiction; Opium and Nicotine

Abstract

The paper traces the dierent history of the concept of addiction in relation to the use of opiates from its history in relation to the use of nicotine. Addiction had its origin in the 19th century, speci®cally through the concept of inebriety, so far as opium was concerned. For nicotine, the concept of addiction is a more recent arrival. The paper identi®es a number of factors which have contributed to the dierent trajectories. These include dierent roles within popular culture and consumption; and the establishment of policy round the acceptance of addiction for drugs as early as the 1920s. Smoking, by contrast, remained on the fringes of the`medical model' at that time. Dierent concepts were subsequently supported by dierent medical coalitions. There has, in the post-war period, been psychiatric ownership of drug addiction by comparison with the initial public health/epidemiologic route for smoking. The paper argues that recent events Ð AIDS for drug use and the concepts both of passive smoking and of addiction for smoking, are bringing the public health and addiction constituencies closer together for both substances.

Medicalisation, smoking and e-cigarettes: evidence and implications

“…Early in the 20th century, tobacco use was seen as problematic by some, but it was not perceived as an inebriating drug like alcohol or opiates, so tobacco use was not categorised as a ‘disease’ like other addictive drugs 8. While some pointed to features of smoking that signalled addiction,9 the term ‘addiction’ was not widespread and addiction was not recognised as a factor in smoking in official government documents.…”

“…First, the tobacco control field emerged from epidemiology and public health 8. Consequently, a medical approach has not displaced the population-based measures that remain central to the field's research and policy advocacy.…”

A thickening plot: components and complexities in the political framing of the smoking problem in Sweden, 1957–1993

“…This perspective sees education and prevention as techniques above all else in the service of improved public health, and it has since the 1990s been underpinned and validated by its own research fieldprevention sciencewhich clearly shifts the responsibility onto the individual while brushing aside the more ideological questions (Roumeliotis, 2015). Much of the post-war New Public Health has focussed on smoking in particular, so much so that, for example, the 1950s coupling of smoking and lung cancer took its cue from New Public Health by stressing the individual's responsibility rather than a smoking ban (Berridge, 1997;2006;Brandt, 1991;Porter, 2008;Saebø, 2012).…”

“…Berridge (2007) argues however that the popular view of smoking as serious dependence kept lacking the institutional or professional legitimacy that could have placed the question on the political agenda in Britain. It was not until the early 1940s that smoking began to emerge as an addiction in the British research, and it took another ten years for psychological dependence to be included in treatment schemes (Berridge, 1997;Elam, 2014). The first British rehabilitation clinic opened in 1962 (Berridge, 1998), while a similar institutionalised treatment model had already found a place in Swedish rehabilitation clinics in the mid-1950s (Elam, 2014).…”

MEANINGS & MOTIVES Experts Debating Tobacco Addiction

“…What constitutes “addiction” and “dependence” has varied across time,2 between national contexts,3 and between substances 4. In the 18th century, the idea began to emerge that drunkenness was not a moral or religious weakness but a disease that required medical attention.…”