Smoking and Other Forms of Tobacco Dependence

Ms. Linda Guhe, MSW, LCSW

The History of Tobacco and Health in America

Tobacco has been around since ancient times and it has been significant throughout American history. When Christopher Columbus discovered America in 1492 he also discovered smoking tobacco. Tobacco proved to be quite appealing to those early explorers. As a result, tobacco from America spread to other parts of the world. Tobacco was first grown commercially in America in the early 1600s. In the 1800s, the revenue from taxed tobacco helped finance the Civil War. In the early 1900s, RJ Reynolds began producing and selling the first brand-name cigarette, Camel.

While popular and appealing, tobacco use has led to serious health problems in the United States and world-wide. Today, approximately 25 percent of Americans smoke. Fifty percent of those who use tobacco will die from a smoking-related illness, approximately 450,000 people each year. The number of Americans using smokeless tobacco ranges from two percent to 9 percent. Financial costs of treating tobacco-related illnesses in the US are more than 50 billion dollars a year.

Health Care Providers and Tobacco Dependence

It may be surprising to learn that tobacco dependence is actually under-diagnosed by providers in the health care community. However, because of an increasing awareness in recent years of the physical dangers to health, along with financial burden for society, tobacco has been gaining more attention in public health education and research. For example, the federal government is focussing on the problem with its Healthy People 2010 initiative.  Among the government’s health objectives for the years 2000 through 2010 is a campaign to promote the cessation of tobacco use.

There are reasons why healthcare professionals have failed in the past to recognize, diagnose, and treat tobacco dependence. For one thing, until recently, the subject of tobacco dependence as a treatable disorder has been limited in the formal training of health care professionals. As a result, in comparison to experts in other kinds of disorders, there are only a small number of researchers and specialists who provide scientific information about the effects of tobacco use and effective methods of treatment.

Money became available to fund tobacco dependence research as a result of the financial settlement of lawsuits filed against the tobacco companies by 46 states in 1994 and 1995. The lawsuits were filed in response to financial burdens experienced by states in treating tobacco-related illnesses. Money and publicity from the 1998 Master Settlement Agreement (MSA) made between tobacco companies and the states that filed the lawsuit has helped fund, draw interest to, and generate tobacco research.

Because of an increase in research in the last several years, we now have a better understanding of tobacco. We now know that tobacco products contain both (1) harmful toxins that damage health and (2) nicotine, which is a powerful addictive drug. Research has also led to the development of evidence-based methods of tobacco cessation treatments. As a result, the number of specialists in tobacco and the treatment of tobacco addiction have been increasing.

Tobacco researchers and specialists are now providing health care providers with the necessary tools and guidelines to talk with their patients about smoking, and for offering tobacco cessation treatment. In addition, there are multiple agencies providing information to the public on smoking and tobacco addiction, and help for quitting.

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