Big Nicotine, Part II: Addiction and the “Cult of Pharmacology”

Last month, the U.S. Food and Drug Administration announced its intention to lower the nicotine content of cigarettes to, ideally, “minimally or nonaddictive” levels. Public health advocates celebrated the decision; on the other hand, Big Tobacco investors began dumping shares at the prospect of supplying an ever-more-elastic demand.

Cigarette critics and capitalists alike belong to what Richard DeGrandpre calls the “cult of pharmacology,” a system of belief that dominates American drug discourse. Rooted in modernist faith in understanding the world through scientific approach, by the early twentieth century many considered drug experience to be a straightforward process of brain and body chemistry, without regard for concepts we might recognize today as set and setting. Historically contingent forces divide drugs into “angel” and “demon” categories, but their effects are similarly reduced to biological mechanism: “‘soul’ was reinterpreted as ‘mind,’ and ‘spirit’ was reinterpreted as ‘biochemistry.’”

But cults are given to blind faith, so it is worth considering the extent to which substances are to blame for problem use. Continue reading →

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Big Nicotine, Part I: Big Tobacco’s Drug Problem

Just over a week ago, the United States Food and Drug Administration announced what new FDA chief Dr. Scott Gottileb called “a cornerstone of our new and more comprehensive approach to effective tobacco regulation”: an initiative to reduce the nicotine content in cigarettes to “minimally or nonaddictive” levels. The 2009 Tobacco Control Act gave FDA authority to reduce any “additives, constituents…, or other component of a tobacco product.”

Obama Tobacco

President Barack Obama signing the Tobacco Control Act

Public health historian Robert Proctor was thrilled. “This is exceptionally good news for tobacco control, and for human health,” he wrote last week in the New York Times. Not so for companies like Altria and British American Tobacco, whose stock value fell within an hour of the statement (and recovered somewhat before the closing bell).

Big Tobacco was reeling for good reason: nicotine is the primary addictive component of cigarette smoking, not incidentally the leading cause of preventable deaths in the U.S. The addictive capacity of nicotine is now practically indisputable. For over sixty years, government regulators, independent researchers, and tobacco company scientists have investigated the extent of that capacity and the danger it poses when delivered via tar-laden cigarettes. Continue reading →