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Allan J. Wilke, MD
Cedar Rapids Medical Education Program Cedar Rapids, Iowa

JAMA. 1986;255(8):1015.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

Dr Hickey's¹ letter in the Sept 13, 1985, issue of JAMA must not go unanswered. Dr Hickey would have us believe that "cigarette smoking, for many persons, is symptomatic of a physiologic deficiency that nicotine tends to alleviate." He later draws a parallel between satisfying hunger by eating and ameliorating a biologic monoamine neurotransmitter shortage by smoking a cigarette. Thank goodness we were not treated to the analogy of a junkie ameliorating his lack of central nervous system opiate receptors by mainlining heroin!

Cigarette smoking is an addiction. Like other addictions, it is associated with drug-seeking behavior and a well-described withdrawal syndrome. The sooner we begin to deal with tobacco abuse in these terms, the sooner we will be able to detoxify its victims.

It is ironic that Dr Hickey's letter appeared in the same issue of JAMA as The Carter Center's report, "Closing the Gap."² . . . [Full Text PDF of this Article]

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