What percentage of users become addicted?
- 4% of people who drink alcohol.
- 8% of people who use marijuana.
- 22% of people who smoke or inject cocaine.
- 35% of people who inject heroin.
- 80% of people who try cigarettes.
A recent study of drug use in the United States estimates that about 35 percent of all people who have tried injected heroin have become heroin addicts. While that’s a very high percentage relative to addiction rates of 22 percent for smoked or injected cocaine, about 8 percent for cannabis, and about 4 percent for alcohol, consider this shocking statistic: 80 percent of all the people who try cigarettes become addicted. In part, that remarkably high number reflects the fact that tobacco is legal and that the health and lifestyle penalties for smoking cigarettes, while significant, are much less than those related to heroin and often take many years to manifest.
Why is cigarette smoking so addictive when its psychoactive effect is comparatively so subtle? The reason is that the cigarette is the Galil assault rifle of the nicotine delivery world: fast and reliable. Consider that while a heroin user injects a hit and feels a potent euphoric rush about fifteen seconds later, he is not going to inject again for many hours. The cigarette smoker, on the other hand, will typically take ten puffs from a single cigarette and will often smoke many cigarettes in the course of a day. Each puff will deliver nicotine to the pleasure circuit about fifteen seconds later, approximately the same delay as for intravenous heroin. So while a typical heroin addict may get two strong, rapidly delivered hits per day, the pack-a-day cigarette smoker will get two hundred weak, rapidly delivered hits per day. But why does the nearly instant delivery of a drug to the brain, as with smoking cigarettes or injecting heroin, carry a higher risk of addiction than slow delivery of the same drug, say, by chewing tobacco or eating opium? One way to think about this is to consider that addiction is a form of learning. When someone uses a drug, associations are made between a particular act (injecting the drug or chewing the tobacco) and the pleasure that follows.
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