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The Natural History of a Dependence Disorder
The natural history of a dependence disorder

By inhaling, the smoker can get nicotine in his brain more rapidly than the heroin addict can get a “buzz” when he shoots heroin into a vein.

—Russell and Feyerabend (1978)

About two thirds of college students have tried tobacco, but far fewer of them will use tobacco throughout their lives. What risk factors make a person susceptible to long-term smoking? And what is it about cigarettes that draws a young person toward experimentation and then moves him or her on to regular use? This chapter explores some of those forces, including cultural attitudes about smoking, biological vulnerability, and tobacco's reinforcing properties.

Picture a 12-year-old hunched over on the front steps of an apartment building ...

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