Two tales of addiction; Opium and nicotine

The paper traces the different history of the concept of addiction in relation to the use of opiates from its history in relation to the use of nicotine. Addiction had its origin in the 19th century, specifically through the concept of inebriety, so far as opium was concerned. For nicotine, the concept of addiction is a more recent arrival. The paper identifies a number of factors which have contributed to the different trajectories. These include different roles within popular culture and consumption; and the establishment of policy round the acceptance of addiction for drugs as early as the 1920s. Smoking, by contrast, remained on the fringes of the 'medical model' at that time. Different concepts were subsequently supported by different medical coalitions. There has, in the post-war period, been psychiatric ownership of drug addiction by comparison with the initial public health/epidemiologic route for smoking. The paper argues that recent events - AIDS for drug use and the concepts both of passive smoking and of addiction for smoking, are bringing the public health and addiction constituencies closer together for both substances. (C) 1997 by John Wiley & Sons, Ltd.