Q What's addicting about cigarettes?

Dr. Koop: Nicotine. Take the nicotine out of cigarettes and smokers lose their interest in smoking. Nicotine is a powerful, fast acting drug that causes change in heart rate, blood pressure, brain chemistry and mood. Each puff delivers a "hit" or "shot" of nicotine to the brain within seven seconds. Over time, smokers become accustomed to a certain amount of nicotine each day. When their nicotine level falls below this "comfort zone," they may experience cravings and other withdrawal reactions, signals that more nicotine is needed. Only nicotine satisfies these cravings and bring relief. Withdrawal reactions are temporary. But they prevent many smokers who want to quit from succeeding.

Q Is nicotine as addictive as other drugs?

Dr. Koop: Yes. Nicotine causes addiction in the same ways that other drugs do. And the need to overcome cravings and withdrawal reaction when you first quit is much the same as for withdrawal from drugs like cocaine, heroin and morphine. Nicotine in cigarettes may be more addicting than other drugs, because the smoker gets so many "hits" of nicotine each day.

Think about it. Each puff of cigarette smoke delivers a "hit" or "shot" of nicotine. Assuming only ten puffs per cigarette, a pack-a-day smoker is getting over 200 "hits" of nicotine each day, over 1,400 each week, over 73,000 each year!

Q How can I tell if I'm addicted to smoking?

Dr. Koop: If you smoke every day, especially if you smoke ten or more cigarettes a day the chances are that you are addicted to nicotine. If you have a hard time going for long periods without smoking, or if you've noticed strong withdrawal reactions when you've tried to quit before, you may be highly addicted. Take the test on the next page to rate your level of addiction