The Deadliest Drug

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THE COURIER-JOURNAL | OP-ED | JANUARY 10, 2015

As lawmakers seek to craft a solution to the state’s heroin problem, they should consider an even more deadly and equally addictive drug that kills far more Kentuckians each year than all other drugs combined.

Most often ingested through “free-basing,” or inhaling fumes, the drug delivers a near-instant hit to receptors in the brain that quickly hooks the user.

Quitting is hard and continued use is life-threatening.

The drug is nicotine and smoking cigarettes is the most common delivery method. Kentucky, where more than a quarter of adults smoke, has the highest rate of smoking in the country.

And last year, nearly 9,000 Kentucky adults died from smoking-related diseases.

By contrast, about 1,000 Kentuckians die from drug overdose deaths each year. In 2013, 230 of those deaths were attributed to heroin.

This is not to suggest heroin and other illegal drugs are not a serious problem in Kentucky. Of course they are.

But smoking also is a serious drug problem that must be confronted.

Sunday marks the 51st anniversary of the U.S. Surgeon General’s report, “Smoking and Health,” that shocked the nation with its conclusion that smoking causes lung cancer.

Dr. Luther Terry, then surgeon general and himself a longtime smoker, recalled afterwards the Jan. 11, 1964 report hit the country “like a bombshell.”

In 1988, then-Surgeon General C. Everett Koop declared nicotine —the key ingredient in tobacco — to be addictive, as addictive as heroin or cocaine.

“Urgings or cravings to use the drug may be recurrent and persistent,” Dr. Koop said of nicotine.

The surge in heroin abuse is recent, thought to result from addicts seeking an alternate fix after the state’s 2012 crackdown over “pill mills,” a source of narcotic drugs.

But Kentucky lawmakers have known for 51 years that cigarette smoking causes lung cancer and is linked to many other deadly diseases.

For 27 years, they have known nicotine is an addictive drug.

Yet lawmakers have been painfully slow to address an acute public health problem that is costing the state thousands of lives and millions of dollars in health costs.

This year, members of the General Assembly could take a modest step by adopting a statewide, smoke-free law, as 24 states have done. It would protect many Kentuckians from secondhand smoke and likely encourage smokers to cut back or quit.

Addressing heroin abuse is important. But if lawmakers truly are concerned about drug deaths, they must not overlook tobacco.

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