According to NIDA (2007), tobacco use resulted in the death of approximately 100 million people in the twentieth century, with a projected total approaching 1 billion by the end of this century at the current rate of usage. Nevertheless, NIDA still currently considers "drug" addiction as a disease, despite its contradictory failure to ascribe the same characterization to nicotine addiction.

In justifying its position that addiction is a "disease of the brain," NIDA (2007) relies primarily on neurological data provided by advanced methods of brainwave studies and brain imaging technologies, which identify characteristic differences between neurological responses to the ingestion of drugs and alcohol by individuals prone to addiction and the responses of individuals less prone to addiction to the same agents.

These studies demonstrate that the brains of addicts respond very differently from those of non-addicts, in intensity, as well as in terms of regional involvement (NIDA, 2007).

However, as Reinarman (2005) and others explain, many of these differences represent learned patterns of autonomic responses rather than inherent physiological differences characteristic of other medical diseases. Similarly, the same brainwaves and other neurological manifestations of drug addiction are equally apparent in the brains of individuals addicted to food, exercise, sex, gambling, caffeine, tobacco, and even shopping. Therefore, in principle, the same criteria should justify classifying as a disease virtually any human behavioral activity that causes these neurological responses.

Conclusion:

Ingesting substances known to produce temporary sensory pleasure, or those known for their value in mood enhancement is a feature of human societies throughout the world, and almost certainly predates recorded history (Brecher, 1972). Whether a particular practice is regarded as an accepted...

Irrespective of their social connotations, a very wide range of human behaviors are capable of resulting in addictive behaviors. Many times, it is the societal perspective associated with the ingestion of a particular substance, more than anything else, that defines addiction to it as a disease, because similar behavior with respect to substances (or behaviors) unattached to social stigma is not similarly designated.
Admittedly, genetic predisposition and external environmental factors contribute to make some individuals more predisposed to addiction than others. Nevertheless, defining addiction as a disease still, necessarily, involves amorphous criteria and subjective determination, precisely because its symptoms vary so much between and among different individuals, as well as because addiction to drugs mirrors addiction to benign behaviors so closely.

Ultimately, what matters more than a definitive classification of drug addiction as bona fide medical disease is that its symptoms be addressed in a manner conducive to their relief and to ending the addiction. Toward that end, the best strategy is to address the factors implicated in addiction before they manifest themselves in addiction, regardless of its precise designation.