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Conceptual and methodological considerations for tobacco addiction research.

The 1988 Surgeon General's Report on nicotine addiction has research and treatment implications. It focuses clinical treatments on tobacco use as an addiction and highlights the importance of examining actions of nicotine relevant to dependence. It also indicates the value of comparing the pharmacologic and behavioral processes underlying use of nicotine with other addictive drugs. This essay points out gaps that remain in our understanding of nicotine addiction. For example, the exact mechanisms underlying nicotine addiction are unknown. Also, the reasons for individual differences in initiation, withdrawal, relapse and reinforcing effects of tobacco use are not understood. Research designed to address these issues should be problem-driven and multidisciplinary. Parallel human and animal studies that include unconditioned as well as conditioned behaviors are particularly valuable.