Editor’s note: ‘Dr. Tom’ has taken thousands of histories from California marijuana smokers and his research has been published in a medical journal.
A significant limitation on my use of cannabis applicant histories as evidence that our drug policy is a huge national mistake is that they are privileged. Thus I’m not free to use them except as anonymous statistics. However, now that I’ve accumulated enough data to make generalizations (that can also be tested by any other pot docs who have taken the trouble to ask similar questions) I also feel free to comment on drug use by public figures appearing in the public domain. One such item is President Obama’s cigarette habit. We already knew that, in addition to having admitted smoking cigarettes in the recent past, he is the only American President to admit trying “marijuana” and getting “high;” also that he experimented with cocaine. What he probably does not realize is that as a biracial male born in the Baby Boom, he fits, to a remarkable degree, the profile I’ve been developing for cannabis use as a modern behavioral phenomenon.
1) male gender: (75%)
2) born in 1946 or later, (96%)
3) trial of inhaled cannabis to the point of getting “high,” (100%)
4) trial of alcohol to the point of intoxication, (100%)
5) inhaling smoke from at least one cigarette. (96%)
Modern “addiction” research, which wasn’t vigorously pursued by behavioral scientists until after passage of the Controlled Substances Act of 1970, has remained focused on the “risk” that adolescents who try certain drugs will subsequently try others. Although such studies quickly gave rise to a “Gateway” theory in the early Seventies, the theory itself has not progressed beyond a disputed, somewhat incoherent hypothesis. The most obvious reason (although not widely admitted) is that federal funding for drug “research” has been limited by Congress to studies that support the drug war; thus it’s hardly unbiased.
To return to the President’s smoking addiction, one of the more prominent characteristics of people who eventually apply for cannabis recommendation is that 96% of them also tried cigarettes and roughly 2/3 became daily cigarette smokers for at least a while. Of those, nearly half were still smoking at the time of their initial interview (one of the benefits of the ad-hoc “renewal” requirement added to Proposition 215 is that it allows for follow-up of those applicants who opt to return). Another unanticipated benefit of the proposition is that it has uncovered subsets of behaviors that might not have been anticipated; for example, nearly everyone now smoking cigarettes feels guilty or foolish and most have tried to quit. One of the variants is “bar smoking,” the practice of accepting (or mooching) cigarettes from friends in social situations, often in association with consumption of alcohol. In fact, another subset are people who only smoke on such occasions and do not progress to full fledged recidivism by starting to buy them again; but, needless to say “bar smoking” is one setting in which recidivism is most apt to occur. Others are increased “stress” or inability to use cannabis. For me, bar smoking or stress preceded each of several returns to cigarettes between 1976 (I had quit completely for the first time in 1974) and 1993.
Since 1993, I have not been tempted and now cannot imagine lighting another cigarette, but also have to acknowledge that my compulsion to smoke them for almost fifty years was not deterred by daily contact with cigarette victims from 1953 on (1953 was my first year in medical school: also when I first pondered the unequivocal link between cigarette smoking and lung cancer established by Wynder and Graham).
I can only wish President Obama well and hope he will not only read these words, but will be inspired to consider his inadvertent culpability as head of the US federal bureaucracy most responsible for an insane global drug policy.
Doctor Tom
