[Skip to Content]
[Skip to Content Landing]
September 26, 1990

Blue Mood, Blackened Lungs: Depression and Smoking

JAMA. 1990;264(12):1583-1584. doi:10.1001/jama.1990.03450120095038

The notion of "self-medication" is one of the most intuitively appealing theories about drug abuse. According to this hypothesis,1 drug abuse begins as a partially successful attempt to assuage painful feelings. This does not mean seeking "pleasure" from the use of drugs. Rather, individuals predisposed by biological or psychological vulnerabilities find that drug effects corresponding to their particular problems are powerfully reinforcing. For example, clinical observations suggest that persons who have difficulty regulating mood may be particularly vulnerable to abuse of cocaine or other stimulant drugs, persons who have difficulty controlling anger to abuse of heroin and other opioids, and persons who have high anxiety levels to abuse of alcohol and other sedatives. Many drug abusers report that their drug helped them to feel "normal," even before they developed physiological dependence with continued drug use necessary to prevent withdrawal symptoms.1

Such clinical observations are supported by the recent