This post is reprinted with permission from Sue’s Substack, by Sue Rusche.
I’ve been thinking a lot lately about the effort to destigmatize addiction by using gentler words. Most scientists agree that addiction is a disease of the brain which gradually changes the way we behave. Writers like Sam Quinones, schooled in using as few words as possible to tell a story, laments “substance use disorder”—three words, seven syllables as opposed to addiction’s one word, three syllables.
Cancer, a disease that affects every organ of the body including our brain, bones, muscles, even our blood, arouses empathy when someone tells you they have it. Addiction? Not so much.
Implicit in the difference between the words “addiction” and “cancer” is the unconscious sense that people with addiction “do it to themselves” as opposed to sympathy for cancer victims. But doesn’t cancer occur in at least some people who “do it to themselves” too? After all, the World Health Organization (WHO) says 40 percent of cancers are preventable with lifestyle changes leading the way. Tobacco kills 480,000 Americans every year. Alcohol kills 178,000 Americans.
Maybe we are barking up the wrong tree. Perhaps we need to focus less on substituting gentle words for addiction and focus more on the commercial forces coming at us. Those forces start when we are children and teenagers. Companies use their billions to market their products to us when we are young and our brains are growing and therefore vulnerable. Their products cause diseases we don’t want when we are older but have spent a lifetime drinking or smoking.
Two articles this month have led me to this thinking. A study the Biden administration commissioned to provide Americans with the latest science about alcohol did not make it into the Dietary Guidelines for Americans 2025-2030. Robert F. Kennedy, head of the National Institutes for Health, rejected it. That study finally saw the light of day this month in the Journal on the Studies of Alcohol and Drugs.
Robert Vinson, then of the Substance Abuse and Mental Health Services Administration (SAMHSA) directed the Interagency Coordinating Committee on the Prevention of Underage Drinking from 2021 to 2025. He wrote an editorial introducing the forbidden study in the journal. The committee was responsible for surveillance, coordination, and reporting to Congress on underage drinking and alcohol-related harm. Mr. Vincent worked for the federal government for nearly four decades but was abruptly fired “as part of a targeted reduction in force that dismantled much of the federal infrastructure for alcohol prevention and treatment policy. The reduction mattered, he says, because it pitted “a federally authorized scientific effort that produced evidence at odds with powerful commercial interests.”
He writes that “Weakening the evidence base does not eliminate alcohol-related harm; it shifts it to communities, families, and public systems already under strain.” (Emphasis added.)
The second article which came across my desk yesterday is from STOP, an organization that connects experts in all aspects of the tobacco industry’s business to expose and counter its relentless efforts to sell harmful, addictive products. Addiction in Every Pocket: Nicotine Pouches and the Seeds of a New Youth Epidemic shows 34 billion nicotine pouches were sold worldwide in 2025, a 660% increase over 2020. What’s more, nicotine pouches in the US alone increased by 1,300% between 2019 and 2025.
“Philip Morris International and British American Tobacco appear to be following the same playbook they used to create the cigarette and e-cigarette epidemics to hook as many people on pouches as they can, before regulations can catch up,” writes STOP.
“They’re doing it by reaching young people on social media, offering dozens of flavors and marketing pouches as both popular lifestyle products and as implied tobacco cessation aids—even though they’re not proven to help people quit smoking,” says the article.
I would note that British American Tobacco is the company that recently bought 40 percent of stock in Charlotte’s Web, the Colorado company that grows hemp “wellness products.” For a clear view of the largest tobacco company investments in the marijuana industry, visit Tobacco Tactics at the University of Bath in the UK.