Transnational Research Associates

Addictive Behaviors Are Not a Matter

of Personal Choice or Preference

Art Madsen, M.Ed.

I. Introductory Remarks

It will be the contention of this paper that addictive behaviors thought by some theorists to be easily controlled by the patient, are, in fact, not personally controllable and are not a simple matter of personal choice or preference. Attention will be given to the rationale supporting this thesis, as found in a sampling of the literature. Several factors in society that lead to subliminal conditioning of the victim will be briefly elucidated, as will physiological conditions related to addictive substances.

To accomplish this objective, classic addictive behaviors will be summarily examined empirically and experientially within the context of studies previously conducted and published either on the Internet or in professional journals. When statements in these articles point to a denial of personal choice or controllability on the part of the patient, this information will be qualitatively documented in tabular form for display on a simplified intra-textual Table. A concerted effort will be made to locate data that support the thesis of this paper, notably that addictive behaviors, regardless of etiology, are not a matter of personal choice, but are imposed psycho-behaviorally or externally by societal pressure. Indeed, general reading in this area demonstrates this to be a factual assertion.

II. The Addiction of Smoking

Smoking of tobacco products has long been considered an addictive behavior. Medical studies indicate that nicotine is highly addictive, not simply habit-forming, and smokers are not able, physiologically, to avoid its appeal. Therefore, smoking is clearly not a matter of choice, but is imposed upon the victim who tries in vain to rid him or herself of this pleasure-producing habit. For instance, the American Lung Association (2001), the Kick-Butt Organization (1999) and the American Heart Association (2000) indicate irrevocably that smokers are drawn inexorably to these products. Furthermore, court cases, many of them highly publicized in the popular press, have also upheld this position, particularly a recent $12.7 million class-action lawsuit brought successfully against R.J. Reynolds Corporation (Speak Out, 2000). The prosecution claimed that no choice was possible for the thousands of smokers who had developed lung cancer, and that this compulsion to smoke was due to the unavoidable chemical properties leading to dependency and then to addiction.

Moreover, there has been a demonstrated pre-conditioning pattern for smoking among children of habitual smokers. For many decades, it has been known that parental smoking has subliminally influenced offspring to smoke later in life, not to mention damage physiologically inflicted by second-hand smoke. Inter-generational smoking patterns comprise, therefore, still another supportive element of the non-choice position taken by this paper.

See the Recapitulative Table below for further insight with respect to the relentless habit-forming features of smoking and four other addictive behaviors to be described textually in more detail.

Addictive Behavior

Major Studies Consulted

Qualitative Thesis Support Rating

Magnitude of Studies

Objective Comments


American Heart Assoc., Kick-Butt Org, American Lung Association

Clearly Conclusive

Millions of subjects

Medical community concurs


Becker, Garrett, Volpicelli,

Highly Supportive

Millions of subjects

General consensus


Schroeder, Hilts, Ghodse

Clearly Conclusive

Millions of subjects





Moderately Supportive

Thousands of subjects

Some dissenting opinions

Chewing Qat


NUPSA, Pantelis, Woody

Highly Conclusive

Nationwide surveys

UN experts concur

Recapitulative Table

III. Addictive Consumption of Alcoholic Beverages

The liquor industry in the United States, Europe and Asia has spent countless billions of dollars defending itself against the medical community’s claims of dependency and addiction of those ensnared by their products. The literature is rich, however, in data suggesting, indeed proving, that hard (whiskey, vodka) and soft liquor (wine, beer) are both able to deny their consumers the option of free choice, as to quantity and frequency of consumption. Studies on the tragedy of alcoholism abound. For example, Volpicelli (2000), as well as Garrett (2000) and Becker (1988), in particular, demonstrate the total helplessness of victims of alcoholism, whether in terms of physiological or psychological addiction. The chemical dependency created by regular use of alcohol has long been understood and acknowledged by therapists everywhere. Lost in the swirl of craving and re-immersion, alcoholics have no choices, no ability even to choose.

IV. Addictive Drugs

Excluding marijuana, which is becoming increasingly acceptable from a societal point of view, with support for its legalization coming from some of the highest officials in the land, truly addictive drugs such as heroine, cocaine and hallucinogens, for example PCP, LSD and Psilocybin, ensnare their users into a no-choice pattern of use and reuse. Studies such as Hilts (1994), Schroeder (2000) and Ghodse (1995) have demonstrated the wide-scale of addictive properties of drugs such as these. In fact, in the United States, and in many of the world’s societies, entire sub-cultures have developed and have been sustained through the common bond of drug dependency. These hundreds of millions of users are trapped in discernable patterns of use that endure for many years. The element of choice is not present, unless external assistance in breaking the habit is available. In most of the world’s countries, including the United States, these no-choice, dead-end addictions lead to deteriorated health and premature death. If preference or choice were options, these victims would certainly have availed themselves of alternatives. However, since an altered state of consciousness is produced, free choice is not a possibility among those who repeatedly inhale, ingest or inject these substances.

V. Compulsive Gambling and Non-Choice Psychological Consequences

At the outset, most gamblers approach this pastime lightheartedly, but soon find themselves deeply habituated and psychologically dependent on the thrills produced by the unrealistic expectation of winning vast sums. Davis (2001), NATI (2001) and CCPG (2000) in descriptions of compulsive gambling patterns among casino patrons have demonstrated that at some point in the growth of this habit, it becomes a regular necessity in the lives of these victims. Davis, in particular, describes compulsive gambling habits among women and her study is being constantly expanded and refined. Whether men or women are involved, the family budget is soon consumed and indebtedness begins to mount. Often, gambling is compounded by other habits such as drinking, and whether alone or combined, an unavoidable, non-choice cycle is produced from which the gambler finds it difficult to emerge. Losses begin to compound and the standard mentality of these habitués dictates that they continue to gamble in the vain hope of recovering their spiraling losses. Not only are issues of personal choice obscured, but clear-minded cognition is impeded. This is symptomatic of a pathological compulsion and is plainly indicative of the elimination of the element of personal choice on the part of the gambler.

VI. Chewing of Qat in Yemen

Although the Government of Yemen is attempting to influence its people against the chewing of Catha edulis, a narcotic plant grown on a par with coffee in Yemen, its use is common among more than four-fifths of the population of the country (NUPSA, 2000). Yemen is the only nation where such a habit has been allowed to reach these proportions! Even though this drug, familiarly called "qat" in Arabic, is addictive, brings about behavioral changes in all users, deprives children of money for food, and is an anorexiant leading to malnutrition, almost all men, and many women, are regular chewers of qat (NUPSA, 2000). They place it in their cheeks, creating little pouches, where they pile one wad of qat onto another all afternoon. A case can be made that this is a social convention (which it has become), although most authorities consulted believe that the properties of qat are both addictive and narcotic (Woody, 1999). Formal studies, notably Pantelis (1989), have been completed on psychosis or aberrant behavioral patterns produced by the smoking or chewing of this substance, in a category apart from normal narcotics because of its broad-based social acceptance in Yemen, Djibouti, and certain other East African locations. Therefore, whether one accepts that this is a social convention or an addiction, there is no personal option for escaping the appeal of qat once begun, usually at the age of 14.

VII. Unassailable Conclusions

By surveying a cross-section of addictive behaviors, and verifying through the literature that addiction in each instance soon becomes entirely non-voluntary, it has been adequately demonstrated that personal choice or preference is not an operative factor in these addictions. Victims ensnared in their initially pleasure-producing habits find, at a later date, that their pleasures have turned to nightmares. Their families have been destroyed financially and emotionally, their personal careers may have been eroded, and their health has more often than not been adversely affected, frequently irreversibly.

The most conclusive evidence examined in this position paper seems to have been the data contained in the tobacco and nicotine studies cited, wherein the linkage between habituation and smoking is clearly stated. There is also conclusive evidence for drugs and Yemeni qat, from which users have great difficulty escaping. While on the surface there is a ‘desire’, but not a conscious choice, to use these substances, it can be said that those affected are compelled psycho-physiologically to pursue, even to the point of self-destruction, these substances.

In the cases of gambling and alcohol, there is strong evidence of the impossibility of emerging from these two labyrinths. Rehabilitation is an option, but long-term external assistance must be forthcoming. As in the case of all substances and habits studied in this paper, compulsive gambling and alcohol-use fall into the non-choice category, according to the literature consulted.

Hope of emergence from these five addictions, and all others, lies in publicly funded or private rehabilitation programs, accessible public health facilities, and in intervention by concerned family members who, in the United States and in other countries, are ultimately responsible for taking the first step to assist their loved ones.

VIII. References

Barry, J. "Should Class Action Suits Force Big Tobacco to Pay for damages?", Speak Out.Com, Washington, D.C., 2001.

Becker, G. "A Theory of Rational Addiction", Journal of Political Economy, August 1988, 675-700.

Davis, D. "Women who took back their lives from compulsive gambling", School of Social Work, Eastern Washington University, Spokane, 2001

Garrett, F.P. "Alcohol Addiction", Behavioral Medicine Associates, Alpharetta, Georgia, 2001.

Ghodse, A.H., Drugs and Addictive Behaviour, Second Edition, Blackwell Science, London, 1995.

Hilts, P.J. "Relative Addictiveness of Drugs", New York Times, August 2, 1994.

Pantelis, C. "Use and Abuse of Khat: A Review of the Distribution, Pharmacology, Side Effects, and a Description of Psychosis attributed to Khat Chewing." Psychological Medicine, 1989, v. 19, 657-668

Rambeck, L.J. "Counseling the Pathological Gambler", National American Training Institute, Minneapolis, Minnesota, 2000.

Schroeder, C. "Addictive Drugs", Saint Rose University, Albany, N.Y., 2000.

Volpicelli, J. Medical Treatments for Alcohol Dependence", University of Pennsylvania Health System, Philadelphia, Pennsylvania, 2000.

Woody, R.C. "Chewing Qat in Yemen", Chihuahuan Desert Neurology Update, El Paso, Texas, Vol. 1, Part 3, Winter 1999.

…………… "Nicotine Addiction", Kickbutt Organization, Seattle, Washington,

……………. "Nicotine Addiction and Cigarettes", American Lung Association, New York, N.Y., 2001.

…………….. "Nicotine Addiction: What Causes Nicotine Addiction?", American Heart Association, New York, N.Y. 2001.

…………….. "What signs to look for with a gambling addiction", California Council on Problem Gambling, Palm Springs, 2000,

……………."Yemen – Land of Coffee and Qat: An Editorial", Network for United Prayer South Africa, December 15, 2000, Johannesburg,