Standing back from the research trenches from time to time to take a wide view of past horizons on what is already known about addiction is vital to scientific progress. 'The 10 most important things known about addiction' has stimulated discussion and debate amongst senior colleagues, as hoped, and contributes to broad reflection on where we are at in our knowledge and strategically direct future research energy.
Rutger Engels wants us to come up with a hundred things known about addiction, ordered according to the ten most important addictions, to capture important detail about separate compulsive disorders. He suggests addiction to tobacco smoking has unique features that inclusion in the broad category of 'addiction' does not give justice to the topic. While acknowledging there are important specific aspects of tobacco addiction, nevertheless, as with other addictions,
'. . . . involves a genetically influenced set of behaviours that become increasingly compulsive with repetition, although consciousness is not particularly required for the learning to take place. Most people who present for help have multiple problems, the majority of whom subsequently run a chronic relapsing course of their [tobacco addiction]. Various psychological treatments appear to produce similar results but the more individualised and broad-based the whole input is, the better the outcomes will be. Empathic listening is central to the beginning of the change process but consolidated lifestyle change takes time, even in those who recover from [tobacco] addiction following a seemingly miraculous life-changing experience'.
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