Perhaps the most important for its survival is that it promises to be not only the most effective but also the most economical model. At this time, research on the dual-diagnoses problem indicates that both problems must be treated effectively for progress to occur in either. The limitations of our current system of care constitute an unnecessary and harsh additional burden for those afflicted with dual and triple diagnoses. The recent tobacco settlements will probably provide funding for the treatment of nicotine dependence on a scale not reached to date. Two of the three most important people in the founding and popularization of Alcoholics Anonymous died of tobacco-caused illnesses.
Nicotine dependence is a marker for almost all substance-related disorders.
If a person has a diagnosis of heroin, alcohol or cocaine dependence, it is highly likely that they will have a diagnosis of nicotine dependence. The public health model of care should provide comprehensive treatment for the full spectrum of nicotine dependence. At one end of the spectrum are those who are able to solve their dependence problems with little or, most frequently, no treatment. This is a population with nicotine dependence of moderate severity, uncomplicated by depression or other DSM-IV disorders. These people tend to have adaptive skills and social and environmental resources.