This paper attempts to explain some of the factors which make it difficult for heavy cigarette smokers to give up smoking, or to switch to cigars or pipe, in spite of the general recognition of the increased risk to their physical health and life expectancy which accompanies heavy cigarette smoking.

Heretofore, all forms of smoking have been usually considered an oral addiction, deriving from the constellation of needs, pleasures, and conflicts relating to the mouth and its activities, sucking, biting, swallowing, spitting, etc.