Any sustained debate about legalizing drugs eventually includes reference to alcohol, a habit-forming psychoactive substance that causes enormous damage as a result of its behavioral and physiological effects. The failure of Prohibition (a constitutional amendment, no less), as illustrated by the passage of Repeal just 13 years later, is the standard cite in the argument for legalizing the currently illegal substances. The first half of this chapter examines Prohibition and the regimes that have evolved since Repeal.

The debate gives little attention to tobacco, the habit-forming psychoactive substance responsible for the greatest number of deaths, beyond occasional reference to the recent declines in cigarette use through regulation and education without prohibition. Yet a great deal of insight about legal regimes for addictive substances can be obtained from examination of experiences with cigarette regulation and use since the 1964 Surgeon General's Report first made the dangers of smoking a matter of common knowledge.

This chapter makes three substantive points. First, the parallel between Prohibition and current drug policy is compelling, but the lessons are quite obscure, primarily because of differences in the history surrounding use of the two substances. Second, U.S. policy toward alcohol and cigarettes has performed poorly in terms of protecting public health; these substances are now the leading causes of preventable death. Third, the reasons for the failures are not idiosyncratic to those substances but are rooted in characteristics of the American legal and political systems.