More than two thirds remissions from cannabis and cocaine dependence occurred within the first decade after onset of dependence, whereas only one-fifth of remissions from nicotine dependence and one-third of remissions from alcohol dependence occurred within that period. The differences in the rate of remission across substances may be explained, at least in part, by the speed at which physical, psychological and social adverse consequences manifest after the onset of dependence. For instance, the risk of early cardiovascular adverse consequences is much higher among individuals with cocaine dependence than among those with nicotine or alcohol dependence [33]. The behavioral disturbances resulting from cannabis or cocaine dependence and their illegal status impose stronger social pressures to remit [15]. The high availability of alcohol and nicotine environmental cues for their consumption may also contribute to explain the difficulty stopping the use of these substances [35]. Particularly for nicotine, the immediate perceived benefits from its use, including anxiety and stress reduction, improved performance on a variety of cognitive tasks, and decreased food consumption and metabolism [35], may initially outweigh the potential perceived harms produced by its chronic use.
