Drug Dependence Symptoms of Substance Dependence Associated with Use of Cigarettes, Alcohol, and Illicit Drugs --- United States, 1991--1992 Each year in the United States, approximately 400,000 deaths result from cigarette smoking, 100,000 from misuse of alcohol, and 20,000 from use of illicit drugs. Many of the adverse health effects associated with the use of tobacco, alcohol, and illicit drugs result from long-term use caused by substance dependence (i.e., addiction)---a cluster of cognitive, behavioral, and physiological symptoms indicating sustained psychoactive substance use despite substance-related problems. In addition, substance dependence