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Charles Carroll of Carrollton had been an early proponent of independence from the mother country, writing often in the Maryland Gazette under the pseudonym First Citizen, and serving on various Committees of Correspondence

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At the same time, the body responds to the lack of the addictive substance through a wide range of physical symptoms.According to results from the 2019 National Survey on Drug Use and Health published in 2020 by the Substance Abuse and Mental Health Services Administration (SAMHSA), substance use disorder (SUD) affected over 20.4 million individuals 12 years of age and older in the previous year

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Over the next 48 years, until his retirement in 2014, he served as an editor of 17 reports of the Surgeon General on smoking and health, as interim director of the Office on Smoking and Health for two years in the 1980s, and as an advisor on smoking and health at the National Cancer Institute