Mintz has argued that a primary reason sugar has escaped social disapproval is that, whatever conspicuous behavioural changes may occur when infants consume sugar, it did not cause the kind of "flushing, staggering, dizziness, euphoria, changes in the pitch of the voice, slurring of speech, visibly intensified physical activity or any of the other cues associated with the ingestion" of other drugs. Sugar appears to cause pleasure with a price that is difficult to discern immediately and paid in full only years or decades later. With no visible, directly noticeable consequences, as Mintz says, questions of "long-term nutritive or medical consequences went unasked and unanswered". Most of us today will never know if we suffer even subtle withdrawal symptoms from sugar, because we'll never go long enough without it to find out.

Sugar historians consider the drug comparison to be fitting in part because sugar is one of a handful of "drug foods", to use Mintz's term, that came out of the tropics, and on which European empires were built from the 16th century onward – the others being tea, coffee, chocolate, rum and tobacco.

Its history is intimately linked to that of these other drugs. Rum is distilled, of course, from sugar cane. In the 17th century, once sugar was added as a sweetener to tea, coffee and chocolate, and prices allowed it, the consumption of these substances in Europe exploded. Sugar was used to sweeten spirits and wine in Europe as early as the 14th century; even cannabis preparations in India and opium-based wines and syrups contained sugar.

As for tobacco, sugar was, and still is, a critical ingredient in the American blended-tobacco cigarette, the first of which was Camel. It's this "marriage of tobacco and sugar", as a sugar-industry report described it in 1950, that makes for the "mild" experience of smoking cigarettes as compared with cigars and, perhaps more important, makes it possible for most of us to inhale cigarette smoke and draw it deep into our lungs.