The neurobiology and treatment of tobacco dependence

Article
  • 33 Downloads

Abstract

Tobacco dependence is a major cause of preventable morbidity and mortality in the United States. Smoking cessation significantly reduces these health consequences. Many smokers want to stop smoking, but few succeed because of the chronic, relapsing nature of nicotine addiction. However, with our growing understanding of the neural effects of nicotine, many effective therapeutic options have been developed and become clinically available. This article summarizes the latest data on the epidemiology, neurobiology, and pharmacotherapies for the treatment of tobacco dependence.

Keywords

Nicotine Smoking Cessation Ventral Tegmental Area Bupropion Nicotine Dependence 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References and Recommended Reading

  1. 1.
    Centers for Disease Control and Prevention (CDC): Annual smoking-attributable mortality, years of potential life lost, and economic costs—United States, 1995–1999. MMWR Morb Mortal Wkly Rep 2002, 51:300–303.Google Scholar
  2. 2.
    NIH State-of-the-Science Panel: National Institutes of Health State-of-the-Science conference statement: tobacco use: prevention, cessation, and control. Ann Intern Med 2006, 145:839–844.Google Scholar
  3. 3.
    Anderson JE, Jorenby DE, Scott WJ, Fiore MC: Treating tobacco use and dependence: an evidence-based clinical practice guideline for tobacco cessation. Chest 2002, 121:932–941.PubMedCrossRefGoogle Scholar
  4. 4.
    DiFranza JR, Rigotti NA, McNeill AD, et al.: Initial symptoms of nicotine dependence in adolescents. Tob Control 2000, 9:313–319.PubMedCrossRefGoogle Scholar
  5. 5.
    Hu MC, Davies M, Kandel DB: Epidemiology and correlates of daily smoking and nicotine dependence among young adults in the United States. Am J Public Health 2006, 96:299–308.PubMedCrossRefGoogle Scholar
  6. 6.
    Breslau N, Johnson EO, Hiripi E, Kessler R: Nicotine dependence in the United States: prevalence, trends, and smoking persistence. Arch Gen Psychiatry 2001, 58:810–816.PubMedCrossRefGoogle Scholar
  7. 7.
    Mayhew KP, Flay BR, Mott JA: Stages in the development of adolescent smoking. Drug Alcohol Depend 2000, 59(Suppl 1):S61–S81.PubMedCrossRefGoogle Scholar
  8. 8.
    Tyndale RF: Genetics of alcohol and tobacco use in humans. Ann Med 2003, 35:94–121.PubMedCrossRefGoogle Scholar
  9. 9.
    Grant BF, Hasin DS, Chou SP, et al.: Nicotine dependence and psychiatric disorders in the United States: results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 2004, 61:1107–1115.PubMedCrossRefGoogle Scholar
  10. 10.
    Zevin S, Gourlay SG, Benowitz NL: Clinical pharmacology of nicotine. Clin Dermatol 1998, 16:557–564.PubMedCrossRefGoogle Scholar
  11. 11.
    Mansvelder HD, McGehee DS: Cellular and synaptic mechanisms of nicotine addiction. J Neurobiol 2002, 53:606–617.PubMedCrossRefGoogle Scholar
  12. 12.
    Anthenelli RM: Recent advances in the treatment of tobacco dependence. Clin Neurosci Res 2005, 5:175–183.CrossRefGoogle Scholar
  13. 13.
    Dani JA, Bertrand D: Nicotinic acetylcholine receptors and nicotinic cholinergic mechanisms of the central nervous system. Annu Rev Pharmacol Toxicol 2007, 47:699–729.PubMedCrossRefGoogle Scholar
  14. 14.
    Benowitz NL: Clinical pharmacology of nicotine: implications for understanding, preventing, and treating tobacco addiction. Clin Pharmacol Ther 2008, 83:531–541.PubMedCrossRefGoogle Scholar
  15. 15.
    Henningfield JE, Benowitz NL, Slade J, et al.: Reducing the addictiveness of cigarettes. Council on Scientific Affairs, American Medical Association. Tob Control 1998, 7:281–293.PubMedGoogle Scholar
  16. 16.
    Benowitz NL, Lessov-Schlaggar CN, Swan GE, Jacob P III: Female sex and oral contraceptive use accelerate nicotine metabolism. Clin Pharmacol Ther 2006, 79:480–488.PubMedCrossRefGoogle Scholar
  17. 17.
    Fiore MC, Bailey WC, Cohen SJ, et al.: Treating Tobacco Use and Dependence: 2008 Update. Rockville, MD: USPHS Department of Health and Human Services; 2008.Google Scholar
  18. 18.
    Rigotti NA: Clinical practice. Treatment of tobacco use and dependence. N Engl J Med 2002, 346:506–512.PubMedCrossRefGoogle Scholar
  19. 19.
    Stead LF, Perera R, Bullen C, et al.: Nicotine replacement therapy for smoking cessation. Cochrane Database Syst Rev 2008, (1):CD000146.PubMedGoogle Scholar
  20. 20.
    Hajek P, West R, Foulds J, et al.: Randomized comparative trial of nicotine polacrilex, a transdermal patch, nasal spray, and an inhaler. Arch Intern Med 1999, 159:2033–2038.PubMedCrossRefGoogle Scholar
  21. 21.
    Hurt RD, Offord KP, Croghan IT, et al.: Temporal effects of nicotine nasal spray and gum on nicotine withdrawal symptoms. Psychopharmacology (Berl) 1998, 140:98–104.CrossRefGoogle Scholar
  22. 22.
    Schneider NG, Olmstead RE, Franzon MA, Lunell E: The nicotine inhaler: clinical pharmacokinetics and comparison with other nicotine treatments. Clin Pharmacokinet 2001, 40:661–684.PubMedCrossRefGoogle Scholar
  23. 23.
    Schneider NG, Lunell E, Olmstead RE, Fagerstrom KO: Clinical pharmacokinetics of nasal nicotine delivery. A review and comparison to other nicotine systems. Clin Pharmacokinet 1996, 31:65–80.PubMedGoogle Scholar
  24. 24.
    Shiffman S, Dresler CM, Hajek P, et al.: Efficacy of a nicotine lozenge for smoking cessation. Arch Intern Med 2002, 162:1267–1276.PubMedCrossRefGoogle Scholar
  25. 25.
    Sweeney CT, Fant RV, Fagerstrom KO, et al.: Combination nicotine replacement therapy for smoking cessation: rationale, efficacy and tolerability. CNS Drugs 2001, 15:453–467.PubMedCrossRefGoogle Scholar
  26. 26.
    Blondal T, Gudmundsson LJ, Olafsdottir I, et al.: Nicotine nasal spray with nicotine patch for smoking cessation: randomised trial with six year follow up. BMJ 1999, 318:285–288.PubMedGoogle Scholar
  27. 27.
    Hughes JR, Stead LF, Lancaster T: Antidepressants for smoking cessation. Cochrane Database Syst Rev 2003, (2):CD000031.Google Scholar
  28. 28.
    Mansvelder HD, Fagen ZM, Chang B, et al.: Bupropion inhibits the cellular effects of nicotine in the ventral tegmental area. Biochem Pharmacol 2007, 74:1283–1291.PubMedCrossRefGoogle Scholar
  29. 29.
    Hays JT, Hurt RD, Rigotti NA, et al.: Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation: a randomized, controlled trial. Ann Intern Med 2001, 135:423–433.PubMedGoogle Scholar
  30. 30.
    Faessel HM, Gibbs MA, Clark DJ, et al.: Multiple-dose pharmacokinetics of the selective nicotinic receptor partial agonist, varenicline, in healthy smokers. J Clin Pharmacol 2006, 46:1439–1448.PubMedCrossRefGoogle Scholar
  31. 31.
    Jorenby DE, Hays JT, Rigotti NA, et al.: Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006, 296:56–63.PubMedCrossRefGoogle Scholar
  32. 32.
    Gonzales D, Rennard SI, Nides M, et al.: Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial. JAMA 2006, 296:47–55.PubMedCrossRefGoogle Scholar
  33. 33.
    Tonstad S, Tonnesen P, Hajek P, et al.: Effect of maintenance therapy with varenicline on smoking cessation: a randomized controlled trial. JAMA 2006, 296:64–71.PubMedCrossRefGoogle Scholar
  34. 34.
    Prochazka AV, Kick S, Steinbrunn C, et al.: A randomized trial of nortriptyline combined with transdermal nicotine for smoking cessation. Arch Intern Med 2004, 164:2229–2233.PubMedCrossRefGoogle Scholar
  35. 35.
    Glassman AH, Stetner F, Walsh BT, et al.: Heavy smokers, smoking cessation, and clonidine. Results of a double-blind, randomized trial. JAMA 1988, 259:2863–2866.PubMedCrossRefGoogle Scholar
  36. 36.
    Dale LC, Ebbert JO, Hays JT, Hurt RD: Treatment of nicotine dependence. Mayo Clin Proc 2000, 75:1311–1316.PubMedCrossRefGoogle Scholar
  37. 37.
    Schnoll RA, Lerman C: Current and emerging pharmacotherapies for treating tobacco dependence. Expert Opin Emerg Drugs 2006, 11:429–444.PubMedCrossRefGoogle Scholar
  38. 38.
    Fagen ZM, Mansvelder HD, Keath JR, et al.: Short-and long-term modulation of synaptic inputs to brain reward areas by nicotine. Ann N Y Acad Sci 2003, 1003:185–195.PubMedCrossRefGoogle Scholar

Copyright information

© Current Medicine Group LLC 2008

Authors and Affiliations

  1. 1.Opiate Addiction Recovery ServicesCincinnatiUSA

Personalised recommendations