Insight into the Potential Factors That Promote Tobacco Use in Vulnerable Populations

Abstract

It is presently unclear why certain populations are more vulnerable to tobacco use and less responsive to smoking cessation interventions. This review considers the contribution of nicotine reward and withdrawal in populations that appear to be more susceptible to tobacco use. Our focus is on populations that have been modeled in rodents including, adolescents, females, and persons with metabolic disorders, such as diabetes. A common feature across these rodent models is heightened nicotine reward, suggesting that vulnerable populations may experience strong rewarding effects of nicotine that promote tobacco use. One distinguishing factor among these rodent models of at-risk populations is with regard to the magnitude of nicotine withdrawal, which is lower during adolescence. These groups also differ with regard to expression of the physical signs versus affective states produced by withdrawal, suggesting that these distinct facets of withdrawal differentially contribute to tobacco use in vulnerable populations. Thus, we may need to apply different diagnostic criteria and/or specialized treatments that target the unique factors that promote tobacco use in different vulnerable populations.