Nicotine

Abstract

Nicotine pharmacology is of interest due to its importance in understanding structure and function of the nervous system, the potential of nicotinic modulating drugs in treating a wide range of disorders, and due to the public health impact of nicotine‐driven tobacco use and disease. This chapter includes two sections: one on the pharmacology of nicotine and one on the pharmacological treatment of nicotine dependence and withdrawal. Implications for public health policy also are discussed briefly. Topics presented in the pharmacology of nicotine section include nicotine receptors and their functional adaptations, neurosubstrates of nicotine reinforcement and withdrawal, and nicotine pharmacokinetics. Topics presented in the pharmacological treatment section include nicotine and non‐nicotine based pharmacotherapies, their mechanism(s) of action, and pharmacokinetics.

Mechanistic insights into nicotine withdrawal

“…The symptoms are irritability/anger/frustration, anxiety, depression/negative affect, concentration problems, impatience, insomnia, and restlessness. Other symptoms (including altered neurohormonal profiles, perturbations of learned behaviors, weight gain, decreased heart rate, constipation, and mouth ulcers) are also likely valid symptoms but require further study [119, 121, 122]. Many of these symptoms are common to other drugs of abuse, but weight gain and decreased heart rate appear to be more specific to nicotine withdrawal [123].…”

Abuse Liability Assessment of Tobacco Products Including Potential Reduced Exposure Products

“…Most research on tobacco addiction has primarily focused on the role of nicotine, which is considered to be the primary tobacco constituent that is responsible for tobacco addiction (3, 14, 32, 33). However, other tobacco ingredients or smoke emissions have been proposed to enhance the reinforcing or rewarding effects of nicotine.…”

Tobacco dependence and withdrawal: Science base, challenges and opportunities for pharmacotherapy☆

“…Each of these symptoms is a potential target for drug development. All drugs that have been approved for smoking cessation have been demonstrated to be effective in reducing nicotine self-administration by animals and/or humans, and provide some degree of substitution with respect to psychoactive or discriminative effects of nicotine (Buchhalter et al, 2007). …”

“…As relates to the actions of nicotine that contribute to tobacco dependence and withdrawal, the scientific discovery process over the past few decades provides a strong foundation for progress toward an expanded range of treatment medications (Royal College of Physicians, 2000; US DHHS, 2004; Henningfield & Benowitz, 2004; Koob and Le Moal, 2006; Buchhalter et al, 2007). The following summary highlights aspects of the neurobiology that we feel are useful to consider in evaluating potential indications for treatment and assessment of their efficacy.…”

“…The nicotine withdrawal syndrome includes impairments in mood and cognitive ability, increased appetite, heightened aggressiveness, disturbed patterns of sleep, and powerful cravings (APA, 2000). Physiological correlates include reduced heart rate, perturbation of a variety of neurohormones, alterations in electroencephalographic theta power, and alterations in regional brain activity, and disruptions in learned behaviors (Koob & Le Moal, 2005; Buchhalter et al, 2007). Although withdrawal symptoms are drug class-specific, some are common across drug classes, such as the abstinence-associated decreases in DA levels in the nucleus accumbens, which have also have been observed with ethanol, morphine, cocaine, and amphetamine (Rossetti et al, 1992; Weiss et al, 1992).…”