Twenty-first century tobacco use: it is not just a risk factor anymore

Abstract

Despite availability of effective treatments for nicotine addiction, smoking remains prevalent with serious health consequences. Most smokers recognize the ill effects of smoking but are unable to quit. Nicotine addiction may be viewed as any other chronic illness that results from exposure to a recognizable agent (tobacco) and manifests with a well-documented set of signs and symptoms. Much like any chronic disease, both environmental and genetic factors determine the occurrence and severity of this affliction. There has been recent focus on uncovering the genetic basis of nicotine addiction. In this article, we have attempted to briefly review the current evidence for the role of genetics in smoking as well as comment on available pharmacotherapeutic options for treating nicotine dependence.

Métodos para abandono do tabagismo e tratamento da dependência da nicotina

“…Molecular biology studies demonstrate that capacity in metabolizing nicotine varies according to each individual7. CYP2A6*2 and CYP2A6*3-allele individuals are less prone to be smokers, and if they do, they tend to consume less tobacco than CYP2A6*1-allele individuals 8 . Vasconcelos et al (2005) 9 analyzed the genetic profile of CYP2A6 in a sample of an adult Brazilian population, composed by 147 Caucasian individuals, 142 Mulattos and 123 Blacks, among which 205 were smokers or ex-smokers, and 207 were non-smokers.…”

“…Similarly to other psychoactive drugs, it releases dopamine in the nucleus accumbens, located in the mesencephalus, stimulating a pleasant and "rewarding" sensation 8,12 . After the discomfort caused by the first drafts of tobacco (sickness, dizziness, nausea), the smoker experience a pleasant sensation with the use of nicotine 7 .…”

“…Epidemiologic studies show that more than 70% of smokers want to quit smoking 8 . However, less than 10% reach their goal by their own, as discomfort caused by nicotine abstinence and craving leads most ex-smokers to relapse 8,13 .…”

“…However, less than 10% reach their goal by their own, as discomfort caused by nicotine abstinence and craving leads most ex-smokers to relapse 8,13 . Relapses usually occur between two days and three months of withdrawal 13 .…”

“…Bupropion is a non-tricyclic antidepressive that inhibits pre-synaptic dopaminergic and noradrenalin mechanisms 8,14,15 . Its action in the central dopaminergic pathways is believed to be the same mechanism responsible for craving reduction in patients under nicotine abstinency 14 .…”