Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug,it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs),except at two nicotinic receptor subunits where it acts as a receptor antagonist.
Smoking cessation,usually called quitting smoking or stopping smoking,is the process of discontinuing tobacco smoking. Tobacco smoke contains nicotine,which is addictive and can cause dependence. As a result,nicotine withdrawal often makes the process of quitting difficult.
Nicotine replacement therapy (NRT) is a medically approved way to treat people with tobacco use disorder by taking nicotine through means other than tobacco. It is used to help with quitting smoking or stopping chewing tobacco. It increases the chance of quitting tobacco smoking by about 55%. Often it is used along with other behavioral techniques. NRT has also been used to treat ulcerative colitis. Types of NRT include the adhesive patch,chewing gum,lozenges,nose spray,and inhaler. The use of multiple types of NRT at a time may increase effectiveness.
A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used in nicotine replacement therapy (NRT),a process for smoking cessation. Endorsed and approved by the U.S. Food and Drug Administration (FDA),it is considered one of the safer NRTs available for the treatment of tobacco use disorder.
Cytisine,also known as baptitoxine,cytisinicline,or sophorine,is an alkaloid that occurs naturally in several plant genera,such as Laburnum and Cytisus of the family Fabaceae. It has been used medically to help with smoking cessation. However,it has been found effective in several randomized clinical trials,including some in the United States and a large one in New Zealand,and is being investigated in additional trials in the United States and a non-inferiority trial in Australia in which it is being compared head-to-head with the smoking cessation aid varenicline. It has also been used entheogenically via mescalbeans by some Native American groups,historically in the Rio Grande Valley predating even peyote.
Varenicline,sold under the brand names Chantix and Champix among others,is a medication used for smoking cessation and for the treatment of dry eye disease. It is a nicotinic acetylcholine receptor partial agonist. When activated,this receptor releases dopamine in the nucleus accumbens,the brain's reward center,thereby reducing cravings and withdrawal symptoms with smoking cessation although less pronounced than a full agonist.
NicVAX is an experimental conjugate vaccine intended to reduce or eliminate physical dependence to nicotine. According to the U.S. National Institute of Drug Abuse,NicVAX can potentially be used to inoculate against nicotine addiction. This proprietary vaccine is being developed by Nabi Biopharmaceuticals of Rockville,MD. with the support from the U.S. National Institute on Drug Abuse. NicVAX consists of the hapten 3'-aminomethylnicotine which has been conjugated (attached) to Pseudomonas aeruginosa exotoxin A.
Nicotine withdrawal is a group of symptoms that occur in the first few weeks after stopping or decreasing use of nicotine. Symptoms include intense cravings for nicotine,anger or irritability,anxiety,depression,impatience,trouble sleeping,restlessness,hunger,weight gain,and difficulty concentrating. Withdrawal symptoms make it harder to quit nicotine products,and most methods for quitting smoking involve reducing nicotine withdrawal. Quit smoking programs can make it easier to quit. Nicotine withdrawal is recognized in both the American Psychiatric Association Diagnostic and Statistical Manual and the WHO International Classification of Diseases.
Tobacco harm reduction (THR) is a public health strategy to lower the health risks to individuals and wider society associated with using tobacco products. It is an example of the concept of harm reduction,a strategy for dealing with the use of drugs. Tobacco smoking is widely acknowledged as a leading cause of illness and death,and reducing smoking is vital to public health.
An electronic cigarette (e-cigarette) or vape is a vaporizer device that simulates tobacco smoking. It consists of an atomizer,a power source such as a battery,and a container such as a cartridge or tank. Instead of smoke,the user inhales vapor. As such,using an e-cigarette is often called "vaping". The atomizer is a heating element that vaporizes a liquid solution called e-liquid,which quickly cools into an aerosol of tiny droplets,vapor and air. The vapor mainly comprises propylene glycol and/or glycerin,usually with nicotine and flavoring. Its exact composition varies,and depends on several things including user behavior.
Nicotine dependence is a state of dependence upon nicotine. Nicotine dependence is a chronic,relapsing disease defined as a compulsive craving to use the drug,despite social consequences,loss of control over drug intake,and emergence of withdrawal symptoms. Tolerance is another component of drug dependence. Nicotine dependence develops over time as a person continues to use nicotine. The most commonly used tobacco product is cigarettes,but all forms of tobacco use and e-cigarette use can cause dependence. Nicotine dependence is a serious public health problem because it leads to continued tobacco use,which is one of the leading preventable causes of death worldwide,causing more than 8 million deaths per year.
Nicotine Anonymous (NicA) is a twelve-step program founded in 1982 for people desiring to quit smoking and live free of nicotine. As of July 2017,there are over 700 face-to-face meetings in 32 countries worldwide with the majority of these meetings occurring in the United States,Iran,India,Canada,Brazil,the United Kingdom,Australia,Russia and in various online community and social media platforms.. NicA maintains that total abstinence from nicotine is necessary for recovery. NicA defines abstinence as “a state that begins when all use of nicotine ceases.
Elbert D. Glover is an American researcher and author in the field of tobacco addiction and smoking cessation. He retired as professor emeritus at the University of Maryland at College Park School of Public Health where he served as Chairperson of the Department of Behavioral and Community Health from 2005 to his retirement in 2015. He was an entrepreneur,editor,publisher,co-founder and principal owner of Health Behavior and Policy Review,and co-founder,owner,editor,and publisher of American Journal of Health Behavior and Tobacco Regulatory Science. Glover was the founder of the American Academy of Health Behavior and served as its first president from 1997 to 2001.
Schizophrenia and tobacco smoking have been historically associated. Smoking is known to harm the health of people with schizophrenia.
The scientific community in the United States and Europe are primarily concerned with the possible effect of electronic cigarette use on public health. There is concern among public health experts that e-cigarettes could renormalize smoking,weaken measures to control tobacco,and serve as a gateway for smoking among youth. The public health community is divided over whether to support e-cigarettes,because their safety and efficacy for quitting smoking is unclear. Many in the public health community acknowledge the potential for their quitting smoking and decreasing harm benefits,but there remains a concern over their long-term safety and potential for a new era of users to get addicted to nicotine and then tobacco. There is concern among tobacco control academics and advocates that prevalent universal vaping "will bring its own distinct but as yet unknown health risks in the same way tobacco smoking did,as a result of chronic exposure",among other things.
Peter Hajek is a British psychologist. He is professor of clinical psychology and director of the Wolfson Institute of Preventive Medicine's Tobacco Dependence Research Unit at Queen Mary University of London. He is known for his research into smoking cessation,including the effectiveness of electronic cigarettes for this purpose.
Jed Eugene Rose is an American academic professor,inventor and researcher in the field of nicotine and smoking cessation. Rose is presently the President and CEO of the Rose Research Center,LLC in Raleigh,North Carolina. Additionally,he is the Director of the Duke Center for Smoking Cessation at Duke University Medical Center.
Judson Alyn Brewer is an American psychiatrist,neuroscientist and author. He studies the neural mechanisms of mindfulness using standard and real-time fMRI,and has translated research findings into programs to treat addictions. Brewer founded MindSciences,Inc.,an app-based digital therapeutic treatment program for anxiety,overeating,and smoking. He is director of research and innovation at Brown University's Mindfulness Center and associate professor in behavioral and social sciences in the Brown School of Public Health,and in psychiatry at Brown's Warren Alpert Medical School.
Nicotine vaccine is a novel immunological strategy for treating nicotine addiction. Nicotine vaccine uses active immunization as the methodology to create polyclonal antibodies to the antigens,which is then used to treat drug abuse. The immune system is then able to identify nicotine as a foreign substance and initiate an immune reaction targeting the drug. As a result,the quantity of nicotine that enters the brain would decrease after receiving the vaccine. In preclinical studies,nicotine vaccines have demonstrated the ability to combat the negative effects of nicotine abuse,but none of the developed vaccines has been authorized for use in clinical trials as a smoking cessation strategy. Theoretically,the decrease of nicotine's rewarding effects should result in smoking cessation. Some companies have tested candidate vaccines in clinical trials,but evidence failed to show the adequate antibody responses or exhibit superior efficacy to factors concerning placebo.
Natalie K. Walker is a New Zealand academic,and is a Professor of Social and Community Health at the University of Auckland,specialising in the reduction of harm from non-communicable diseases such as cardiovascular disease and cancer. She has an interest in smoking cessation but also researches on alcohol,cannabis and sugar.
