Understanding Nicotine and Tobacco Addiction

Cigarette smoking is estimated to lead to 4.9 million prematuredeaths per year worldwide. This is predicted to rise to 10 millionby 2020. In western countries it kills half of all smokers who failto stop.
The prevailing model for tobacco addiction is that nicotine fromcigarettes rewards smoking and punishes abstinence, tapping into amotivational system of operant conditioning that requires noconscious awareness. However, there are also accounts which involvecognitive biases and the effect of nicotine on impulse control. Thebrain pathways involved have been studied extensively, but the roleof different nicotine receptor subtypes and other neurotransmittersystems is still subject to debate.
In western countries, cigarette smoking as an adult has aheritability of 30-50% and candidate genes have been identifiedthat may contribute in part to addiction susceptibility. Manysocio-cultural correlates of cigarette smoking have beenestablished, but a comprehensive model that accounts for these andlinks them with the psychobiological aspects of nicotine addictionhas not been forthcoming. Structured behavioural support programmesaid cessation attempts, as do a number of pharmacotherapies, mostnotably nicotine replacement treatments and bupropion, but theunderlying mechanisms are unclear.
This book deals with the problems involved in understanding andtreating nicotine and tobacco addiction. Topics covered include thenature of the worldwide health problem posed by cigarette smoking,the psychodynamics of cigarette addiction, and the basicpharmacology and biochemistry of nicotine and its effect on thebrain. Further chapters analyse the genetic basis of susceptibilityto nicotine addiction. Finally, the contributors address approachesto therapy. A continuing theme in the discussions throughout thebook is how best to treat nicotine addiction, given that manysmokers would like to stop smoking but are unable to do so becauseof their addiction.
This book will be of great value to all psychologists andpsychiatrists working on addiction, specifically to nicotine butalso to other compounds and behaviours. It will also be of interestto neuroscientists and pharmacologists working on nicotinereceptors and the brain pathways involved in dependence, as well asto biochemists, molecular biologist and to public health officials.