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Introduction
Roughly one-fourth of American adults smoke, and each of
them faces increased risk of death or illness from cardiac
and respiratory diseases, including cancer. But they also
face the likelihood that they will fail in their attempt
to quit smoking—relapse occurs in more than half of
all quitting attempts within 6 months. Success is more likely
for smokers who use medications to help them quit. However,
pharmacological treatment is currently limited to nicotine
replacement therapy, which delivers nicotine by a skin patch,
gum, or inhaler instead of a cigarette, and the use of bupropion,
an antidepressant that has been found to help some smokers
overcome the craving associated with nicotine withdrawal.
Development of effective pharmacological treatments to help smokers quit
is a complicated, expensive, and slow process. It begins
with scientific research to identify the molecular mechanisms
of nicotine’s
effects in the brain and continues through development
of candidate medications that
must be extensively tested in animal and human trials,
meet regulatory requirements for safety and effectiveness,
and be carefully monitored
after being approved for use. Even after a medication has
been approved, it can be truly successful only if it is
widely available, easily administered,
and affordable.
In an effort to encourage collaborative efforts and stimulate innovations
that may speed up the development process, the National
Institute on Drug Abuse (NIDA), along with the National
Cancer Institute and the National
Institute on Alcohol Abuse and Alcoholism, sponsored a
symposium on drug discovery, development, and delivery
as part of the 2003 Annual Meeting
of the Society for Research on Nicotine and Tobacco. The
symposium consisted of three components, featuring examples
of collaborative efforts in the
discovery of targets for potential medications, the development
of medications based on a platform of existing targets,
and the delivery and adoption
of medications.
During
the Discovery section of the program, speakers
addressed the most recent findings in the field of nicotinic receptor
biology and CNS neurochemical systems—such as GABA and glutamate—that
play a role in nicotine effects in the brain. The Development
section of the program provided a background on the drug development
process, presentations on emerging medications, such as antidepressants
and nicotine vaccines, and an overview of medications in late-phase
development. Presentations on Delivery focused
on strategies for developing widespread access and use of medications
within the health care system and beyond.
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Society for Research on Nicotine and Tobacco 9th Annual Meeting
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