Revised June 2012
NIDA-supported research identified nicotine as the main addictive ingredient in tobacco. Nicotine activates reward pathways in the brain and increases levels of dopamine—a key chemical behind the desire to consume drugs.
But nicotine may not be the only psychoactive ingredient in tobacco. Animal research shows that acetaldehyde, another chemical constituent of tobacco smoke, dramatically increases the rewarding properties of nicotine. This effect may be age-related, with adolescent animals displaying far more sensitivity to it than adults. It may also be a reason why adolescents are more vulnerable to becoming addicted to tobacco than adults.
Smoking plays a major role in morbidity and mortality among women. Lung cancer is the leading cause of cancer death among women, surpassing breast cancer in the late 1980s. In 2012, almost 73,000 women are expected to die from lung cancer and an estimated 110,000 women will be newly diagnosed with the disease.
Women who smoke are at higher risk for other cancers as well, including liver and colorectal cancer. They are also at higher risk for infertility, early menopause, and lower bone density and hip fracture after menopause.
It’s alarming that roughly 1 in 6 pregnant women aged 15 to 44 were regular smokers in 2010. Women who smoke during pregnancy subject themselves and their unborn children to risks including complications during pregnancy, premature delivery, low birth weight, stillbirth and sudden infant death syndrome (SIDS), as well as compromised fetal growth and development.
Quitting smoking can greatly reduce a person’s risk of smoking-related diseases and premature death. While the relative health benefits are greater for people who stop smoking at earlier ages, smoking cessation is beneficial at any age. Some smokers can quit on their own; however many need assistance. Research has shown that treatments for tobacco addiction can help. Unfortunately, even with treatment, long term quit rates are often disappointing – most smokers relapse within 6 months. Thus, relapse prevention remains the priority for tobacco cessation research.
Medications
Nicotine replacement therapies (NRTs), such as nicotine gum, lozenge, and the transdermal nicotine patch, can be used (in conjunction with behavioral support) to relieve withdrawal symptoms—they generally provide users with lower overall nicotine levels than tobacco and thus have little abuse potential. NRTs also do not expose the lungs to carcinogens and gases associated with tobacco smoke.
Other medications include:
On the Horizon:
Behavioral Treatments
Behavioral interventions play an integral role in smoking cessation, either in conjunction with medication or alone. They employ various methods to assist smokers in quitting, ranging from self-help materials to individual cognitivebehavioral therapy. These interventions teach individuals to recognize high-risk smoking situations, develop new coping strategies, manage stress, improve problem solving skills, and increase social support. To make behavioral approaches more accessible, researchers have been adapting them for mobile devices and web formats.