Disrupting nicotine reinforcement: from cigarette to brain.
Cigarette smoking is a tenacious addiction that is maintained to a significant extent by the reinforcing effects of nicotine. An emerging theme in smoking cessation treatment is the development of methods for interfering with these reinforcing effects. By attenuating nicotine reinforcement, treatments may enhance a smoker's chances of successfully remaining abstinent. Several treatment approaches will be described, including the use of denicotinized cigarettes, nicotine vaccines, nicotinic receptor agonists and antagonists, and modulators of brain reinforcement processes. These techniques highlight the numerous sites along the path between the cigarette and the brain that can be targeted for intervention. In addition to unimodal therapies, treatment combinations will be discussed that might more effectively block cigarette reward and thereby further enhance smoking abstinence.
Rose
Jed E
JE
Duke University Medical Center, Durham, NC, USA. rose0003@mc.duke.edu
D000818:Animals; D001921:Brain / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects; D002415:Cats; D002986:Clinical Trials as Topic; D006801:Humans; D016233:Immunotherapy, Active; D018377:Neurotransmitter Agents / Q000494:pharmacology / Q000627:therapeutic use; D009538:Nicotine / Q000009:adverse effects / Q000032:analysis / Q000494:pharmacology* / Q000627:therapeutic use; D018733:Nicotinic Antagonists / Q000494:pharmacology* / Q000627:therapeutic use; D011978:Receptors, Nicotinic / Q000187:drug effects / Q000502:physiology; D012054:Reinforcement, Psychology; D012137:Respiratory System / Q000187:drug effects; D012201:Reward; D012677:Sensation; D012906:Smoke / Q000009:adverse effects / Q000032:analysis; D012907:Smoking / Q000188:drug therapy / Q000378:metabolism / Q000523:psychology / Q000628:therapy; D016540:Smoking Cessation; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy / Q000517:prevention & control / Q000523:psychology; D014026:Nicotiana / Q000737:chemistry; D014029:Tobacco Use Disorder / Q000175:diagnosis* / Q000378:metabolism / Q000523:psychology
D018377:Neurotransmitter Agents; D018733:Nicotinic Antagonists; D011978:Receptors, Nicotinic; D012906:Smoke; D009538:Nicotine