title: [Tobacco use and illicit substance use disorders: what should we have to do?].
abstract: Tobacco use is a commonplace phenomenon in our society. Its use is responsible for more death and disease than any other noninfectious cause. More deaths are caused each year by tobacco use than by all deaths from HIV, illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined. Tobacco remains responsible for greater morbidity than alcohol and all other drugs combined. Tobacco dependence is highly prevalent among drug-dependent patients. Substance abuse patients smoke more and are more vulnerable to the effects of smoking than general populations. Traditional substance abuse therapeutic programs too frequently focus only on treatment of alcohol or other drugs rather than including treatment for tobacco dependence. Currently, there are no official medical recommendations for the treatment of tobacco addiction in illicit polysubstance users.
  
  
  METHODS
  A comprehensive literature search from a range of electronic databases (PubMed, Embase, PsycInfo, Google Scholar) was conducted for the period from 1988 to September 2012, using the following keywords alone or in combination: tobacco, nicotine, cocaine, cannabis, amphetamines, opiates, substance abuse, substance dependence, addiction, treatment. There were no restrictions on the identification or inclusion of studies in terms of publication status, language and design type.
  
  
  RESULTS
  Our literature review will focus on epidemiological, neurobiological, clinical interactions between tobacco, alcohol and other illicit drugs. It will also focus on therapeutic programs in this dual addictive disorder. The aim of this literature review is to make proposals for the treatment of tobacco addiction in polysubstance users entering in specific therapeutic programs.
authors.affiliation: AP-HP, université Paris-Sud 11, hôpital universitaire Paul-Brousse, centre d'enseignement, de recherche et de traitement des addictions, CEA-Inserm U1000, 94800 Villejuif, France. laurent.karila@pbr.aphp.fr
authors.forename: Laurent
authors.initials: L
authors.lastname: Karila
authors.forename: Aymeric
authors.initials: A
authors.lastname: Petit
authors.forename: Rim
authors.initials: R
authors.lastname: Zarmdini
authors.forename: Sarah
authors.initials: S
authors.lastname: Coscas
authors.forename: William
authors.initials: W
authors.lastname: Lowenstein
authors.forename: Michel
authors.initials: M
authors.lastname: Reynaud
mesh_terms: D016739:Behavior, Addictive; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D003131:Combined Modality Therapy; D015897:Comorbidity; D004198:Disease Susceptibility; D004298:Dopamine / Q000502:physiology; D014943:Global Health; D006801:Humans; D013287:Illicit Drugs / Q000494:pharmacology; D002189:Marijuana Abuse / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D009538:Nicotine / Q000494:pharmacology; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D017448:Receptors, Dopamine D2 / Q000819:agonists / Q000502:physiology; D011978:Receptors, Nicotinic / Q000502:physiology; D012054:Reinforcement, Psychology; D012201:Reward; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D016540:Smoking Cessation; D019966:Substance-Related Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D014029:Tobacco Use Disorder / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D013287:Illicit Drugs; D017448:Receptors, Dopamine D2; D011978:Receptors, Nicotinic; D009538:Nicotine; D004298:Dopamine