Nicotine is one of the most widely abused substances, with over a billion people smoking globally and a little less than 100 million in the Unites States. Tobacco kills almost half a million people a year in the U.S. alone, more than alcohol, cocaine, homicide and AIDS combined. Tobacco is the leading preventable cause of death. Smoking is responsible for more than 5 percent of health care costs in the United States. The direct and indirect consequences are estimated to cost around 140 billion dollars per year.

What Does Nicotine Do?

Nicotine acts through the cholinergic nicotinic receptor, and can act as both a stimulant and a sedative. Immediately after exposure to nicotine, the adrenal glands produce epinephrine, resulting in stimulating effects experienced by the user. The discharge of epinephrine causes a sudden release of glucose as well as an increase in blood pressure, heart rate and respiration. It also inhibits the insulin output from the pancreas, which results in the fact that smokers are always lightly hyperglycemic. Furthermore, it releases dopamine in the brain regions that are responsible for feelings of pleasure and motivation. It is this mechanism that is thought to underlie the feelings of pleasure that many smokers claim to experience.

Treatments

• Several treatments have been developed, as a result of a better understanding of the mechanism behind addiction and the identification of nicotine as an addictive drug. Nicotine gum, transdermal patches, nasal sprays and inhalers all seem to be equally effective as a treatment, being used by more than a million people who are addicted to nicotine. It is believed that these types of treatment help in relieving the withdrawal symptoms experienced by those who try to quit smoking. They also produce less severe physiological alterations than those experienced when trying tobacco-based systems. In general, it can be said that these treatments provide the users with lower nicotine levels than they would receive with tobacco. In addition, exposure to smoke and its deadly components is totally and completely eliminated.
• Recently, the first non-nicotine prescription drug, called bupropion, which is in fact an anti-depressant marketed as Zyban, has been approved for use as a pharmacological treatment against nicotine addiction.
• Another important aspect of a possible treatment, are behavioral therapies that can help an individual in learning coping skills to prevent both short- and long-term relapse. These therapies can assist in eliminating the psychological need for a cigarette as a stress decreasing mechanism.