Cited by 979Smoking Behavior and CessationNicotinic Acetylcholine Receptors StudySubstance Abuse Treatment and Outcomes

Pharmacology of nicotine: addiction, smoking-induced disease, and therapeutics

Open access
Benowitz, Neal L.·2009·Annual Review of Pharmacology and Toxicology

Abstract

Nicotine sustains tobacco addiction, a major cause of disability and premature death. Nicotine binds to nicotinic cholinergic receptors, facilitating neurotransmitter release and thereby mediating the complex actions of nicotine in tobacco users. Dopamine, glutamate, and gamma aminobutyric acid release are particularly important in the development of nicotine dependence, and corticotropin-releasing factor appears to contribute to nicotine withdrawal. Nicotine dependence is highly heritable. Genetic studies indicate roles for nicotinic receptor subtypes, as well as genes involved in neuroplasticity and learning, in development of dependence. Nicotine is primarily metabolized by CYP 2A6, and variability in rate of metabolism contributes to vulnerability to tobacco dependence, response to smoking cessation treatment, and lung cancer risk. Tobacco addiction is much more common in persons with mental illness and substance abuse disorders, representing a high proportion of current smokers. Pharmacotherapeutic approaches to tobacco addiction include nicotine replacement, bupropion, and varenicline, the latter a selective nicotine receptor partial agonist.

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Crossref · 10.1146/annurev.pharmtox.48.113006.094742

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  • Gestational nicotine exposure causes alterations to development in regions such as the PFC, VTA, NA, and caudate and may contribute towards the development of ADHD, schizophrenia, anxiety, obesity, and future adolescent substance abuse.

    “Moreover, clinical, and preclinical research has demonstrated that gestational nicotine exposure causes alterations to development in regions such as the PFC, VTA, NA, and caudate and may contribute towards the development of ADHD, schizophrenia, anxiety, obesity, and future adolescent substance abuse [17].”

    From Prenatal nicotine exposure during pregnancy results in adverse neurodevelopmental alterations and neurobehavioral deficits (2023) · cites this paper as [17]

    The ‘Pharmacodynamics of Nicotine: Contributions to Smoking-Related Disease’ section (page not supplied) identifies fetal neuroteratogenic effects as a suspected adverse effect of nicotine, supporting a general concern about prenatal brain development. It does not establish developmental alterations in the named brain regions or link gestational exposure to the listed conditions and later substance abuse. The ‘Neuropharmacology’ section names some of those regions, but describes acute nicotine effects rather than gestational development. (LLM, conf=0.88)

    Experimental — accuracy not yet measured
  • The pharmacokinetic profile of nicotine during cigarette smoking is a rapid rise and fall in plasma nicotine concentrations.

    “The pharmacokinetic profile of nicotine during cigarette smoking is a rapid rise and fall in plasma nicotine concentrations [5].”

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Authors
Benowitz, N. L.
Affiliations
San Francisco General Hospital (US)
Corresponding author
Benowitz, Neal L.
Venue
Annual Review of Pharmacology and Toxicology
Published
2009-02-01
Volume
49
Issue
1
Pages
57-71
ISSN
  • 0362-1642 (ISSN-L)
  • 1545-4304
OpenAlex
W2137599927
Cited by
979
References
90
Citations by year
2026: 75 · 2025: 89 · 2024: 91 · 2023: 89 · 2022: 72 · 2021: 70 · 2020: 60 · 2019: 56 · 2018: 42 · 2017: 55 · 2016: 37 · 2015: 42 · 2014: 43 · 2013: 39 · 2012: 35
FWCI
2.95
Type
journal article
Language
en
Open access
Locations
  • The Annual Review of Pharmacology and Toxicology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • U.S. Public Health Service
  • National Institute on Drug Abuse (DA20830, DA02277, R01DA002277, U01DA020830, R37DA002277)
Topics
  • Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Nicotinic Acetylcholine Receptors Study
  • Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
Keywords
nicotine, tobacco dependence, nicotine dependence, nicotinic acetylcholine receptors, nicotine withdrawal, dopamine release, glutamate release, GABA release, corticotropin-releasing factor, genetic susceptibility, CYP2A6, nicotine metabolism, lung cancer risk, smoking cessation, mental illness, substance abuse, nicotine replacement therapy, bupropion, varenicline, partial agonists
MeSH terms
Varenicline, Animals, Benzazepines, Nonprescription Drugs, Ganglionic Stimulants, Humans, Nicotine, Quinoxalines, Smoking, Tobacco Use Disorder, Bupropion, Behavior, Addictive, Nicotinic Agonists

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