Cigarette Smoking

In the last decade, the importance of nicotine in maintaining smoking and in cessation difficulty has been acknowledged. Consequently, this has led to efforts to measure nicotine dependence. This paper focuses on a widely used, paper-and-pencil test of nicotine dependence--the Fagerstrom Tolerance Questionnaire (FTQ). The findings indicate that the FTQ correlates with other proposed measures of nicotine dependence (carbon monoxide, nicotine, and cotinine levels). The connection between FTQ scores and withdrawal symptoms is weak. In clinic outcome trials, the FTQ predicted success where no pharmacologic treatment was involved, while nicotine replacement appeared to mask the relation between FTQ scores and outcome. However, the FTQ may predict outcome with nicotine replacement as a function of dose. In placebo-controlled, nicotine replacement trials, FTQ scores were related to success by treatment. Problems with the FTQ are described with focus on item difficulties and analyses of the scale.

The question of whether nicotine, the neuroactive compound of tobacco, is addictive has been open to considerable scientific and public discussion. Although it can serve as a positive reinforcer in several animal species, including man, nicotine is thought to be a weak reinforcer in comparison with addictive drugs such as cocaine and heroin, and has been argued to be habit forming but not addictive. Here we report that intravenous nicotine in the rat, at doses known to maintain self-administration, stimulates local energy metabolism, as measured by 2-deoxyglucose autoradiography, and dopamine transmission, as estimated by brain microdialysis, in the shell of the nucleus accumbens. These neurochemical and metabolic effects are qualitatively similar to those of other drugs, such as cocaine, amphetamine and morphine, which have strong addictive properties. Our results provide functional and neurochemical evidence that there are specific neurobiological commonalities between nicotine and addictive drugs.