Nicotine addiction and comorbidity with alcohol abuse and mental ...

Tobacco use is the leading cause of preventable death in developed countries1. Smoking commonly begins during adolescence, and about half of those who do not quit eventually die from smoking- related diseases2. In the United States alone, smoking annually causes over 400,000 deaths and $50 billion in medical costs3. The addictive power of tobacco is exemplified by the difficulty in quitting4-6. Most smokers wish to quit and try repeatedly. About one-third of smokers attempt to quit each year, but fewer than 10% succeed. Despite imperative medical reasons, 50% of heart attack survivors and of those hospitalized for other serious smoking-related illness relapse to cigarettes within weeks of leaving the hospital. Of the roughly 3,000 ingredients in cigarette smoke, nicotine is the main addictive component that motivates continued tobacco use despite its harmful effects 4,6-10 . Nicotine is addictive in the absence of tobacco, and it supports self-administration, enhances reward from brain stimulation and reinforces preference for the place where nicotine is administered (place preference). It also produces a withdrawal syndrome that is relieved by nicotine replacement 6-8,