Archive 1992–2014

Aim. To present contemporary views on the biological mechanisms underlying nicotine dependence, and treatment methods.

Review. Smoking is a chronic problem and at present about 40 percent of adults in Poland are cigarette smokers. The dopamine pathway seems to be one of the mechanisms leading to the development of nicotine addiction from tobacco smoking. This pathway originates from dopaminergic neurons of the midbrain and ascends to the nucleus accumbens and the prefrontal fields of the cerebral cortex. The dopamine system activation not only plays an important role in the onset of dependence, but also enhances motivation and increases efficacy of cognitive functions. Besides dopamine, many other mediators are released by nicotine, including noradrenaline, serotonin, endorphines, and acetylocholine. Bupropion being a dopamine re-uptake inhibitor is a useful drug in the tobacco smoking cessation treatment.

Conclusions. Tobacco dependence is the leading preventable cause or death; cigarette smoking is responsible for 1 in every 5 deaths. Half of the regular smokers die prematurely of tobacco-related diseases. Smoking cessation reduces the risk of tobacco-related diseases, slows the progression of already existing tobacco-related conditions, increases life expectancy, and improves quality of life in ex-smokers.