Subjective and behavioural effects of nicotine in humans: some sources of individual variation

Sex Differences in Subjective Responses To Moderate Versus Very Low Nicotine Content Cigarettes

Introduction

Men and women may be differentially sensitive to the acute perceptual responses to smoking cigarettes that vary in nicotine content ("dose") but are matched on non-nicotine constituents.

Methods

Dependent adult smokers (43 M, 31 F) took four controlled puffs from Spectrum research cigarettes that were moderate (16-17 mg/g) or very low (0.4 mg/g) in nicotine content, and matched on "tar." To ensure reliable responses, each cigarette was administered singly five times in random order under blind conditions, with one or the other provided every 15 minutes over a 2.5-hour session following overnight abstinence. Subjective perceptions (eg, "satisfying", "how much nicotine") were rated after each cigarette.

Results

Subjective ratings differed due to cigarette nicotine content, as expected, and did so differentially between men and women. The interaction of nicotine content by sex was significant for most rated subjective perceptions of the cigarette, as multivariate analyses showed that differences due to nicotine content were highly significant for men (p < .001) but only marginal for women (p = .08).

Conclusions

Relative to men, women's subjective responses to acute smoking are less sensitive to differences in cigarette nicotine content. To our knowledge, this is the first comparison of sex differences in response to very carefully controlled doses of smoked nicotine per se. Further research should examine possible sex differences in nicotine dosing administered by other smoked and nonsmoked methods, as well as the developmental pattern of these differences during onset and during cessation of dependent smoking.

Implications

Subjective perceptions of smoking cigarettes varying in nicotine contents differ between men and women. These results with research cigarettes are similar to other studies with carefully dosed nicotine administration by other means, supporting the notion that women, relative to men, are less sensitive to pharmacological factors and more sensitive to nonpharmacological factors in acute cigarette smoking. Future studies are warranted to examine sex differences in other responses to controlled nicotine intake via smoking, and via other smoked and nonsmoked methods of administering nicotine doses.

Evaluation of menthol per se on acute perceptions and behavioral choice of cigarettes differing in nicotine content

Subjective perceptions and self-administration of cigarettes are each influenced by nicotine. Yet, differences specifically due to menthol in perceptions and choice of cigarettes varying in nicotine, and the association between these responses, have not been directly tested. Using a mixed between- and within-subjects design, acute responses to each of two menthol or non-menthol Spectrum research cigarettes, moderate (16-17 mg/g) versus very low (0.4 mg/g) in nicotine contents, were compared following brief abstinence in adult smokers preferring menthol ( n=44) or non-menthol ( n=29) brands. To ensure reliable perceptions, they experienced five exposures to each cigarette, then chose between them. All perceptions and choices were greater for moderate vs very low nicotine, as expected, and the magnitude of difference in four of six perceptions was associated with subsequently greater choice of the moderate nicotine cigarette. Importantly, virtually no differences were found between menthol and non-menthol, as nearly all perceptions, cigarette choices, and the association between perceptions and choice were not moderated by menthol or the interaction of nicotine by menthol. Our results indicate perceptions and reinforcement from cigarettes do not differ due to menthol when nicotine content and smoking topography are carefully controlled. Thus, regardless of menthol, smoking perceptions directly predict self-administration behavior.

Factors affecting exposure to nicotine and carbon monoxide in adult cigarette smokers

Exposure to cigarette smoke among smokers is highly variable. This variability has been attributed to differences in smoking behavior as measured by smoking topography, as well as other behavioral and subjective aspects of smoking. The objective of this study was to determine the factors affecting smoke exposure as estimated by biomarkers of exposure to nicotine and carbon monoxide (CO). In a multi-center cross-sectional study of 3585 adult smokers and 1077 adult nonsmokers, exposure to nicotine and CO was estimated by 24h urinary excretion of nicotine and five of its metabolites and by blood carboxyhemoglobin, respectively. Number of cigarettes smoked per day (CPD) was determined from cigarette butts returned. Puffing parameters were determined through a CreSS® micro device and a 182-item adult smoker questionnaire (ASQ) was administered. The relationship between exposure and demographic factors, smoking machine measured tar yield and CPD was examined in a statistical model (Model A). Topography parameters were added to this model (Model B) which was further expanded (Model C) by adding selected questions from the ASQ identified by a data reduction process. In all the models, CPD was the most important and highest ranking factor determining daily exposure. Other statistically significant factors were number of years smoked, questions related to morning smoking, topography and tar yield categories. In conclusion, the models investigated in this analysis, explain about 30-40% of variability in exposure to nicotine and CO.

Excitatory conditioning to the interoceptive nicotine stimulus blocks subsequent conditioning to an exteroceptive light stimulus

Previous research has shown that a nicotine conditional stimulus (CS) can compete with (i.e., overshadow) a brief light CS. Another form of competition, blocking, has not yet been examined with the nicotine CS. Groups of rats were assigned to an element training condition. For the N+ group, during each daily 2h element training session, there were ten intravenous nicotine infusions (0.03 mg/kg) followed 30s later with 4s access to sucrose. In the N- group, nicotine and sucrose presentations were explicitly unpaired. The chamber alone group (C alone) had no stimulus presentations. Element training was followed by compound training in all groups. A 30-s houselight was included during the time between the nicotine infusion and paired sucrose delivery. Non-reinforced element presentations assessed relative control of the goal tracking conditioned response (CR). The N+ group showed a higher proportion of CR control by the nicotine than the light. The opposite pattern was found in the N- and C alone groups indicating that nicotine CS controlled less of the CR than the light. Thus, excitatory conditioning with the nicotine CS blocked later conditioning to the light. This finding adds to literature examining the interaction between interoceptive drug CSs and other environmental stimuli.

Hormones, nicotine, and cocaine: clinical studies

Nicotine and cocaine each stimulate hypothalamic-pituitary-adrenal and -gonadal axis hormones, and there is increasing evidence that the hormonal milieu may modulate the abuse-related effects of these drugs. This review summarizes some clinical studies of the acute effects of cigarette smoking or IV cocaine on plasma drug and hormone levels and subjective effects ratings. The temporal covariance between these dependent measures was assessed with a rapid (2 min) sampling procedure in nicotine-dependent volunteers or current cocaine users. Cigarette smoking and IV cocaine each stimulated a rapid increase in LH and ACTH, followed by gradual increases in cortisol and DHEA. Positive subjective effects ratings increased immediately after initiation of cigarette smoking or IV cocaine administration. However, in contrast to cocaine's sustained positive effects (<20 min), ratings of "high" and "rush" began to decrease within one or two puffs of a high-nicotine cigarette while nicotine levels were increasing. Peak nicotine levels increased progressively after each of three successive cigarettes smoked at 60 min intervals, but the magnitude of the subjective effects ratings and peak ACTH and cortisol levels diminished. Only DHEA increased consistently after successive cigarettes. The possible influence of neuroactive hormones on nicotine dependence and cocaine abuse and the implications for treatment of these addictive disorders are discussed.

Mechanism-based medication development for the treatment of nicotine dependence

Tobacco use is a global problem with serious health consequences. Though some treatment options exist, there remains a great need for new effective pharmacotherapies to aid smokers in maintaining long-term abstinence. In the present article, we first discuss the neural mechanisms underlying nicotine reward, and then review various mechanism-based pharmacological agents for the treatment of nicotine dependence. An oversimplified hypothesis of addiction to tobacco is that nicotine is the major addictive component of tobacco. Nicotine binds to alpha4beta2 and alpha7 nicotinic acetylcholine receptors (nAChRs) located on dopaminergic, glutamatergic and GABAergic neurons in the mesolimbic dopamine (DA) system, which causes an increase in extracellular DA in the nucleus accumbens (NAc). That increase in DA reinforces tobacco use, particularly during the acquisition phase. Enhanced glutamate transmission to DA neurons in the ventral tegmental area appears to play an important role in this process. In addition, chronic nicotine treatment increases endocannabinoid levels in the mesolimbic DA system, which indirectly modulates NAc DA release and nicotine reward. Accordingly, pharmacological agents that target brain acetylcholine, DA, glutamate, GABA, or endocannabonoid signaling systems have been proposed to interrupt nicotine action. Furthermore, pharmacokinetic strategies that alter plasma nicotine availability, metabolism and clearance also significantly alter nicotine's action in the brain. Progress using these pharmacodynamic and pharmacokinetic agents is reviewed. For drugs in each category, we discuss the mechanistic rationale for their potential anti-nicotine efficacy, major findings in preclinical and clinical studies, and future research directions.

Acquired appetitive responding to intravenous nicotine reflects a Pavlovian conditioned association

Recent research examining Pavlovian appetitive conditioning has extended the associative properties of nicotine from the unconditioned stimulus or reward to include the role of a conditional stimulus (CS), capable of acquiring the ability to evoke a conditioned response. To date, published research has used presession extravascular injections to examine nicotine as a contextual CS in that appetitive Pavlovian drug discrimination task. Two studies in the current research examined whether a nicotine CS can function discretely, multiple times within a session using passive iv infusions. In Experiment 1, rats readily acquired a discrimination in conditioned responding between nicotine and saline infusions when nicotine was selectively paired with sucrose presentations. In Experiment 2, rats were either trained with nicotine paired with sucrose or explicitly unpaired with sucrose. The results showed that rats trained with explicitly unpaired nicotine and sucrose did not increase dipper entries after the infusions. Nicotine was required to be reliably paired with sucrose for control of conditioned responding to develop. Implications of these findings are discussed in relation to tobacco addiction, learning theory, and pharmacology.

Nonsynaptic Chemical Transmission Through Nicotinic Acetylcholine Receptors

This review attempts to organize the different aspects of nicotinic transmission in the context of nonsynaptic interactions. Nicotinic acetylcholine receptors (nAChRs) dominantly operate in the nonsynaptic mode in the central nervous system despite their ligand-gated ion-channel nature, which would otherwise be better suited for fast synaptic transmission. This fast form of nonsynaptic transmission, most likely unique to nAChRs, represents a new avenue in the communication platforms of the brain. Cholinergic messages received by nAChRs, arriving at a later phase following synaptic activation, can interfere with dendritic signal integration. Nicotinic transmission plays a role in both neural plasticity and cellular learning processes, as well as in long-term changes in basic activity through fast activation, desensitization of receptors, and fluctuations of the steady-state levels of ACh. ACh release can contribute to plastic changes via activation of nAChRs in neurons and therefore plays a role in learning and memory in different brain regions. Assuming that nAChRs in human subjects are ready to receive long-lasting messages from the extracellular space because of their predominantly nonsynaptic distribution, they offer an ideal target for drug therapy at low, nontoxic drug levels.

Molecular mechanisms underlying the motivational effects of nicotine

In addition to the primary rewarding properties of nicotine and the alleviation of withdrawal symptoms, cues associated with smoking are critical contributors to maintenance of smoking behavior. Nicotine-paired cues are also critical for precipitating relapse after smoking cessation. An accumulation of evidence suggests that repeated exposure to tobacco, including the primary psychoactive ingredient, nicotine, changes brain neurochemistry in a way that promotes the control that cues associated with smoking or other rewards have over behavior. This chapter will consider the neurochemical mechanisms underlying these neuroadaptations. Targeting these molecular alterations may provide novel treatments for smoking cessation.

It is not "either/or": activation and desensitization of nicotinic acetylcholine receptors both contribute to behaviors related to nicotine addiction and mood

Nicotine can both activate and desensitize/inactivate nicotinic acetylcholine receptors (nAChRs). An ongoing controversy in the field is to what extent the behavioral effects of nicotine result from activation of nAChRs, and to what extent receptor desensitization is involved in these behavioral processes. Recent electrophysiological studies have shown that both nAChR activation and desensitization contribute to the effects of nicotine in the brain, and these experiments have provided cellular mechanisms that could underlie the contribution of both these processes to nicotine-mediated behaviors. For instance, desensitization of nAChRs may contribute to the salience of environmental cues associated with smoking behavior and activation and desensitization of nAChRs may contribute to both primary and conditioned drug reward. Similarly, studies of the antidepressant-like effects of nicotinic agents have revealed a balance between activation and desensitization of nAChRs. This review will examine the evidence for the contribution of these two very different consequences of nicotine administration to behaviors related to nicotine addiction, including processes related to drug reinforcement and affective modulation. We conclude that there are effects of nAChR activation and desensitization on drug reinforcement and affective behavior, and that both processes are important in the behavioral consequences of nicotine in tobacco smoking.

Altered anxiety-related responses in mutant mice lacking the beta4 subunit of the nicotinic receptor

Nicotine, acting at nicotinic acetylcholine receptors (nAChRs), is the primary addictive component of tobacco. Smokers often report an anxiolytic effect of cigarettes. This relief of anxiety, attributed to nicotine, is an important contributor to relapse when smokers try to quit. Hence, the study of the anxiolytic effects of nicotine is important for understanding the mechanisms underlying nicotine addiction. Mammalian nAChRs are pentameric ion channels usually composed of alpha andbeta subunits. Taking advantage of beta4-homozygous-null mice (beta4-/-), we examined the role of the nAChR beta4 subunit in anxiety-related behaviors. The beta4-/- mice behaved as though they were less anxious than wild-type littermates on the elevated-plus and staircase mazes, tests that measure anxiety-related behaviors. To obtain an independent, physiological indication of the stress produced by several tests, we measured changes in heart rate using telemetry. Consistently with the behavioral phenotype, beta4-/- mice had a smaller heart rate increase in the elevated-plus maze than did wild-type littermates. In contrast, during social isolation, a separate test for anxiety,beta4-/- mice exhibited a greater increase in heart rate than did wild-type littermates. Finally, beta4-/- mice were indistinguishable from their wild-type littermates in the open field, the light/dark box, and the mirrored chamber. The overall results demonstrate that beta4-containing (beta4*) nAChRs influence behavioral responses during anxiety-related tests, and that this effect depends on the type of anxiety-provoking experience. Through their influence on anxiety-related behavior, beta4* nAChRs might influence both tobacco consumption and smoking relapse.

Cellular mechanisms of nicotine addiction

In developed countries, tobacco use is estimated to be the largest single cause of premature death [Lancet 339 (1992) 1268]. Nicotine is the main addictive component of tobacco that motivates continued use despite the harmful effects. Nicotinic acetylcholine receptors (nAChRs) are widely distributed throughout the mammalian central nervous system (CNS), where they normally respond to acetylcholine (ACh) and modulate neuronal excitability and synaptic communication. Nicotinic receptors are structurally diverse and have varied roles. Presynaptic and preterminal nAChRs enhance neurotransmitter release. Postsynaptic and somal nAChRs mediate a small proportion of fast excitatory transmission and modulate cytoplasmic second messenger systems. Although the impact of nicotine obtained from tobacco is not completely understood, a portion of nicotine's addictive power is attributable to actions upon the dopaminergic systems, which normally help to reinforce rewarding behaviors. As obtained from tobacco, nicotine activates and desensitizes nAChRs, and both processes contribute to the cellular events that underlie nicotine addiction.

Long-lasting enhancement of glutamatergic synaptic transmission by acetylcholine contrasts with response adaptation after exposure to low-level nicotine

Attempts to mimic synaptic delivery of acetylcholine (ACh) with brief, repetitive pulses of high concentration ACh at synapses of medial habenula (MHN) and interpeduncular nucleus (IPN) neurons in vitro elicited temporally distinct facilitation and inhibition of glutamate secretion via nicotinic and muscarinic ACh receptor-mediated pathways, respectively. ACh-induced nicotinic facilitation was sustained for up to 2 hr, whereas muscarinic inhibition was transient. Prolonged exposure to nicotine inactivated nicotinic receptors selectively, thus decreasing the relative contribution of the facilitatory versus inhibitory influences of ACh. The net effect of ACh in modulating glutamatergic transmission at MHN-IPN synapses may be determined by pre-exposure to nicotine, because the drug appears to switch the balance between the facilitatory and inhibitory actions of ACh.

Nicotine as an Addictive Substance: A Critical Examination of the Basic Concepts and Empirical Evidence

The present review is a critical analysis of the concepts behind and the empirical data supporting the view that tobacco use represents an addiction to nicotine. It deals with general aspects of the notion of addiction, while concentrating on specific problems associated with incorporating nicotine into current frameworks. The notion of addiction suffers from unprecedented definitional difficulties. The definitions offered by various authorities are very different, even contradictory. Definitions that reasonably include nicotine are so broad and vague that they allow many trivial things, such as salt, sugar, and watching television, to be considered addictive. Definitions that exclude the trivia also exclude nicotine. The addiction hypothesis, in general, is strongly shaped by views that certain drugs bring about a molecular level subversion of rationality. The main human evidence for this is verbal reports of smokers who say that they can't quit. On the other hand, the existence of many millions of successful quitters suggests that most people can quit. Some smokers don't quit, but whether they can't is another matter. The addiction hypothesis would be greatly strengthened by the demonstration that any drug of abuse produces special changes in the brain. It has yet to be shown that any drug produces changes in the brain different from those produced by many innocuous substances and events. The effects of nicotine on the brain are similar to those of sugar, salt, exercise, and other harmless substances and events. Apart from numerous conceptual and definitional inadequacies with the addiction concept in general, the notion that nicotine is addictive lacks reasonable empirical support. Nicotine does not have the properties of reference drugs of abuse. There are so many findings that conflict so starkly with the view that nicotine is addictive that it increasingly appears that adhering to the nicotine addiction thesis is only defensible on extra-scientific grounds.

Overview of nicotinic receptors and their roles in the central nervous system

Alzheimer's disease is a complex disorder affecting multiple neurotransmitters. In particular, the degenerative progression is associated with loss within the cholinergic systems. It should be anticipated that both muscarinic and nicotinic mechanisms are affected as cholinergic neurons are lost. This review focuses on the basic roles of neuronal nicotinic receptors, some subtypes of which decrease during Alzheimer's disease. Nicotinic acetylcholine receptors belong to a superfamily of ligand-gated ion channels that play key roles in synaptic transmission throughout the central nervous system. Neuronal nicotinic receptors, however, are not a single entity, but rather there are many different subtypes constructed from a variety of nicotinic subunit combinations. This structural diversity and the presynaptic, axonal, and postsynaptic locations of nicotinic receptors contribute to the varied roles these receptors play in the central nervous system. Presynaptic and preterminal nicotinic receptors enhance neurotransmitter release, and postsynaptic nicotinic receptors mediate a small minority of fast excitatory transmission. In addition, some nicotinic receptor subtypes have roles in synaptic plasticity and development. Nicotinic receptors are distributed to influence many neurotransmitter systems at more than one location, and the broad, but sparse, cholinergic innervation throughout the brain ensures that nicotinic acetylcholine receptors are important modulators of neuronal excitability.

Alteration of the behavioral effects of nicotine by chronic caffeine exposure

The prevalence of tobacco smoking and coffee drinking place nicotine and caffeine among the most used licit drugs in many societies and their consumption is often characterised by concurrent use. The pharmacological basis for any putative interaction between these drugs remains unclear. Some epidemiological reports support anecdotal evidence, which suggests that smokers consume caffeine to enhance the effects of nicotine. This paper reviews various aspects of the pharmacology of caffeine and nicotine, in humans and experimental animals, important for the understanding of the interactions between these drugs. In particular, recent experiments are reviewed in which chronic exposure to caffeine in the drinking water of rats facilitated acquisition of self-adminstration behavior, enhanced nicotine-induced increases in dopamine levels in the shell of the nucleus accumbens and altered the dopaminergic component of a nicotine discrimination. These studies provide evidence that the rewarding and subjective properties of nicotine can be changed by chronic caffeine exposure and indicate that caffeine exposure may be an important environmental factor in shaping and maintaining tobacco smoking.

Current models of nicotine dependence: what is known and what is needed to advance understanding of tobacco etiology among youth

Youth smoking has risen dramatically during the last 5 years, leading one to the conclusion that prevention interventions have not been particularly effective. This paper provides an examination of features that define adult nicotine dependence and argues that these features need to be considered in any studied examination of youth etiology and development to nicotine dependence. We review the historical context for the concept of nicotine dependence, features that define the concept and current models of substance dependence more generally. Recommendations for future research are provided.

Nicotine modulates evoked GABAergic transmission in the brain

The effects of nicotine on evoked GABAergic synaptic transmission were examined using whole cell recordings from neurons of the lateral spiriform nucleus in embryonic chick brain slices. All synaptic activities were abolished by the GABA(A) receptor antagonist, bicuculline (20 microM). Under voltage-clamp with KCl-filled pipettes (holding potential -70 mV), nicotine (0.1-1.0 microM) increased the frequency of spontaneous GABAergic currents in a dose-dependent manner. Nicotine enhanced electrically evoked GABAergic transmission only at relatively low concentrations of 50-100 nM (but not 25 nM), which approximate the concentrations of nicotine in the blood produced by cigarette smoking. At higher concentrations nicotine had either no effect (0.25 microM) or diminished (0.5-1.0 microM) evoked GABAergic neurotransmission. Nicotine had no significant effect on the postsynaptic current induced by exogenous GABA (30-50 microM). These data imply that nicotine levels attained in smokers are sufficient to enhance evoked GABAergic transmission in the brain, and that this effect is most likely mediated through activation of presynaptic nicotinic receptors.

Rationale for cigarette smoking and for mentholation preference in cocaine- and nicotine-dependent outpatients

We asked 43 cocaine- and nicotine-dependent outpatients at a substance abuse clinic their reasons for combining cocaine and cigarette use, and for preferring either mentholated or nonmentholated cigarettes. Responses to open-ended questions asked during a semistructured interview were categorized by an analysis of expressed motives for cigarette smoking. Responses that did not fit the categorization were analyzed separately in a qualitative design. Sedating, stimulating, or addictive effects were frequently stated as reasons for the combined use of cigarettes with cocaine. Sedating or calming effects of cigarette smoking included reduction of cocaine-induced paranoia. Cocaine-substituting and cocaine-enhancing effects of cigarette smoking were categorized as stimulating effects. Addictive effects included craving for cigarette smoking on its own or triggered by cocaine use. Sensorimotor or stimulating effects were frequently stated as reasons for a preference for mentholated or nonmentholated cigarettes. Sensorimotor effects of menthol included taste, anesthetic, cooling, and decongestant properties. Some responses provided by our patient sample suggest a need for research on the effect of cigarette smoking on absorption of smoked cocaine.

Individual variability in responses to nicotine

Individual variability in acute responses to nicotine, which may be defined as variable magnitude of effects following controlled dosing, is generally attributed to stable characteristics of tobacco users such as genetic/constitutional factors or to chronic behavioral factors (e.g., long-term use of other drugs). Often overlooked, however, is that such variability may also be due to the transient influence of the situational factors in which people consume nicotine, such as acute stress or physical activity. Results of selected studies from the author's laboratory provide examples of each of these sources of variability in nicotine responding on subjective, behavioral, and physiological measures. All studies used a nasal spray method of nicotine dosing or controlled smoking (paced puffing) to control acute nicotine exposure, an essential methodological feature of any research on individual differences in acute responses to nicotine. As an example of genetic/constitutional factors, gender differences in nicotine responding have begun to receive some attention, with few differences emerging. However, females may be more responsive than males to nonnicotine stimuli associated with smoking (e.g., sight and taste of smoke). In terms of chronic behavioral factors, long-term use of nicotine produces attenuation of most subjective and some behavioral effects of nicotine, reflecting chronic tolerance, and the possibility that chronic use of other drugs may alter responses to nicotine (i.e., cross-tolerance or cross-sensitization) deserves greater study. Of particular emphasis in this review is the modulating influence of acute situational factors on nicotine responding. Human studies have shown that magnitude of nicotine's subjective effects may depend on the predrug subjective state, level of physical activity vs. rest, and concurrent acute intake of other drugs, among other situational factors. Proper consideration of these situational factors may reveal the greatest source of individual variability in responding to nicotine and clarify the impact of more stable genetic/constitutional or chronic environmental factors.

Acute tolerance to nicotine in smokers: lack of dissipation within 2 hours

Greater understanding of development and dissipation of acute tolerance to nicotine may help explain temporal patterns of nicotine self-administration in smokers. The time course of dissipation of acute tolerance to nicotine was examined in 16 smokers (8M, 8F) participating in four sessions differing on pretreatment exposure or time interval prior to nicotine (20 micrograms/kg) challenge: placebo 30 min before, or nicotine (20 micrograms/kg) 30, 60, or 120 min before challenge. Nicotine and placebo were administered by measured-dose nasal spray. The measurement battery consisted of subjective, cardiovascular, thermal pain detection, and behavioral performance measures. Results demonstrated significant acute tolerance (i.e. smaller responses to nicotine challenge following nicotine versus placebo pretreatment) for most subjective measures and for heart rate. Acute tolerance dissipated with lengthening inter-dose interval for two subjective measures, dose strength and arousal, but there was no tolerance dissipation for other measures. In contrast, nicotine pretreatment resulted in acute sensitization of finger temperature (vasoconstriction) response, which dissipated with lengthening interval. No acute tolerance was observed for thermal pain detection or performance measures. These findings demonstrate that acute tolerance develops quickly to some subjective and cardiovascular effects of nicotine. However, acute tolerance to most effects did not dissipate over 2 h, suggesting that, following acute tolerance development during initial exposure, most smokers generally obtain similar magnitude of effects from each subsequent nicotine exposure (i.e. cigarettes smoked later in the day).

The psychopharmacological basis of nicotine's differential effects on behavior: individual subject variability in the rat

Nicotine, the presumed active pharmacological agent in tobacco, produces variable effects on behavior that are at best described as "paradoxical" in nature. Thus, nicotine, via tobacco use in humans or nicotine administration in experimental animals, tends to transpose behavior depending on predrug baseline rates of behavior. High rates of behavior appear to be reduced, while low rates of behavior appear to be increased by nicotine. This work further proposes that nicotine's variable effects on behavior may be related to its capacity to act as a behavioral agonist and/or antagonist via its ability either to activate or to desensitize distinct central nicotinic acetylcholinergic receptors (nAChR's). Nicotine is portrayed as a neuronal modulating agent that can affect behavior contingent upon the genetic makeup of the individual subject being studied. Depending on the structure, function, and location of distinct nAChR's, nicotine appears to be able to induce a wide range of behavioral effects important to the tobacco user. However, this does not rule out the role the importance that other biogenic amine systems (i.e., serotonin or dopamine) may have in the genetics of tobacco use or nicotine's variable effects on behavior.

Individual differences in sensitivity to nicotine: implications for genetic research on nicotine dependence

Recent evidence suggests that cigarette smoking has a heritability index around 53%. While related research on underlying mechanisms also supports the idea that genetic factors contribute to nicotine dependence--as well as to cofactors such as substance use and mood disorders--the nature of the behavioral traits and biological capacity for reinforcement that constitutes vulnerability to nicotine dependence is not well understood. The present review explores the problem of why some people become highly nicotine dependent, others develop a pattern of occasional use, and still others avoid the drug entirely despite extensive exposure and widespread experimentation with tobacco in the population. Recent research--both infrahuman and human--suggests that vulnerability to nicotine dependence is related to high initial sensitivity to nicotine and that the development of tolerance is more rapid and self-administration more extensive in such individuals. Relevant findings from neuroscience and biobehavioral research are reviewed in order to identify variables and methodologies that might improve the reliability and validity of behavioral and molecular genetic studies on cigarette smoking. The integration of research in these areas may lead to new insights in the understanding of nicotine dependence as well as to improved techniques for prevention and treatment.

Acute pharmacodynamic tolerance to the subjective effects of cigarette smoking

A brief feeling state questionnaire was completed before and after each cigarette, over a day of smoking. Feelings of stress/anxiety demonstrated a pattern of repetitive vacilation over the day, with high stress before smoking, reduced stress after smoking, and stress levels increasing again between cigarettes. There was no evidence of acute pharmacodynamic tolerance, with cigarettes leading to altered feelings of anxiety/stress over the whole day of smoking. Self-rated feelings of arousal also demonstrated a pattern of vacilation over the day, with low arousal pre-smoking increased arousal post-smoking, but arousal levels reducing again between cigarettes. The ANOVA drug x time interaction was significant, with the greatest arousal change following the first cigarette of the day. However, later cigarettes led to similar amounts of arousal change over the rest of day, thus questioning whether acute pharmacodynamic tolerance was occurring. Instead, the heightened arousal response to the first cigarette of the day may reflect the influence of two other factors. Firstly, overnight deprivation, with the first cigarette of the day leading to the greatest increase in plasma nicotine. Secondly, low early-morning arousal with its associated potential for increased arousal. Overall, therefore, there was little indication of acute pharmacodynamic tolerance to the subjective effects of nicotine. Cigarettes were associated with altered feelings of stress and arousal, over the whole day of smoking.

Individual differences in stress and arousal during cigarette smoking

Self-rated feelings of stress and arousal were monitored before and after each cigarette, over a day of normal smoking. Subjects comprised 105 unpaid volunteers (65 female, 40 male; mean age 30.4 years; mean consumption 12.4 cigarettes on test day). Feelings of arousal were significantly higher post-smoking than pre-smoking. The degree of arousal change was monotonically related to scores on the smoking motivation questionnaire (SMQ) stimulant subscale, with high stimulant smokers reporting the greatest arousal modulation. However stimulant smokers reported low arousal before smoking, rather than high arousal after smoking. Feelings of stress were significantly lower post-smoking than pre-smoking. The degree of stress change was monotonically related to scores on the SMQ sedative subscale, with high sedative smokers reporting the greatest stress change. This confirms the criterion validity of this second SMQ subscale. However, as with the arousal data, sedative smokers tended to report high stress before smoking, rather than low stress after smoking. Smoking did not therefore produce advantageous post-cigarette feeling states. Instead, mood modulation largely comprised the alleviation of poor psychological states prior to smoking. These stress and arousal changes often occurred simultaneously, against the predictions of the arousal modulation theory. Arousal modulation and stress modulation should therefore be seen as separate and independent processes. Lastly, feelings of stress and arousal fluctuated repeatedly over the day, with improved moods immediately after smoking, but impaired moods developing between cigarettes. These mood reversals provide a clear psychological rationale for the repetitive (addictive) nature of nicotine use.

The favorite cigarette of the day

The choice of a favorite cigarette smoked during a given day varies considerably. Preferences are related to nicotine dependence and the lifestyles of smokers. In a sample of 5124 smokers, the "after-dinner cigarette" was chosen as the cigarette which they would miss most, while the next largest proportion of smokers (33%) said that they would miss the "first cigarette of the morning" most. The latter group scored highest on tests of nicotine dependence. In contrast, infrequent smokers ("chippers") chose the after-dinner cigarette.

Neurobehavioral mechanisms of nicotine action: role in the initiation and maintenance of tobacco dependence

Basic neuroscience research conducted over the last quarter century has provided us with much information concerning potential biobehavioral and neuromolecular mechanisms involved in the initiation and maintenance of tobacco dependence. Nicotinic-acetylcholinergic receptors (AChRs), in addition to having a primary locus on cholinergic neurons, appear to be also located on a variety of noncholinergic neurons (presynaptic and/or postsynaptic sites). Nicotine therefore appears to be able to affect a variety of neuronal pathways involved in behavioral reward and arousal processes, which appear paramount to tobacco dependence. Nicotine appears to have several unique properties at the cellular level that allow it to act both as an agonist and as a potential antagonist at select AChRs. Nicotine's ability to act as an agonist appears to be contingent on an action at nAChRs, which initially open a receptor-linked cation channel, eliciting the entrance of CA++ (or other cations) into the cell. Cation entrance into the cell, therefore, may be the cellular transducer of nicotine's behavioral and dependence-producing effects. Subsequent to this initial agonist effect, the nicotinic receptor is believed to undergo a refractory period, via a desensitization process, during which Ca++ is prevented from further entrance into the cell. It is this ability to induce receptor desensitization which seems central to nicotine's ability to act as an antagonist. The duration of nAChR desensitization may also be useful in explaining individual variability to nicotine's behavioral effects and may be related to the induction of acute and/or chronic tolerance in both animals and man. Nicotine-induced desensitization may also be important to relapse in the smoker if conditioned stimuli are able to provoke such mechanisms, which could lead to the need to smoke. Finally, a model is presented to account for individual smoking patterns and level of tobacco dependence which is partially based on the proposed cellular mechanisms of nicotine action and desensitization at the nAChR.

Differences between smokers and never-smokers in sensitivity to nicotine: a preliminary report

Sensitivity to nicotine was explored using test doses administered via intra-nasal aerosol in 10 smokers and 10 never-smokers. Smokers received 1.50 mg nicotine (in 2 sprays, < 5 seconds apart, one spray per nostril); never-smokers received either 0.50 mg (n = 3) or 0.25 mg (n = 7) nicotine. Accumulation of nicotine in plasma, per unit dose administered, was nearly four times greater in never-smokers than in smokers, indicating differences in pharmacokinetic tolerance. To examine sensitivity to nicotine without this confound, peak physiological reactivity (heart rate and blood pressure changes) was divided by peak plasma nicotine increment and the ratio was expressed as a function of cotinine level prior to dosing, thereby relating sensitivity to nicotine to history of exposure. In smokers, functional sensitivity to nicotine was inversely related to customary nicotine intake, replicating previous findings for light and heavy smokers. The observation that never-smokers were not much more sensitive to nicotine than light smokers is notable given the disparity in previous history of exposure.

Effect of acute and subchronic nicotine treatment on cortical efflux of [3H]-D-aspartate and endogenous GABA in freely moving guinea-pigs

1. The [3H]-D-aspartate preloading of the parietal cortex of freely moving guinea-pigs equipped with epidural cups makes it possible to investigate drug effects on the efflux of this radiolabel, assumed as a marker of the glutamatergic structures underlying the cup. In the same model, the efflux of [3H]-gamma-aminobutyric acid ([3H]-GABA) and endogenous GABA can be measured. 2. Nicotine, 0.9-3.6 mg kg-1, s.c., or 3-5 micrograms, i.c.v., increased the efflux of [3H]-D-aspartate but reduced that of GABA. 3. These effects were mediated through mecamylamine-sensitive receptors but the ganglionic blocking agent was devoid of any primary activity. 4. The inhibition of GABA efflux induced by nicotine 3.6 mg kg-1, s.c., was abolished by methysergide 2 mg kg-1, i.p. and was reduced by naloxone 3 mg kg-1, i.p. pretreatment, suggesting the involvement of tryptaminergic and opioid systems. In contrast, muscarinic and catecholamine antagonists were ineffective. 5. Chronic treatment with nicotine (3.6 mg kg-1, twice daily for 16 days) reduced the facilitatory effect of [3H]-D-aspartate and abolished the inhibition of endogenous GABA efflux. 6. A slight increase in the number of nicotinic binding sites (by use of [3H]-nicotine as ligand) was found in the neocortex of chronically treated guinea-pigs. 7. The higher degree of tolerance to chronic nicotine treatment shown by GABA as compared with [3H]-D-aspartate efflux suggests that adaptative changes of the inhibitory neuronal pools prevail. This may contribute to the reinforcing and addictive properties of nicotine.

Beneficial effects of nicotine

Nicotine in tobacco brings illness and death to millions of people. Yet nicotine in its pure form has the potential to be a valuable pharmaceutical agent. Nicotine fairly specifically binds to the cholinergic nicotinic gating site on cationic ion channels in receptors throughout the body. This action stimulates the release of a variety of neurotransmitters including especially catecholamines and serotonin. When chronically taken, nicotine may result in: (1) positive reinforcement, (2) negative reinforcement, (3) reduction of body weight, (4) enhancement of performance, and protection against; (5) Parkinson's disease (6) Tourette's disease (7) Alzheimers disease, (8) ulcerative colitis and (9) sleep apnea. The reliability of these effects varies greatly but justifies the search for more therapeutic applications for this interesting compound.