Smoking relapse

Cohen S and Lichtenstein E (1990). Perceived stress, quitting smoking, and smoking relapse. Health Psychology, 9, 466-478. 

Hays JT, Hurt RD, Rigotti NA, et al Sustained-release bupropion for pharmacologic relapse prevention after smoking cessation. Ann Intern Med 135 423 33, 2001 Henningfleld JE Nicotine medications for smoking cessation. N Engl J Med 333 1196-1203, 1995... 

Around half of American and British adults who used to smoke have now stopped. Furthermore, 80-85% of current smokers state that they would like to quit and wish they had never started. However, quitting can be difficult, with many smokers relapsing... 

Bupropion A drug that inhibits the presynaptic neuronal reuptake of both dopamine and noradrenaline which is used as an antidepressant and to prevent relapse following smoking cessation. 

Nicotine is responsible for the highly addictive properties of tobacco products. Addiction occurs in 30% of those who experiment with tobacco products, and more than 80% of those who attempt to quit smoking will relapse within a year. Withdrawal from nicotine produces a syndrome characterized by nicotine craving as well as dysphoria, anxiety, irritability, restlessness and increased appetite. It is treated with nicotine replacement therapies, such as nicotine gum and patches, and/or with buproprion, a drug that is classified as an antidepressant but has multiple and complex effects in brain. Buproprion reduces craving in some smokers. Nicotine addiction has been reviewed recently at cellular and systems levels [38-41]. 

Abrams DB, Monti PM, Carey KB, Pinto RP, Jacobus SI (1988) Reactivity to smoking cues and relapse two studies of discriminant validity. Behav Res Ther 26(3) 225-233 American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn (DSM-IV). American Psychiatric Association, Washington, DC Asghari V, Sanyal S, Buchwaldt S, Paterson A, Jovanovic V, Van Tol HH (1995) Modulation of intracellular cyclic AMP levels by different human dopamine D4 receptor variants. J Neurochem 65(3) 1157-1165... 

Fig. 1 Simplified diagram of sex differences in nicotine addiction. Considering both human smoking conditions and nicotine administration in animals, there are consistent sex differences, specifically during transition from use to dependence and during quit attempts, withdrawal, and relapse. Females take a shorter time to become addicted than males, make fewer attempts to abstain, and have shorter abstinent periods. Finally, females relapse more than males, indicating lower success in quitting...

Varenicline increases smoking cessation rates in smoking cessation trials and appear to prevent relapse. 

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