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Toxins in tobacco smoke, not nicotine, are
responsible for smoking-related diseases1
 Tobacco smoke
FACT:
Tobacco smoke, not nicotine, contains >60 known
carcinogens and >4,800 chemical substances, many
of which are toxic, such as carbon monoxide, arsenic,
and ammonia.1,2
The activity of nicotine
FACT:
Nicotine exerts its effects by binding
to several types of nicotinic receptors,
which stimulates the release of
neurotransmitters, including3:
- Catecholamines
- Dopamine, norepinephrine,
epinephrine
- Acetylcholine
- GABA
- Glutamate
FACT:
In the brain of cigarette smokers,
the density of the nicotinic receptors
is up to 3 times higher than in
nonsmokers (up-regulation).3
Commit: therapeutic nicotine
Treating nicotine addiction
- Unlike cigarettes, therapeutic nicotine in Commit helps smokers wean off nicotine, eventually becoming tobacco and nicotine free
Venous blood concentrations in nanograms of nicotine per milliliter of blood as a function of time.
- Unlike the rapid addictive nicotine delivery of cigarettes, Commit therapeutic nicotine is delivered gradually and without the sharp peaks associated with smoking4,5
In a major clinical trial, the popular nicotine replacement therapy (NRT) product, Nicorette® (nicotine polacrilex gum) was also proven effective in relieving situational cravings. This multi-center, randomized, placebo-controlled study was conducted with smokers (n=296) who quit by using either active gum (Nicorette 4 mg for heavy smokers; 2 mg for light smokers) or inactive gum (control) for 3 days. On the 3rd day, participants were exposed to strong situational stimuli (ie, handling cigarettes; smelling cigarette smoke), after which they were allowed to chew the gum. Cravings assessment scales in 167 participants identified as "reactors" to stimuli demonstrated that:
- Use of Nicorette resulted in significantly greater reductions in craving (F1,285=13.81, P<0.001) than control6
- Craving dropped significantly faster among subjects using active gum (F1,158=10.65, P=0.001) compared to control6
- In minutes 10-15, subjects using active gum showed significantly steeper drops in craving (F1,158=7.35, P=0.008); by 15 minutes, and at every time point thereafter, participants on active gum demonstrated significantly lower craving than those on control6
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Sources:
1. Tobacco use in the United States [CDC Web site]. Available
at: http://www.cdc.gov/tobacco/overview/tobus_us.htm. Accessed June
12, 2003.
2. Hoffmann D, Hoffmann I. The changing cigarette, 1950-1955.
J Toxicol Environ Health. 1997;50:307-364.
3. Kellar KJ. Neuropharmacology
and biology of neuronal nicotinic receptors. National Institute on Drug
Abuse Web site. Available at: http://www.drugabuse.gov/meetsum/
nicotine/Kellar.html. Accessed May 25, 2006.
4. Benowitz NL, Porchet H,
Sheiner L, Jacob P. Nicotine absorption and cardiovascular effects with
smokeless tobacco use: comparison with cigarettes and nicotine gum. Clin
Pharmacol Ther. 1988;44:23-28.
5. Choi JH, Dresler CM, Norton MR, Strahs
KR. Pharmacokinetics of a nicotine polacrilex lozenge. Nicotine Tob Res.
2003;5:635-644.
6. Shiffman S, Shadel WG, Niaura R, et al. Efficacy of acute administration of nicotine gum in relief of cue-provoked cigarette craving. Psychopharmacology. 2003;166:343–350
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