Tobacco

Citation

Attwood A, Aveyard P, Bauld L, Britton J, Hajek P, Hastings G, McNeill A, Munafo M, Murray R, Shahab L & West R (2013) Tobacco. In: Miller P (ed.) Principles of Addiction: Comprehensive Addictive Behaviors and Disorders, Volume 1. Amsterdam: Elsevier, pp. 767-776. http://www.sciencedirect.com/science/article/pii/B9780123983367000772; https://doi.org/10.1016/B978-0-12-398336-7.00077-2

Abstract
This chapter provides a comprehensive overview of the major issues associated with tobacco use in modern society. Tobacco use is linked to numerous negative health outcomes and is one of the leading causes of preventable death worldwide. It is also associated with a robust dependence profile that drives continued use despite these negative outcomes. The mechanisms underlying tobacco dependence are discussed, with a focus on the role of nicotine, which is the primary psychoactive constituent of tobacco. The prevalence of global tobacco use is also discussed and groups particularly vulnerable to tobacco use and dependence are identified. Modern research suggests that tobacco dependence may be under some degree of genetic control, which may explain individual differences in smoking profiles. Recent research in this area is reviewed and the clinical applications of these findings are considered. Information is also provided on the current therapeutic interventions - both psychological and pharmacological - for smoking cessation, and on the issues surrounding how the efficacy of such treatments are assessed in clinical trials. Due to the increasing recognition of the health impacts of smoking, there has been a large public focus on strategies that can reduce smoking rates at a population level. This chapter ends with a review of shifts in governmental tobacco control policy and discusses the role of tobacco marketing in promoting use.