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Nicotine and Tobacco

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Textbook of Addiction Treatment: International Perspectives

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Abstract

Although rates of tobacco use and dependence have been reduced substantially over the past 40 years, one in five Americans continues to smoke. The prevalence of smoking appears to be substantially higher in persons with psychiatric and substance use disorders and has remained unchanged, as these smokers have less success in quitting smoking. The epidemiology of tobacco use and dependence and the pharmacological effects of nicotine and tobacco are reviewed followed by a discussion of the clinical assessment of tobacco users. We then review behavioral and pharmacological treatments, including the FDA-approved pharmacotherapies: nicotine replacement therapies (NRTs), sustained-release bupropion, and varenicline. Finally, integration of tobacco dependence treatment into mental health settings is discussed with the view that tobacco dependence is a chronic medical disorder and that more effective treatment of this comorbidity in psychiatric disorders may require targeted treatments based on a better understanding of the pathophysiology of individual psychiatric disorders.

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Authors and Affiliations

  1. Institute of Medical Sciences, University of Toronto, 250 College Street, M5T 1R8, Toronto, ON, Canada

    Kristen M. Mackowick & Tony P. George

  2. Division of Brain and Therapeutics, Department of Psychiatry, University of Toronto, 250 College Street, M5T 1R8, Toronto, ON, Canada

    Tony P. George

  3. Schizophrenia Division, Centre for Addiction and Mental Health (CAMH), 250 College Street, M5T 1R8, Toronto, ON, Canada

    Kristen M. Mackowick & Tony P. George

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  1. Kristen M. Mackowick
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  2. Tony P. George
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Correspondence to Tony P. George .

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Editors and Affiliations

  1. Department of Psychiatry, Alberta Gambling Research Institute University of Calgary, Calgary, Alberta, Canada

    Nady el-Guebaly

  2. Faculty of Brain Sciences UCL Division of Psychiatry, University College London, London, United Kingdom

    Giuseppe Carrà

  3. Division of Alcoholism & Drug Abuse, New York University School of Medicine, New York, New York, USA

    Marc Galanter

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Mackowick, K.M., George, T.P. (2015). Nicotine and Tobacco. In: el-Guebaly, N., Carrà, G., Galanter, M. (eds) Textbook of Addiction Treatment: International Perspectives. Springer, Milano. https://doi.org/10.1007/978-88-470-5322-9_17

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