Abstract
Rationale
Nicotine is almost universally believed to be the primary agent motivating tobacco smoking and the main impediment to cessation. A principal argument in support of the presumed reinforcing properties of nicotine is that smokers self-administer pure nicotine. However, the evidence for nicotine self-administration in smokers has not been critically examined.
Objectives
To review and examine the empirical basis for the assertion that smokers self-administer pure nicotine.
Methods
We reviewed all the studies we were able to locate that are cited as demonstrating self-administration of nicotine, isolated from tobacco, in normal smokers and non-smokers. These studies investigated self-administration of intravenous nicotine, nicotine gum and nicotine spray. Using the authors’ own criteria, we examined whether these studies in fact demonstrate nicotine-self administration.
Results
None of the studies we reviewed demonstrated nicotine self-administration in smokers. Both smokers and non-smokers failed to show preference for nicotine over placebo in any of these studies, including in a series of six reports of overnight abstinent smokers having access to nicotine nasal spray, a rapidly absorbed form of nicotine.
Conclusions
The common statement that smokers self-administer pure nicotine lacks empirical support. Smokers in fact do not administer pure nicotine in any of the forms studied to date, even when abstinent and presumably nicotine-deprived. This conclusion necessitates a critical re-examination of the nicotine addiction thesis.
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The authors have received fees for consulting to lawyers working with tobacco companies. However, the work associated with this review was not supported by any non-university funds.
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Dar, R., Frenk, H. Do smokers self-administer pure nicotine? A review of the evidence. Psychopharmacology 173, 18–26 (2004). https://doi.org/10.1007/s00213-004-1781-2
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DOI: https://doi.org/10.1007/s00213-004-1781-2