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Why does smoking so often produce dependence? A somewhat different view
  1. John R Hughes
  1. Department of Psychiatry, University of Vermont, Burlington, Vermont, USA
  1. John R Hughes MD, Department of Psychiatry, University of Vermont, 38 Fletcher Place, Burlington, VT 05401–1419,


The usual explanation for why smoking produces dependence focuses on the effects of nicotine on dopamine and other neurobiological explanations. This review offers four somewhat different explanations: (1) nicotine can offer several psychopharmacological benefits at the age when such benefits are especially needed; (2) cigarettes provide for a rapid, frequent, reliable and easy-to-obtain reward; (3) nicotine is not intoxicating, allowing chronic intake; and (4) the long duration of the nicotine withdrawal syndrome effectively undermines cessation. This article reviews the evidence for the above views and the tobacco control activities these views suggest.

  • nicotine
  • substance use disorder
  • substance withdrawal
  • tobacco use disorder

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