INDIVIDUAL DIFFERENCES IN
SENSITIVITY TO NICOTINE
Background
Nicotine
dependence implies a pattern of heavy consumption
that is resistant to change, as well as the
development of tolerance and regulation of
nicotine intake within relatively narrow limits
(Pomerleau et al., 1983b). While relief from
withdrawal is clearly important in maintaining
the smoking habit, events independent of the
nicotine withdrawal cycle also exert considerable
control over smoking behavior (Pomerleau &
Pomerleau, 1984). Given that only one third
to one half of those who experiment with tobacco
go on to smoke regularly (McNeil, 1991), it
is important to identify individual smoker
characteristics that indicate heightened susceptibility
to nicotine dependence. One explanation of
variability in nicotine dependence posits
that people who become highly nicotine-dependent
are more sensitive to nicotine initially —
experiencing
a combination of effects (Pomerleau et al.,
1993; Pomerleau, 1995); this is in contrast
to earlier explanations that emphasized the
effects of continued exposure to nicotine
and assumed that individuals with greater
sensitivity experienced more adverse effects
during initial exposure and were less likely
to persist in smoking (Friedman et al., 1985;
Silverstein et al., 1982). The sensitivity
model posits that highly reactive individuals
experience both negative and positive effects
during initial exposure to nicotine and that,
with repeated exposure, tolerance to nicotine's
aversive consequences develops and the smoking
habit becomes entrained; in contrast, individuals
who experience less intense nicotine effects
initially are less likely to become dependent
as they find the smoking experience less rewarding
and they have reduced a potential for developing
tolerance.
Several
lines of evidence provide support for the sensitivity
model: At the animal level, a series of studies
by Collins demonstrated that strains of mice
displaying increased innate responsivity to
nicotine developed tolerance more quickly and
to a greater degree (Marks et al., 1991) and
self-administered nicotine most extensively
(Collins & Marks, 1991). A preliminary study
in humans adjusting for nicotine level obtained
in different subjects (Pomerleau et al., 1993)
found that heaviest smokers were most reactive
to nicotine administration during smoking abstinence,
that light smokers were less reactive, and that
nonsmokers were the least reactive. These results
were in accord with clinical observations made
by Russell and West (Russell, 1989; West &
Russell, 1985; 1988) that heavily dependent
smokers were the most responsive to the first
cigarette smoked after 24 hours of abstinence.
In keeping with these findings, Shiffman et
al. (1992) found that occasional, non-dependent
smokers (chippers) were relatively insensitive
to nicotine and demonstrated little or no withdrawal
during abstinence. Finally, in studies of the
first experiences with cigarette smoking, Pomerleau
et al. (1998; 1999) noted that, while unpleasant
reactions to the first cigarettes do not seem
to protect against continuing to smoke, people
who ended up becoming highly dependent smokers
reported more pleasurable sensations during
their initial exposures to tobacco, supporting
the hypothesis that the progression to smoking
dependence is influenced by constitutional sensitivity
to nicotine. At this point, a variety of studies
have reported enhanced initial reactivity in
more dependent smokers in various populations
and different age groups (Chen et al., 2003;
Eissenberg and Balster, 2000; DiFranza et al.,
2004).
References
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