Multiple brain pathways and receptors underlying tobacco addiction.

Over the last 20 years much progress has been made in understanding the pharmacologic basis of tobacco addiction. In particular, the role of nicotine in reinforcing smoking behavior has been studied from a variety of perspectives. This article discusses two important aspects of this topic: (1) brain pathways underlying tobacco addiction; and (2) the actions of nicotine at nicotinic cholinergic receptors. Recent evidence will be reviewed indicating that nicotine reinforces smoking behavior by acting on more than one subtype of nicotinic receptor. Similarly, the role of several brain pathways in tobacco addiction will be considered. Tobacco addiction may thus be seen as a complex neuropsychopharmacological disorder; further progress in smoking cessation treatment may require that we address the multiple molecular and brain components of this addiction.