Russo Patrizia, Nastrucci Candida, Alzetta Giulio, Szalai Clara
IRCSS (Istituto di Ricovero e Cura a Carattere Scientifico) San Raffaele Pisana, Rome, Italy.
Perspect Biol Med. 2011 Autumn;54(4):557-77. doi: 10.1353/pbm.2011.0047.
This article reviews the cultural history of man's relationship with tobacco and the steps in the discovery of tobacco addiction. Nicotine dependence (ND) or nicotine addiction (NA), among other forms of drug addiction, continues to be a significant public health problem in the world, as it is associated with major severe diseases such as cardiovascular disease and cancer. Evidence for a genetic influence on smoking behavior and ND has prompted a search for susceptibility genes. Proof has recently accumulated that single nucleotide polymorphisms (SNPs) in the genetic region encoding the nicotinic acetylcholine receptor (nAChR) subunits α5, α3, and β4 are associated with smoking and ND. In this review, we consider tobacco as the archetype of substance addiction and describe the evolution of the tobacco habit from elite users to lower socioeconomic abusers (by mass marketing and specific targeting of vulnerable groups by the tobacco industry) to exemplify detrimental behavior with major threats to public health. Finally, we discuss the reasons for the difficulty of quitting addictions/habits and highlight possible solutions.
本文回顾了人类与烟草关系的文化史以及烟草成瘾发现过程中的各个阶段。尼古丁依赖（ND）或尼古丁成瘾（NA），与其他形式的药物成瘾一样，仍是全球一个重大的公共卫生问题，因为它与心血管疾病和癌症等主要严重疾病相关。吸烟行为和尼古丁依赖受遗传影响的证据促使人们寻找易感基因。最近有越来越多证据表明，编码烟碱型乙酰胆碱受体（nAChR）亚基α5、α3和β4的基因区域中的单核苷酸多态性（SNP）与吸烟和尼古丁依赖有关。在本综述中，我们将烟草视为物质成瘾的典型，并描述烟草使用习惯从精英使用者到社会经济地位较低的滥用者（通过大众营销以及烟草行业对弱势群体的特定 targeting）的演变，以例证对公共卫生构成重大威胁的有害行为。最后，我们讨论成瘾/习惯难以戒除的原因，并强调可能的解决办法。
