Receptor Loops and Real-World Quits: A Practice-Focused Nicotine Dependence, Biomarkers, and Treatment Pathways

DOI

10.2991/978-2-38476-533-1_55How to use a DOI?

Keywords

Nicotine dependence; Nicotinic acetylcholine receptors; Dopamine reward; Biomarkers; Cessation strategies; Pharmacotherapy; Exposure assessment; E-cigarettes

Abstract

Nicotine dependence arises from rapid CNS delivery and reinforcement via nicotinic acetylcholine receptors, producing dopamine mediated reward, receptor desensitization, neuroadaptation, conditioned cues, and withdrawal cycles that sustain use. This paper integrates mechanistic, clinical, and translational evidence on nicotine dependence with emphasis on biomarker detection and cessation implementation. Evidence is synthesized on dependence biology (nAChR activation/desensitization, glutamate/GABA modulation), health burdens linked to sustained exposure, and validated biomarkers (nicotine/cotinine) quantified by HPLC, LC-MS/MS, GC-MS, and rapid immunoassays to support exposure assessment and treatment monitoring. Results indicate that alternative delivery systems (e-cigarettes, cigars, pipes, hookah) do not reliably mitigate dependence risk; nicotine exposure and toxicant profiles vary by product and user behavior, and evidence for cessation benefit remains mixed. First-line cessation strategies center on pharmacotherapy (nicotine replacement, bupropion SR, varenicline) paired with counseling, with dose-structured regimens and clinical cautions tailored to comorbidity profiles. Managing nicotine dependence requires closing the gap between neurobiological understanding, objective exposure measurement, and guideline-concordant treatment, while avoiding unintended substitution with products that perpetuate dependence. This paper links receptor-level mechanisms to bedside decisions, prioritizing measurable biomarkers and evidence-based cessation pathways to improve quit durability.

Copyright

© 2025 The Author(s)

Open Access

Open Access This chapter is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits any noncommercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

Download article (PDF)

TY  - CONF
AU  - Mainak Mitra
PY  - 2025
DA  - 2025/12/31
TI  - Receptor Loops and Real-World Quits: A Practice-Focused Nicotine Dependence, Biomarkers, and Treatment Pathways
BT  - Proceedings of the International Conference on Smart Systems and Social Management (ICSSSM-2 2025)
PB  - Atlantis Press
SP  - 928
EP  - 939
SN  - 2352-5398
UR  - https://doi.org/10.2991/978-2-38476-533-1_55
DO  - 10.2991/978-2-38476-533-1_55
ID  - Mitra2025
ER  -