Drug Therapy for Nicotine Addiction (DP IB Psychology): Revision Note

Drug therapy for nicotine addiction

• Nicotine addiction is often treated using agonist substitution therapy, where a safer alternative to tobacco is given in the form of Nicotine Replacement Therapy (NRT)

• NRT is a prescription medication which:

  • acts as an agonist on nicotinic receptors in the brain

  • stimulates dopamine release, mimicking nicotine’s effects but in a safer, controlled dose

  • is available as gum, skin patches, sprays, or pouches

  • is released into the bloodstream more slowly than from cigarettes

  • lacks the harmful chemicals found in tobacco smoke

  • is reduced gradually over 2–3 months, managing withdrawal until the user can quit completely

• Another NRT option is naltrexone (commonly used for opioid addiction)

  • It works by blocking the rewarding effects of nicotine

  • It reduces the desire to smoke by removing its pleasurable effects

Research support for drug therapy & nicotine addiction

Stead et al. (2012)

Aim: 

• To compare the effectiveness of NRT with a placebo and other biological treatments in quitting smoking

Method:

• A literature review of research of 150 drug trials, including over 50,000 participants

• Focused on randomised trials and dose comparisons

Results:

• NRT (gum, patches, sprays) increased quit rates by 50–70% compared to the placebo

• Heavily addicted smokers responded best to higher doses of NRT gum

• Higher doses of NRT patches did not significantly benefit heavily addicted smokers

• Combination therapy (patch + rapid delivery form such as gum) was more effective than single NRT use

Conclusion: 

• NRT is an effective and viable treatment for quitting smoking

Evaluation of drug therapy for addiction

Strengths

• Drug treatment is accessible and it is cheaper and easier to engage with than CBT, requiring only a prescription and medical supervision

• Drug therapy frames addiction as a medical condition, not a moral weakness, so it reduces stigma and encourages more people to seek help

Limitations

• Drug therapies can have side effects, such as sleep disturbances, digestive issues or headaches, which may result in non-compliance and relapse

• The effectiveness of drug therapy is not universal, as small genetic variations between people can have a significant effect on the outcome of drug treatments

  • E.g., naltrexone’s effectiveness depends on variations in the μ-opioid receptor gene

Link to concepts

Perspective

• Although NRT clearly plays a role in reducing nicotine addiction (and, subsequently, in quitting smoking), it cannot work in isolation

  • The smoker must want to quit smoking to begin NRT in the first place

  • Motivation and, to some extent, self-efficacy are key factors in any decision to improve one’s health

Change

• Research on the effectiveness of NRTs should necessarily include follow-up studies which assess the longevity of the treatment’s effect

  • NRTs may only work in the short-term so it is in the interest of public health to investigate the extent of their effectiveness over time