NICOTINE SUBSTITUTION IN SMOKING CESSATIO N - MODES OF ACTION, MODALITIES AND EVALUATION OF RESULTS

Failure in smoking cessation is linked with behavioural factors and wi th nicotine dependence, due to the psychoactive effects of the drug, m ainly on locus ceruleus and on mesolimbic dopaminergic system. Nicotin e substitution partially controls the withdrawal syndrome, sometimes v ery intense in smokers with pharmacological dependence. After transder mal nicotine administration, nicotine blood levels are relatively low bur steady, nicotine chewing gum can be used alone or in combination w ith transdermal administration Both methods can double biologically co ntrolled success rates. Risks are limited in comparison with those of continued smoking. Recent data from the literature allow a better unde rstanding of indications and limits of the pharmacological approach to cessation, that should address smokers firmly decided to stop, and be completed by behavioural support, including changes in the way of lif e.