Tobacco use is the Nation's most profound public health problem. Each year, tobacco use accounts for an estimated $50 billion in health care costs, and the human cost is even more staggering. More than 400,000 Americans die annually from tobacco-related diseases. Of course, most smokers want to reduce their risks of heart and lung diseases, cancers, and strokes, but once addicted, smokers and other tobacco users find it very difficult to stop.
NIDA's contribution to the Nation's efforts to reduce tobacco use has been critically important. NIDA-supported research has led the way to development of smoking-cessation medications and has illuminated the causes of addiction. Recent studies have shown how the social and environmental influences that lead people to begin using tobacco conspire with powerful biological effects to quickly produce addiction to nicotine.
NIDA-funded investigations have made major advances in understanding, preventing, and treating tobacco use, but a complete understanding of the complex mechanisms of smoking initiation and nicotine addiction requires a comprehensive and coordinated research effort. NIDA has long recognized the need for an inter-disciplinary approach to nicotine research and has forged partnerships with other research institutions in collaborative efforts to reduce nicotine addiction.
In 1998, NIDA cosponsored a groundbreaking conference that brought together leading investigators from throughout the Nation. At this conference, the researchers identified research hypotheses and approaches that have great potential to yield information that will significantly improve our ability to reduce tobacco use and nicotine addiction.
Following up on ideas generated at the conference, NIDA joined with the National Cancer Institute and the Robert Wood Johnson Foundation to establish the Transdisciplinary Tobacco Use Research Centers (TTURCs). These research coalitions have improved our understanding of nicotine addiction at levels from the cellular to the societal, from the role of individual genes to the effects of gender. For example, TTURC researchers have found that genetic influences may help explain why some young people begin smoking while others do not (see "Genetic Variation in Serotonin System May Play Role in Smoking Initiation," NIDA NOTES, Vol. 17, No. 2). Other TTURC investigators have helped identify factors that may improve women smokers' chances of successfully quitting (see "Women and Smoking: Sensory Factors, Attitudes About Weight, Phase of Menstrual Cycle All Keys to Quitting," NIDA NOTES, Vol. 17, No. 4).
To amplify the success of these research partnerships, NIDA plans continued support for TTURC researchers and an expanded scope of collaborative efforts. We are joining with the National Institute of Mental Health in a research partnership (RFA MH-03-008) to identify and develop pharmacological compounds that can be used to investigate the roles of specific neurochemical receptors in mood disorders and nicotine addiction. These receptors are important: They are the sites on brain cells where nicotine initiates the cascade of neurochemical activities that contribute to development of dependence and addiction (see "Nicotine's Multiple Effects on the Brain's Reward System Drive Addiction"). This collaboration with NIMH--the National Cooperative Drug Discovery Group Program--will encourage academic and pharmaceutical industry researchers to develop compounds that bind to specific subtypes of nicotine receptors. This will, in turn, make possible the development of specifically targeted medications for treating nicotine addiction.
Another NIDA initiative--Translating Tobacco Addiction Research to Treatment (RFA DA-03-010)--supports the development of new treatment and prevention options. The initiative encourages researchers from diverse disciplines in their efforts to move beyond animal studies and basic science to clinical applications. Specifically, it will support the use of phase I-style clinical studies or laboratory studies with human volunteers to investigate approaches built upon what we now know about the biological and behavioral mechanisms of nicotine addiction and tobacco use. Behavioral research, for example, demonstrates the important role of environmental cues in drug craving; neurochemical research has identified some of the brain pathways involved in cue-induced craving. Under this new initiative, researchers could investigate the effectiveness of medications that target the neurochemical processes that underlie craving.
NIDA's achievements in nicotine and tobacco research are impressive. NIDA-supported research identified nicotine as the addictive component of tobacco smoke, and NIDA-funded research laid the foundation for the most effective medication now available to treat nicotine addiction--skin patches, gum, and inhalers used to deliver nicotine replacement therapy. But the research, and the results, must continue.
Each day, 3,000 adolescents start smoking; each year more than 30 million smokers try to quit, but most are unsuccessful. NIDA's commitment to new initiatives, as well as continued basic and clinical research, will speed the development of new programs that prevent young people from becoming smokers and will make available new treatments for the millions of Americans who smoke and want to quit.