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Pneumologie 2008; 62(9): 553-561
DOI: 10.1055/s-2008-1038159
Serie: Tabakprävention
© Georg Thieme Verlag Stuttgart · New York

Mechanismen der Nikotinabhängigkeit

Mechanisms of Nicotine DependenceA.  Mobascher1 , G.  Winterer1
  • 1Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf/Rheinische Kliniken Düsseldorf, Düsseldorf
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Publication History

Publication Date:
23 April 2008 (online)

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Zusammenfassung

In der westlichen Welt rauchen ca. 30 % der Bevölkerung. Die meisten Raucher tun dies, weil sie nikotinabhängig sind. Neben einer intensiven Fortführung der Aufklärung über die gesundheitlichen Folgen des Rauchens und einer Erschwerung des Zigarettenkonsums in der Gesellschaft ist es nötig, die Mechanismen der Nikotinabhängigkeit besser zu verstehen, um effektivere Therapien und Raucherentwöhnungsprogramme zu entwickeln. Diese Übersicht fasst den aktuellen Kenntnisstand über die Mechanismen der Nikotinabhängigkeit zusammen. Im Zentrum stehen zelluläre Effekte von Nikotin sowie die Effekte auf 3 neurophysiologische Funktionssysteme, die bei der Nikotinabhängigkeit eine Rolle spielen: a) Belohnungssystem, b) kognitive Netzwerke und c) Stress-Response-System. Das Belohnungssystem wird durch Nikotin und andere Suchtstoffe aktiviert. Es ist eng mit dem Emotionsregulationssystem verknüpft. Darüber hinaus moduliert Nikotin die kognitiven Netzwerke für Aufmerksamkeit und Lernen/Gedächtnis, wobei die meisten Daten auf kurzfristig günstige Effekte hindeuten. Schließlich beeinflusst Nikotin auch das Stress-Response-System, wobei abhängig vom Stadium der Nikotinabhängigkeit unterschiedliche Effekte resultieren. Die nikotinische Modulation dieser Netzwerke durch Zigarettenrauchen wird wenigstens bei Subpopulationen von Rauchern als Selbstbehandlungsversuch klinischer oder subklinischer Beschwerden in den Bereichen Stimmungsregulation/Depression, Aufmerksamkeit/Gedächtnis und Stress-Bewältigung angesehen.

Abstract

About 30 % of the population in Western societies smoke. Most smokers do so due to nicotine dependence. In concert with ongoing education about the detrimental consequences of tobacco abuse and further restriction of public smoking, further scientific effort is needed to investigate the mechanisms of nicotine dependence, in order to develop more effective treatments and smoking cessation programmes. This review summarises our current knowledge of the mechanisms of nicotine dependence, focussing mainly on the cellular effects of nicotine and the effects on three neurophysiological systems that contribute to nicotine dependence: a) reward system, b) cognition/attentional networks and c) stress response system. The reward system that is connected with the mood regulatory system is activated by nicotine and other addictive substances. Furthermore, nicotine modulates cognitive networks involved in attention and learning/memory. Most data point to positive effects of acute nicotine administration on these networks. Finally nicotine influences the stress response system, however, the effects depend on the stage of nicotine addiction. Nicotinic modulation of these networks by means of smoking may reflect an attempt to self-medicate clinical or subclinical symptoms in the areas of mood regulation/depression, attention and learning/memory and stress coping, at least in a subset of smokers.

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Prof. Dr. med. G. Winterer

Klinik und Poliklinik für Psychiatrie und Psychotherapie, Heinrich-Heine-Universität Düsseldorf/Rheinische Kliniken Düsseldorf

Bergische Landstr. 2

40629 Düsseldorf

Email: georg.winterer@uni-duesseldorf.de

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