Tobacco Use Disorder

Tobacco use disorder is highly prevalent and over a billion individuals use tobacco worldwide. Popular views on the addictive potential of tobacco often underestimate the complex neural adaptations that underpin its continued use. While sometimes trivialized as a “minor” substance, the effects of nicotine on behavior invariably lead to profound morbidity over a lifetime of exposure. Innovations in tobacco processing have led to potent forms of tobacco, and delivery devices that maximize the reinforcing capacity of nicotine. Most recently, proactive treatment strategies have emerged that focus on pharmacotherapeutic interventions to address tobacco use disorder. Innovations on the horizon hold significant promise for helping clinicians address this problem in a more phenotypically-tailored manner. However, efforts will be needed to prevent use of tobacco for future generations.