Vaccination for Nicotine Addiction Could be Lifesaver for Smokers
Mike Zhang’s aunt struggled with nicotine addiction, and he ultimately had to look on as she died from lung cancer as a result of heavy smoking. Many Americans have this experience every year, watching while family members continue to smoke and ultimately risk their lives to keep dosing themselves with nicotine. Zhang, a professor of biological systems engineering at Virginia Tech, has just received the go-ahead – and $2.4 million from the National Institutes of Health – to develop a vaccine for nicotine addiction and conduct testing on mice. If successful, he may produce a medicine with the power to save the lives of over 400,000 Americans per year by short-circuiting the addictive nature of smoking and helping people quit.
Cigarette smoke contains 250 toxic chemicals, and around 70 of those are known carcinogens. Smoking-related diseases cause an estimated 443,000 deaths in the U.S. per year, and around 8.6 million people suffer from at least one serious illness caused by smoking. Smoking is the most significant cause of preventable disease and premature death worldwide. Globally, it’s estimated that 1 billion smokers suffer from nicotine addiction, which is the core reason behind all smoking-related death and disease. Without the addictive effects of nicotine, there would be no reason to smoke.
Understanding Nicotine Addiction
Nicotine is a drug, and just like such illicit substances as cocaine and more everyday ones like caffeine, it has addictive potential. When the brain receives a dose of nicotine, it leads to an increase in dopamine production (just like cocaine does, for example), and when it receives regular doses, the brain has to adapt. Rather than be in a constant state of heightened dopamine, the brain reduces its production of the substance so that future doses of the drug merely bring levels back to normal. At this point, the individual becomes tolerant to the effects of nicotine and will suffer withdrawal symptoms if he or she stops because this would leave the brain deficient in dopamine. This is how nicotine addiction takes hold.
Zhang adds, “Nicotine is one of the most dependency-inducing drugs out there. It’s just as addictive as much harder drugs such as heroin or cocaine.”
Vaccinating Against Nicotine Addiction
The theory behind addiction vaccines is that if the pleasurable effects of the drug in question are blocked, the individual would have no reason to continue using the drug. Zhang’s method involves using biodegradable nanoparticles of the vaccine (varying between 100 and 500 billionths of a meter in size) that would interact with the nicotine in the bloodstream and prevent it from entering the brain, thereby cutting out the positive effects of the substance. The vaccine particles bond to small molecules called haptens, which create an immune response when attached to a larger protein molecule.
Zhang comments, “Our vaccine will hopefully boost the rates of those who are able to quit smoking once they decide they are ready.”
This all sounds very promising, but it’s worth noting that the idea is still in the early stages. The research has been funded, but tests on mice haven’t even been conducted yet. Even if the vaccine does work as intended, the animal tests would have to be completed, then further refinements and more testing would likely be needed before human tests would be considered. Then, if human tests were successful, the medicine could finally be made available to the general public.
Could a Vaccine Really Solve Nicotine Addiction?
Assuming all of the testing goes well, a nicotine vaccine still might not be the “magic bullet” it seems to be. As Zhang himself commented, smokers would have to actively decide to take the vaccine. Although most do want to quit, it’s unrealistic to expect every smoker to do so.
There is a bigger problem, though, and that is addiction itself. The overall issue of addiction isn’t related to the interaction of one specific substance — such as nicotine — with the brain. Instead, it’s a poor psychological coping mechanism developed to deal with deeper-seated issues or unpleasant emotions (speaking broadly). Just because somebody no longer uses nicotine as a coping mechanism doesn’t mean he or she will stop using all harmful coping mechanisms. Realistically, there is a significant chance that a vaccinated smoker would simply increase his or her drinking or start using other drugs to compensate.
All addiction vaccines suffer from this same problem: the psychological elements of addiction take precedence over the physical ones. You can stop one substance with a vaccine, but you can’t stop years of ingrained usage of maladaptive coping strategies. The only real way to beat addiction (rather than just one specific substance) is through psychological treatment. That isn’t to say Zhang’s nicotine vaccine wouldn’t be a valuable addition to treatment, but it certainly is no magic bullet. It can’t work alone.