Vasileia Karasavva’s paper, “The implication of the corticotropin releasing factor in nicotine dependence and what this means for pharmacotherapy in smoking cessation,” published in the March 2019 issue of the Journal of Young Investigators, highlights the need for more efficient, effective treatments and methods for quitting smoking.
The paper explores the possibility that anxiety brought on by attempts to quit smoking may in fact prolong nicotine dependence. This anxiety is associated with increased levels of the stress hormone, corticotropin releasing factor (CRF). Increased levels of CRF have been linked to repeated failed attempts to quit smoking. Karasavva’s paper reviews the last two decades of research into the role of CRF in the body’s addiction to nicotine, in addition to discussing the therapeutic implications of an agent-containing CRF1 antagonist drug.
Karasavva, an undergraduate studying neuroscience and mental health at Carleton University, says the intention of the paper was “[to] put a stop to anxiety to quit smoking.”
“Quitting smoking is very anxiety-inducing and difficult. That being said, we are slowly but surely making steps towards producing more effective smoking cessation therapies,” maintains Karasavva.
Corticotropin release factor (CRF) is a hormone identified as a key signal for the initiation of biological responses to stress. Some scientists have hypothesized that nicotine dependence involves the withdrawal-induced overactivation of the CRF receptor system within the nervous system. This overactivation produces the poor emotional state seen in those experiencing nicotine withdrawal. This emotional state, in turn, creates the desire for nicotine and consequently increases nicotine-seeking behavior.
Current prescription therapeutics target two types of neurons that are activated during initial drug use. These treatments can limit cravings significantly and stave off withdrawal symptoms; however, the effect on the neurons drops drastically after approximately 12 weeks. Past studies have revealed that poor stress regulation after taking treatments generally results in a greater susceptibility to relapse, which suggests that more treatments need to focus on the release of stress hormones such as corticotropin. CRF and another norepinephrine – another neurotransmitter – are activated during the development of addiction, so this is where new treatments are being targeted.
Recent research has concluded that the length of an individual’s smoking habit is directly proportional to the negative health implications that occur due to the intake of tobacco. The goal, therefore, is to extend the length of smoking cessation. Using pharmacological interventions to block CFR1 receptors in the brain has shown promise in weakening nicotine-seeking behavior, indicating that CRF1 antagonists may be a key to extending smoking cessation.
Karasavva’s findings illustrate the need for more effective treatment to aid nicotine addiction. Smoking has massive negative implications for public health and the global economy. Finding more effective pharmacological interventions has the potential to improve the lives of millions of smokers.