A Molecular Basis for Nicotine as a Gateway Drug

Abstract

On the historic occasion of the 122nd Shattuck Lecture and the 200th anniversary of the New England Journal of Medicine, we chose to address a topic that is at once scientific and personally historic. In recent debates over legalizing marijuana, from all-out acceptance in Colorado to narrow decriminalization in Maryland, the scientific question of the role of marijuana as a gateway drug (i.e., a drug that lowers the threshold for addiction to other agents) has loomed large. Both opponents and proponents of legalization have distorted what science does and does not tell us—and both sides have overlooked the importance of nicotine as a gateway drug. Epidemiologic studies have shown that nicotine use is a gateway to the use of marijuana and cocaine in human populations. What has not been clear is how nicotine accomplishes this. In this article, we describe how our personal collaboration allowed us to bring the techniques of molecular biology to bear on this question and to reveal the action of nicotine in the brain of mice. We then apply our conclusions to the public health concerns that are being raised as the popularity of electronic cigarettes (e-cigarettes) has soared. In the process, we show the potential benefits to society of translating epidemiologic findings into public health policy. (PsycINFO Database Record (c) 2014 APA, all rights reserved)