Naltrexone-related decreases in dropouts and relapse would be a welcomed addition to the treatment armamentarium and further support a common neurobiology of addiction and relapse. I'm also very interested in the idea that one of the reasons people fail is there's no maintenance alternative offered, which some people may need, because as I already said, some changes in the brain resulting from smoking are long-lasting and some may even be permanent. I think we've minimized severity of cigarette dependence by not testing or giving a maintenance option. A talk show host used to joke that he started the gum and years later was still chewing it. But it may be that there'd be relatively no negative health consequences of doing that.
People are definitely confused about what the difference is between smoking and nicotine.
There's no doubt to me that there are some factors in the smoke that have physical effects, including metabolism, which are slower to recover. Regarding cocaine, it's been demonstrated that dopamine systems in general and cocaine's dopamine transporter binding site in particular is necessary for cocaine to produce its psychostimulant effects. Molecular cloning has identified a single gene encoding the dopamine transporter and explaining the binding of cocaine to the carrier protein. Anti-cocaine antibodies targeted at cocaine reinforcement sites on the dopamine transporter may yield a cocaine vaccine. Catalytic antibodies to cocaine facilitate the breakdown of cocaine to inactive ecgonine methyl ester and benzoic acid.