Nicotine increases dopamine via the Acetylcholine radical. Here are the Acetylcholine neural transmitter sites and coming in through the nicotine receptor sites.

Today we know that, a child who is carrying his or her own cigarettes at aged 13 or less, is 100% certain to develop a drug or alcohol problem. (The study is not yet complete for compulsivity problems). Nicotine has increased the child’s dopamine levels and brought him or her significant relief. Nicotine is thus an entry drug.

I've treated a seven year old alcoholic. His parents would leave cigarettes on the table at night.  He would go downstairs for a smoke and eventually he began helping himself from the liquor cabinet. This child had no shame or guilt; he was drinking for relief. He'd found that when he drank he felt better. So what's going on? Obviously chemistry is what's going on.

When we did a study on 4,000 doctors who had relapsed, we found that 90% of them were smokers, only 10% were non-smokers. If anyone in 12 Step recovery is still smoking, they are really in danger, because they are still screwing around with their brain chemistry.

Richard Hurt of the Mayo Clinic testified that, by the mid 50s, the tobacco companies knew exactly what to do to deliver dopamine to the brain and geared all their efforts to that end. They alkalinised their tobaccos and filtered out everything which might retard the release of dopamine. Some of the best neuro-scientists at that time were working for the tobacco companies. These people have been doing their best to capture our brains since the 50s.

Some people ask should we quit smoking when we quit drinking? There are caveats about whether to quit at the same time or not and these need to be heeded. Smoking needs to be discussed with one’s sponsor, to decide whether to stop everything at the same time or to taper off, but always in conjunction with a strong 12 Step programme. I'm not telling you to stop. What I said was, if you're still smoking in a 12 Step programme, you're stilling screwing around with some of the same brain chemistry that our disease is founded on.