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Chronic nicotine use also leads to changes in multiple neurotransmitter systems, particularly increasing dopamine release in the reward pathway and altering nicotinic acetylcholine receptors (nAChRs)

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In an editorial accompanying the new study, Esteve Fernndez, an associate professor of epidemiology at the University of Barcelona, and Simon Chapman, a professor of public health at the University of Sydney, argue that many real-world quitters fare better than those included in the review