BMJ 1998; 317 doi: https://doi.org/10.1136/bmj.317.7151.154 (Published 11 July 1998) Cite this as: BMJ 1998;317:154

Nicotine has comparatively mild psychoactive effects—in other words, it doesn't give much of a buzz—but research on rats has shown (Nature Medicine 1998;4:659-60) that it changes activity in the “brain reward” pathways in a manner indistinguishable from the actions of major drugs of abuse. So people who complain that giving up smoking is as difficult as giving up heroin or cocaine have science on their side.

It is a testament to the addictive properties of alcohol that alcoholic patients continue to drink even after the trauma of a liver transplant operation (Gut 1998;43:140-4). About half the patients in this British series admitted to regular drinking after receiving their transplant, many returning to drink within the year. The investigators were further worried by signs of liver damage in this group and have intensified their psychosocial support for patients as a result.

Vaccination against varicella (chickenpox) has since 1995 been recommended in the United States for all children aged 12-18 months, so deaths from this disease in infants are now seen as avoidable. Three deaths in children described in the Morbidity and Mortality Weekly Report (1998;47:365-8) are a reminder that as recently as the early 1990s this disease …

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