Evidence supporting the use of: N-acetyl-cysteine (NAC)
For the health condition: Addictions (tobacco smoking or chewing)

Links: Go back one page, Tool main page, Ingredients list, Health conditions list, Body systems list

Synopsis

Source of validity: Scientific
Rating (out of 5): 3

N-acetyl-cysteine (NAC) has garnered interest as a potential adjunct in the treatment of various addictions, including tobacco smoking and chewing. The rationale for its use is grounded in its ability to modulate glutamatergic neurotransmission and restore extracellular glutamate homeostasis in the brain’s reward circuitry, particularly in the nucleus accumbens. Dysregulation of this system is implicated in addictive behaviors and cravings.

Preclinical studies in animal models have demonstrated that NAC can reduce drug-seeking behavior for substances such as nicotine, cocaine, and heroin. Clinical trials in humans have provided mixed, but generally promising, results. For example, a double-blind, placebo-controlled trial published in Biological Psychiatry (2011) showed that NAC (2400 mg/day) significantly reduced cigarette use and cravings in treatment-seeking smokers. Other studies have found NAC to be moderately effective in reducing cravings and use for a range of substances, including tobacco and cannabis.

However, the overall quality of evidence is moderate and not yet definitive. Meta-analyses suggest that while NAC is well-tolerated and may have a modest beneficial effect on cravings and relapse prevention, more large-scale, high-quality randomized controlled trials are needed to establish its efficacy. Current clinical guidelines do not formally recommend NAC as a first-line treatment for tobacco addiction, but it is sometimes considered as an adjunct to standard therapies.

In summary, there is scientific rationale and preliminary human evidence to support the use of NAC for addiction, especially tobacco, but the strength of evidence is moderate (rated 3/5).

More about n-acetyl-cysteine (NAC)
More about Addictions (tobacco smoking or chewing)