The addiction begins when nicotine acts on nicotinic acetylcholine receptors to release neurotransmitters such as dopamine, glutamate, and gamma-aminobutyric acid.
The binding of two acetylcholine molecules results in a conformational change in the receptor that opens the sodium-potassium channel of the nicotinic receptor.
Flushing occurs in many patients treated therapeutically with nicotinic acid, and as a result, nicotinamide holds more clinical value as it is not associated with the same uncomfortable flushing.
