Nicotine

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Nicotine
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Nicotine

• Where does it come from?
• leafy green tobacco plant grown mainly in the
  Americas
• nicotine very toxic when concentrated
• discovered in 1400s in New World and imported
  to Europe
• grew to be very popular quickly seen as a
  panacea (Jean Nicot)

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Nicotine

• How is it used?
• smoked most nicotine in cigarettes is not
  ingested - just a small portion when tobacco is
  burned and inhaled in smoke
• (but 90 of inhaled nicotine is absorbed)
• cigarettes are the only product advertised that
  are lethal when used as intended
• snuff powdered tobacco mixed with salts, oils
  can be used intranasally
• chew loose leaf form

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Nicotine Prevalence of Use

• NHSDA data
• __ of Americans reported current smoking, which
  translates into about __ million people.
• Monitoring the Future Study University of
  Michigan
• Among 12th graders, about 36 current smokers
  (1997)
• In 2003, 26 males and 22 females puffed in last
  30
• Smoking during pregnancy
• in 1996, about 14 of pregnant women reported
  smoking during their pregnancy, compared to about
  20 in 1990

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Nicotines Pharmacology

• when smoked, nicotine reaches brain in about7
  seconds, quicker than mainlined heroin
• about 4,000 chemical substances are generated by
  chemical reactions from the intense heat of a lit
  cigarette
• ACH is the major neurotransmitter involved
• affects body/brain significantly
• it is a psychoactive substance
• increases BP, heart rate, arousal level,
  attention
• biphasic nature gt higher doses can relax muscles

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WHAT ABOUT EXPECTANCY EFFECTS?

• Why Do People Say They Use This Drug
• To increase concentration, stimulation, attention
• To decrease appetite
• To reduces stress to relax
• Ritual use offers ceremony, habit, and therefore
  comfort

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Addiction Withdrawal Indicators

• Is it Addictive? How do we know?
• Tolerance develops quickly, yet cant overdose on
  cigarettes (but 1 drop of pure nicotine can kill
  you)
• Withdrawal symptoms occur and may last from 1-3
  days psychological symptoms may last longer-
  Difficulty concentrating - Anxiety
  irritability- Headache -
  Drowsiness- Coughing -
  Constipation
• DSM criteria for dependence and withdrawal

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Consequences

• Short-term high BP, SOB, direct damage of lung
  tissue bad breath, allergic reactions
• Long-term most preventable cause of premature
  death cancer, heart disease, COPD use of
  smokeless tobacco produces increased risk of oral
  and digestive tract cancers
• long-term alcohol use can contribute to
  smoking-related cancers about 80-95 alcoholics
  smoke
• Social passive smoking effects - kids asthma
• Psychological smokers may feel like outcasts

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Why How to Quit

• Stages of Change
• Most relapse after serious attempts to quit
• The majority who do quit do so on their own,
  usually after repeated unsuccessful efforts
  cessation programs can be effective
• Tobacco as a Gateway Drug

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TREATMENT OF SUBSTANCE USE DISORDERS

• MOTIVATION AND STAGES OF CHANGE
• Pre-Contemplation (Denial?)
• Contemplation (Ambivalence)
• Preparation (Commitment Goal-setting)
• Action (explicit change activities)
• Maintenance (Relapse)

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Advertising and Exporting Nicotine

• e.g. to China, Asia
• Billboards advertising cigarettes are now banned
  in Florida and elsewhere around the nation
• New, aggressive PSA campaigns (body bag
  commercial etc.)

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Current History Issue

• Developments in lawsuits of states suing tobacco
  companies for health care costs
• Debate themes
• Weak vs. strong (looking for something to blame)
• Genetic vs. choice behavior
• Where does my space/privacy stop and yours begin?
• Slippery slope argument

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