Transcript No Slide Title - University of West Florida

Nicotine
Nicotine
• Where does it come from?
– leafy green tobacco plant grown mainly in
the Americas
– nicotine very toxic when concentrated
– “discovered” in 1400’s in New World and
imported to Europe
– grew to be very popular quickly; seen as a
panacea (Jean Nicot)
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
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
Nicotine’s Pharmacology
 when smoked, nicotine reaches brain in about
7 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 > higher doses can relax muscles
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
Addiction & Withdrawal
Indicators
• Is it Addictive? How do we know?
 Tolerance develops quickly, yet can’t 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
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 - kid’s asthma
• Psychological: smokers may feel like outcasts
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
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) **
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.)
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