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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?
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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 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 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 > 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