TOWARD A TOBACCO-FREE SOCIETY

Chapter 11

Psychoactive Drugs and Changes in Brain Chemistry

Psychoactive drugs produce most of their key effects by acting on brain chemistry in a characteristic fashion

Consider the route of entry for different types of drugs Ex. Oral drugs dissolve in stomach absorbed into

bloodstream liver, heart and lungs heart brain

The more quickly a drug reaches the brain, the more likely the user is to become dependent

Once in the brain, psychoactive drugs act on one or more neurotransmitters by increasing/decreasing their concentrations and actions Ex. Dopamine is thought to play a role in

reinforcement Heroin, nicotine, alcohol, and

amphetamines also affect dopamine levels

Psychoactive Drugs and Changes in Brain Chemistry

Who Uses Tobacco?

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71 million Americans smoke

24% of men and 18% of women smoke

The more education a person has, the less likely they are to smoke

Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking

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Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking

Why People Use Tobacco

A nicotine addiction Nicotine is a powerful psychoactive

drugMany researchers consider nicotine the

most physically addictive of all psychoactive drugs

Reaches the brain via the bloodstream in seconds

Why People Use Tobacco

Loss of control Tobacco users live according to a rigid cycle of

need and gratification; on avg. can go for no more than 40 min. between doses of nicotine

Tolerance and withdrawal Sudden abstinence from nicotine produces

predictable withdrawal symptoms: severe cravings, insomnia, confusion, tremors, difficulty concentrating, fatigue, muscle pains, headache, nausea, etc., increased heart rate and bp

Why People Use Tobacco

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Social and Psychological Factors Secondary reinforcers are activities the

smoker associate with tobacco use Genetic Factors

CYP2A6 DRD2 (reward gene)

Why Start in the First Place?

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90% of all new smokers in this country are children and teenagers

1,300 children and adolescents start smoking every day

Average age to start 13 for smoking 10 for spit tobacco

Rationalizing the dangers, invincible Emulating smoking in the media??

Health Hazards

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Contains hundreds of damaging chemical substances Unfiltered cigarettes = 5 billion particles per

cubic mm 50,000 times more than in an equal volume of smoggy urban

air Condensed particles in the cigarette produce a

sticky brown mass called cigarette tar

Carcinogens and Poisons in Tobacco Smoke

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43 chemicals are linked to development of cancer Benzo(a)pyrene is a carcinogen- research has found that this causes

mutations in lung cancer cells identical to those found in many lung cancer patients

Urethane- also a carcinogen (directly causes cancer) Cocarcinogens (ex. formaldehyde)

Combine with other chemicals to cause cancer Poisonous substances

Arsenic Hydrogen cyanide

Carbon monoxide Contains amounts 400 times greater than is considered safe in

industrial workplaces Displaces oxygen in red blood cells

Additives Humectants, sugars, bronchodilators, ammonia, things to make

sidestream smoke less obvious

“Light” and Low-Tar Cigarettes

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Low-tar, low-nicotine, or filtered cigarettes No such thing as a safe cigarette Users often smoke more, inhale

more deeply, blocking ventilation holes

Less likely to quit than smokers of regular cigarettes As of June 2010, federal law

prohibited the use of terms such as “light” and “mild”

Menthol Cigarettes

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About 70% of African American smokers smoke menthol cigarettes These individuals absorb more nicotine and

metabolize it slower than other groups Anesthetizing effect of menthol, means smokers

inhale more deeply and hold smoke longer in the lungs

Immediate Effects of Smoking

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Nicotine can either Excite or Tranquilize the Nervous System Depending on Dosage Constricts blood vessels, elevates HR and BP Stimulates adrenal glands to discharge adrenaline In adults can increase alertness, concentration, information

processing, etc.) opposite effect in young people Can act as a sedative, and relieve symptoms of anxiety and

irritability Depresses hunger

The Long-Term Effects of Smoking

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Cardiovascular Disease Coronary heart disease

(CHD) causes just as many deaths from smoking as lung cancer

Atherosclerosis leading to angina pectoris and myocardial infarction (heart attack)

The Long-Term Effects of Smoking

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Lung cancer and other cancers The risk of developing lung cancer

increases w/ number of cigarettes smoked each day and number of years smoking

Research has linked smoking to cancers of the trachea, mouth, esophagus, larynx, pancreas, bladder, kidney, breast, cervix, stomach liver, colon and skin

Chronic obstructive pulmonary disease Emphysema and Chronic bronchitis

Additional Health, Cosmetic, and Economic Concerns

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• Ulcers• Impotence• Reproductive health problems• Dental diseases• Diminished physical senses• Injuries• Cosmetic concerns• Economic costs

Cumulative Effects

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People who smoke before 15 yrs. old and continue to smoke are half as likely to live to 75 versus those who did not smoke

Smokers spend one-third more time away from their jobs because of illness than nonsmokers

Both men and women show a greater rate of acute and chronic diseases

Other Forms of Tobacco

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Spit (smokeless) tobacco Contains at least 28 chemicals

known to cause cancer Cigars and pipes

Users do not need to inhale in order to ingest nicotine - its absorbed through gums and mouth

Cigars contain more tobacco than cigarettes more nicotine

The Effects of Smoking on the Nonsmoker

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Environmental Tobacco smoke (ETS) Consists of mainstream smoke (exhaled by

smokers) and sidestream smoke (smoke from burning end of a cigarette, cigar, or pipe)

Sidestream smoke has twice the tar and nicotine,~ 3X the benzo(a)pyrene, CO, and ammonia

EPA designated ETS as a class A carcinogen and Surgeon General has concluded that there is no safe level of exposure to ETS.

ETS Effects

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Develop cough, headaches, nasal discomfort, eye irritation, breathlessness, and sinus problems

Allergies will be exacerbated Causes 3,000 deaths due to lung cancer Contributes to about 35,000 heart disease

deaths each year Nonsmokers can be affected by effects of ETS

hours after they leave a smoky environment Carbon monoxide lingers in bloodstream 5 hours later

Infants, Children, and ETS

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Children exposed to ETS are more likely to have SIDs and low-birth weight Bronchitis, pneumonia, and asthma Reduced lung function Middle-ear infections Lung cancer, emphysema, and chronic

bronchitis later in life

Smoking and Pregnancy

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Estimated 4600 infant deaths in the U.S.

Increased risk of miscarriage, premature birth, low birth weight, SIDS, and long term impairments in growth and intellectual development

What Can Be Done?

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The best way to avoid all of the added chemicals in cigarettes is to stop smoking right now!! This very minute!! THE BENEFITS OF QUITTING ARE IMMEDIATE!

Action at many levels CDC-Tips From Former Smokers Smokefree.gov

Individual action-Talk with your friends and family who have quit smoking and see what helped them, 'quit smoking' products

How A Tobacco User Can Quit

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The benefits of quitting Options for quitting

“Cold-turkey” Changes to routines Over-the-counter prescription products Support from family and friends Smoking cessation programs Free telephone quitlines

1-800-QUITNOW

TOWARD A TOBACCO-FREE SOCIETY

Chapter 11