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1. [6]
2. * 2 ( ) : . * 2 : .^^
3. .
4. addiction
5. CEO. House Energy subcommittee in April 1994 are (from left)
Robert Sprinkle III (American Tobacco), Donald Johnston (American),
Thomas Sandefur Jr. (Brown and Williamson), Edward Horrigan Jr.
(Liggett), Andrew Tisch (Lorillard), Joseph Taddeo (U.S. Tobacco),
James Johnston (Reynolds) and William Campbell (Philip Morris). (AP
Photo) All swore, under oath that nicotine was not an addictive
drug!
6. 1 : 1/6 2 : 1/2
7. : 1/6 : = * : 42,000, 120 * : 17,700, 50
8. (Ramstrom LM, 1997) 1: 2: / 3: / . 4: / .
9.
10. 1. 2. 1) 2) bupropion 3)
11. : . . 97% .
12. All smokers ~70% 1 ~30% 2 ~23% 3 1. Bridgwood et al,
General Household Survey 1998. 2. West, Getting serious about
stopping smoking 1997. 3. Arnsten, Prim Psychiatry 1996.
16. Plasma nicotine (ng/ml) 25 Cigarette 20 15 Spray 10
Gum/Inhaler/Tablet 5 Patch 0 0 10 20 30 40 Time (minutes) Adapted
from: Tobacco Advisory Group of the Royal College of Physicians
2000. 50 60
32. Nucleus Accumbens (NAcc) Ventral Tegmental Area (VTA) NIC 4
2 2 2 4 42 NIC 36
33. , ~300% . 37
34. Nucleus accumbens Foulds (2006) Int. J Clin. Prac 38
35. Partial agonist, specifically designed to bind with high
affinity & selectivity to the 42 receptor So it mimics nicotine
and stimulates moderate dopamine release reducing the severity of
craving and withdrawal symptoms But also partially blocks the
receptors so nicotine from cigs. can not stimulate the receptor
39
36. Pharmacological Properties: Steady-state reached within 4
days :~24 hours 40
38. Fagerstrm test for nicotine dependence 1. ? 60 31-60 5-30 5
2. ? 3. ? Classification of dependence 0-2 : Very low 10 11-20
21-30 31 3-4 : Low 5. ? 5: Moderate 6-7 : High 8-10 : Very high 6.
? 4. ? Heatherton, et al., 1991 Park, et al., 2004
39. 12 , 4 2 . ? ? ? .
40. Three Important Points: (To Drive Home) 1. Nicotine does
not cause Cancer! Nicotine does not cause Heart Disease! 2.
Nicotine does not cause Lung Disease! 3.
41. Smokerlyzer Micro IV CO (HbCO) CO COHb 15
42. Cotinine / Urine Test kit for Tobacco Use Nicotine 80~90% .
; cotinine, 1-N-nicotine oxide ; nicotine (2hrs), cotinine (13hrs)
Heavy smoker; 304 cotinine .