Tobacco Addiction NS184 K Farwell, PhD, RN, CARN-AP
Dec 26, 2015
Statistics
An estimated 66.5 million Americans reported current use (past month use) of a tobacco product in 2001, a prevalence rate of 29.5 percent for the population aged 12 or older.
Among that same population, 56.3 million (24.9 percent of the total population aged 12 or older) smoked cigarettes, 12.1 million (5.4 percent) smoked cigars, 7.3 million (3.2 percent) used smokeless tobacco, and 2.3 million (1.0 percent) smoked tobacco in pipes (Figure 4.1). Between 2000 and 2001, the percentage reporting past month cigar smoking increased from 4.8 to 5.4 percent, which was similar to the rate reported in 1999 (5.5 percent). There were no other significant changes in the rates of current use of other tobacco products.
Source: .S. Department of Health and Human Services. Substance Abuse and Mental Health Services Administration. (2002, September 4). Results from the 2001 National Household Survey on Drug Abuse: Volume I. Summary of National Findings
Potency
Nicotine is: 1000 X more potent than alcohol 10-100 X more potent than barbiturates 5-10 X more potent than cocaine or
morphine
Aspects of Nicotine Addiction Physiological Dependence
Tolerance, dependence, & withdrawal
Psychological Dependence Stimulation, tension, craving, habit, relaxation
Socio-cultural Factors Tied to rituals, select activities, family of origin,
and cultural practices
Body’s Response to Smoking(within 7-10 seconds)
Short-term bp Short-term pulse Short-term blood flow from heart Causes arteries to narrow Carbon monoxide, oxygen Acts on reward center in the brain
Neurotransmitter Effects Dopamine: Pleasure, suppress appetite Norepinephrine: Arousal, suppress appetite Acetylcholine: Arousal, cognitive enhancement Vasopressin: Memory improvement Serotonin: Mood modulation, suppress appetite Beta-endorphin: Reduce anxiety / tension
How long does nicotine stay in the body? From 85– 90 percent of nicotine in the blood is
metabolized by the liver and excreted from the kidney rapidly.
The estimated half-life for nicotine in the blood is two hours. However, smoking represents a multiple dosing situation with considerable accumulation during smoking.
Therefore, it can be expected that blood nicotine would persist at significant levels for six to eight hours after smoking stopped
Increased Risk of Heart Attack Carbon monoxide may damage the inner walls of
the arteries, encouraging fatty buildups in them. Over time, this causes the vessels to narrow and
harden. Nicotine may also contribute to this process.
Smoking also causes several changes in the blood that make clots — and heart attack — more likely.
About Secondhand Smoke: Cigarette smoke hurts many more people than
just the smoker. Children under the age of one whose parents smoke are more than 2 times as likely than children of nonsmokers to suffer asthma, bronchitis, pneumonia, and other respiratory tract illnesses Source: Committee on Passive Smoking, Board of
Environmental Studies and Toxicology, National Research Council. (1986). Environmental tobacco smoke: Measuring exposures and assessing health effects. Washington, DC: National Academy Press.
A child’s lung tissue is especially vulnerable to damage, even when the concentration of secondhand smoke is relatively low
Source: Pedreira, FA, Guandolo, VL, & Feroli, EJ. (1985). Involuntary smoking and incidence of respiratory illness during the first year of life. Pediatrics. 75, 594-595.
This means that smoking in a car, even with the windows open, is still dangerous to a child. The younger the child, the more vulnerable the lung tissue
Source: Guyatt, GH, & Newhouse, MT. (1985). Are active and passive smoking harmful? Determining causation. Chest, 88, 445-451.
Alcohol Use & Smoking
per person, smokers drink about twice as much alcohol as non-smokers
people who drink heavily are more likely to smoke heavily too reducing drinking helps people quit smoking? quitting smoking helps with sobriety among alcoholics relapse to drinking may cause smoking relapse
Source: National Institute on Alcohol Abuse and Alcoholism. Alcohol Alerts. No. 39: Alcohol and Tobacco. Site accessed 11/1/01. http://www.niaaa.nih.gov/publications/aa39.jtml
The Big Three Health Benefits Of Quitting Greatly reduced risk of premature death:
Quitting lowers your risk of dying early by 50% within 5 years of quitting. After 15 years the risk is the same as if you had never smoked Source: Benowitz, N.L. (1996). Pharmacology of
nicotine: addiction and therapeutics. Annual Review of Pharmacology and Toxicology, 36, 597-613.
Reduced risk of lung cancer, emphysema, and bronchitis:
Your risk of lung cancer drops by 30%-50% after 10 years of being smoke-free. The longer you stay quit, the lower the risk. If you’ve begun to develop emphysema and or chronic bronchitis, quitting will essentially stop the progression of the disease and allow your respiratory system to compensate for damaged tissue.
Source: Benowitz, N.L. (1996). Pharmacology of nicotine: addiction and therapeutics. Annual Review of Pharmacology and Toxicology, 36, 597-613.
Reduced risk of coronary heart disease:The potential for smoking-related heart disease is cut in half one year after quitting. Within 15 years the risk is the same as that of someone who never smoked Source: American Lung Association. What are the
benefits of quitting smoking? Site accessed 11/1/01. http://www.lungusa.org/tobacco/quit_ben.jtmll
Quitting Cold Turkey 91.2% of all successful long-term quitters
are today quitting entirely on their own They have done so without using Zyban,
Wellbutrin, hypnosis, acupuncture, magic herbs, and without toying with any gradual nicotine weaning products like the patch, gum, lozenge, spray, or inhaler. Source: Cancer Facts & Figures 2003
Possible Withdrawal Symptoms irritability anger hostility anxiety nervousness panic poor concentration disorientation lightheadedness sleep disturbances constipation
mouth ulcers dry mouth sore throat-gums- or tongue pain in limbs sweating depression fatigue fearfulness sense of loss, craving tobacco –May persist for 6
months or longer hunger coughing
(body getting rid of the mucus clogging the lungs).
100% Nicotine Free for 72 Hours: Blood is now 100% nicotine-clean 90% of nicotine's metabolites have passed
through their urine Chemical withdrawal has peaked in intensity and
is now beginning to gradually subside. Any nicotine use at this point constitutes chemical
relapse that will require them to repeat nicotine detox all over again
If you had stopped smoking last week, you would have already:
Lowered your blood pressure and pulse Normalized your carbon monoxide and oxygen levels in your
blood Decreased your chances of having a heart attack Improve your sense of taste and smell Increased your lung capacity Made your breathing easier Improved your circulation Began the process of your lungs cleaning themselves Reduced your coughing Increased your energy level
Quitting Interventions
Source for information:
Accessed 2/10/06 at http://www.quitnet.com/library/guides/Quitnet/B/getting_r
eady.jtml#methodsofquitting
Nicotine Replacement Therapy On average, all nicotine replacement
products are equally effective, roughly doubling the chances of quitting successfully
NRT minimizes withdrawal symptoms and helps control cigarette cravings to allow you to concentrate on using behavioral techniques to stay smoke-free
4 different types of nicotine replacement therapies
nicotine patch nicotine gum nicotine spray* nicotine inhaler*
*Require prescription from your physician
What NRT does not do It doesn't work equally well for everyone. It doesn't eliminate withdrawal symptoms
entirely. It doesn't give you any more willpower.
What NRT does do: It does let you concentrate on your habit
before breaking the physical addiction to nicotine.
Medication: Zyban:™
Zyban is a prescription medication that was originally used to treat depression
Zyban is at least, if not more, effective than the nicotine patch
Zyban is thought to work by blocking nicotine withdrawal, making smoking less reinforcing by stimulating certain centers of the brain, and improving mood.
Other Quitting Aids: Counseling – Individual or Group, Telephone or Internet Support and Self-Help Groups Nicotine fading:
Rate fading and brand fading are two strategies of gradually reducing the amount of nicotine in your system before you quit. They are different than the approach of cutting back since the ultimate goal is quitting, not continued smoking at a lower level. Smoking fewer cigarettes and smoking low nicotine cigarettes are still hazardous to your health.
Note: Naltrexone (Trexan) is NOT used to help people quit smoking----it must have been my wishful thinking!
Nicotine Anonymous Non-Profit 12 Step Fellowship of men and women
helping each other live nicotine-free lives. Welcomes all those seeking freedom from
nicotine addiction, including those using cessation programs and nicotine withdrawal aids.
The primary purpose of Nicotine Anonymous is to help all those who would like to cease using tobacco and nicotine products in any form.
The Fellowship offers group support and recovery using the 12 Steps as adapted from Alcoholics Anonymous to achieve abstinence from nicotine.