1. Nicotine

2. 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)

3. 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

4. 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 12 th 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

6. 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

7. 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

8. 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

9. 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

10. 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

11. 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) **

12. 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.)

13. 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