TOBACCO/VAPING: NICOTINE Flashcards
(47 cards)
1
Q
nicotine history
A
- comes from nicotania tabacum plant
- Spanish monopolized tobacco market
- addictive properties 17th century
- isolated from tobacco leaves in 1828
- extremely toxic similar to cyanide
2
Q
tobacco medical properties
A
- applied externally for pain (internal & external)
- treat diseases of ears, eyes, mouth, and nose
3
Q
air curing
tobacco processing
A
- hung and allowed to dry 4-8 weeks
- cigar & burley tobaccos
- low sugar, light-sweet flavor, high nicotine
4
Q
fire curing
A
- hung to dry near burning hardwood for 3-10 days
- pipe & chewing tobacco, snuff
- low sugar, smoky, high nicotine
5
Q
flue curing
tobacco processing
A
- strung onto tobacco sticks & hung in flue
- exposed to low heat without any smoke for about a week
- high sugar, medium-high nicotine
6
Q
sun curing
tobacco processing
A
- dries leaves uncovered in the sun
- oriental tobacco
- low sugar, low nicotine
7
Q
report on smoking and health
A
- surgeon general’s warning added 1964
- detailed cigarettes as a cause of cancer, heart disease, effects to pregnancy
- this warning helped decrease cigarette use
8
Q
why study smoking?
A
- social and clinical significance (global issue)
- ubiquitous (no target demographic; everyone)
- addictiveness (most addictive) → most common drug in adolescents
9
Q
biological reason why smoking starts at a young age
A
- adolescent brain is more sensitive to rewarding/reinforcing effects of nicotine
- feelings of euphoria more intense at younger age
10
Q
biopsychological reason smoking starts at a young age
A
- personality characteristics (hostility & aggression) have increased stimulation by nicotine
- nicotine both stimulant & relaxant → either depletes hostility or increases it
- having these personality characteristics create predisposition to continued use
11
Q
psychological reason smoking starts at a young age
A
- novelty seekers are more receptive to tobacco ads that advertise fun
- sensation seeking → more likely to be influenced fun, cool status in ads
12
Q
social reason smoking starts at a young age
A
- trying to fit in
- parent/family acceptance of nicotine use
13
Q
PK of nicotine
A
- small molecule, both lipid & water soluble
- 7-20 seconds to reach brain when smoked
- amount absorbed into bloodstream depends on: type of tobacco, smoked vs. chewed, using filter
- receptors saturated quickly → decreasing effects after first puff
- short lived psychoactive effects → repeatedly dose themselves
- receptors occupied so subsequent puffs with decreasing effects
- if all receptors accessible, 1 puff saturates a lot of receptors
14
Q
inhalation
A
- absorbed with lungs
- nicotine reaches brain in 10sec
- absorbed into bloodstream with oxygen through lungs
- ~20% cigarette nicotine absorbed to blood
15
Q
smokeless tobacco
A
- peak plasma level ~15min
- slowest method
- usually under tongue
16
Q
nicotine gum
A
- peak plasma level ~30min
- used as treatment
17
Q
transdermal
A
- patch
- peak plasma levels in ~5-12hrs
- used as treatment
18
Q
nicotine inhaler
A
- nasal absorption within 1min
- used as treatment
19
Q
nicotine and liver
A
- metabolized & eliminated in ~2hrs
- converted to cotanine (lipophilic)
- detectable for weeks
20
Q
monoamine oxidase inhibitors (MAOIs)
A
- found in tobacco
- inhibits enzyme for monoamines
- monoamine (dopamine) not metabolized → continued activation of reward pathway
21
Q
nicotine PD
A
- nicotine = agonist of nicotinic acetylcholine receptors (nAChR)
- nAChR found on DA neurons in VTA
- depolarizes neurons (more -)
- both PNS & CNS
- primary peripheral = NEUROMSUCULAR JUNCTION
- results in increased dopamine in NAC
- tobacco also MAOIs (inhibit enzyme) → even more dopamine
- neuro-effector & chemosensitive sites & stimulate receptors
22
Q
nicotine binding preference
A
- higher affinity for brain vs. peripheral nACh receptors
- subunits of receptor
23
Q
acute pharmacological nicotine effects
AS GENERAL CNS STIMULANT
A
- increases behavioral activity
- may produce tremors
- stimulates vomiting center in brain (quickly develop tolerance)
- release of anti-diuretic hormone → constricts blood vessels & increased BP
- reduces muscle tone
- enhances alertness, learning, & memory
24
Q
physiological effects
A
- increases HR, BP, and contraction of heart
- initiates dilation of arteries because increased oxygen demand with nicotine
25
nicotine toxicity
* fatal dose in adults = 60mg
* rapid symptom onset
* nausea, salivating, abdominal pain, vomiting, diarrhea, cold sweat, headache, dizziness, disturbed vision/hearing, mental confusion
* falling BP & labored breathing
26
nicotine tolerance
* tolerance created throughout day with more intense effect first time in day
* builds throughout day
* crashes once asleep before waking up
* nausea & dizziness absent with repeated intake
27
nicotine withdrawal
* craving is primary symptom
* leads to relapse
* depressed mood & anxiety
* insomnia
* irritability, frustration, anger, impatient
* difficulty concentrating
* decreased HR
* increased appetite & weight gain
28
nicotine use disorder
* one of the hardest additions to break
* molecule involvement causes receptor dysregulation
* NAC/VTA role in DA release
* glutamatergic/cholinergic synaptic transmission
* GABAergic effects
* environmental stimuli drive learned behavior
* behavioral tolerance not reversible
29
titration hypothesis of nicotine dependence
* person creates constant level of nicotine to avoid withdrawal, maintains nicotine levels
* need smoke breaks often because of metabolism
30
nicotine positive reinforcement
* behavioral/learning stage
* 10 puffs/cig at 1 pack/day means user positively reinforces behavior 200 times daily
* new smoker most likely will increase use from reinforcement & RITUALS → strengthens psychological dependence
31
nicotine negative reinforcement
* occurs during dependence
* smoking to remove unpleasant effects of acute withdrawal
32
tar
* multiple ingredients
* dark, sticky combo of 100s of poisons & cancer-causing chemicals
* levels vary
* heavy smokers will smoke "light" cigs but need to smoke more to achieve nicotine level → still smoking MORE
33
carbon monoxide
* forms when tobacco burned
* poisonous emission from cars
* replaces oxygen in red blood cells, COHb
34
smoking & cancer
* not from nicotine; from SMOKE
* increased cervical risk in women
* other admin. not inhaled still increase risk of oral cancer when chewed
* smoke contains potent mutagen (BaP) & metabolized into BPDE
* BPDE damages gene that supresses tumors in lungs
* hot spots on lungs
35
smoking & cancer
* not from nicotine; from SMOKE
* increased cervical risk in women
* other admin. not inhaled still increase risk of oral cancer when chewed
* smoke contains potent mutagen (BaP) & metabolized into BPDE
* BPDE damages gene that supresses tumors in lungs
* hot spots on lungs
36
smoking & COPD
* coronary obstructive
* 80-90% smokers
* several lung diseases
* emphysema → alveoli rupture
37
smoking & cardiovascular disease
* smokers' hearts need to work harder
* lack of oxygen in lungs = heart works harder to pump
* blood vessels narrow & harden (antherosclerosis)
* clotting (thrombosis)
38
cardiovascular lung disease
* caused by CO & nicotine (PNS effects)
* heart attack, artery hardening, high BP
* kills > lung cancer
39
second hand smoke
high rates of cancer & cardiovascular disease from exposure of smoke/nicotine
40
electronic nicotine delivery systems (ENDS)
* thought to be healthier alternative because less carcinogens BUT
* contains toxic chemicals (propylene glycol, flavorants)
* metal coil can flake off metal particles damaging lungs
* varied nicotine levels
* increased use in adolescents
41
intrinsic motivation
| smoker treatment
* internal drive to want to quit
* fear of getting sick (cancer, COPD, etc)
* still difficult to quit
42
extrinsic motivation
| smoker treatment
* external drive
* being force to quit/nagged
* difficult to quit regardless
43
treatment options
*
44
physicians' 4 As
* brief interventional tactic
* **ask, advise, assist, arrange**
45
nicotine replacement
| treatment
* patches, gum, nasal spray, lozenges
* efficacy vs. effectiveness
* reduces negative reinforcing symtpoms (crash with withdrawal)
46
medications
| treatment
* used to alleviate withdrawal symptoms
* Wellbutrin to inhibit dopamine reuptake
* some nicotine agonist - reduces craving
* can combine with CBT to decrease tobacco reward
47
nicotine vaccine
* creates antibodies & blocks nicotine from crossing BBB
* makes smoking less pleasurable
* FDA fast tracked 2006
