Lecture 23- treating tobacco addiction

Question 1

Why is there a socio-economic gradient with tobacco use?

Answer 1

• Education
• Lack of healthcare
• Families of smokers- normalised

Question 2

Tobacco related disease

Answer 2

Single biggest cause of preventable morbidity and mortality in the UK

Question 3

markers of addiction

Answer 3

• use despite knowledge of harmful consequences
• cravings during abstinence
• failure of attempts to stop
• withdrawal symptoms during abstinence

Question 4

cigarette smoking is classes as an addiction because

Answer 4

1. Cigarette smoking is a chronic relapsing disorder that starts in adolescence
2. Nicotine (but not harmful in itself) causes the addiction, not harm (from tobacco)

Question 5

Nicotine- physiology

Answer 5

1. Nicotine acts on nicotinic Ach receptor stimulating dopamine release
2. Results in satisfaction associated with smoking
3. Following chronic nicotine exposure, ACh enter upregulates states- increasing affinity and functional sensitivity to an agonist
4. A drop in nicotine levels leads to craving and withdrawal
5. 1-2 puffs of a cigarette binds to 50% of ACh receptors
6. ACh receptors take between 6-12 weeks to desensitise after last cig

Question 6

what prompts people to stop smoking (form most common to least common)

Answer 6

• family/friend
• health proffessional
• advert
• poster
• restrictions
• health problems

Question 7

3 As

Answer 7

ask

advice

act

Question 8

Pharmacological treatment

Answer 8

• Long acting- nicotine patches
• Short acting- gum, lozenges, vape

Question 9

Harm reduction strategy

Answer 9

e.g. introducing vape

Question 10

negatives of vape

Answer 10

• contineued nicotine use
• long ter effects unknown
• dual use perpetuates smoking
• renormalise smoking
• promotes nicotine in young
• gateway to tobacco
• products unsafe
• e-cigs made by tobacoo companies
• joint marketing of tobacoo and e-cigs

Question 11

positives of vape

Answer 11

• nicotine minor health risk
• negligible compared to tobacoo
• quite rate continue to decrease
• normalise E-cigs not tobacco
• compared to tobacco favourable
• experimenters are same group
• about to be regulated
• bigger reach for harm reduction
• regulations in place