Nicotine 2

Question 1

Teen E-Cigarette Use

Answer 1

Teens are more likely to use an e cigarette than a regular cigarette
Teens dont believe that e-cigarettes are harmful

Question 2

Tolerance

Answer 2

Develops over time
Use grows to 2-2.5 packs per day
Chronic nicotine use results in an increase in the number of nicotinic receptors and a chronic desensitization of the receptors

Question 3

Withdrawal Signs and Symptoms

Answer 3

Mood: irritability, anxiety, frustration
Physiologic Symptoms: Drowsy, fatigue, restless, difficulty concentrating
Physiologic Signs: Weight gain, decreased heart rate, sleep disturbances, mouth ulcers

Question 4

Time Course of Withdrawal

Answer 4

Mood changes peak mid week and subside by day 5
Irritability persists for 5 weeks
Hunger and weight gain continue for 10 weeks- often leads subject to relapse
Craving difficult to measure, but found in 66% of subjects

Question 5

What to tell adolescents

Answer 5

Reduced fertility
early menopause
decreased athletic ability
wrinkles
yellowed fingers
yellowed teeth

Question 6

Smokeless Tobacco Pro and Con

Answer 6

Advantages: No lung cancer, less expensive, convenient, more socially acceptable, no second hand smoke
Disadvantages: Increased risk for oral cancer, easier to start using, contains carcinogens
20% of highschool boys and 2% highschool girls use it- Destroys teeth and gums

Question 7

Difficulties in Treatment

Answer 7

Many unproven or ineffective treatments
One year failure rate for people using commercial clinics, cessation aids or special techniques
No proven method to match a treatment with person

Question 8

Changing Trends in Treatment

Answer 8

Treatment was aimed at the over learned “habit” of smoking and not on nicotine replacement
Nicotine Replacement method gaining popularity
Application of multiple behavioral techniques with pharmacotherapy has increased success rate 40 to 50 %

Question 9

Polacrilex (gum)

Answer 9

Oral consumption
Low abuse potential
2 and 4mg usually deliver 1 or 2 mg nicotine
Delivers nicotine on demand
Compliance problems related to chewing demands

Question 10

Polacrilex (lozenge)

Answer 10

From 2mg delivers 1 mg nicotine
Low abuse liability
Fewer compliance problems than gum

Question 11

Transdermal Path

Answer 11

Slow even delivery of nicotine
Delivers less nicotine than from one pack
Very low abuse liability
No ability to respond to momentary urges
Overnight use might reduce morning craving

Question 12

Nicotine Nasal Spray

Answer 12

Used to relieve and/or prevent withdrawal symptoms and reduce cravings
Provides a “safer” alternative to smoking for individuals and those around them

Question 13

Non-Nicotine based Treatment

Answer 13

Bupropion- antidepressant: reduces withdrawal, helps cessation
Clonidine(antihypertensive)- approved for use alleviated withdrawal
Buspirone (antianxiety) encouraging initial studies

Question 14

Chantix

Answer 14

Nicotine receptor partial agonist
- Reduces cravings for nicotine
- Decreases pleasurable effects of nicotine
- Treat up to 12 weeks
- One year success rate is 23%
FDA released warning that Chantix may cause mood changes: anxiety, depression, suicidal thoughts

Question 15

Nicotine Vaccine

Answer 15

Newest concept in treating abuse
Currently in clinical trials
Designing an antibody that would bind to nicotine and make it too big to cross the blood brain barrier

Question 16

Four Step Program

Answer 16

1. Set a quit date
Write all positive things about quitting
Write down every time you smoke
2. Keep positive list
Try to eliminate one cigarette each day
Don't carry matches or keep cigarettes
3. Never buy carton of cigarettes
Change brands twice a week to lower tar/ nicotine content levels
Don't buy another pack till you finish the first
4. Quit
Increase physical activity
Avoid smoking related situations