Nicotine

Question 1

Tar

Answer 1

Total particulate matter in smoke, excluding nicotine and water

Question 2

Varying levels of tar

Answer 2

ultra light- 1-6 mg
light- 6-16 mg
regular- >15 mg
Attained by ventilating filters to dilute smoke
Many smokers block the vents while smoking to increase the amount of tar and nicotine

Question 3

Trends

Answer 3

Average tar yield decreased 44% from 68-98
Average nicotine yield decreased 38%
Use of low-tar products increases with
age
in females
income
Many believe low-yield menthol or additive free cigarettes to be “safer”- WRONG
Many switch to these brands instead of quitting

Question 4

Epidemiology

Answer 4

1.1 billion smokers in the world
930 million in developing countries
Tobacco kills 6 million people each year
>5 million of those deaths are result of direct tobacco use
600,000 due to second hand smoke
84% are male
Teenagers largest growing group of nicotine users
Price the only good deterrent

Question 5

Types of Cigarette Smoke

Answer 5

Mainstream- smoke inhaled
Sidestream- Smoke coming off the cigarette
Second-hand- Smoke that has been exhaled

Question 6

Abuse Liability

Answer 6

Cigarette and other forms of tobacco are reinforcing and produce dependence
Nicotine is the chemical that is responsible for tobacco’s reinforcing effects

Question 7

Nicotine Levels

Answer 7

Baseline increases as the number of cigarettes increase

Question 8

Behavioral Profile after 1 Cigarette

Answer 8

Dysphoria
Euphoria
within 1/2 an hour

Question 9

Behavioral profile of IV nicotine

Answer 9

Dysphoria and Euphoria within 30 minutes

Question 10

Nicotine potency vs frequency

Answer 10

Higher the concentration

Lower the frequency

Question 11

Absorption

Answer 11

Absorbed in lungs, buccal cavity, nasal mucosa, transdermal, GI tract
Inhalation most rapid, then mucosal, then dermal

Question 12

Metabolism

Answer 12

Nicotine carried to liver
Metabolized to 90% cotinine, 10% nicotine N-oxide
Nicotine is the active agent

Question 13

Nicotinic Receptors

Answer 13

Acetylcholine sensitive, found in both the CNS and PNS (brain, basal ganglia and striated muscle)
CNS sites include substantia nigra, ventral tegmentum and associated with DA neurons
Found on presynaptic sites- explains how it is able to release DA and serotonin

Question 14

Cholinergic Receptor Function

Answer 14

Acetylcholine provides an influx of Na into the cell
Decreases the negative potential, increases neuron firing rate
Consists of 5 protein subunits
Total of 9 alpha and 5 beta discovered

Question 15

Nicotinic Cholinergic Receptors

Answer 15

Nicotinic acetylcholine receptors contain a b2 subunit are most prevalent
Mediate the reinforcing effects of nicotine
Abnormally high concentration due to chronic nicotine use can interfere with maintaining abstinence

Question 16

CNS effects- novel smokers

Answer 16

Dizziness, lightheadedness, vertigo
Nausea, vomiting secondary to stimulation of chemoreceptor trigger zone, Can also occur in chronic smokers, under forced rapid smoking
Reduces the tremor of Parkinson’s disease, but elicits a physiologic tremor secondary to NE and DA release and sympathetic stimulation

Question 17

Nicotine Reinforcement

Answer 17

Glucocorticoids, ACTH and endorphins involved
Nicotine receptors on ventral tegmental area project to nucleus accumbens, stimulate DA neurons, and releases DA
Nicotine has both positive and negative reinforcement
Autonomic nervous system effects may serve as secondary reinforcers
Nicotine is a primary positive reinforcer
Depending on dose, has both stimulant and depressant like effects
Smokers rate IV nicotine as rewarding, similar to morphine and anphetamines- euphorigenic
Because of indirect effects on DA, upper limits of reinforcement are limited

Question 18

E-Cigs

Answer 18

Released many disposable versions of the e-cigarette
Many different flavors from which to choose
Wide range of nicotine levels are provided
Cartridges sold separately and contain liquid/nicotine solution as well as flavorings
Smoke does not contain any combustion products, so seen as safer, but there are still wide range of chemicals

Question 19

Strength of E-Cig

Answer 19

4 flavors, nicotine free, light, medium, full flavor
Full flavor = 16-24 mg
Light = 4-8 mg
Not intended to be smoked all in one sitting

Question 20

FDA investigation

Answer 20

1. Diethylene glycol and other carcinogens found
2. Nicotine levels did not correspond with labels
3. Nicotine levels were not consistent among products
4. Traces of nicotine in nicotine free packages were found
5. Marketed to younger generations without appropriate labeling
   FDA does not approve