Tobacco Cessation Flashcards
What % of smokers have mental disorders?
44%
When does smoking usually start?
mid-teens/early adulthood
Characteristics of nicotine
- most addictive agent in tobacco products
- NOT carcinogenic
- half life is 1-2 hrs
What substances are in cigarettes? What do physiological effects do they have?
- nicotine: vasoconstriction
- carbon monoxide: plaque buildup
- over 7,000 toxins and carcinogenic additives
How did Marlboro make nicotine more addictive in the 1970’s?
added chemical additives high in ammonia
removes H+ from nicotine -> makes more basic and accepted as bio-friendly -> quick passage to lungs and brain
Highest nicotine found in what tobacco product?
hookah
Physiology behind addictive nature of nicotine
- nicotinic receptors in brain release dopamine, which stimulates reward pathway
- nicotine remains in receptors for 2 hrs
- once dopamine shuts off, nicotine cravings begin
How does smoking affect number of nicotinic receptors?
receptors multiply as patient continues to smoke
if they quit smoking, the extra receptors dissolve away
How does smoking affect MAO?
smoking condensate inhibits MAO-A and B; inhibition blocks breakdown of dopamine
Effects of Menthol in cigarettes
pull condensates deeper into lungs
makes smoking easier as it eases harsh sensation of inhalation
What groups does Menthol target?
young, African American, Hispanic, woman
How does nicotine physiologically affect the sexes differently?
Men: drug reinforcement
Women: habit formation, mood-related
How is e-cigarette different than regular cigarette?
- no combustion of tobacco leaves so no carbon monoxide
- still use heating element to turn nicotine liquid into “vapor”
- still has nicotine and carcinogens
Current first line meds for tobacco cessation
- Nicotine Replacement Therapy (NRT); 5 routes (lozenge, gum, patch, nasal spray, inhaler)
- Bupropion (Wellbutrin)
- Varenicline (Chantix)
Varenicline (Chantix) MOA
dopamine agonist; binds to nicotinic-ACh receptors to block nicotine from cigarettes
