TOBACCO/VAPING: NICOTINE Flashcards
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
Q
nicotine toxicity
A
- 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
Q
nicotine tolerance
A
- 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
Q
nicotine withdrawal
A
- craving is primary symptom
- leads to relapse
- depressed mood & anxiety
- insomnia
- irritability, frustration, anger, impatient
- difficulty concentrating
- decreased HR
- increased appetite & weight gain
28
Q
nicotine use disorder
A
- 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
Q
titration hypothesis of nicotine dependence
A
- person creates constant level of nicotine to avoid withdrawal, maintains nicotine levels
- need smoke breaks often because of metabolism
30
Q
nicotine positive reinforcement
A
- 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
Q
nicotine negative reinforcement
A
- occurs during dependence
- smoking to remove unpleasant effects of acute withdrawal
32
Q
tar
A
- 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
Q
carbon monoxide
A
- forms when tobacco burned
- poisonous emission from cars
- replaces oxygen in red blood cells, COHb
34
Q
smoking & cancer
A
- 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
Q
smoking & cancer
A
- 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
Q
smoking & COPD
A
- coronary obstructive
- 80-90% smokers
- several lung diseases
- emphysema → alveoli rupture
37
Q
smoking & cardiovascular disease
A
- smokers’ hearts need to work harder
- lack of oxygen in lungs = heart works harder to pump
- blood vessels narrow & harden (antherosclerosis)
- clotting (thrombosis)
38
Q
cardiovascular lung disease
A
- caused by CO & nicotine (PNS effects)
- heart attack, artery hardening, high BP
- kills > lung cancer
39
Q
second hand smoke
A
high rates of cancer & cardiovascular disease from exposure of smoke/nicotine
40
Q
electronic nicotine delivery systems (ENDS)
A
- 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
Q
intrinsic motivation
smoker treatment
A
- internal drive to want to quit
- fear of getting sick (cancer, COPD, etc)
- still difficult to quit
42
Q
extrinsic motivation
smoker treatment
A
- external drive
- being force to quit/nagged
- difficult to quit regardless
43
Q
treatment options
A
*
44
Q
physicians’ 4 As
A
- brief interventional tactic
- ask, advise, assist, arrange
45
Q
nicotine replacement
treatment
A
- patches, gum, nasal spray, lozenges
- efficacy vs. effectiveness
- reduces negative reinforcing symtpoms (crash with withdrawal)
46
Q
medications
treatment
A
- used to alleviate withdrawal symptoms
- Wellbutrin to inhibit dopamine reuptake
- some nicotine agonist - reduces craving
- can combine with CBT to decrease tobacco reward
47
Q
nicotine vaccine
A
- creates antibodies & blocks nicotine from crossing BBB
- makes smoking less pleasurable
- FDA fast tracked 2006
