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Nicotine < Back

By Erik Buchholz

History

Nicotine is found in the tobacco plant, and it acts as a natural insecticide. Historically, natives of North America gifted tobacco to Christopher Columbus in 1492. When he brought tobacco back to Europe, smoking did not immediately become popular. Some Europeans, such as Rodrigo de Xerez, were jailed by the Inquisition for breathing smoke and looking like demons. By the early 1600s, pipe smoking had increased substantially in England. By 1850, cigarette use had increased in Europe and spread to the United States. Today, nearly a quarter of the world’s adult population smokes tobacco on a regular basis.

How It’s Used

While smoking is the most common form of nicotine use, some individuals choose to chew tobacco or to sniff tobacco (i.e. snuff). Tobacco itself contains an array of chemicals unrelated to nicotine which can increase the risk of side effects such as mouth and lung cancer. Six million people die from smoking illness each year in the United States, and smoking is responsible for 80-90% of lung cancer deaths each

year. Smoking can lead to heart disease and heart attacks due to plaque buildup in arteries. On average, smokers have a life expectancy that is ten years shorter than nonsmokers.

An increasingly popular method for consuming nicotine is “vaping”, which involves using a heating device to vaporize liquid nicotine, which is then inhaled. While many people consider this to be a safer way to take nicotine as it prevents inhalation of the other chemicals found in tobacco, there is evidence that nicotine itself is carcinogenic, and long-term studies of the health effects of vaping have not been conducted.

How It Works

Once tobacco enters the bloodstream, it immediately stimulates the adrenal glands to produce adrenaline. Increased blood pressure, heart rate, and breathing result. While regular smokers may experience increased arousal and attention, non-smokers may experience nausea and headaches after the first dose of nicotine. Within seven seconds of smoking, nicotine enters the brain. Nicotine binds to nicotinic cholinergic receptors (nAChRs) in the brain, which trigger the release of dopamine. This neurotransmitter leads to craving and dependence. Furthermore, smokers learn to associate environmental cues with cravings, such as smell, taste, and mouth stimulation. When nicotine is not available, withdrawal symptoms can result, including irritability, attention deficits, and sleeping problems. Both withdrawal symptoms and environmental cues serve as powerful motivators for smokers to continue smoking.

Treatment

Although 70% of smokers report wanting to quit, only 50% actually make an attempt. Of those 50%, about 10% of succeed in quitting (6% overall). Simply stopping “cold turkey” is often ineffective. Most treatment options focus on maintaining a low level of nicotine in the body to prevent withdrawal symptoms. Nicotine gum, lozenges, patches, nasal spray and inhalers have all been used to help people quit. Combining several of these treatments (e.g., patch + gum) tends to be more effective than using one kind of nicotine replacement therapy. For instance, patches may deliver a constant stream of nicotine, but they do not match the periodic nature of nicotine delivery that occurs with smoking. Nicotine gum can assist with this drawback. Furthermore, gum can satisfy the oral stimulation that cigarettes provide but patches lack. Some people may find even greater success by supplementing combination treatment with a behavioral therapist. Such therapists can provide social support and emotional strategies that make quitting difficult. Individuals may also seek out specific medications, such as buproprion (Zyban ®) and varenicline (Chantix ®), which bind to nicotine receptors in the brain and reduce withdrawal symptoms.


References

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Centers for Disease Control and Prevention. (2011). Quitting smoking among adults--United States, 2001-2010. MMWR. Morbidity and mortality weekly report, 60(44), 1513.Retrieved from https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6044a2.htm?s_cid=mm6044a2_w#tab1

Centers for Disease Control and Prevention. (2016, December 1). Tobacco-Related Mortality. Retrieved from https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/

Centers for Disease Control and Prevention. (2017, April 14). What are the Risk Factors for Lung Cancer? Retrieved from https://www.cdc.gov/cancer/lung/basic_info/risk_factors.htm

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National Heart, Lung, and Blood Institute. (2016, June 22). How Does Smoking Affect the Heart and Blood Vessels. Retrieved from https://www.nhlbi.nih.gov/health/health-topics/topics/smo

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National Institute on Drug Abuse. (2017, March). Cigarettes and Tobacco Products. Retrieved from https://www.drugabuse.gov/publications/drugfacts/cigarettes-other-tobacco-products

World Health Organization. (2017a). WHO Global Report on Trends in Tobacco Smoking 2000-2025. Retrieved from http://www.who.int/tobacco/publications/surveillance/reportontrendstobaccosmoking/en/index4.html

World Health Organization. (2017b, May). Tobacco Fact Sheet. Retrieved from http://www.who.int/mediacentre/factsheets/fs339/en/