Tobacco smoking addiction
and nicotine addiction foreword
What is nicotine? Strongly addictive stimulant as just one,
small piece of jigsaw puzzle
A substance that makes us addicted to cigarettes, cigars, hookah, pipes, bidis, chewing tobacco is an ingredient of leaves of the tobacco plant – nicotine. Nicotine has powerful addictive properties and is a stimulant which increases levels of sugar in blood. More sugar in blood means that you're less hungry – that's why smoking suppresses appetite. Nicotine is believed to be the so-called "gate drug", which opens the door to other substance abuses especially among young people. May 31 is World No Tobacco Day (created by World Health Organization in 1987). Nicotine molecule looks like this:
nicotine molecule
some useful data on nicotine in 'Harmful Chemical Substances Catalog'
Health effects of tobacco smoking addiction
Modern world is haunted by the cancer diseases of many classes, which kill several million people every year. Tobacco smoking and nicotine addiction plays one of the crucial roles in this sad situation. It may be hard to believe but tobacco smoking is belived to be responsible for one-third of all deaths due to cancer in U.S. Main risk of this abuse is lung cancer and 90% of its incidences are the result of excessive tobacco smoking and dependency.
You have to know that although nicotine is 'not as good' for human health as some smoker would like it to be (one drop of chemically pure nicotine kills an adult man!), health problems originate from a wide range of toxic chemicals like polycyclic aromatic hydrocarbons, that are products of burning tobacco. They are not its initial ingredients. Some of those chemicals are extremely carcinogenic. It means that nicotine is just one small piece of jigsaw puzzle responsible mainly for addiction and problems with how to quite smoking. However, other stuff is generally more frightful. Please, notice that tobacco smoke contains some radioactive isotopes, like polonium 210. The situation is dramatic. You have to know that cancer risk is one side of problem. To tell you the truth: tobacco smoking and nicotine addiction kills more people by other diseases than by lung cancer. It suggests that number of people whose life's ended too early because of one stupid habit is hard to imagine.
Most important and proved health problems related to tobacco smoking are:
- cancer of lung
- cancer of mouth, pharynx, larynx and tongue
- cancer of oesophagus
- aortic aneurysm
- cardiovascular disease
- heart attack
- diseases of the respiratory tract
- peripheral vascular disease
- chronic bronchitis and emphysema
- pulmonary heart disease
- asthma
- pneumonia
- peptic ulcer
- Crohn's disease
- impotence
Factors that influence tobacco smoking health risks are:
- amounts of tobacco smoked and way of smoking
- period of time during life when one smokes
- type of tobacco or type of cigarette smoked
R. Peto and R. Doll during symposium called 'Understanding Nicotine and Tobacco Addiction' concluded very accurately:
A billion people now smoke: hundreds of millions of them will be killed by their habit, but if even a moderate proportion of those who now smoke can manage to escape the habit, many tens of millions of premature deaths will be avoided.[1]
Cigarettes history and lung cancer
What's interesting and thrilling at the same time: in the late-19th century there was an invention of machinery for fast and simple cigarette making. It was indeed an opening of the new era of tobacco industry. Cigarettes becomes very popular and trendy. For example during World War I they were standard part of soldiers food supply. It may be hard to believe but before both World Wars lung cancer was really a rare disease. Number of cases increased extremely fast in the second part of XXth century. Nowadays this mortar disease is responsible for over 1 million deaths worldwide annually. Smokers! Think about it, please.
The smoking ban – tobacco smoking restrictions
Passive smoking problem and controversy
Because of world attempts to increase societies health levels (passive smoking problem is under special concern) and because of well known and proved mischievousness of tobacco smoking a lot of countries (not only highly developed ones) enforced some law restrictions. Tobacco sales and advertising are restricted by law in many of them, special warnings on cigarettes packaging are in common, smoking in public places is also restricted in many cases. Obviously there are also age restrictions.
Tobacco smoking is an egoistic activity. Many people who suffer from smoking addiction cannot hold back their need of smoking and smoke cigarettes while other people are present in their surroundings. Sometimes it's hard even if someone tries to quit smoking. Passive smoking (also known as second-hand smoking (SHS) or environmental tobacco smoke (ETS)) occurs when smoke is inhaled by one who's not smoking himself. Such a person is called a passive smoker. According to scientific knowledge passive smoking is nearly as much dangerous for health as active (direct) smoking. Public places like night clubs and restaurants where smoking is prohibited at all are gaining popularity in well developed countries. In many others there are special areas for smokers and no-smokers separated from each other.
Of course you have to notice that mechanism of inhaling tobacco smoke differs among passive and active smokers. Therefore also health effects and their intensity differs. Smoke inhaled by active smoker directly from the cigarette is not the same smoke inhaled by passive smoker from air. There's different chemical composition, particle sizes, ageing, toxicology and different environmental factors like concentration of harmful compounds – it's obvious that tobacco smoke inhaled passively from air is much more diluted. Nicotine concentration does not vary strongly, but for example 'passive smoke' cytotoxity has been proved to be low while cytotoxity of 'active smoke' (one coming directly from cigarette) is high. Most people think that there's no difference between active and passive smoke, what is, as is mention here, completely wrong. Specific and careful scientific and medical research is undoubtly needed to ascertain real health risks among passive smokers.
A lot of investigations have been carried out. Passive smoking is harmful for our health, however many researchers say that its mischievousness is exaggerated and public opinion's fear is over-coloured. Lung cancer, which is a characteristic, fatal disease people suffer from due to active tobacco smoking, seems to be especially controversial at aspect of the passive smoking. Adlkofer write in his article published in 2001:
Toxicological findings may indeed speak in favor of a causal relationship between passive smoking and lung cancer, but this is based more on the theoretical assumption of a no threshold level for genotoxic substances than on unequivocal scientific data.
…increased risk of lung cancer due to ETS exposure is a matter of opinion rather than of scientific evidence.[2]
However, author underlines that such a statement does not mean that there's no risk of lung cancer due to passive smoking – he just say that there's no real scientifically proven evidence.
Tobacco smoking abuse
There's no other drug of abuse such as nicotine, which increases mortality so much. As was mentioned above tobacco smoking addiction is responsible for many fatal diseases including several types of cancer. Statistics show that smoking abuse is common, for example: according to some surveys about 25% of Americans are addicted to nicotine. According to World Health Organization data about nearly 6 trillion cigarettes are sold each year and then smoked by over 1 billion people. Many of them are strongly addicted to nicotine and overuse it. Overusing, in general, leads to chemical dependency and addiction (which is both physiological and psychological) which is a quick developing response to abuse.
Tobacco smoking is believed to occur with other substance abuses simultaneously. Statistical data confirm it and according to surveys it is known that the prevalence of smoking is especially high among those people who exhibit caffeine addiction and/or alcohol addiction. There's also some connection between tobacco smoking and psychiatric disorders – about 80% of patients with schizophrenia are addicted to nicotine.
Tolerance to nicotine
Tolerance to nicotine isn't as much important as tolerance to other drugs of abuse among other addicts. According to scientific data researchers believe that tolerance to nicotine, which is moderate and do not play role in all tobacco smoking effects, is not strongly associated with nicotine dependency. It was proven, that among smokers (i.e. those who are dependent or addicted to smoking, and those who are not) all individuals exhibit the same levels of tolerance to nicotine.
Tobacco smoking withdrawal effects
Chronic users may experience typical symptoms of withdrawal when an abrupt cessation of nicotine use takes place:
- confusion
- restlessness, insomnia
- irritability, frustration, petulance
- anxiety
- dysphoria or depressed mood
- difficulty concentrating
- decreased heart rate
- increased appetite or weight gain
- craving for nicotine
Evaluation of tobacco smoking addiction and nicotine addiction
Before any attempt to treat tobacco smoking addiction, physicians have to evaluate nicotine dependency and addiction. This evaluation is based on interview with patient, which aim is to make an accurate diagnosis and choose the best addiction treatment method possible.
You, as a patient would have to answer many questions asked by physician and honestly define your situation. Typical questions include: Why do you want to quit smoking cigarettes?, What are the sources of nicotine intake? (cigarettes or others), How many and how often do you smoke? What about your prior quit attempts? Why didn't those attempts finished with success? How long did you remained in abstinence state? Did you ever taken an advance of medical help and treatment? If yes – what treatment was used?
Some medical measures are also carried out. Physician may need to measure carbon monoxide (CO) level in your breath (what is an evidence of tobacco smoking and its intensity). Some investigations may be also carried out on your blood, urine and saliva. You may be asked about your psychiatric disorders if any, about your tobacco smoking addiction history, and about past or present substance abuses other than nicotine addiction
You can also solve a Fagerström Test for Nicotine Dependence on your own to check how far did your chemical dependency to nicotine developed.
Tobacco smoking addiction treatment
read main article: 'Nicotine addiction treatment'
How do other people pull through when they try to quit smoking?
Statistics show that:- 70% of U.S. people with nicotine addiction say that they have tried to quit smoking at least once in their life but with no success,
- 33% of U.S. people with nicotine addiction say that they try to quit smoking every year but with no success,
- 30% of U.S. people with nicotine addiction who want to quit it search for professional help and addiction treatment.
Those data come from National Health Interview Survey.
our 12 advices how to quit smoking
Short notes about tobacco smoking addiction
Well, is that all I wanted to say? Here comes some additional information and piece of my advice in shorter version:
for lovers: Smoking suppresses your sexual activity and you have chance to become an impotent earlier than your friends. I'll repeat: smoking suppresses your sexual activity. And who would like to kiss someone whose mouth smells like an ash-tray? Sad, isn't it? If you want to be happy in your relationship – don't smoke.
for good looking: Smoking makes your skin older and older. Age of your face is penetrating the future much faster than rest of your body and it's not proportional to your real, biological age. Number of wrinkles is directly proportional to number of cigarettes you've swallowed.
for mathematicians: Tobacco smoke contains 4,000 noxious substances, 40 of them can cause cancer. 5,500,000,000,000 cigarettes are produced globally every year. And we are able to smoke it! Every day because of tobacco smoking few thousands of people simply die...
for those who claim that they need medical help to give up and there is no doctor at hand: 90% of success in giving up depends on your own strong will. Only 10% of smokers need medical help. So just keep trying!
for young people who did not started yet: maybe it's fun to smoke, maybe in your group it's trendy. Remember that nicotine is very additive. It's really hard to give up – I know something about it. So think about someone you love or would like to love and read 'for lovers'. Think about your face and read 'for good looking'.
References
[1]Peto R., Doll R.; The hazards of smoking and the benefits of stopping, Understanding Nicotine and Tobacco Addiction: Novartis Foundation Symposium 275, Volume 275
[2] Adlkofer F.; Lung cancer due to passive smoking – a review; Int. Arch. Occup. Environ. Health., 2001, 74, 231
