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smoking, cigarette smoking, tobacco addiction, cigar smoking, pipe tobacco smoking, chewing tobacco, nicotine use, chain smoking

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Definition

The term “abuse” refers to any drug use (be it legal or illicit) that is not intended to treat any condition, does harm to the body or mind, or interferes with responsibilities such as work, school or family life

Nicotine is one of the most addictive drugs known to man. It is one of the more than four thousand chemicals found in tobacco and is the primary psychoactive substance in cigarettes, cigars, pipes and snuff.

In its pure form, nicotine is a clear, odorless alkaloid that turns brown when burned and takes on the scent of tobacco when exposed to air. It is a potent nerve toxin, and is secreted by tobacco plants (and to a much lesser extent, other members of the nightshade family such as potatoes, green peppers, tomatoes and eggplants) as an insecticide.

In small doses, nicotine acts upon the body as a stimulant, increasing alertness, activity and memory. It also raises blood pressure and heart rate while reducing appetite. Larger doses cause vomiting and nausea. Even yet larger doses (40-60mg) are the recognized the level at which lethality is likely.

Cigarette, pipe or cigar smoking and chewing tobacco/snuff use rapidly releases nicotine into the bloodstream. This crosses the blood-brain barrier and stimulates the nicotinic acetylcholine receptors and causes an increase in the production in adrenaline which leads to nicotine’s stimulant effects. It also acts on the brain’s pleasure/reward center by facilitating the release of dopamine, which explains the relaxing effect of nicotine.

Nicotine users get an immediate kick from smoking. Nicotine causes the adrenal cortex to discharge epinephrine which stimulates the nicotine user’s central nervous system and endocrine glands. These cause a sudden release of glucose. However stimulation is quickly followed by fatigue and depression leading the abuser to seek more nicotine.

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Symptoms

When used frequently over a short period of time, nicotine quickly develops tolerance and dependence effects. Soon, more nicotine is required more often to gain the relaxing/stimulating effect, and withdrawal symptoms begin to develop if use is discontinued. Symptoms of withdrawal include restlessness, insomnia and irritability; as well as difficulties with concentration and cognitive functioning. These symptoms often persist for 4 to 6 weeks after quitting smoking; although psychological withdrawal periods of months or even years are not unheard of. Physical withdrawal symptoms reach peak severity 48 to 72 hours after the last exposure to nicotine.

Psychological dependence on nicotine is very severe as well. Cravings for nicotine can be very powerful, continuing to be triggered years after ceasing use. The smell and sight of cigarette smoking can trigger cravings. It is thought that the psychological dependence is behaviorally based. Former smokers associate the act of obtaining, holding and lighting a cigarette to the pleasure and relaxation promoted by smoking, leading to a very strong urge to “light up”. It is often said that nicotine may be even more addictive than the illegal and highly addictive drugs cocaine and heroin.

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Implication

Almost all health authorities agree that smoking is one of the worst public health risks in the world. Smoking is often thought to be responsible for 90% of all lung cancers and one third of all other cancers. Cigarette smoking is the most common form of using nicotine since early 20th century. All forms of tobacco including cigarette, rolled tobacco, chewing tobacco, pipe tobacco and cigars are addictive. Nicotine causes the addiction and smoking has been identified as a major cause of stroke and cardiovascular disease and is recognized as a leading cause of death worldwide. Smoking is known to substantially raise the risk of developing heart disease. Smoking makes artery walls more apt to collect plaque and cholesterol which speeds up the development of blockages that lead to heart attacks. It is estimated that one fifth of all cases of heart disease are directly linked to the use of tobacco.

Smoking can cause a variety of lung ailments.

Cigarette smoke also contains thousands of other chemicals. Amongst them are cyanide, benzene, carbon monoxide and arsenic. Many of these chemicals are carcinogenic (cancer causing), and although the amounts found in a single cigarette may be miniscule, the buildup over the course of several thousand cigarettes contributes to the lethality of smoking.

Smoking damages the circulatory system as well. Men who smoke may become impotent. Other circulatory problems are sometimes only noticed by the symptom of having cold hands. However, this may also cause significant difficulties in cold weather, increasing a smoker’s susceptibility to such exposure conditions as frostbite and hypothermia.

When smokers and nicotine addicts stop taking nicotine, they experience withdrawal symptoms, increased hostility, anger and aggression and diminished social cooperation. If they are under stress, smokers take longer to regain their emotional equilibrium and during periods of abstinence and craving, nicotine addicts show impairment across a wide range of cognitive and psychomotor functions such as ability to create strategies, do math or comprehend language. The effect is similar to those brought on by aging. Women smokers experience earlier menopause and may suffer from symptoms of menopause for a longer period

Pregnant women who smoke cigarettes have increased risks of stillborn or premature babies or infants that are born with low weights. Their babies have an increased risk of developing conduct disorders. When women who smoke cigarettes or are otherwise addicted to nicotine also take birth control medicines and oral contraceptives, they increase their likelihood of contracting cardiovascular and cerebrovascular diseases compared to other smokers. This risk increases even further for omen who are older than 30.

Aside from nicotine, cigarette smoke contains more than a dozen gases including carbon monoxide and tar. Carbon monoxide in the cigarette smoke increases the chance of cardiovascular diseases. The tar in a cigarette increases the user’s risk of developing potentially fatal diseases such as pneumonia, bronchial disorders, emphysema and lung cancer. Tar in tobacco damages and clogs the lungs damaging the alveoli which can lead to symptoms such as shortness of breath, persistent coughing and wheezing.

Cigarette smoking has also begun to have a public stigma attached to it and have social implications. Some workplaces are now beginning to refuse to hire smokers, citing financial pressures such personnel put on health insurance plans. Cosmetic implications of smoking include yellowing or browning teeth, yellow-stained fingers and bad breath. Most public indoor spaces have prohibited smoking entirely.

One of the main causes of house fires in the industrialized world is dropped cigarettes. This has prompted manufacturers to start making “fire safe” cigarettes which will extinguish themselves without constant puffing. Although it will invariably save lives by preventing fires in the home, this may cause smokers to puff more frequently or deeply on their cigarettes in order to keep them lit, increasing the lung damage done.

Not only does smoking damage the health of the person who smokes, it is potentially risky to the health of those nearby. Secondhand smoke causes lung cancer in adults and significantly increases the risk of respiratory illness in children and sudden infant death.

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Possible Causes

Nicotine addiction almost always starts with experimental or occasional smoking. The most frequent reason that people begin smoking is peer pressure and a desire to “fit in” with other smokers. Still others cite a desire to concentrate or relax. Soon after smoking regularly, users of tobacco products become heavily addicted to nicotine. Most smokers begin smoking while they under the age of sixteen, and many of those people continue to smoke until the day they die.

After addiction sets in, the body begins to become dependent on nicotine for the production of dopamine. A lack of dopamine production results in depression, irritability, and all the other symptoms of nicotine withdrawal. Although the physical affects of nicotine addiction are well understood, the mental craving still remains a mystery; although it is often thought that smoking becomes a conditioned behavior after years of tobacco use, making it a very difficult subconscious habit to break.

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Treatment Options

Smoking cessation is not difficult. There are a number of treatments that can lessen the symptoms of withdrawal and assist in reducing cigarette cravings. Studies show that pharmacological treatment when combined with counseling and behavioral modification coaching including psychological support results in the highest long-term abstinence rates.

The rate of relapse for smoking cessation is highest in the first few weeks and diminishes greatly after three months of abstinence. Nicotine addicts must remain strong during this period.

Nicotine replacement programs are quite effective at increasing the chances of quitting successfully. There are a number of non-prescription transdermal patches and chewing gums and sprays and inhalers that release small amounts of nicotine into the body, reducing the intensity of withdrawal symptoms and cravings.

The prescription drug bupropion was originally intended to treat people with obsessive compulsive disorder, researchers began finding that people who were taking this drug also began to spontaneously quit smoking. After further research, a small dosage of bupropion was released to assist in smoking cessation under the name Zyban. Zyban is often effective in reducing the desire to smoke in patients. It makes nicotine craving or thoughts of using cigarettes controllable in addicts who are trying to quit smoking.

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Home Care & Natural Remedies

Some herbs have been touted as excellent complimentary treatments for smoking cessation symptoms. Lobelia and valerian root have both been recognized as herbs that may help curb the anxiety and nervousness that comes from withdrawal from nicotine.

Antioxidants like grape seed extract, Co Q10 and vitamins A, C and E all help decrease the risk of cancer, and are essential for both current and ex smokers who are at risk.

Chromium is known to slow the metabolism of sugar in the body. Some researchers have suggested that it is possible that low blood sugar levels may be responsible for cigarette cravings, as the combined irritability and stress of nicotine withdrawal and lowered blood sugar cause the patient to self medicate with a cigarette. Chromium may assist in reducing irritability and help increase the chances of quitting successfully.

Many smokers blame their need for nicotine on the stress levels in their lives. A Vitamin B complex can assist the individual cope better with stress and overcome it

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Nicotine Abuse