Table of Contents:
[
General /
Adrenergic /
Amphetamine
]
[
Ergogenic /
Hormones /
Steroids
]
[
Over the Counter /
Recreational
]
[ Related / Drugs
Interactive Module ]
[ Alcohol
/ Caffeine / Tobacco ]
[ Cocaine / Marijuana
/ Heroin ]
What is the history of tobacco use?
The word tobacco comes from the word "tabacco," which
was a two pronged tube that was used by Central American natives
to take snuff.
- The Maya considered tobacco as divine incense that would
bring rain in the dry season
- Native Americans used tobacco in pipes, cigars and cigarettes.
Tobacco was also used as a syrup to be swallowed or applied
to gums, chewed or snuffed or administered rectally as a
ceremonial enema
- In the 18th century tobacco smoking in Turkey and the
middle eastern countries was considered a crime
- The Russian Tsars publicly tortured smokers and exiled
them to Siberia
- Snuffing became fashionable in France and spread throughout
the European aristocracy
- The wide spread use of tobacco caused an international
debate over its harms and benefits. Proponents of tobacco
described it as a holy healing herb and recommended the
use of tobacco as a cure for many illnesses. Opponents of
tobacco considered it as an evil plant
- In an attempt to limit the use of tobacco King James I
of England raised the import tax on tobacco
- Regardless of the harsh rules the use of tobacco dramatically
increased in Europe
- In 1642 Pope Urban VIII issued a decree forbidding the
use of tobacco in church
What is the history of tobacco use in the United States?
- At the beginning of the 20th century chewing and snuffing
were the most common ways of using tobacco. In the U.S.
cigars became popular in the early 1800s
- Around 1920 cigarette smoking was more popular than cigars
- In the middle of 20th century smoking became fashionable
and was a sign of sophistication and maturity
- In 1964 the Advisory Committee to the U.S. Surgeon General
reported that cigarette smoking was causally related to
lung cancer
- In 1965 Congress passed the Federal Cigarette Labeling
and Advertising Act requiring health warning on all cigarette
packages
- In 1965 the National Clearinghouse for Smoking and Health
was set up by Congress. This organization is responsible
for the monitoring and review of medical literature regarding
the health consequences of smoking
- Since November 1, 1970 all cigarette packages and cartons
have a warning label
- In 1971 tobacco advertising on radio and television was
prohibited
- In 1973 Congress enacted the "Little Cigar Act"
banning little cigar ads from television and radio
- In 1978 Utah enacted the first state law banning tobacco
advertising on any billboard street signs, street cars or
buses
- The 1979 publication "Smoking and Health: A Report
of Surgeon General" contained information on research
regarding the effects of tobacco on cardiovascular disease,
cancer, peptic ulcers, bronchial and pulmonary disease,
and pregnancy
- The 1981 Surgeon General's Report "The Changing Cigarette"
provided more information on the health hazards of smoking
- The 1982 Surgeon General's Report focused on smoking and
cancer
- The 1983 Surgeon General's Report focused on smoking and
cardiovascular disease
- The 1984 Surgeon General's Report focused on smoking and
chronic obstructive lung disease
- In 1984 Congress enacted the Comprehensive Smoking Education
Act requiring health warnings on cigarette packages and
advertisements
- The 1986 Surgeon General's Report focused on the health
consequences of involuntary smoking
- In 1986 Congress enacted the Comprehensive Smokeless Tobacco
Health Education Act requiring the three health warnings
on smokeless tobacco packages and banning smokeless tobacco
advertising on broadcast media. Minnesota enacted the first
state law to ban free distribution of smokeless tobacco
samples
- Congress doubled the federal excise tax on cigarettes
to 16 cents per pack from 1983 to 1985
- Legislation was enacted in 1992 and mandated that States
adopt and enforce restrictions on tobacco sales to minors
- A transdermal nicotine patch was introduced in 1992
- In 1993 the FDA prohibited over the counter smoking deterrent
products because they had not been shown to be effective
- In 1994 a Surgeon General's Report focused on tobacco
use among youth. Congress enacted the Pro-Children Act of
1994 requiring funded children's services to become smoke-free
- The Philip Morris Company recalled its cigarette brands
due to the presence of contaminants in 1995. FDA Commissioner
Kessler testifies that cigarettes may qualify as drug delivery
systems bringing them within the jurisdiction of the FDA.
- Mississippi became the first state to sue the tobacco
industry to recover Medicaid costs for tobacco related illnesses
- Today many tobacco companies are paying billions of dollars
as compensation to states for health care costs of smokers.
What are the patterns of tobacco use in the United States?
Every day 3000 young people become regular smokers. Every day
6000 teens under 18 smoke their first cigarette. Every day more
than 1000 adults die prematurely as a result of an adolescent
decision (USDHHS, 1996). Tobacco is considered a major gateway
drug. The majority of heroin addicts initially begin using gateway
drugs such as alcohol or tobacco products. The use of gateway
drugs leads to the development of patterns of behavior that
makes it easier for an individual to try other drugs. Cigarette
smokers are more likely to use alcohol, marijuana, and cocaine
than nonsmokers are.
For more information on tobacco visit the following
web sites:
What is the chemical composition of tobacco?
The burning of tobacco generates approximately 4000 compounds.
The smoke can be separated into gas and particulate phases.
The composition of the smoke delivered to the smoker depends
on the composition of tobacco and how densely it is packed,
the length of the column of tobacco, the characteristics of
the filter and the paper, the temperature at which the tobacco
is burned.
Among the gaseous phase components are carbon
monoxide, carbon dioxide, nitrogen oxides, ammonia, volatile
nitrosamines, hydrogen cyanide, volatile sulfur containing compounds,
volatile hydrocarbons, alcohols and aldehydes and ketones. Some
of these compounds inhibit ciliary movement in the lungs. Tar
is the compound in tobacco that remains after the moisture and
nicotine are subtracted and consists of polycyclic aromatic
hydrocarbons, which are carcinogens. Non-volatile nitrosamines
and aromatic amines play an etiologic role in bladder cancer.
The actual content of nicotine in tobacco can vary from 0.2%
to 5%.
What are the different forms of spit tobacco?
Spit tobacco exists as: loose leaf tobacco which is placed in
foil pouches and placed between cheek and lower gum where it
is sucked and chewed; snuff, which is moist or dry powdered
tobacco is sold in small round containers. The use of snuff
is referred to as "dipping" which involves leaving
a pinch of tobacco between the cheek and the lower gum. Chewing
tobacco and snuff are two types of smokeless tobacco products
that are commonly referred to as "spit tobacco." Compressed
tobacco is used in pieces and each piece is called a "plug."
The user bites off a small piece and places in the mouth. Nicotine
gum is another form of oral nicotine intake mainly used by individuals
who are trying to quit smoking.
How safe are spit tobacco products compared with cigarettes?
Taking a pinch of snuff has the same effects as smoking three
or four cigarettes. The possibility of getting oral cancer increases
significantly for individuals who use SLT on a daily basis for
3.5 years or longer. Continued use of SLT can cause cancer of
the pharynx and esophagus. Long-term snuff users have a 50%
greater risk of developing oral cancer than non-users. There
is also severe inflammation of gum tissue, tooth decay, and
tooth loss associated with the use of SLT. The Comprehensive
Smokeless Tobacco Health Education Act of 1986 was enacted by
the Congress and required the rotation of three health warnings
on SLT packages and advertisements and bans SLT advertising
on broadcasting media.
What is the chemical composition of nicotine?
Nicotine is the most abundant of the volatile alkaloids in the
tobacco leaf. Nicotine is a colorless, and volatile liquid alkaloid
found in smoking and smokeless tobacco which turns brown and
acquires the odor of tobacco upon exposure to air. The alkaloid
is water-soluble and forms water-soluble salts.
What is the pharmacology of nicotine?
Diverse effects of nicotine occur as a result of both stimulant
and depressant actions on various central and peripheral nervous
system pathways. This drug can increase the heart rate by excitation
of the sympathetic nervous system, or by paralyzing the parasympathetic
nervous system. Nicotine affects the medulla in the brain to
increase heart rate. Nicotine causes a discharge of epinephrine
from the adrenal medulla, which causes an increase in heart
rate and raises blood pressure.
What are the physiological effects of nicotine?
Briefly, nicotine can stimulate the brain at all levels, significantly
increase breathing, lower HDL ( the good fats) levels, increase
blood pressure and constrict peripheral blood vessels.
Some individuals experience nausea and vomiting,
decreased urinary flow, increased free fatty acids. Nicotine
increases the oxygen requirements of the heart muscle, but lowers
oxygen supply, and this effect may lead to heart attacks. Nicotine
initially stimulates the salivary and bronchial secretions and
then inhibits them. Cigarette smoke causes the excessive saliva
associated with smoking. Nicotine inhibits hunger and also causes
a slight increase in blood sugar, and deadens the taste buds.
Smokers often report weight gain and appetite increase after
quitting smoking.
What are the psychological effects of nicotine?
Nicotine is a highly addictive drug. More than 24 billion packages
of cigarettes are purchased annually in the United States and
approximately 400,000 deaths are attributed to cigarette smoking.
Nicotine is so addictive that approximately 70% of smokers who
want to quit smoking cannot and about 83% of smokers smoke every
day. Smokers report that cigarettes help them to relax. Nicotine
is a cholinergic agonist and stimulates the brain. Smokers experience
withdrawal symptoms when trying to quit smoking.
What is the relationship between tobacco use and chronic
illnesses?
A dose response relationship exists between the number of cigarettes
smoked per day and particular illnesses. Men who smoke two packs
of cigarettes per day have a four time higher risk of developing
chronic bronchitis or emphysema than nonsmokers.
In the long run lung tissue is damaged leading
to emphysema. Cigarette smoking also increases the risk of cardiovascular
disease and smoking is a major risk factor for heart attacks.
The probability of heart attack is related to the amount smoked,
which has a synergistic relationship to other risk factors such
as obesity. Smoking is a major risk factor for arteriosclerotic
disease and aneurysm.
A direct relationship (in men and women) has been
found between amount of cigarettes smoked and the development
of lung cancer
The risk for developing lung cancer increases:
- with the amount smoked
- duration of smoking
- age at which person started to smoke
- degree of inhalation
- tar and nicotine levels of the cigarettes.
A relationship also exists between smoking and
cancers of the oral cavity, esophagus, urinary bladder, kidneys
and pancreas. Cigarette smoking is the leading cause of bronchopulmonary
disease. Respiratory infections are also more prevalent and
more severe among smokers than nonsmokers. Lower birth weight
and survival rate of infants born to women who smoke during
pregnancy is a major concern. Infants born to mothers who smoke
are more likely to die from sudden infant death syndrome (SIDS).
Long term effects been observed in their physical growth, mental
development and behavioral characteristics.
How is nicotine metabolized?
Nicotine is absorbed from the respiratory tract, and through
mouth tissue and skin. Approximately 80% to 90% of nicotine
is metabolized in the liver, kidneys and lungs. The lungs metabolize
a major portion of inhaled nicotine. The major metabolites of
nicotine are cotinine and nicotine. The half-life of nicotine
after inhalation or injection administration is about 2 hours.
The kidney eliminates both nicotine and its by-pruducts. The
rate of urinary excretion of nicotine is dependent on the pH
(acidity) of the urine. Excretion is reduced when the urine
is alkaline. Nicotine is also excreted in the milk of lactating
women who smoke. Mammary milk of heavy smokers may contain 0.5
mg of nicotine per liter of milk.
What are the clinical uses of nicotine?
Cigarettes, cigars and spit tobacco have no role in clinical
medicine. Nicotine chewing gum (nicorette)may be useful for
individuals who are trying to quit smoking.
What are the effects of nicotine on athletic performance?
Athletes participating in an NCAA survey (2001) reported using
spit tobacco for recreational or social purposes, to deal with
the stresses of college athletics and to feel good. About 53%
of the athletes who use spit tobacco reported using it 1-5 times
daily. The use of nicotine in high doses is toxic and can cause
nicotine poisoning.
Signs of nicotine poisoning are vomiting, sweating,
mental confusion, diminished pulse rate, headache, breathing
difficulty, respiratory failure caused by muscle paralysis and
death. Impaired oxygen transport secondary to increases in carboxyhemoglobin.
In many cases smoking will increase breathing rate during submaximal
exercise, and this will reduce athletic performance.
