Some random things about smoking and nicotine

Dopamine and related effects of nicotine

pleasure, appetite suppression

Norepinephrine and related effects of nicotine

arousal, appetite suppression

Acetycholine and related effects of nicotine

arousal, cognitive enhancement

glutamate and related effects of nicotine

learning, memory enhancement

serotonin and related effects of nicotine

mood modulation, appetite suppression

Beta-Endorphin and related effects of nicotine

reduction of anxiety and tension

GABA and related effects of nicotine

reduction of anxiety and tension

Withdrawal symptoms

irritability, frustration, anger, anxiety, difficulty concentrating, restlessness, impatience, depressed mood, insomnia, impaired task performance, increased appetite, weight gain, cravings

When do nicotine withdrawal symptoms occur?

symptoms usually manifest within the first 1-2 days and peak within the first week. Then subside within 2-4 weeks

Factors that contribute to tobacco use

Individual (sociodemographic, genetic predisposition, coexisting medical conditions), pharmacology (alleviation of withdrawal symptoms, weight control, pleasure, mood modulation), and environment (tobacco ads, conditioned stimuli, social interactions)

Drugs that have a decreased effect due to induction of CYP1A2 with smoking

Bendamustine, caffeine, clozapine, fluvoxamine, olanzapine, tacrine, theophylline, warfarin

Drugs that may have an increased effect due to induction of CYP1A2 with smoking

clopidogrel

Key points regarding caffeine and smoking

constituents in tobacco smoke induce CYP1A2 enzymes, which metabolize caffeine (caffeine levels increase ~56% upon quitting). Insomnia can be due to increased caffeine levels or a side effect of a smoking cessation drug (varenicline, bupropion). Patients should decrease caffeine intake by about half when quitting, and individuals with a typical bedtime should eliminate caffeine by early afternoon

Smokers who use combined hormonal contraceptives have an increased risk of what?

serious cardiovascular adverse effects such as stroke, MI, thromboembolism. Women who are 35 or older AND smoke at least 15 cigarettes per day are at significantly elevated risk.

Does smoking decrease the efficacy of hormonal contraceptives

NO!

How many cigarettes are in a pack?

20

How much total nicotine is in a cigarette

~13.3 mg (range 12.4 - 14.2)

What is the nicotine yield per cigarette

approximately 1-2 mg

What is nicotine absorption dependent on

pH (in acidic media it is ionized and poorly absorbed across membranes, while in alkaline media it is nonionized and well absorbed across membranes)

What pH is nicotine readily absorbed in?

physiological pH

What is the main metabolite of nicotine?

Cotinine (makes up 70-80%)

What test is used to assess nicotine dependence?

Fagerstrom Test for Nicotine Dependence (FTND). Most common research measure of nicotine dependence (sometimes used in clinical practice). Scores range from 0-10 with a score of greater than 5 indicates substantial dependence

What is the biggest opponent to tobacco control efforts?

The tobacco industry itself :))))) For every $1 spent by the states, the tobacco industry spends $12.50 to market its product

How man proven or suspected human carcinogens are found in tobacco smoke?

72

How many deaths annually are attributable to smoking?

480,000 (cigarette smoking is causally linked to diseases of nearly all organs of the body, diminished health status, and harm to the fetus)

Annual cost of smoking 1 pack per day?

$3,062