Facts About Nicotine and
Tobacco Products
About 62 million people in the United
States ages 12 and older, or 29 percent of the population, were current
cigarette smokers, according to the 1996 National Household Survey on Drug
Abuse. That made nicotine, the addictive component of tobacco, one of the
most heavily used addictive drugs in the United States.
The numbers for the United States for
2010 are:
- 19.0% of all adults (43.8 million people)
- cigarette smoking costs more than $193 billion (i.e.,
$97 billion in lost productivity plus $96 billion in
health care expenditures)
- Secondhand smoke costs more than $10 billion (i.e.,
health care expenditures, morbidity, and mortality).
The cigarette industry spends billions each
year on advertising and promotions.
- $8.05 billion total spent in 2010
- $22 million spent a day in 2010
Effects of Nicotine
When a person inhales cigarette smoke,
the nicotine in the smoke is rapidly absorbed into the blood and starts
affecting the brain within 7 seconds. In the brain, nicotine activates
the same reward system as do other drugs of abuse such as cocaine or
amphetamine, although to a lesser degree. Nicotine's action on this
reward system is believed to be responsible for drug-induced feelings of
pleasure and, over time, addiction. Nicotine also has the effect of
increasing alertness and enhancing mental performance. In the
cardiovascular system, nicotine increases heart rate and blood pressure
and restricts blood flow to the heart muscle. The drug stimulates the
release of the hormone epinephrine, which further stimulates the nervous
system and is responsible for part of the "kick" from nicotine. It also
promotes the release of the hormone beta-endorphin, which inhibits pain.
People addicted to nicotine experience
withdrawal when they stop smoking. This withdrawal involves symptoms
such as anger, anxiety, depressed mood, difficulty concentrating,
increased appetite, and craving for nicotine. Most of these symptoms
subside within 3 to 4 weeks, except for the craving and hunger, which
may persist for months.
Health Effects of Tobacco Products
Besides nicotine, cigarette smoke
contains more than 4,000 substances, many of which may cause cancer or
damage the lungs. Cigarette smoking is associated with coronary heart
disease, stroke, ulcers, and an increased incidence of respiratory
infections. Smoking is the major cause of lung cancer and is also
associated with cancers of the larynx, esophagus, bladder, kidney,
pancreas, stomach, and uterine cervix. Smoking is also the major cause
of chronic bronchitis and emphysema.
Women who smoke cigarettes have earlier
menopause. Pregnant women who smoke run an increased risk of having
stillborn or premature infants or infants with low birthweight. Children
of women who smoked while pregnant have an increased risk for developing
conduct disorders.
Cigar and pipe smokers and users of
chewing tobacco and snuff can also become addicted to nicotine. Although
cigar and pipe smokers have lower death rates than cigarette smokers do,
they are still susceptible to cancers of the oral cavity, larynx, and
esophagus. Users of chewing tobacco and snuff have an elevated risk for
oral cancer.
Treatment
Like addiction to heroin or cocaine,
addiction to nicotine is a chronic, relapsing disorder. A cigarette
smoker may require several attempts over many years before that person
is able to permanently give up smoking. Less than 10 percent of unaided
quit attempts lead to successful long-term abstinence. However, studies
have shown significantly greater cessation rates for smokers receiving
interventions compared to control groups who do not receive the
interventions. Interventions that involve both medications and
behavioral treatments appear to show the most promise.
The primary medication therapy currently
used to treat nicotine addiction is nicotine replacement therapy, which
supplies enough nicotine to the body to prevent withdrawal symptoms but
not enough to provide the quick jolt caused by inhaling a cigarette.
Four types of nicotine replacement products are currently available.
Nicotine gum and nicotine skin patches are available over the counter.
Nicotine nasal spray and nicotine inhalers are available by
prescription. On average, all types of nicotine replacement products are
about equally effective, roughly doubling the chances of successfully
quitting.
Another medication recently approved by
the Food and Drug Administration as an aid for quitting smoking is the
antidepressant bupropion, or Zyban¨. The association between nicotine
addiction and depression is not yet understood, but nicotine appears to
have an antidepressant effect in some smokers. Paradoxically, though,
buproprion is more effective for treating nicotine addiction in
nondepressed smokers than in smokers who are depressed.
Source: National Institute on Drug Abuse (NIDA)
and The CDC on tobacco |
