Nicotine and Tobacco
Drugs and Our Society
Part 14
Nicotine and Tobacco
1.
One of the most pervasive / destructive drugs known
- entrenched in our culture
- integral role in our history
- “War of Independence”
a. Efforts to regulate
- latter part of 1800s
b. Anti-tobacco legislation
- characterized by two themes
Nicotine / Tobacco, cont.
- fire hazards
- morality of smoking
c. Beginning of 1900s
- became less important
- economic benefits associated
- tobacco taxes source of revenue
d. Today: $45 billion industry
- significant revenue source (state / federal)
Nicotine / Tobacco, cont.
2.
1995: FDA proposal to regulate
- unsuccessful due to politics
a. Current emphasis
- control sale to minors
- control promotion of cigarettes
b. Rate of smoking declined: adult smoker
- 50% less from 20 years ago
Nicotine / Tobacco, cont.
c. Perception of tobacco
- increasingly negative
- once viewed: “dirty habit” / “dirty practice”
- now a “life-threatening addiction”
3.
Nicotine: addictive ingredient
- C. Everett Koop (former Surgeon General)
- first official to warn of dangers
- claimed: nicotine dependence powerful as
heroin / cocaine dependence
Nicotine / Tobacco, cont.
a. Tobacco more available
- can be considered more addictive
b. 90% of all smokers = become addicted
- alcohol also available
- most drinkers do not become alcoholics
3.
American Psychiatric Association
- recognized dependency as a disorder
- depression common
- suicide: 100% higher than non-smokers
Nicotine / Tobacco, cont.
a. Comes from green tobacco plant
- genus: Nicotiana
- 60 species
- only nicotiana rustica / tabacum smoked
b. Tobacco from these plants are used in:
- cigars / cigarettes
- pipes
- snuff
- chewing tobacco
Nicotine / Tobacco, cont.
1.
History of tobacco use
- stone carving / Southern Mexico / 600 – 900 AD
- smoke blown through pipe
a. Columbus travels
- dried tobacco leaves as gifts (late 1400s)
- returned with tobacco seeds / planted
- became popular in Europe
b. Believed to be medical treatment
History, cont.
- skin disease / injuries / internal disorders
- cure diseases of eyes / nose / mouth
- smoke could breath life into another person
c. 1828: nicotine isolated
- poisonous / addictive
- medical value declined
d. Next 30 years:
- religious leaders / physicians /educators
questioned the medical value
History, cont.
e. Attacked for causing problems in society
- mental illness / delirium tremens / impotence
- and sexual perversions
f. Despite warnings:
- tobacco use for pleasure flourished
2.
Jamestown: early settlement in the colonies
- early 1600s / brutal winters / food shortages
- settlers prepared to abandon
History, cont.
a. John Rolfe
- convinced to plant tobacco
- crop flourished / Jamestown prospered
b. Tobacco farming spread
- established as valuable commodity
- used as form of currency
c. Financed by French government
- funded Revolutionary War
History, cont.
3.
Late 1800s: cigarettes rolled by hand
- 1883: invented rolling machine
- started being massed produced
a. 1891: Richard Joshua Reynolds (RJR)
- saccharine in tobacco
- sweeter / longer shelf life
b. Also introduced Prince Albert (1907)
- sterilized in licorice casing
History, cont.
- delightful / harmless tobacco
d. Introduced other brands:
- Camel
- Turkish / domestic leaves
- less expensive / highly popular
e. Competition:
- American Tobacco Co / Lucky Strike
- Liggett and Meyers / Chesterfield
History, cont.
4.
Opposition escalated
- first critic: Dr. Benjamin Rush (1798)
- condemned for adverse health effects
a. Women’s Christian Temperance Union
- with others
- supported controlling use / sale
b. Several states banned sale to children
- chewing / smoking
History, cont.
c. Wisconsin / Nebraska
- possession illegal
- both adults / children
5.
Despite efforts: popularity continued
- WWI: YMCA / US Army distributed to soldiers
- after war: use escalated
a. Morality / medical concerns took backseat
- public desire first
History, cont.
- taxes contributed to revenue
b. WWII
- manufacturer’s donated to soldiers
- patriotic gesture
6.
Costs of Smoking
- one factor to reduce demand
- increase cost
a. 1992: average tax = .62 cents
Costs, cont.
- states continue to raise
- proceeds to government programs
- smoking prevention / treatment / schools
- Washington state, 2nd highest ($3.025)
b. Lawsuit settlement
- billions given to states
- programs for anti-tobacco use
- health care cost for tobacco related illness
- “bartered” away
Costs, cont.
c. Sold half of award = get money now
- offset state budget deficits
d. Used in other programs
- not going to anti-smoking
- nor treatment for illness
7.
Extent of tobacco use
- 1975 – 2000: 62.5% high school seniors smoked
- 11.3% half pack or more daily
Extent, cont.
a. Office on Smoking / Health
- Center for Disease Control / Prevention
b. 2003: more than 65% high school seniors
- Caucasian = higher than Hispanic
- African-Americans least likely
c. Peaked in 1964
- Surgeon General’s Report
- dangers of smoking
Extent, cont.
d. 1964 – today:
- more than 43 million quit
- continues to decline among adults
e. Data confusing:
- total number of smokers = increased
- percentage has decreased
- cigarettes smoked per capita: not decreased
f. People who smoke tend to smoke heavily
Extent, cont.
g. Filters more popular than plain tip
- 2% in 1952
- 60% in 1963
- 90% today
h. Tar / nicotine sharply reduced
- cause people to smoke more
- seek same amount nicotine
- inhale more deeply / hold in lungs longer
- just smoke more cigarettes
Demographics of Smoking
1.
More adult males smoke
- females gaining
a. Manufacturer’s market to women
- link to independence / equality
- “Virginia Slims”
b. College students
- 28% recent increase
- all ethnic groups
Demographics, cont.
- average starting age: 19
- 18%: 5 or more attempts to stop
c. Teens: more likely if sibling smokes
- high school or less: more likely than college
- blue-collar: more likely than white-collar
2.
Women / smoking
- differences diminishing
a. 22% women smoke / 26% men (4%)
Demographics, cont.
- 1965: 52% men / 34% women (18%)
b. Level of education (correlation)
- through 11th grade: 3 times more likely
- than women with 16 years / more
c. Since 1980: over 3 million women died
- prematurely from related diseases
d. Reduces life by 14 years
Demographics, cont.
e. 25% of all cancer deaths
3.
Tobacco Use by Young People
- begin during childhood / adolescence
- 89%: initiated by age 19
a. Average 2 / 3 years to become regular smoker
- earlier in life
- more likely regular smoker
b. Study of childhood smokers:
Young People, cont.
- 4%: 3rd / 4th grade students
- 42%: 8th / 9th grade students
- most experimental
- 8th / 9th grades: 9% current smokers
- mean age to start: 12.5 years
c. Teenage rates gone up
- as advertising expenditures go up
- 3 times more responsive than adults
d. 89% start as teenagers
Young People, cont.
e. 14.9% age 12 – 17 current smokers (21/2 mil)
- currently smoke: more likely to use drugs
Nicotine Tolerance / Dependence
1. Build up tolerance quickly / matter of weeks
a. Continue to use: it is addictive
- usually associate with narcotics
- ignore nicotine addictiveness
b. Effects: highly reinforcing
Tolerance / Dependence, cont.
- reaches brain in seconds
c. Not last long in body
- to compensate: light up another
- characteristic: other forms of addiction
d. Develop tolerance
- need more nicotine
- strong desire: continued use
- if not: undergo withdrawals
Tolerance / Dependence, cont.
2.
Rituals – become ingrained
- light up after eating
- talking on phone
- driving vehicle
- after sex
a. Symptoms of withdrawal
- not fatal
- varies
- uncomfortable
Tolerance / Dependence
b. Proportional to intake
- more nicotine / greater withdrawal
(1) Most acute: 24 to 48 hours after ending
- craving: last weeks / months / years
(2) Symptoms:
- lower heart rate / blood pressure / heart
palpitations / difficulty maintaining
attention / aggressiveness / insomnia /
tremors / hunger / headaches / fatigue
Pharmacology
1.
Nicotine
- 6000 chemical substances in tobacco smoke
- insecticide
- carcinogenic
a. Stimulant
- similar to amphetamines / cocaine
(1) Injected intravenously
- 5 to 10 times more reinforcing than cocaine
Pharmacology, cont.
(2) Absorbed immediately by lungs
- brain: 10 seconds
- feel effects every inhale
(3) Quickly distributed in body
- traverses blood / brain
- placenta pregnant women = fetus
- breast milk
b. Liver metabolizes
Pharmacology, cont.
- almost all before kidney excretion
- stays: 8 to 12 hours
1.
Passive smoke
- involuntary / environmental / second-hand
- detrimental effects: not limited to smokers
a. Indoor pollution
- home / workplace
b. Blamed for 3,800 lung cancer deaths yearly
Passive Smoke, cont.
- 8,000 to 26,000 asthma cases in children
- extent of harm: degree of exposure
- emotional discomfort around smokers
c. Classified: mainstream / sidestream
(1) Mainstream
- smoke exhaled
- 58% nitrogen/13% carbon dioxide/12 %
oxygen/8% particles (nicotine, tar, waxes
dyes)/3.5% carbon mono./0.5% hydrogen
Passive, cont.
(2) Sidestream
- comes from burning end of product
- not pass through filter
- hotter temperature
- more nicotine / carbon monoxide
c. Laws against smoking in public places
- precipitated by effects of sidestream smoke
2.Effects on non-smokers
Effects, cont.
- besides irritating nose / eyes
- passive causes significant health problems
a. Linked to: lung / urinary tract problems
- also liver / pancreatic cancers
- increase in breast cancer
b. Lung cancer: higher living with smoker
- smoke at work increases risk (bar / restaurant)
- 3 times more likely
Effects, cont.
c. EPA (1993): secondhand smoke a carcinogen
- 1998 smoking prohibited California bars/taverns
- NYC passed ban on smoking in public places
d. Effects on children
- more likely: respiratory infections
- colds / bronchitis / pneumonia
(1) 17% lung cancer deaths
- high levels of exposure
Effects, cont.
(2) Women who smoke during pregnancy
- children exhibit impulsiveness / risk-taking /
rebelliousness
3. Rights of smokers vs. nonsmokers
- difficult to balance
a. Anti-smoking legislation
- federal (1998): minimum age of 18 to buy
- under age 27 must show ID
Rights, cont.
(1) Occurred because:
- local laws passed
- 1,000 local ordinances
(2) Tobacco petitioned state legislators
- 75% support measures to limit
- sales / possession
(3) Laws vary:
- Greensboro, NC = restricted smoking
Rights, cont.
- San Francisco = no smoking in public /
private workplaces
- Massachusetts = police / fire fighters
- Vermont = raised taxes .26 pack
- Washington = .50 cents
- Congress = 1 of 4 warnings (rotate)
- Depts. Of Labor / Defense = smoking ban
(4) Airlines (1990)
- no smoking = domestic flights
Rights, cont.
- flights shorter than 6 hours
b. Companies / corporations
- passed non-smoking policies
c. Local governments
- will not hire smokers
- upheld
d. Tobacco settlement
- $206 billion / over 25 year period