2. NICOTINE PREPARATION
INTODUCTION TO NICOTINE
ROUTE OF ADMINISTRATION
EFFECT OF NICOTINE
ADDICTION STATISTIC
SYMPOTMS OF NICOTINE ADDICTION
FACTS ABOUT NICOTINE
REFERENCES
3. Tobacco & Nicotine Preparations
The leaves of the tobacco plant are cured and
prepared in different ways, depending on the
intended use of the tobacco
Leaves dried, then grounded
Cigars, cigarettes, pipe tobacco, chewing
tobacco, moist snuff
5. Nicotine is a colorless, toxic alkaloid made up of
carbon, hydrogen and nitrogen.
The primary reason why nicotine use has turned
into worldwide concern is because of its ability to
induce a state of euphoria in the brain of the smoker
thus leading to addiction.
When a person smokes and inhales nicotine, the
active substances are absorbed through alveoli into
the lungs which initiate.
6. Chemical reactions in the nerve endings which
increases heart rate, memory, alertness and
reaction time.
Neurotransmitters called dopamine and later
endorphins are released in the brain producing
feelings of pleasure and satisfaction.
As an addictive drug, nicotine has two very
potent issues –it is a stimulant as well as
depressant.
7. ORALLY
Not readily absorbed from digestive system;
pH lower than 6, not very lipid soluble
Significant first pass metabolism (high rate of liver
metabolism)
SNIFFED/SNUFFED
Nicotine absorbed through mucous membranes
of nasal cavity
8. SMOKED
90 percent of inhaled nicotine absorbed through mucous
membranes of lungs
Volume of smoke inhaled vs. duration of inhalation
Fun Factoid:
Why do we inhale cigarette smoke but not pipe or
cigar?
Curing of tobacco: cigarettes vs. pip & cigar
Flue-cured tobacco acidic smoke; lowers salivary pH to 5.3
Air-cured tobacco basic smoke with pH of 8.5; ionization <50%
OTHER DELIVERY SYSTEMS
Patch
Nicotine inhaler
Lozenges
Gum
9. Waldum et al. (1996)-No harmful effect
when inhaled in its pure form
Quik (2007)-Alleviates dyskinesia in
Parkinson’s patients
Newhouse-Boosts cognitive functions in
Alzheimer’s patients
Study- Beneficial effects in Tourette’s
patients
Study (2006)-Decreases depressive feelings
10. Neuromuscular Junctions of Striated or Voluntary Muscles
• Curare blocks junctions, leading to paralysis and respiratory
arrest.
Effects on the Body
• Muscle tremors
• Decrease in partellar reflex (knee jerk)
At doses found in cigarette smoking
• Increased heart rate and blood pressure
• Constriction of blood vessels in the skin; deleterious effects
on aging.
• Inhibits stomach secretions & stimulated activity of bowel
• Acts as a laxative with low tolerance
11. Effects of Nicotine – PNS & CNS Communication
Adrenal Glands in PNS affect CNS
Nicotine stimulates release of epinephrine
Causes CNS arousal and decrease in alpha activity
Brain Stem Centers
Reticular Activating System
Direct stimulation causes arousal
Widespread cholinergic projections`1`.3
Substantial nigra, basal forebrain, thalamus, & cerebellum.
Medullary Respiratory Centers
Direct and indirect stimulation
Overdose of nicotine
Blocking of these centers and neuromuscular junctions
Respiratory arrest
12. Area Postrema / Vomit Center
5HT system from Raphe to cortex
Site of action for Antidepressant drugs
13. Nicotine may enhance an individual’s level of
alertness.
Tobacco abuse and dependence may stimulate a
frantic, almost manic picture.
The speech may also be accelerated in line with
the behaviour.
Tobacco use can contribute to irritability often
soothened by a dose of nicotine.
14. Tobacco addiction is the leading preventable cause
of death
And is the second leading cause of death in the
world.
The WHO estimates that there are 1.3 billion
smokers worldwide today and contributes to
approximately 5 million deaths each year.
With the present smoking trends, tobacco will kill
10 million people each year by 2020.
15. Non smokers exposed to environmental tobacco
smoke have a significantly higher risk of
developing cancers and pulmonary diseases.
Children exposed to second hand smoke
develop a variety of respiratory disorders
16. Tolerance to nicotine with decreased effect and
increasing dose to obtain same effect
Withdrawal symptoms after cessation
Smoking more than usual
Persistent desire to smoke despite efforts to
decrease intake
Extensive time spent smoking or purchasing
tobacco
Postponing work, social or recreational events in
order to smoke
Continuing to smoke despite health hazards.
17. AMERICAN PSYCHIATRIC ASSOCIATION
An individual diagnosed with tobacco use disorder needs
to meet all of the following criteria:
A problematic pattern of tobacco use leading to clinically
significant impairment or distress, as manifested by at
least two of the following, occurring within a 12-
month period:
18. Tobacco is often taken in larger amounts or over a
longer period than was intended.
There is a persistent desire or unsuccessful efforts to cut
down or control tobacco use.
A great deal of time is spent in activities necessary to
obtain or use tobacco.
Craving, or a strong desire or urge to use tobacco.
Recurrent tobacco use resulting in a failure to fulfill
major role obligations at work, school, or home (e.g.,
interference with work) Important social, occupational,
or recreational activities .
19. Continued tobacco use despite having
persistent or recurrent social or
interpersonal problems caused or
exacerbated by the effects of tobacco
(e.g., arguments with others about
tobacco use).
Recurrent tobacco use in situations in
which it is physically hazardous (e.g.,
smoking in bed).
Tobacco use is continued despite
knowledge of having a persistent or
recurrent physical or psychological
problem that is likely to have been caused
or exacerbated by tobacco.
20. Tolerance, as defined by either of the following:
A need for markedly increased amounts of tobacco to
achieve the desired effect.
A markedly diminished effect with continued use of the
same amount of tobacco.
Withdrawal, as manifested by either of the following:
The characteristic withdrawal syndrome for tobacco:
Daily use of tobacco for at least several weeks.
21. Abrupt cessation of tobacco use, or reduction
in the amount of tobacco used, followed
within 24 hours by four (or more) of the
following signs and symptoms:
Irritability, frustration, or anger.
Anxiety.
Difficulty concentrating.
22. Increased appetite.
Restlessness.
Depressed mood.
Insomnia.
Tobacco (or closely related substance, such as nicotine)
is taken to relieve or avoid withdrawal symptoms.
23. Transdermal
patch releasing
nicotine
Provides low
levels of
nicotine
Reduces physical
signs of
withdrawal
symptoms
24. • Battery-powered
vaporizer which creates a
mist
• Vaporizes e-liquid:
Vaping
• May not be as safe as the
manufacturers claim it to
be
• Seattle- Sickness due to
liquid nicotine ingestion
25. Herbal cigarettes
which are not
addictive
Used in acting
scenes by
performers
Consist of herbs
and are made of
rolling paper and
filter
Made up of corn
silk, mint,
cinnamon,
lemongrass, rose
26. • Helps in quitting
smoking
• Smoking cessation
aids
• Decreases withdrawal
symptoms and urges
to smoke
27. There are about 4000 chemicals in tobacco, and out of the
100 identified poisons, 63 are known to cause cancer
Nicotine is an addictive drug that takes only 6 seconds to
reach your brain
Smoking kills more people than cocaine, heroin, alcohol, fire
automobile accidents, homicides, suicides, and AIDS
combined.
Every 8 seconds, someone in the world dies from a tobacco
related illness
More than 3 million people under the age of 18 smoke about
a ½ billion cigarettes each year, over half of those people
consider themselves dependent on cigarettes
28. Smoking is responsible for every 1 out of 5 American
deaths
About 430,000 people die needlessly every year from
smoking, which means smoking kills about 1,200 people
every day
A person who smokes dies an average 7 years earlier
than someone who doesn’t smoke
Kids who smoke experience changes in the lungs, and
reduced lung growth. They risk not achieving normal
lung function as an adult
29. Peer Pressure
They think it’s “cool”
Their parents smoke
Because they want to be skinny (fashion)
Because they find it relaxing
Rebellion
30. •Pleasurable feeling
•Tolerance to the drug
•Weight gain
“GIVING UP SMOKING IS THE EASIEST
THING IN THE WORLD. I KNOW
BECAUSE I’VE DONE IT THOUSANDS OF
TIMES.”
-MARK TWAIN
31. To live longer
Better breath
You’ll save a lot of money
You’ll be around to see your grand children
You won’t harm people around you
You’ll cough less
You won’t have to hide the habit from family
You’ll be able to smell and taste food better
Your teeth will become whiter
You’ll have a smaller chance of getting emphysema
Waldum et al-The effect on the rat of long-term (two years) inhalation of nicotine was studied. The rats breathed in a chamber with nicotine at a concentration giving twice the plasma concentration found in heavy smokers. Nicotine was given for 20 h a day, five days a week during a two-year period. We could not find any increase in mortality, in atherosclerosis or frequency of tumors in these rats compared with controls. Particularly, there was no microscopic or macroscopic lung tumors nor any increase in pulmonary neuroendocrine cells. Throughout the study, however, the body weight of the nicotine exposed rats was reduced as compared with controls. In conclusion, our study does not indicate any harmful effect of nicotine when given in its pure form by inhalation.
Quik-
A 2007 study suggests that nicotine treatment could help alleviate the dyskinesia often experienced by Parkinson's patients being treated with L-dopa.
Parkinson’s involves a loss of dopamine, a neurotransmitter that regulates not only movement but also addictive behaviors. It has long been observed that people who develop Parkinson’s tend to be more low-key and risk-averse than average, as if their innate dopamine levels have always been on the low side. When they take L-dopa, however, some have been known to swing to the other side of the reward-seeking spectrum, developing gambling or sexual addictions. Nicotine might push such patients back to a middle ground.
Newhouse-A study of Alzheimer's patients showed that those who wore nicotine patches were better able to remember and pay attention than those who didn't. Another study showed that nicotine boosted cognitive function in older people who didn't have Alzheimer's, but were showing signs of age-related mental decline.Nicotine is chemically similar to acetylcholine, a neurotransmitter in the brain that declines in Alzheimer's disease. Drugs such as Aricept help people with Alzheimer's by boosting brain levels of acetylcholine. Apparently, nicotine binds to the receptors in the brain normally occupied by acetylcholine, which benefits people who need more, but it has no apparent effect on those who don't. Even people with HIV, which appears to cause accelerated cognitive decline, may benefit.
Study-Tourette's syndrome is a genetic disorder resulting from basal ganglia abnormality that is typically treated with dopaminergic antagonists, such as the antipsychotic drug haloperidol. Animal studies have suggested that the use of nicotine could have beneficial effects in patients with Tourette’s.
Study (2006)-In 2006, Duke scientists found that people with depression who were treated with nicotine patches reported a decrease in their depressive feelings. The results were perhaps not surprising for a drug associated with imparting a "buzz." However, the research also showed a direct link between nicotine and an increase in the release of dopamine and serotonin, two vital neurotransmitters. A lack of dopamine or serotonin is a common cause of depression.
A nicotine patch is a transdermal patch that releases nicotine into the body through the skin. It is used as an aid in nicotine replacement therapy (NRT), a process for smoking cessation.
14 patches for around rs.4,500 in India. There are companieswhich provide 17.5 mg 30 patches for rs.2800.
Nicotine patch is a smoking deterrent. It works by providing low levels of nicotine, which may help you to quit smoking by lessening the physical signs of withdrawal symptoms. However, there is a lack of good quality evidence on the effectiveness of NRT in pregnant smokers.
It was also shown in the famous Sherlock tv show.
An electronic cigarette (e-cig or e-cigarette), personal vaporizer (PV) or electronic nicotine delivery system (ENDS) is a battery-powered vaporizer which has the feel of tobacco smoking. They produce a mist rather than cigarette smoke.[1][2] In general a heating element vaporizes a liquid solution known as e-liquid. E-liquids usually contain a mixture of propylene glycol, glycerin, nicotine, andflavorings.[1] Others have similar ingredients but without nicotine.[3] Evidence suggests e-cigarettes may be safer than smoking tobacco products.[6][7] To encourage e-cigarette use as a harm reduction and cessation aid in cigarette users is premature.[8] They may possibly be as safe as other nicotine replacement products, but there is not enough data to draw conclusions.
For conventional cigarette smokers, the battery-powered vaporizer devices are considered a safer route of nicotine delivery than burning tobacco and as a possible aid to smoking cessation.
But the findings suggested that "for users that are trying to quit tobacco cigarettes by switching to e-cigarettes, there is a possibility that they are actually inhaling more nicotine than is labeled," possibly counteracting their attempts to cut back, Reinhardt and Goniewicz explained.
Their study involved a random sample of 32 e-cigarette refill solutions from 16 brands purchased via online vendors in the U.S. that were tested with gas chromatography for nicotine content.
The findings should have implications for regulation by the FDA, they argued.
"This science can inform health policy organizations as they determine e-cigarette regulations, which can and should include ... standards for accurate labeling," Andrew Hyland, PhD, also of Roswell Park, commented in a statement.
The process of using an e-cigarette is called "vaping" rather thansmoking, according to Hilary Tindle, an assistant professor of medicine and director of the tobacco treatment service at the University of Pittsburgh Medical Center. She said that people who use electronic cigarettes are called "vapers" rather than smokers.
SEATTLE - A shocking number of children have become sick after ingesting liquid nicotine found in e-cigarettes, says the Washington Poison Center. The total number of calls to the center about e-cigarettes is up 600 percent compared with recent years. There’s also a staggering increase in the number of kids exposed to serious levels of nicotine.
Herbal cigarettes (also called tobacco-free cigarettes or nicotine-free cigarettes) are cigarettes that do not contain any tobacco, instead being composed of a mixture of various herbs and/or other plant material.[1] Such cigarettes are not to be confused with non-additive or natural tobacco cigarette varieties. Like herbal smokeless tobacco, they are often used as a substitute for standard tobaccoproducts (primarily cigarettes), and many times are promoted as a tobacco cessation aid.[2][3] Herbal cigarettes are also used in acting scenes by performers who are non-smokers, or—as is becoming increasingly common—where anti-smoking legislation prohibits the use of tobacco in public spaces.[4][5][6]
Paper and filter[edit]
Herbal cigarettes are most often made using standard-issue rolling papers and cigarette filters.
Herbal blend[edit]
A wide range of consumable products may be used as a filling, in lieu of tobacco. Corn silk and a number of flavorful herbs, such as mint,cinnamon or lemongrass, have been utilized by a wide number of herbal cigarette producers.[7] Other manufacturers have included non-herbs like rose petals or clover leaves. Some use the flavorless bagasse and make the herbal cigarette depend on the flavoring; this is especially common in shisha. Some are made with dried lettuce.
Herbal cigarettes are not viewed as physically addictive, as they do not contain addictive substances.[citation needed]
In India,Nirdosh.
Nicotine chewing gum is used to help people stop smoking cigarettes. Nicotine chewing gum should be used together with a smoking cessation program, which may include support groups, counseling, or specific behavioral change techniques. Nicotine gum is in a class of medications called smoking cessation aids. It works by providing nicotine to your body to decrease the withdrawal symptoms experienced when smoking is stopped and as a substitute oral activity to reduce the urge to smoke.
If you smoke your first cigarette more than 30 minutes after waking up, use the 2-mg gum. People who smoke their first cigarette within 30 minutes of waking up should use the 4-mg gum. Nicotine gum may be used regularly by chewing one piece of gum every 1 to 2 hours for the first 6 weeks, followed by one piece every 2 to 4 hours for 3 weeks, and then one piece every 4 to 8 hours for 3 weeks. If you have strong or frequent cravings, you may chew a second piece within one hour. To improve your chances of quitting smoking, chew at least 9 pieces of nicotine gum each day for the first 6 weeks.
Chew nicotine gum slowly until you can taste the nicotine or feel a slight tingling in your mouth. Then stop chewing and place (park) the chewing gum between your cheek and gum. When the tingling is almost gone (about 1 minute), start chewing again; repeat this procedure for about 30 minutes. Avoid eating and drinking for 15 minutes before and during chewing of nicotine gum.
In India, Nicorette.
Nicotine produces pleasurable feelings that make the smoker want to smoke more and also acts as a depressant by interfering with the flow of information between nerve cells. As the nervous system adapts to nicotine, smokers tend to increase the number of cigarettes they smoke, and hence the amount of nicotine in their blood. After a while, the smoker develops a tolerance to the drug, which leads to an increase in smoking over time. Eventually, the smoker reaches a certain nicotine level and then smokes to maintain this level of nicotine.
you gained twenty or thirty pounds, maybe even more, the last time you tried to quit.
