E N D Presentation Transcript Developing a Smoking Cessation Program in the Acute Care Setting Understanding Tobacco Dependence Janis M Dauer, MS, CAC Alliance for the Prevention and Treatment of Nicotine Addiction [email protected] Understanding Tobacco DependenceNICOTINE Increases alertness/attention Improves task performance Acts as stimulant & sedative Acts as antidepressant and/or anti-anxiety agent Nicotine:Wonder Drug Causes adrenaline rush and release of glucose, suppresses insulin output Increases heart rate, respiration & BP Understanding Tobacco DependenceNICOTINE Decreases appetite, interferes with absorption of nutrients Vasoconstrictor: decreases circulation in extremities 90% of nicotine in cigarette smoke is absorbed in the lungs Takes about 10 seconds to reach brain (and to feel the effects) Understanding Tobacco DependenceNICOTINE Dose easy to modify by how cigarette is smoked (1-2 mg extracted/cigarette on average) Each cigarette: 10 puffs taken over 5 minutes (200 Ahits@ per pack) Short half-life results in withdrawal symptoms soon after last dose Toxic in high doses Cigarettes/tobacco: cheap, easy to get, portable References: 1-4 Understanding Tobacco DependenceNICOTINE ADDICTION The Health Consequences of Smoking NICOTINE ADDICTION A Report of the Surgeon General, 1988 Major Conclusions Cigarettes/tobacco products are addicting Nicotine is the drug that causes addiction Pharmacologic/behavioral processes deter-mining tobacco addiction are similar to those determining addiction to heroin/cocaine Understanding Tobacco DependenceNICOTINE ADDICTION Criteria for Drug Dependence Highly controlled or compulsive use Psychoactive effects Drug-reinforced behavior Behavior often involves: Stereotypic use patterns Recurrent drug cravings Use despite harmful effects Drug often produces: Tolerance Physical dependence Pleasant (euphoriant) effects Reference: 5 Understanding Tobacco DependenceNICOTINE ADDICTION Nicotine acts on brain receptors leading to release of dopamine, norepinephrine and serotonin
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In another flashback, Eli and Nucky are under the boardwalk, waiting for the dirty little monkey. He finally arrives, and Eli grabs him
Tobacco control can save billions of dollars and millions of lives 10 January 2017 | GENEVA Policies to control tobacco use, including tobacco tax and price increases, can generate significant government revenues for health and development work, according to a new landmark global report from WHO and the National Cancer Institute of the United States of America
See, this is what it looks like when a member of Congress IS just making a joke
The droplets should come off easily
