Sunday, October 16, 2011

Cigarette Smoking and Nicotine


       Cigarette smoking kills approximately 5 million people worldwide each year and is currently raising. Smoking is set to kill roughly 8.3 million people in the year 2030!
       Nicotine is the addictive quality in tobacco that causes people to reach for another cigarette. When you inhale tobacco smoke, the nicotine in the smoke moves quickly from your lungs into your bloodstream. Nicotine replacement therapy (NRT) helps reduce nicotine withdrawal and craving by supplying your body with nicotine. It contains about one-third to one-half the amount of nicotine found in most cigarettes.
       People become dependent on the nicotine in cigarettes because it increases the levels of certain chemicals, such as dopamine and norepinephrine, in their brains. When people quit smoking, the levels of those chemicals drop, and their bodies react by having nicotine withdrawal symptoms such as grouchiness and hunger. Nicotine from medicines increases the levels of dopamine and norepinephrine just like nicotine from cigarettes does. Chemical levels in the brain are kept level so withdrawal symptoms are reduced.
       Nicotine replacement therapy is safe when used properly. Nicotine by itself is not nearly as harmful as smoking. Tars, carbon monoxide, formaldehyde, ammonia and other toxic chemicals in tobacco cause harmful effects, not the nicotine. NRT doubles the chances of successful quitting compared to not using any aid (cold turkey).
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Nicotine Patch
A nicotine patch can be used overnight (24 hours) or removed before going to bed for day use only (16 hours).
The patch is placed on the skin releasing a steady stream of nicotine into the bloodstream.
The patch is beneficial for those people who have early morning cravings.
Nicotine patches come in 3 doses: 7mg, 14mg, and 21mg. The starting dosage for a person vaires depending on their smoking history.
The patch can be used alone or in combination with the nicotine inhaler or nicotine chewing gum.

How to use the patch:

• Apply to clean dry area
• Rotate site every day
• Remove old patch before applying new one
• Do not use lotion, moisturizing soap on the area the patch is to be applied
• May need to clean area with alcohol wipe
• Touch only small corner of adhesive
• Rub patch after application – ensure all corners are stuck
• Wash hands in water after application –don’t use soap
• Discard old patch out of reach of children, animals – can still be harmful
Possible Side Effects:
Skin irritations may result at the site of the patch; it is important to rotate the site daily to avoid this.
The patch may cause sleep disturbances or vivid dreams when worn overnight. If this occurs, stop using        patch overnight and try managing night time cravings with the nicotine inhaler, or gum.
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Nicotine Inhaler
Nicotine inhalers are thin plastic canisters resembling cigarettes into which nicotine cartridges are inserted.
Inhalers provide the "hand to mouth" action similar to smoking cigarettes.
The inhaler can be used alone in combination with the patch or gum.

How to use the inhaler:

The inhaler is meant to be “puffed” similar to a cigar and not inhaled deeply into the lungs.
The inhaler can be used up to 20 minutes continuously or as needed.
Possible Side effects:
When using the inhaler, the person may notice a burning, warm or cool sensation. This is not dangerous.
Throat or mouth irritations are possible.
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Nicotine Gum
Nicotine Gum comes in 2 doses: 2 mg or 4mg.
Nicotine is absorbed via buccal mucosa and is absorbed into the bloodstream faster than the patch.
The gum can be used alone or in combination with the inhaler or patch to respond to immediate urges, similar to breakthrough pain medication.
Not recommended for those with dentures or throat, mouth, or jaw dysfunctions.

How to use the gum:


“Chew and Park” method:
• Bite the gum a few times slowly
• Then park it between your cheeks and gum
• Wait a minute while the nicotine is released
• Repeat bite
Possible side effects:
If chewed improperly stomach upset/aches and hiccups can result.
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Nicotine Withdrawal
Nicotine Withdrawal
       Typically nicotine withdrawal can occur within a few hours of abstinence from nicotine, peak within a few days, and can last up to six months or longer. It is important to be able to identify nicotine withdrawal.
Immediate Onset
• Cravings to smoke
• Frustration
• Anger
• Anxiety
• Difficulty concentrating
• Restlessness
Later Onset (These symptoms tend to be more mild than immediate onset but can also last up to six months or longer)
• Nausea
• Diarrhea/constipation
• Shakiness
• Dizziness
• Appetite changes
• Fatigue
• Sleep disturbances
• Headaches
• Clumsiness
Myth: Smoking while on the patch increases the risk of a heart attack.
Fact: Use of NRT while smoking does not increase the smoker’s cardiovascular risk


References

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