Flashcards: Understanding Tobacco: History, Pharmacology, and Cessation — 20 cards

Use of tobacco by indigenous Americans

Used for religious and spiritual rituals.

Tobacco introduced to Europe

By Columbus in the late 15th century.

20th-century tobacco propaganda

Promoted smoking as glamorous and healthy.

Public health challenges today

Smoking-related diseases and addiction.

Nicotine's action in VTA

Activates α4β2* receptors, releasing dopamine.

Nicotine's effect on dopamine

Stimulates release in the nucleus accumbens.

Nicotine's effects

Enhances pleasure, concentration, reduces anxiety.

Withdrawal symptoms peak

Within 3 days, lasting up to 1 month.

Long-term cravings

Can persist for years after quitting.

Nicotine's mood effects

Inhibits monoamine oxidase, elevating neurotransmitters.

Harmful substances from combustion

Arsenic, benzene, cadmium, cyanide, formaldehyde, tar, CO, nitrogen oxides.

Menthol in tobacco

Acts as a cooling agent, may produce toxic compounds when burned.

Ammonia in smoke

Enhances nicotine absorption, increasing addiction.

Nicotine pharmacokinetics

Rapid absorption; half-life α=1.35h, β=17h; metabolized by CYP2A6.

Nicotine replacement therapy

Provides controlled nicotine to reduce withdrawal.

Timing of NRT initiation

When patient is ready to quit.

Forms of NRT

Patches, gums, inhalers, pastilles, vaporizers.

Pharmacological treatments

Varenicline and bupropion modulate addiction pathways.

Behavioral support role

Enhances cessation success through counseling and motivation.

Factors in treatment choice

Dependence level, health, preferences, comorbidities.