Smoking as the Leading Cause of Preventable Death: Getting Rid of the Dangerous Addiction - Research Paper Example

 When Christopher Columbus discovered America in the late 15th Century, he witnessed the widespread use of tobacco among the Native Americans. The Europeans were particularly influenced by the American Indian culture that described tobacco as a magical herb that cured all sorts of illnesses, sexually transmitted diseases to mental sicknesses (1). As early as 1612, John Rolfe, started cultivating tobacco in Virginia. When he discovered that his tobacco was far inferior to that grown in the Spanish colonies, he started importing tobacco plants from West Indies (3). By 1619 tobacco had become a major export of Virginia, which was eventually used as a basis of currency (2). The sailors were primarily responsible for spreading tobacco to various parts of the world. In the Philippines and other ports of call, seeds of Tobacco were left by Magellan’s crew. Similarly, The Hottentots and the Polynesians received tobacco from the Dutch and the Portuguese respectively. Thus, within a few decades, tobacco plant and tobacco addiction spread all over the world. Tobacco was chewed, snuffed and was even administered rectally in some religious ceremonies (4). Discovery and origin of the name nicotine: Tobacco is the name of any plant that belongs to the genus nicotiana of the solanaceae family (2). The chief commercial species is called nicotiana tabacum. In 1550, John Nicot, a French ambassador to Portugal, introduced tobacco to queen consort and the regent of France, Catherine de medicis, thus inspiring the historians to name the genus after his name. Since then, the genus nicotiana, and nicotine came into existence (1). Social acceptance of cigarette smoking : The tale of Sir Walter Raleigh, convincing the queen to partake in smoking, elevated the status of tobacco to a whole new level. Consumption of Tobacco was thus considered an elitist privilege in England and France. Settlers in the Americas, like visitors, learned to smoke (1). In England, prices soared as demand for tobacco exceeded supply. By 1612, even the poor started using tobacco. As early as 1527 Bishop Bartolome de las Casas reported that the Spanish settlers on the island of Haiti smoked cigars like the Indians (4). As tobacco farming became increasingly lucrative and popular around the globe, the elitist image of smoking began to fade. By the mid-1800's smoking became a socially accepted phenomenon and the production of rolling machines in the late 1880s only multiplied the number of smokers. As early as 20th Century, cigarettes were available for buyers in most metropolitan cities (1). In most countries, cigarette is offered as a friendly gesture and it is absolutely normal to smoke in social gatherings and public places. Advertisements used to be responsible for encouraging some teens to smoke. New regulations have become a hurdle for advertisers to promote smoking to young people. However, people smoking in movies and television shows are still common, often in a positive light. This is definitely a major influence on the attitude toward smoking in children and adolescents (6). Campaigns against smoking have made victims and potential smokers realize the adversities of nicotine. Government laws against smoking in public places have certainly developed an old-fashioned image of smoking cigarette. Addictive Properties of Nicotine The addictive nature of nicotine was clearly visible by the mid-seventeenth century when it spread throughout Europe, Asia, Africa and Australia. In 1662 it was reported that In Bohemia , "the common people are so given up to the abuse that they imagine they cannot live without several pipes of tobacco a day-thus squandering in these necessitous times the pennies they need for their daily bread."(4). According to a 2005 report by the U.S. Centers for Disease Control and Prevention (CDC), more than 20% of the adults in United States smoke. Tobacco, a mood changing and a behavior altering substance which is psychoactive and abusable, is believed to be as potentially addictive as cocaine, morphine and alcohol (6). When smokers become dependent on nicotine, they may go through strong emotional and physical withdrawal symptoms when they try to quit. These symptoms may be dizziness, headaches, irritability, changes in appetite ,anxiety, feeling of anger, tiredness, depression, disturbed sleeping pattern , constipation, lack of concentration as well as an incredible cravings for nicotine(5). Most of these symptoms can be controlled by other methods and can be overcome once the preliminary stages of withdrawal have passed. The lethal effects of smoking are understood by most people that can also be due to other substances present in cigarettes and cigar, however, nicotine is the main component that is responsible for addiction and continuation of smoking. The scientific evidence reveals that nicotine is the addictive drug in tobacco smoke: Nicotine is a volatile and alkali active product present in the tobacco juice which was first noticed by Vauquelin, a French scientist, in 1809. Followed by this, Poselt and Riemann of Heidelberg’s University isolated and purified nicotine and gave its name nicotine in the honor of John Nicot in the year 1828. By mid 20th century, first studies of the metabolism of nicotine was done and scientists publicly expressed the negative hazardous effect of nicotine on health (7).Studies in both men and animals have proved that nicotine is addictive (8).Smoking researchers firmly accepted the report produced by U.S. Surgeon general in 1988 and regarded nicotine as addictive in the same sense as heroine and cocaine (8). When smoke is inhaled, nicotine is absorbed and enters the bloodstream through the lungs and lining of the mouth. Nicotine is also absorbed through the nose when used as oral snuff or cigarette smoking (9). Research has revealed that nicotine increases the flow of the neurotransmitter dopamine in the brain. This in turn creates pleasurable feelings and a craving to keep nicotine in the bloodstream that will maintain these feelings. Absence of nicotine causes withdrawal symptoms in smokers (2). Every year only 4% to 7% can successfully quit smoking without any professional help or medicine(9). According to a report by Massachusetts department of health, the amount of nicotine in cigarettes is steadily increasing over the years that make it harder for smokers to quit. Testing in 2004 showed that 93% of cigarette brands contained the highest range for nicotine (6). Nicotine in the Cigarette Smoke Absorption: The huge surface area of the alveoli and small airways in our lungs help rapid absorption of nicotine from cigarette smoke. In alkaline solution, it may pass through skin and mucous membranes (10). Distribution: Once the nicotine is absorbed, it enters the bloodstream. At Ph approximately 7.4 nicotine becomes almost 70% ionized. Research on mice shows that intravenous administration of c14 labeled nicotine is about one minute. Thus, the action of nicotine on the brain occurs almost immediately. The body responds to nicotine when it acts on the receptors in the brain and nervous system and the physiological functions of many brain systems are changed. Nicotine easily crosses the placenta in pregnant women and has been found in amniotic fluid, umbilical cord, breast milk as well as cervical mucous (10). Metabolism: About 80% to 90% of nicotine is metabolized in the liver .To a smaller extent, the lungs also participate in metabolism. Cotinine is the major metabolite of nicotine. Cotinine levels in various biological fluids are used to determine intake of nicotine by tobacco users (10). Elimination of nicotine: Nicotine and its metabolites are released in the urine. At an urinary Ph of 5% or less, 23% is eliminated unaltered. If the ph level is 8%, only 2% are excreted. Nicotine is also be secreted in the saliva which goes down into the stomach. Together with the nicotine trapped in the acidic gastric fluid and re-absorption from the small bowel, provides a route for nicotine recirculation (10). Adverse Health Effects of Smoking Every year about 443,600 Americans die of tobacco related diseases. Nicotine and other components present in cigarette increase the risk of cancer (especially in the lung, larynx, mouth, tongue, lips, stomach, bladder, esophagus, bladder, cervix, kidney, and pancreas), strokes, heart attacks, and chronic lung disease. Statics shows that nine out of 10 lung cancer deaths occur because of nicotine addiction. More people die of smoking in America than car accidents or AIDS, alcohol, suicides, and illegal drugs combined (9). Smokeless tobacco (chewing and snuffing) are even more dangerous because it is absorbed through the digestive system and produces a 50 fold increase in the risk of gingivitis, tooth loss and oral cancer (6). Short term effects on the smoker and those exposed to secondhand smoke: As soon tobacco is used, a nicotine addict experiences a modest sense of well being. Nicotine acts as a mood booster, suppresses fits of anger, enhances concentration and short term memory as well as gives some temporary relief to any kind of depression (11). When tobacco or a cigarette is burnt, second and smoke is produced. This smoke contains formaldehyde, carbon monoxide, DDT and arsenic which make it a potential killer. Second hand smoke can be responsible for infant pneumonia, asthma and sudden infant death syndrome (SIDS) as well as middle ear infections in toddlers and older children. In adults it can cause to stroke, asthma, cardiovascular disease, cancer, and even respiratory failure (12). Among non-smokers around 3000 lung cancer deaths occur every year due to secondhand smoke (9). Long term effects of smoking particularly on women (including pregnant women), teens and children : Nicotine is a very powerful addiction. One in three smoker eventually die of nicotine addiction and probably die 10 or 15 years earlier than they would have die of any other cause(9). Women who smoke cigarette and take oral contraceptives are more prone to cerebrovascular and cardiovascular diseases than non-smokers, Women may also go through early menopause as a result of smoking. Prolonged smoking also poses a higher risk of giving birth to low birth weight infants, premature infants or still born babies. Young Babies can also face the risk of sudden infant death syndrome (SIDS) (5). Respiratory disease and asthma may occur, if nicotine enters the system of children and teens. Furthermore, children of the mothers who smoked during pregnancy may also develop behavior issues. Teens are more likely to smoke if their friends or parents smoke. As they start form a very early age, they face more difficulty in giving up smoking and eventually end up facing the consequences. Smoking Cessation Products Depending on personal preferences the smoking cessation product must be chosen. Rate of success, cost, individual body response are some of the criteria in choosing the best product (13). Nicotine Replacement Products (prescription and over-the counter): All the nicotine replacement products approved by U.S. food and drug administration (FDA) include nicotine patch, nicotine lozenges, nicotine nasal spray, and nicotine inhaler. Nicotine patch, gum and lozenges are available over the counter. Nasal spray, and inhaler are only available by prescription. All these products deliver a small dose of nicotine in the system which helps to relive cravings and the withdrawal symptoms. Smokers must stop smoking before they start using nicotine replacement products because overdose of nicotine may cause vomiting, dizziness, nausea, rapid heart beat, diarrhea, or weakness (13). Products not containing nicotine (Chantix and Zyban) and their common side effects: Bupropion and varenicline, marketed as zyban and chantix respectively, are products that do not contain nicotine. Both these products are FDA approved and are only available by prescription. Some common side effects of Bupropion are headaches, skin rash, dry mouth, difficulty sleeping, and dizziness. This product should not be used by people suffering from seizures, eating disorders or if they are taking any medicine containing ibupropion hydrochloride. Alcohol intake must be avoided when using this product because it increases the risk of seizure. Some common side effects of varenicline are vomiting, nausea, gas, changes in dreaming, and constipation (13). People suffering from kidney problems must avoid using this product. Women who are planning to become pregnant or are pregnant or breastfeeding should not use chantix (13). Conclusion Out of curiosity or as a means of social acceptance, people fall under the prey of nicotine addiction and find it very difficult to quit. The addictive nature is considered to be similar to heroine or cocaine. Once the body gets use to the initial dose of nicotine, it craves for more to restore the normal function. According to a report, only 4% to 7% of people have successfully given up smoking every year without medicine or help. Any age group can suffer the ill-effects of nicotine. Both men and women face the risk of several types of cancer and chronic lung diseases. Women who smoke cigarette during pregnancy face the risk of having still birth babies, low infant birth weight, or premature babies. Smoking is the leading cause of preventable death. Fortunately, there are nicotine replacement products well as non-nicotine replacement products that can help in getting rid of this dangerous addiction. Physicians or pharmacist must be consulted before choosing the best product. Smoking cessation products would only work if the smoker is determined and committed toward giving up. Bibliography 1.History of tobacco and nicotine in the Western Society, http://www.essortment.com/all/nicotinetobacco_ruml.htm, 10th March, 2010. 2. Tobacco History, http://www.questia.com/library/science-and-technology/life-sciences-and-agriculture/agriculture/tobacco-history.jsp , 10th March, 2010. 3. Reich, J.R. Colonial America, Pearson Education, 2001 5. History of Nicotine, http://nicotinefacts.weebly.com/history-of-nicotine.html, 10th March, 2010. 4. Brecher, M.E., The History of nicotine addiction, Consumer reports magazine, 1972, http://ffn.yuku.com/topic/11279, 10th March, 2010. 6. Nicotine addiction, http://www.healthcentral.com/copd/understand-addiction-000041_2-145.html?ic=506019, 11th March, 2010. 7.The history of nicotine, http://www.chm.bris.ac.uk/motm/nicotine/E-historique.html, 12th, March, 2010. 8. The scientific case that nicotine is addictive, http://www.springerlink.com/content/f758v682pu21j464/, 12th, March, 2010 9. Cigarette Smoking, http://www.cancer.org/docroot/PED/content/PED_10_2X_Cigarette_Smoking.asp, 12th, march, 2010. 10. Nicotine, http://www.inchem.org/documents/pims/chemical/nicotine.htm#SectionTitle:6.1%20Absorption%20by%20route%20of%20exposure , 12th, March, 2010. 11. Smoking how to stop, http://www.ehealthmd.com/library/smoking/SMO_whatis.html 12th, March, 2010. 12. Nicotine: An instrument of Death, http://health.discovery.com/centers/addiction/smoking/articles/nicotine_02.html, 12th march, 2010 13. Quitting Smoking: Why to Quit and How to get Help, http://www.cancer.gov/cancertopics/factsheet/Tobacco/cessation, 13th,march,2010 Read More