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29 Cards in this Set
- Front
- Back
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Does nicotine addiction have a genetic predisposition?
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almost certainly
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What factors play a role in nicotine dependence?
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environmental
psychosocial genetics |
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How many tobacco smokers globally?
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1.3 billion
(47% of men, 12% of women worldwide) |
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How many smokers in U.S.?
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45 million adults (20.9% of adults)
(23.4% of males, 18.5% of females) |
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Environmental factors that influence smoking:
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cultural influences
societal influences peer pressure marketing and advertising |
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States with most and least smoking?
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Kentucky - 32.6%
Utah - 12.7% |
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What percent of smokers want to quit?
What percent of smokers remain smoke free at end of one year? |
70% want to quit:
81% have tried to quit at least once 35% try to quit every year may require 10 attempts 7% are smoke-free at one year |
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What is the addictive component of cigarretes?
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Tobacco - carcinogenic
Nicotine - not carcinogenic (but addictive) |
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Does smoking low tar cigarretes reduce disease risk?
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NO!
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Diseases associated w/ smoking:
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COPD
cancer ischemic heart disease |
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What percent of deaths are related to tobacoo use?
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18% of all deaths (37.5% of preventable deaths)
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What percentage of smokers will shorten their lifespan due to tobacco use?
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1/3
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Most common smoking related mortality:
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cancer, ischemic heart disease, COPD
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How does quitting smoking help life expectancy?
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quitting at any age increases life expectancy
if you quit b/w 35-44, your life expectancy will end up being almost identical to those who never smoked |
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Why is nicotine so addictive?
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1. absorbed quickly
2. rapid, intense, and short-acting effects on DA release in brain |
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What other drugs is nicotine similar to and why?
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cocaine, amphetamines, and opiates also release DA...
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MOA of nicotine:
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primary binding site of nicotine is VTA on the nicotinic receptor (alpha-4-beta-2**) --> projects to nucleus accumbens and releases DA --> reward and pleasure
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What subunit is critical for dependence?
What subunit is critical for sensitivity? |
alpha = dependence/reward
beta = sensitivity/self-admin |
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What causes tolerance to nicotine?
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1. up-regulation (increased number) of nicotine receptors
2. desensitization of nicotine receptors in VTA |
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What causes nicotine withdrawl?
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drop in nicotine level, in combo w/ up-regulation and decreased sensitivity of nicotine receptor --> withdrawl and craving
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Nicotine withdrawl symptoms:
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-irritability
-difficulty concentrating -restlessness -depressed mood -anxiety -insomnia -increased appetite -decreased HR |
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Keys to success for helping someone quit smoking:
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1. motivation of the smoker!
2. education of smoker and family members 3. assess possible underlying psychopathology 4. obtain family hx for psych problems including addictions 5. provide frequent contacts during early weeks of smoking cessation 6. provide behavior modification program 7. exhibit supportive, non-judgemental, non-punitive attitude |
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3 components of tobacco cessation:
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1. physiological
2. psychosocial 3. psychological |
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What do all NRTs have in common?
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they contain nicotine**
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What happens when people go off an NRT?
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they start smoking again b/c they have nicotine withdrawl symptoms
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What is bupropion?
Believed MOA? |
the first non-addictive FDA-approved med for use a aid to smoking cessation
MOA: weak inhibitor of neuronal reuptake of DA |
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Which drugs have highest estimated abstinence rate?
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nicotine nasal spray
buproprion both about 30% abstinence |
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What is varenicline?**
What is the abstience rate w/ this drug? |
MOA: a highly selective α4β2 ACh partial* agonist and antagonist --> lessens amount of DA release from VTA at nAcc and prevents nicotine binding of α4β2 receptors
abstinence rate is far superior than any other available drug |
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What is Chantix?
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varenicline
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