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Tobacco and Nicotine: History, Effects, and Addiction - Prof. David W. Pittman, Study notes of Pharmacology

An in-depth exploration of tobacco and nicotine, covering their history, types, administration routes, neurophysiological and behavioral effects, adverse health consequences, addiction and treatment. It also discusses the differences in absorption rates and blood concentration, as well as the distribution, metabolism, and excretion of nicotine.

Typology: Study notes

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Uploaded on 08/19/2009

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Tobacco / Nicotine
Where are we going today?
Tobacco History & Types of Tobacco
Tobacco Routes of Administration
Nicotine Absorption & Distribution
Metabolism & Excretion
Neurophysiological Effects
Behavioral Effects
Adverse Effects
Tolerance & Withdrawal
Addiction & Treatment
2
History of Tobacco
Originated in the Americas
Brought to Europe – Spain & France 1500’s
1559: Jean Nicot introduced snuff to the
royalty of France – popularization
1809 – nicotine named as active ingredient
1604 – King James I – anticipated the adverse
health effects of smoking tobacco
Very popular in England despite King’s Taxes
and cost of import from Spain
3
Tobacco – a CA$H crop
1616 – John Rolfe in Virginia colony grew
Spanish tobacco seeds with great success
Supply and Demand = $MONEY$
governmental taxes of tobacco became an
integral source of revenue in early 1600’s
Continued popularity until the 1960’s when the
harmful effects of tobacco became public
4
Tobacco – a drug?
Nicotine is unregulated by the FDA
FDA –defines drug as intended to affect a
structure or function of the body or used as a
treatment, cure, or disease prevention
5
Administration – Oral (Transdermal)
Tobacco chewed in the mouth – nicotine
absorbed transdermally into blood stream
rarely consumed through digestive system
nicotine = highly toxic poison
produces nausea & vomiting
metabolized fast in the liver – 1st pass
metabolism cuts down on nicotine
entering blood supply when digested
Differences in curing process manipulated the
pH of tobacco for better absorption in mouth!
6
Types of Tobacco
Chewing tobacco
cured: air-cured dark
pH: 8 = < 50% ionization
Pipe & Cigar tobacco
drying process: air-cured light
pH: 8.5 = < 50% ionization
Cigarette tobacco
drying process: flue-cured or bright
pH: 5.3 = close to 100% ionized – why?
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Tobacco / Nicotine

Where are we going today?

  • Tobacco History & Types of Tobacco
  • Tobacco Routes of Administration
  • Nicotine Absorption & Distribution
  • Metabolism & Excretion
  • Neurophysiological Effects
  • Behavioral Effects
  • Adverse Effects
  • Tolerance & Withdrawal
  • Addiction & Treatment

History of Tobacco

  • Originated in the Americas
  • Brought to Europe – Spain & France 1500’s
  • 1559: Jean Nicot – introduced snuff to the royalty of France – popularization
  • 1809 – nicotine named as active ingredient
  • 1604 – King James I – anticipated the adverse health effects of smoking tobacco
  • Very popular in England despite King’s Taxes and cost of import from Spain

3

Tobacco – a CA$H crop

  • 1616 – John Rolfe in Virginia colony grew Spanish tobacco seeds with great success
  • Supply and Demand = $MONEY$
    • governmental taxes of tobacco became an integral source of revenue in early 1600’s
  • Continued popularity until the 1960’s when the harmful effects of tobacco became public

4

Tobacco – a drug?

  • Nicotine is unregulated by the FDA
  • FDA –defines drug as intended to affect a structure or function of the body or used as a treatment, cure, or disease prevention

5

Administration – Oral (Transdermal)

  • Tobacco chewed in the mouth – nicotine absorbed transdermally into blood stream - rarely consumed through digestive system - nicotine = highly toxic poison - produces nausea & vomiting - metabolized fast in the liver – 1st^ pass metabolism cuts down on nicotine entering blood supply when digested
  • Differences in curing process manipulated the pH of tobacco for better absorption in mouth!

6

Types of Tobacco

  • Chewing tobacco
    • cured: air-cured dark
    • pH: 8 = < 50% ionization
  • Pipe & Cigar tobacco
    • drying process: air-cured light
    • pH: 8.5 = < 50% ionization
  • Cigarette tobacco
    • drying process: flue-cured or bright
    • pH: 5.3 = close to 100% ionized – why?

Administration - Inhalation

  • Snuff – fine powder absorbed through the nasal mucus membrane (stomach / lungs) TRANSDERMAL
  • Smoke – vaporized nicotine dissolves in the mucus membrane of the lungs into the blood - similar to administration of anesthesia - ammonia or other additives can facilitate nicotine release and absorption

Administration - Inhalation

  • Nicotine from lungs to heart → brain
  • Rapid effect
  • Chemicals in smoke are different
  • drug cannot be exhaled
  • Large dose per puff – little metabolism

9

Administration - Inhalation

  • Rapid absorption in the lungs
    • Amount of nicotine absorption per cigarette influenced by the number of puffs from a cigarette
    • 0.3 mg to 3.2 mg (8-9 mg cigarette)
    • Duration of smoke in lungs plays little role increasing nicotine absorption
    • CHAIN SMOKING

10

Rates of Absorption

  • Comparison of absorption rates per admin. Route
  • Exposure time and rate

11

Blood Concentration

  • Remember this during treatment section
  • Effectiveness of administration route on blood concentration

12

Distribution

  • Route of administration effects distribution
  • Inhalation = increased concentration in brain
  • Transdermal = more equal distribution through blood stream
  • After 30 minutes:
    • higher concentrations of nicotine in the salivary glands and stomach due to pH
    • higher concentrations of nicotine in the kidneys and liver due to metabolism

Neurophysiological Effects

  • Peripheral Effects
    • tremors from stimulation of the neuromuscular junction
    • inhibition of reflexes (knee jerk)
    • release of epinephrine activates sympathetic - Increased heart rate & blood pressure - Reduced blood flow to skin - Inhibits stomach secretions & stimulates bowels (less digestion, more excretion)

Behavioral Acute Effects

  • Addiction Research Center Inventory scores
    • nicotine by smoke or intravenous injection
    • smokers reported increased scores in liking
    • effects similar to morphine & amphetamine
    • peak at 1 min, gone within a few minutes
    • single cigarette: 30s after puff, 11s duration
  • Nesbitt’s Paradox: ↑ brain activity ↓ stress
    • behavioral ritual allows distraction (relax)
    • relief from withdrawal
    • situation-depend effect of arousal or relaxation

21

Performance Effects

  • Different effects - smokers versus nonsmokers
  • Smokers – nicotine increases performance from nonsmoking measures
  • Can increase vigilance & tracking abilities
  • Monotonous tasks:
    • sustains performance, faster motor reaction, speed & accuracy of processing

22

Benefits of Nicotine?

  • Antidepressant characteristics?
  • 2nd^ effect facilitates serotonin release
  • Primary effect of nucleus accumbens (pleasure)

Depression Index Ratings w/ Nicotine Patch Administration

23

Benefits of Nicotine?

  • Increased performance on learning tasks
  • Improved some cognitive impairments associated with Alzheimer’s disease
  • Increased arousal
  • Direct effect on the hippocampus LTP
  • Limited effect worth the negative consequences?

24

Problems with Nicotine

  • Adverse Physiological Effects yes, they exist!
  • Addiction, Tolerance, & Withdrawal

Adverse Effects

  • Heart Disease – 200,000 (noncancer)
  • Lung Disease – 82,000 (noncancer)
  • Cancer – 115,000 (lung) & 30,000 (nonlung)
  • -14 minutes per cigarette & 50 million US

Cardiovascular Effects

  • Carotid artery wall thickness
  • N: nonsmoker
  • P: past smoker
  • C: current smoker
  • +E: environmental exposure
  • -E: environmental exposure

27 Heart Disease - multiple effects 28

Lung Disease – 70% related

  • Ash and tars are deposited on the lung tissue
  • 2 mechanisms of removal
    • cilia agitate pollutants until coughed out
    • phagocytes surround and destroy particles
  • Both systems become compromised in chronic smoking – partially reversible - susceptible to bacteria and viruses - chronic bronchitis - emphysema: irreversible lung damage 57k

29

Cancer – 112,000 US deaths

  • Nicotine is not a carcinogenic but the other components of tobacco and smoke are!
  • Benzo[a]pyrene 20-30 ng per cigarette is one of the most potent mutagens and carcinogens
  • Metabolized to BPDE = ultimate carcinogen
  • BPDE damages a cancer suppression gene resulting in mutagensis of cells in lung tissue
  • Not just lung cancer - mouth, voice box, throat
  • 50% 10K bladder cancer & two-fold increase in uterine cervix cancer How much? How long?

30

Reproductive Effects

  • Nicotine crosses the placental barrier and is excreted in lactation
  • Prenatal exposure slows cognitive development – seen as late as 7 years old
  • Both low level of oxygen and chemical concentrations (nicotine) in the blood