Addiction Solution Source

In the January issue of Pediatrics, researchers at MassGeneral Hospital for Children (MGHfC) describe how tobacco smoke contamination lingers even after a cigarette is extinguished – something defined as “third-hand” smoke.

“When you smoke – anyplace – toxic particulate matter from tobacco smoke gets into your hair and clothing,” says lead study author, Jonathan Winickoff, MD, MPH, assistant director of the MGHfC Center for Child and Adolescent Health Policy. “When you come into contact with your baby, even if you’re not smoking at the time, she comes in contact with those toxins. And if you breastfeed, the toxins will transfer to your baby in your breastmilk.”

Particulate matter from tobacco smoke has been proven toxic. According to the National Toxicology Program, these 250 poisonous gases, chemicals, and metals include hydrogen cyanide, carbon monoxide, butane, ammonia, toluene (found in paint thinners), arsenic, lead, chromium (used to make steel), cadmium (used to make batteries), and polonium-210 (highly radioactive carcinogen). Eleven of the compounds are classified as Group 1 carcinogens, the most dangerous.

A UC Riverside study shows that smoke from “light” or “low-yield” harm-reduction cigarettes retains toxicity and that this toxicity can affect prenatal development.

The research also studied the effects of two kinds of cigarette smoke: mainstream smoke, which is smoke actively inhaled by smokers; and sidestream smoke, which is smoke that burns off the end of a cigarette.

Tobacco companies market harm-reduction cigarettes as being safer than traditional “full-flavored” brands, leading many smokers to conclude that the use of harm-reduction brands lowers their exposure to toxicants.

“Many chemicals found in harm-reduction cigarette smoke have not been tested, and some are listed by manufacturers as safe,” said Prue Talbot, a professor of cell biology who led the study. “But our tests clearly show that these chemicals adversely affect reproduction and associated development processes. Pregnant women would be particularly vulnerable to the effect of smoke from these cigarettes.”

Can you believe this photo!

A nurse helps her patient light up a cigarette in a 1943 Saturday Evening Post cover. (Image courtesy of UCLA)

A recent UCLA School of Nursing study is the first to reveal the devastating consequences of smoking on the nursing profession. Published in the November–December edition of the journal Nursing Research, the findings describe smoking trends and death rates among U.S. nurses and emphasize the importance of supporting smoking cessation programs in the nursing field.

“Nurses witness firsthand how smoking devastates the health of their patients with cancer and respiratory and cardiovascular diseases,” said principal investigator Linda Sarna, D.N.Sc, a professor at the UCLA School of Nursing. “Yet nurses struggle with nicotine addiction like the rest of the 45 million smokers in America. We are concerned that nurses who smoke may be less apt to support tobacco-control programs or encourage their patients to quit.”

Sarna led a team of researchers who analyzed data from the Nurses’ Health Study, a historic study on women’s health. Launched at Brigham and Women’s Hospital in the mid-1970s, the study relied upon surveys completed every two years by 237,648 female registered nurses about their health, including smoking habits.

“The Nurses’ Health Study is the largest study of women’s health in the world,” Sarna said. “From a workforce perspective, however, the findings also hold a mirror up to the well-being of nurses, the largest group of health care professionals in the country.”

The current UCLA research explored changes in smoking trends and death rates among female nurses enrolled in the Nurses’ Health Study between 1976 and 2003, a span of 27 years.

The research compared the differences in death rates among nurses who never smoked, former smokers and current smokers. In all age groups, roughly twice as many current smokers had died in comparison to nurses who never smoked.

Smoking can have numerous negative effects. Information gathered from various research studies point that out.

In one such study, Dr. Gary Shaw of the March of Dimes and colleagues from institutes in Norway, Holland, and Texas, studied serum samples collected between 2003 and 2005 from pregnant women enrolled in the California Expanded AFP (alpha fetoprotein) program. The researchers measured the levels of cotinine, a metabolite of nicotine, to determine whether the mothers smoked during pregnancy. They found that women who smoked during pregnancy were nearly 2.5 times more likely to have babies with oral clefts.

According to Dr. Shaw, “Babies with oral clefts require significant medical care. Often necessary are four surgeries by age two, and they may have speech, hearing, and feeding problems.”

In a related study, Dr. Laura Stroud and colleagues from Brown University studied the effects of cigarette smoke exposure on infant behavior. The researchers studied 56 otherwise healthy infants and used questionnaires and cotinine measurements to determine cigarette smoke exposure. They found that the 28 babies who had been exposed to cigarette smoke were more irritable and difficult to sooth.

In a recent research report, Kristen Saxone-Moeller from the University of Melbourne, stated that Australians with mental illness smoke at four times the rate of the general population.

The research also found that:

* Smokers with mental illness consumed 50 per cent more cigarettes a day than the general population, averaging 22 cigarettes a day;

* The heaviest smokers in the group smoked up to 80 cigarettes in a day;

* Almost three in five (59 per cent) said they wanted to quit smoking;

* Almost three quarters (74 per cent) said they wanted to cut down;

“Smoking compounds many of the health problems already experienced by people with mental illnesses,” she said. “Combined with drug therapies that often make them overweight, they are at even greater risk of diabetes, heart attacks and strokes if they smoke.”

“The biggest cause of death among people with mental illness is not suicide, it is cardiovascular disease.”

Overall cost to Australia showed more than $30 billion a year but little was being done to help people quit.

From past research, it’s known that the children of mothers who smoked during pregnancy are at greater risk of ADHD (Attention Deficit Hyperactivity Disorder).

Young people with ADHD are not only at increased risk of starting to smoke cigarettes, they also tend to become more seriously addicted to nicotine and more vulnerable to environmental factors such as having friends or parents who smoke.

It appears that those with more ADHD related symptoms such as prominent inattention, distraction, overactivity or impulsivity of the smokers, the more serious their dependence on nicotine.

Dr. Timothy Wilens, Associate Professor of Psychiatry at Harvard Medical School and co-author of a recent study, stated that, “it looks like interplay between the dopamine system, more substantially related to ADHD and addiction, and the cholinergic system related to smoking is probably important”. (The study was supported in part by the National Institute on Drug Abuse.)

Peer pressure, including the media, is one of the main reasons many people smoke.

Before World War I, tobacco was smoked mainly in the form of cigars and primarily by the wealthy. Cigarettes, which were basically leftovers of the cigar making process, were used by the less fortunate.

The number of people who smoked cigarettes boomed when tobacco companies started to mass-produce them. Their clientele: soldiers of World War I. This marketing broadened of course after the war.

In my research, I discovered ads from JAMA – The Journal of the American Medical Association that promoted various brands. One ad pictured a military doctor promoting Camels. Wow! Not only are you being patriotic by using them but a doctor is promoting the brand. I am sure this ad influenced many to smoke, especially military men and women. If your peer was a soldier next to you that was smoking, don’t you think that would have a powerful influence on you?

Another JAMA ad I discovered was telling you how much more “pleasure” you will get with the Chesterfield brand. An ad will state anything favorable to entice you to take it up.

It is my understanding that the AMA did not take a position against smoking until the 1980s even though there was plenty of evidence that it was dangerous to your health and could cause cancer among other diseases. Do you think money influenced this attitude?

Smoking has been very prevalent in the movies and especially in the 1950s and 1960s, on television. Even the actors were advertising various brands in commercials during a TV show. They made it seem classy and romantic.

Some of you may recall the “Marlboro Man” (rugged-looking cowboy). There were actually several men who modeled for print and TV ads. At least two of them have died of lung cancer from smoking.

Once you start smoking it is hard to stop because the nicotine contained in tobacco products is so quickly addictive and is even considered to be as addictive as heroin or cocaine.

Why?

When a cigarette is smoked, nicotine-rich blood passes from the lungs to the brain within 7 – 10 seconds and immediately stimulates the release of many neurotransmitters including dopamine (pleasurable feeling).

It is important to note that nicotine is very powerful and poisonous for the nervous system. There is enough (50 mg) in four cigarettes to kill a person within just minutes if it were injected directly into the bloodstream.

The problem is the effects from smoking are short-lived, lasting only a few minutes to a couple of hours. This leads people to smoke throughout the day to dose themselves with this deadly chemical because they want to continue to have whatever positive effects they think they are receiving. Add to this the fact that you can become tolerant to nicotine’s effects — you need to use more and more of it to reach the same degree of stimulation or relaxation — and you can see how people would quickly move from smoking one cigarette to a pack a day habit.

A typical smoker will take 10 draws on a cigarette over a period of 5 minutes. Therefore, a person who smokes about 1-½ packs (30 cigarettes) daily, is getting 300 “hits” of nicotine to the brain each day.

According to recent research, cigarette companies have manipulated the menthol content in cigarettes to lure young people into smoking.

Menthol masks the harshness and irritation of cigarettes, allowing delivery of an effective dose of nicotine, the addictive chemical in cigarettes. There was a deliberate strategy to recruit and addict young smokers by adjusting menthol to create a milder experience for the first time smoker.

For example, Marlboro introduced Marlboro Milds in 2000, with a lower menthol concentration while raising the menthol content in Marlboro Menthol, favored by older smokers. Menthol brands with the greatest market share growth among young adults had the lowest menthol levels (Marlboro Milds and Newport) among the brands tested.

This is another example of the cynical behavior of the tobacco industry to hook teens and African Americans to a deadly addiction. This is after the industry told the American public it had changed its marketing practices.

A five year study funded by The Canadian Cancer Society and carried out by the Unversity of Montreal, determined that kids begin to think about quitting smoking very soon after their first puffs but increasingly find it difficult to do.

As cravings, withdrawal symptoms and tolerance grew, novice smokers began to lose confidence in their ability to quit. After two years, many had discovered that breaking the habit was not so easy. In the course of the study, more than 70 percent of the teens wanted to quit, but only 19 percent actually managed to stop smoking for at least a year.

The research was published in the American Journal of Public Health by Dr Jennifer O’Loughlin. She is a professor in the Department of Social and Preventive Medicine at the University of Montreal and Canada Research Chair in the Early Determinants of Adult Chronic Disease.

Dr. O’Loughlin said the study shows that there are milestones in the process of becoming addicted to tobacco. Understanding the steps that lead to addiction could uncover critical periods when kids might be most open to education and support.