Introduction
Nowadays, smoking remains one of the leading causes of severe health consequences, such as cancers, lung and heart diseases, and even death due to the adverse effects it brings to one’s health. Despite the grave danger tobacco brings, it is largely distributed worldwide in many different forms. Various social instances actively battle increasing tobacco use as a preventable cause of mortality and health disparities. The question of such a vast contribution of tobacco begins to arise when addiction’s scientific basis gets undercovered. It is essential to research the questions of how and what tobacco affects people’s bodies concerning various social and psychological factors to find the best treatment strategy for all groups of people.
How does tobacco deliver its effects?
Smoking combusts an Immense amount of gases into the lungs while burning tobacco in cigarettes. It sums to over being affected by over 7000 potentially detrimental chemicals in tobacco itself or released when burning it (NIDA, 2020). Cigarettes create an easy system of drug delivery to the organism. When inhaling the smoke, up to 1-2 milligrams of nicotine go into a smoker’s system. It quickly flows in the bloodstream and reaches the brain, where it stimulates adrenal glands and causes a discharge of adrenaline. As result, adrenaline release activates the feelings of pleasure and reinforcement through reward pathways in a human’s brain. However, it also leads to increased heart rate, respiration, and blood pressure.
Why is nicotine addictive?
Nicotine is the primary component of tobacco that develops the addiction. It forces smokers to seek and use tobacco compulsively. The reason for the addiction lies in the effect nicotine has on the brain. The release of endorphins in reward circuits brings a smoker a brief euphoric feeling after the nicotine is delivered. The other neurotransmitter dopamine also gets increased because of nicotine to reinforce the behavior of tobacco intake. Thus, tobacco’s repeated use leads to decreased circuits’ sensitivity towards dopamine and affects other brain parts responsible for stress and learning. The dependence on endorphins and dopamine results in long-term brain changes that makes it increasingly hard for the regular smoker to quit. The lack of nicotine can cause depression, anxiety, and increased irritability from the time of withdrawal.
What other tobacco products are available besides cigarettes?
There is a wide range of tobacco products depending on the consumption method. Cigarettes remain the most popular products for using tobacco, but more and more tobacco products such as heated tobacco products begin to arise (Glantz, 2018). Smoked tobacco products take in pipes and hookahs (McNeill et al., 2018). Tobacco can also be chewed in the form of snuff, dip, chewing tobacco, and snus (Etter, 2018). Besides snuff and chewing tobacco, various vapes, and e-cigarettes that also deliver nicotine grow popular in recent years.
What are the physical health consequences of tobacco use?
Smoking has a wide range of adverse effects on a person’s body and possibly becomes the cause of death. The primary health concern for smokers is lung cancer which is not directly caused by nicotine but by carcinogenic chemicals in tobacco (Al-Bashaireh et al., 2018). Smoking affects not only the lungs but causes cancers of the larynx, pharynx, stomach, mouth, and many other organs in the human body (Seng et al., 2020). Bronchitis, emphysema, and asthma are the other possible lung diseases besides cancer that are triggered by smoking (West, 2017). Besides lung diseases, smoking can also increase the risk of heart diseases such as stroke or a heart attack.
What are the effects of secondhand and thirdhand tobacco smoke?
Secondhand and thirdhand smoke is a significant public health concern that is developed in smoke-free policies. The health consequences of tobacco use do not only limit to smokers but the surrounding people as well. Passive smoking increases the risk of many diseases, including lung cancer (Torres et al.,2018). Children get significantly affected by secondhand smoke, which often results in them developing asthma. Thirdhand smoke is known as a remainder of chemicals on surfaces that stay some time after the smoke disappeared (Roberts et al., 2017). It also starts to alert a large number of people who unwillingly get subjected to potential health risks. Children are mostly subjected to it if touching the surfaces for common use. The potential risks can affect the lungs, liver, and even behavior, leading to hyperactivity.
What effects has tobacco use on the nervous system?
Nicotine quickly gets into the blood and reaches the brain to produce its effect. When it arrives in the brain, it affects several systems, including the nervous one as a stimulant or a depressant. Nicotine is a stimulant to the central nervous system because it releases epinephrine that stimulates the system and gives a “kick” with pleasant feelings (Vňuková et al., 2017). Moreover, the beta-endorphin hormone gets released to restrain pain. However, such a “kick” of nicotine also has its negative effect as a depressant when the intake passes and is followed by fatigue and lower mood, which in return leads to a more prominent nicotine use to avoid this condition.
What neurotransmitter is affected by nicotine use?
Nicotine has a powerful influence on the human body on all levels, including neurons. Tobacco use produces a cumulative impact on neurotransmission, which is believed to establish dependence on it. Neurotransmission itself is the act of the brain, responding to various experiences (Flores-González et al., 2017). When a new situation occurs, the information passes from neuron to neuron to send the signal to other organs and determine what a person does and feels. The neurotransmitter responsible for transporting nicotine is acetylcholine which delivers it to the cholinergic system (Flores-González et al., 2017). It also indirectly increases the glutamate level that accelerates neuron activity in the brain (Alasmari et al., 2019). Of course, nicotine, like all drugs, also dramatically increases dopamine, leading to pleasure and desire to repeat through dopamine.
What areas of the brain does nicotine affect?
The nicotine reaches the brain within a few seconds and sends impulses to several parts of the brain. The brain’s primary area responsible for impulses and emotions is the prefrontal cortex (Vergara et al., 2017). It is significantly affected while smoking because of its vulnerability to nicotine. Young people are significantly affected by nicotine since the prefrontal cortex does not finish developing until a person is 25 years old (Tega et al., 2018). Such an effect can lead to developing impulsive or reckless behaviors. It also becomes more and more challenging to stay focused.
How does smoking affect psychiatric medications such as antipsychotics, antidepressants, hypnotics, and anxiolytics?
Nicotine use affects the drug interaction in the organism primarily because of tobacco rather than nicotine. The nicotine replacement therapy can thus be used without consideration of medication interactions. Psychiatric medications, such as antidepressants, on the other hand, are largely affected by smoking. The medication concentration in the blood decreases when smoking and can lead to the drug’s reduced efficiency (Taylor et al., 2020). It often results in higher doses of medication, which is not always appropriate.
Why do people with mental illness smoke use tobacco more often than the general population?
Tobacco use and mental disorders often accompany each other because of their high comorbidity. Statistics show that people with mental disorders smoke two to four times more than the general population, especially those with a serious mental illnesses (Drope et al., 2018). 70 to 85 percent of people with schizophrenia and 50 to 70 percent of people with bipolar disorder are reported to smoke (Skora, 2018). The most prevalent smoking rates are among patients with anxiety, depression, and substance use disorders since nicotine can temporarily reduce the depressive symptoms of the illness, such as low mood or stress. Nicotine allows to chemically release dopamine to reduce anxiety and enhance mood, which makes addiction even worse.
Are there gender differences in tobacco smoking?
The social image of smokers often tends to be more masculine due to the statistical prevalence of male smokers because of several physiological, cultural, and behavioral factors. Neuroimaging results support a hypothesis that smoking access men’s reward pathways more than women (Kong et al., 2017). Men appear to have greater relief from smoking than women. The stress from abstinence is also perceived differently by genders. Women felt a stronger urge to smoke based on the irritating stress impulses. Thus, the statistics imply that women are less likely to succeed in quitting than men.
What are the treatments for tobacco dependence?
However, negative consequences to a person’s health due to tobacco use often make people battle their addiction. Tobacco cessation is best performed through behavioral therapies combined with FDA-approved medications (Sheffer et al., 2016). Various medications such as antidepressants, varenicline, or bupropion are used to assist with this process. Behavioral treatment is reported to result in higher quit rates than basic interventions (Sheffer et al., 2016). Behavioral counseling may include cognitive behavioral therapy, motivational interviewing, mindfulness exercises, and telephone or social media support. The medicine itself needs to be accompanied by personalized treatment sessions to achieve the best possible results and avoid nicotine abstinence’s adverse effects.
What research is being done on tobacco use?
Understanding the tobacco effect increases with more in-depth research being done to develop better treatment and prevention strategies. Genetics and epigenetics are the centers for the appearing research since more than 50 percent of the nicotine addiction risk arise from genetic factors (CITE). Genetics also influence the effectiveness of the treatment and the influence of nicotine metabolism. These factors comprise the chances of successfully quitting tobacco use. Neuroimaging is another sphere of research that is crucial for understanding brain activity associated with tobacco use and dependence. Functional magnetic resonance imaging (fMRI) allows scientists to visualize the effect smoking has on the human brain to link it with possible triggers and monitor treatment.
Research on tobacco use and its effect allows to competently shape the understanding and urgency of the issue in the general population and specific age or gender groups. It also becomes the ground for developing and upgrading the smoking problem’s treatment options, especially for patients with mental illnesses. The combination of multiple factors about tobacco and its users is essential in creating a qualitative study that uncovers the issue altogether and multilaterally.
References
Alasmari, F., Crotty Alexander, L., Hammad, A., Bojanowski, C. M., Moshensky, A., & Sari, Y. (2019). Effects of chronic inhalation of electronic cigarette vapor containing nicotine on neurotransmitters in the frontal cortex and striatum of C57BL/6 mice. Frontiers in Pharmacology, 10, 885.
Al-Bashaireh, A. M., Haddad, L. G., Weaver, M., Kelly, D. L., Chengguo, X., & Yoon, S. (2018). The effect of tobacco smoking on musculoskeletal health: A systematic review. Journal Of Environmental And Public Health, 2018, 1-106.
Drope, J., Liber, A. C., Cahn, Z., Stoklosa, M., Kennedy, R., Douglas, C. E.,… & Drope, J. (2018). Who’s still smoking? Disparities in adult cigarette smoking prevalence in the United States. A Cancer Journal for Clinicians, 68(2), 106-115.
Etter, J. F. (2018). Gateway effects and electronic cigarettes. Addiction, 113(10), 1776-1783.
Flores-González, L. A., Gutiérrez-Ramírez, J. M., & Constanza, L. (2017). Quantic analysis of the effect of nicotine on neurotransmitters. World Journal of Pharmaceutical Research, 6(4), 317-326.
Glantz, S. A. (2018). Heated tobacco products: The example of IQOS. Tobacco Control, 27 (Suppl 1), s1-s6.
Kong, G., Kuguru, K. E., & Krishnan-Sarin, S. (2017). Gender differences in US adolescent e-cigarette use. Current AddictionRreports, 4(4), 422-430.
McNeill, A., Brose, L. S., Calder, R., Bauld, L., & Robson, D. (2018). Evidence review of e-cigarettes and heated tobacco products 2018. Public Health England.
NIDA. (2020). How does tobacco deliver its effects? National Institute on Drug Abuse.
Roberts, C., Wagler, G., & Carr, M. M. (2017). Environmental tobacco smoke: Public perception of risks of exposing children to second-and thirdhand tobacco smoke. Journal of Pediatric Health Care, 31(1), e7-e13.
Seng, S., Otachi, J. K., & Okoli, C. T. (2020). Reasons for tobacco use and perceived tobacco-related health risks in an inpatient psychiatric population. Issues in Mental Health Nursing, 41(2), 161-167.
Sheffer, C. E., Payne, T., Ostroff, J. S., Jolicoeur, D., Steinberg, M., Czabafy, S.,… & Perry, B. (2016). Increasing the quality and availability of evidence-based treatment for tobacco dependence through unified certification of tobacco treatment specialists. Journal of Smoking Cessation, 11(4), 229-235.
Skora, A. (2018). Tobacco-related disparities among individuals affected by mental illness. The Journal, 2018, 50-56
Taylor, G. M., Itani, T., Thomas, K. H., Rai, D., Jones, T., Windmeijer, F.,… & Taylor, A. E. (2020). Prescribing prevalence, effectiveness, and mental health safety of smoking cessation medicines in patients with mental disorders. Nicotine and Tobacco Research, 22(1), 48-57.
Tega, Y., Yamazaki, Y., Akanuma, S. I., Kubo, Y., & Hosoya, K. I. (2018). Impact of nicotine transport across the blood–brain barrier: Carrier-mediated transport of nicotine and interaction with central nervous system drugs. Biological and Pharmaceutical Bulletin, 41(9), 1330-1336.
Torres, S., Merino, C., Paton, B., Correig, X., & Ramírez, N. (2018). Biomarkers of exposure to secondhand and thirdhand tobacco smoke: Recent advances and future perspectives. International Journal Of Environmental Research And Public Health, 15(12), 2693.
Vergara, V. M., Liu, J., Claus, E. D., Hutchison, K., & Calhoun, V. (2017). Alterations of resting state functional network connectivity in the brain of nicotine and alcohol users. Neuroimage, 151, 45-54.
Vňuková, M., Ptáček, R., Raboch, J., & Stefano, G. B. (2017). Decreased central nervous system grey matter volume (GMV) in smokers affects cognitive abilities: A systematic review. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research, 23, 1907.
West, R. (2017). Tobacco smoking: Health impact, prevalence, correlates and interventions. Psychology & Health, 32(8), 1018-1036.
World Health Organization. (2017). WHO report on the global tobacco epidemic, 2017: Monitoring tobacco use and prevention policies. World Health Organization. Web.
