An Introduction To The Health Effects of Nicotine

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An Introduction To The Health Effects of Nicotine
A Small Dose of Nicotine
Mayan priest in Central America, 1000 B.C.
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What Is This?
CH3
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Nicotine
CH3
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Question

• Have you every tried nicotine?
• What were the immediate effects?

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Historical Awareness

• 2,000 years ago (maybe 6,000) - natives of the
  Americas used tobacco as a medicine, in religious
  ceremonies, and as offerings to spirits.
• 1492 - Christopher Columbus introduce tobacco and
  nicotine to Spain

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Historical Awareness

• 1612 - British colony at Jamestown, Virginia,
  exporting tobacco to England became an
  essential source of money
• 1700-1800s - Farms used slaves to cultivate
  tobacco

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Historical Events
1614 Cigarettes were invented by beggars in
Seville, Spain (from scrap of cigars) 1763
Nicotine used as an insecticide 1828 Nicotine
isolated from tobacco leaves 1850s Cigarettes
increased in popularity 1880 Machine to roll
cigarettes patented (10,000 per hour)
cigarettes get cheaper
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Quote - Quitting

• To cease smoking is the easiest thing I ever
  did. I ought to know, I've done it a thousand
  times."
• Mark Twain

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Sir Walter Raleigh
Sir Walter Raleigh popularized pipe smoking in
England. He was beheaded on October 28, 1618 but
before his head dropped he requested to smoke a
final bowl full of tobacco.
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Modern Events
1964 U.S. surgeon general linked cigarette
smoking with lung cancer and coronary artery
disease. 1996? FDA finds that nicotine is
addictive 1999? US Supreme Court rules that FDA
can not regulate nicotine 2000? Tobacco
companies required to pay billions to compensate
for health effects 2000 World wide tobacco
consumption continues to increase
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Tobacco CEOs
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Smoking

• Nicotine in a cigarette 8 to 10 mg
• Smoking delivers about 1 mg to the smoker
• Technique of smoker can increase nicotine (time
  smoke is in lungs, rapid puffing)

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Nicotine Absorption

• Lung (nicotine enters brain in 7 seconds)
• Skin (slower absorption, more constant blood
  levels)
• Stomach poor (nicotine is strong base stomach
  is acid)
• Intestine better

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Acute Adverse Effects

• Acute nicotine exposure
• (From insecticide sprays or tobacco)
• Nausea, vomiting, salivation, diarrhea,
  dizziness, mental confusion, weakness
• Fatal exposure (60 mg fatal for adult)
• Decreased blood pressure, difficulty breathing,
  irregular pulse, convulsions, respiratory failure
  and death

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Fetal Effects

• Chronic nicotine exposure to developing fetus
• Decreased birth weight
• Attention deficit disorder
• Cognitive impairment

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Withdrawal Effects

• Restlessness
• Anxiety, hostility
• Irritability, impatience
• Difficulty concentrating
• Increased appetite (weight gain)
• Depression

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Metabolism

• Cotinine - Major metabolite
• Lung First site of metabolism
• Liver Major site
• Half-life about 2 hours

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Excretion

• Nicotine and metabolites
• Primarily in urine
• Breast milk (heavy smoker 0.5 mg per liter of
  milk (infant is small large dose)
• Insurance companies look for cotinine (longer
  half-life)

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Mechanism Of Action

• Low dose Stimulation Binds nicotinic receptors
  (cholinergic)
• High dose Blocks receptors

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Mechanism Of Action
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Nicotine as Insecticide

• Mimics the action of acetylcholine
• Muscle tremor
• Convulsions
• Death (respiratory paralysis)

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Reducing Exposure

• Dont use tobacco
• Handle nicotine insecticides carefully

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Smokeless Tobacco Health

• Addiction to nicotine
• Gum recession
• Sores in the mouth
• Cancer of the mouth
• Increased blood pressure
• Heart disease
• Ulcers
• Generally not good

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Smokeless Tobacco Money

• In the U.S.
• Sales - 112.2 million pounds sold in 2001
• Revenues - 2.13 billion in 2001
• Advertising 236.7 million in 2001
• U.S. Federal Trade Commission Smokeless Tobacco
  Report for the years 2000 to 2001

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Regulatory Status
March 22, 2000 The United States Supreme Court
ruled in a 5-4 decision that the U.S. Food and
Drug Administration (FDA) cannot regulate tobacco
products.
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Summary
Nicotine is toxic and addictive Dont Start
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A Small Dose of Nicotine
Questions or Comments?
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Additional Information

• Web Sites
• World Health Organization (WHO). Online.
  lthttp//www.who.int/health_topics/tobacco/en/gt
  (accessed 2 April 2003).
• Covers tobacco and international efforts to
  track and reduce use of tobacco.
• Health Canada - Tobacco (CDC). Online.
  lthttp//www.hc-sc.gc.ca/hecs-sesc/tobacco/index.ht
  mlgt (accessed 9 April 2003).
• Heath Canada information on the health
  effects of tobacco.

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Authorship Information
This presentation is supplement to A Small
Dose of Toxicology
For Additional Information Contact Steven G.
Gilbert, PhD, DABT E-mail smdose_at_asmalldoseof.org
Web www.asmalldoseof.org