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Smoking



NICOTENE
rapidly absorbed
most addictive chemical in smoke
cotinine is most important metabolite, can be detected in blood or urine
polycyclic hydrocarbons are the primary carcinogens
smokeless still is addictive and cancer causing

SECONDHAND/PASSIVE INHALATION
worst impact on kids
more resp and middle ear infx
worse asthma

BENEFITS OF QUITTING
risk of CV dz and lung CA approaches that of nonsmoker after 15 years
risk of stroke approaches nonsmoker after 5-15 years
reduced risk of CA of the mouth, larynx, esophagus, pancreas, urinary bladder
inproved pulmonary function
reduced risk of pneumonia, influenza, bronchitis

RISK TO FETUS INSIDE SMOKER MOM
growth retardation
low birth weight

SYSTEMIC EFFECTS ASSOCIATED WITH TOBACCO USE
CV: more MIs, sudden death, peripheral vasc dz, HTN
CNS: more strokes, intracerebral or subarachnoid hemorrhage
GI: oropharyngeal, esophageal, pancreatic CA, reflux dt relaxation of LES, delayed PUD healing
General: decreased activation of neut adhesion mols, decr ascorbic acid and beta-carotene conc
GU: cervical CA (SCC), decr test/est by gender, kidney CA (RCC), bladder CA (transitional CC)
Integument: wrinkling incr
MS: osteoporosis dt decr est in female, test in male
Resp: laryngeal CA (SCC) COPD (bronchitis, emphysema), Lung CA (SCC, small cell, adenocarc)
Special senses: decr smell and taste sense, macular degeneration-->blindness, cataracts

NERVOUS SYSTEM HOOK IN
there are two types of cholinergic receptors in the body: nicotinic and muscarinic
Nicotinic receptors exist in these locations:
autonomic ganglia
sympathetic and parasympathetic ganglia
adrenal medulla
neuromuscular junctions

DRUGS THAT INHIBIT
hexamethonium inhibits the ganglia
tubocuranine inhibits the motor endplate receptors
(atropine inhibits muscarinic receptors)

Comments

( 9 comments — Leave a comment )
machmed
Jul. 31st, 2009 02:19 am (UTC)
Yeah, and not to mention, it increases cortisol! For almost the past five years I've been suffering from extremely high levels of cortisol, which especially peaked late at night/early in the morning. I had gone to a countless number of physicians, both naturopathic and not. I had tried virtually anything and everything under the sun to lower my cortisol levels so that I could return to normal sleep patterns (or get any sleep at all. Towards the end, my body had essentially become incapable of entering REM sleep).

To make a long story short, I quit smoking three weeks ago after reading some questionably reliable information about how nicotine can increase cortisol. (Note that I came across this information entirely on my own. To my frustration, NONE of the doctors helped me make this connection.) Sure enough, my cortisol levels are back to normal and I'm sleeping again and not feeling like complete death anymore. All this after almost five years of complete and utter hell.

Go figure...the problem was right under my nose all along--literally! For a long time I've thought smoking was a dangerous and disgusting habit. But I didn't realize how true that intuition was until I finally quit after smoking after more than 12 years of addiction (I started when I was 14 and am now almost 27).

I actually plan to post in my journal about this soon, as its been--at the risk of hyperbole--a life changing experience for me. Though I kind of lack motivation to because I'm not sure anyone there will care or take it seriously, honestly. :P

Nevertheless, keep up the good work in spreading the word about the dangers of this deadly drug!
liveonearth
Aug. 1st, 2009 05:54 am (UTC)
Thanks for your comment! I have heard that smoking reduces appetite and increases blood sugar, but I did not know the mechanism. Cortisol would explain it. I had thought perhaps it was due to glucagon.... Do you have any sources for this finding, aside from your personal experience?
machmed
Aug. 1st, 2009 06:50 am (UTC)
Well, here's the main study which, after reading, motivated me to consider smoking cessation as a way to lower my cortisol:

http://www.psychosomaticmedicine.org/cgi/content/full/68/2/299#R11-18

Here's an article that I found less reliable and much more confusing, but I think it's conclusion is similar:

http://www.medscape.com/viewarticle/496223_4

And here's another publication that discusses the subject, but is only available in full for subscribers to the site:

http://www.springerlink.com/content/g55w7r6p83w86t58/

I'm surprised there isn't more research in this area. I'm also surprised that the only research that I've found has been done by scientists not directly related to naturopathic medicine, as it was only the naturopathic doctors that were willing to consider cortisol as a cause of my insomnia in the first place (which, to be sure, was an incredibly helpful step in the right direction for me, even if those doctors weren't able to identify smoking as the underlying culprit).

Once I can afford it, I do plan on having my cortisol tested again to confirm what I believe is going on here. But after having dealt with this for such long time, I can confidently say that my smoking cigarettes was somehow increasing my cortisol and subsequently causing my insomnia.
liveonearth
Aug. 1st, 2009 02:13 pm (UTC)
smoking kicks adrenals into high gear
Awesome links! Thanks. I am hereby more educated than I was.

Smoking acutely elevates not just cortisol from the adrenal zona fasciculata, but also catecholamines (dopa-->norepi-->epi) from the adrenal medulla and DHEA production from the zona reticularis. I had no idea that cigs were responsible for such adrenal overstimulation. It kind of makes sense esp when I think of smokers I know who crave that very first morning cigarette the most. Because they need the kick to get their adrenals working! Cool.

There is also a relaxing effect of cigs, that has something to do with the binding of nicotinic receptors. Know anything about that?

I have to focus on other matters for a few days, I will be interested to hear the results of your cortisol test! The fact that you are sleeping better is pretty convincing. I bet your levels have already normalized.
liveonearth
Aug. 1st, 2009 05:58 am (UTC)
Hey I forgot to CONGRATULATE you. Congratulations!! Stopping cigs is one of the toughest habits to break. How did you do it? And how are you managing cravings now?
machmed
Aug. 1st, 2009 07:01 am (UTC)
Thank you!! I won't lie: it's been incredibly difficult at times. I usually can get through it, but when my nicotine cravings were typically the strongest (usually after about 7pm until I'd go to bed), I now have strong cravings for food instead---especially food I otherwise never used to eat, such as sweets. I've never had much of a "sweet tooth" until now.

Unfortunately, I've given in to these cravings, with the fear that I will relapse on smoking cessation if I ignore them. But as I was telling my friend the other night, I'd rather be fat than be addicted to smoking. :P
Besides, this is something I can easily overcome in time. That's not the case with smoking.

Ultimately I'd say the main source of motivation for me is the reminder of what I went through over the last four and a half years. Honestly, I'd rather have to deal with the most severe nicotine withdrawal symptoms for the rest of my life than to EVER have to live like that again. That's how bad it was.
liveonearth
Aug. 3rd, 2009 12:25 am (UTC)
Hey I just found out more about why nicotene causes adrenal response. There are nicotinic receptors on the autonomic ganglia, both sympathetic and parasympathetic, as well as in the adrenal medulla and in the neuromuscular junction. There must be a lot more effects than anybody is talking about!

Congrats again. You are doing well. I know it's hard. I have never been hooked but I have watched a number of friends go through quitting. Have your read The Easy Way to Quit Smoking by Carr? It's not super-sciency but it does explain a lot about the way that nicotene gets a person hooked.
machmed
Aug. 3rd, 2009 03:42 am (UTC)
Thanks so much for your support! I really appreciate it. One thing that has made this the especially hard for me is feeling completely alone as a "non smoker" since I'm usually surrounded by smokers. Most of my friends and family are smokers, and it's been that way for many years. I've kind of been intentionally isolating myself from people I know so that I can get over the nicotine withdrawals before being exposed to smokers again.

As for the affect nicotine has on the adrenals, I'm not surprised to hear this. The difference I've felt since quitting is so incredibly drastic, it's difficult to put it into words. I've gone from an extreme emotional, mental and physical low point to feeling as positive and alive as I ever have.

I should note, however, that I do suspect I might have a sensitivity to nicotine that many other smokers don't (not to say smoking isn't harming them too, though). Who knows, I might even be allergic to it. That's something else I want to look into.

Anyway, I just Google'd that book and it does sound interesting. I think I'm going to try to pick it up soon. Thanks for the suggestion and your encouragement!
liveonearth
Aug. 4th, 2009 01:42 pm (UTC)
According to Carr the physical/chemical withdrawals are over in 3 days. After that it's psychological. But as you know, our minds are soooo powerful.

I can only imagine the challenge of being surrounded by smokers, because the smell is such a trigger, and the sight is another. You may find that you need to change your life a lot in order to stay free of it. For sure you need to make friends with some nonsmokers. There are lots of us out here!!

The other thing (I remember when my grandmother quit) is that you can take up some substituting habit that you can do around the smokers. My grandma started chewing on toothpicks. She ate a lot of wood, but she didn't relapse! Eventually she didn't need the toothpicks anymore, but for a while she really just needed something to DO with her hands and mouth.
( 9 comments — Leave a comment )

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