Tobacco123
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This document provides information about substance abuse, with a focus on tobacco and alcohol. It discusses the composition of tobacco and cigarette smoke, noting they contain over 4,000 chemicals including nicotine and carcinogens. The health effects of smoking include increased risk of cancer, cardiovascular and lung diseases. Smoking during pregnancy can also increase lead levels in mothers and impact fetal development. The document also discusses sheesha/hookah smoking and notes it contains high levels of nicotine, carbon monoxide and tar. A section on alcohol discusses low risk drinking guidelines and factors impacting blood alcohol levels.
![Tobacco
Tobacco isa plantwithinthe genus Nicotianaof the Solanaceae (Nightshade) family.There are more than70
species of tobacco.Productsmanufacturedfromdriedtobacco leaves include cigars,cigarettes, snuff,pipe
tobacco, chewingtobacco(Gutka/Pan) andflavored Shishatobacco.Furtherusesof tobaccoare in plant
bioengineeringandasornamentals,andchemical componentsof tobaccoare usedinsome pesticidesand
medications. Nicotine isthe mainactive ingredientandmostaddictive substance intobacco
The plant isdividedintotwo:
1. Nicotianatabaccum
2. Nicotianarustica- thisisnotusedcommercially
Composition.
Polycyclicaromatichydrocarbons(PAHs) are one class of chemical compoundsthat are presentatlowto trace
levelsinunburnedcigarette filler, andare predominantlygeneratedduringcombustion.Accordingtoa recent
reportof the International AgencyforResearchonCancer,10 carcinogenicPAHstogetherwith53 otherknown
carcinogensare presentincigarette smoke.
Cigarette smoke isacomplex mixture of variousclassesof compounds,includingnumerousPAHs.
The PAH levelsvariedamongthe differentcommercial cigarettebrands,withthe amountof total mainstream
smoke PAHsrangingfrom1 to 1.6 microgper cigarette.Undermachine smokingconditions,the mainstream
smoke fromdomesticcigaretteshadindividual PAHsrangingfrombenzo[k]fluoranthene atlevelsbelow10
ng/cigarette tonaphthaleneatlevelsof around500 ng/cigarette.
solanesol, a45-carbon,trisesquiterpenoidalcohol anaturallyoccurringcomponentintobaccothat isdeposited
duringsmokinginthe cigarette filterbutt.
Nicotine andcarbonmonoxide,whichare only2 of the more than4,000 differentchemicalspresentincigarette
smoke.
Several carcinogenshave beenidentifiedinCigerateSmoke,the tobacco-specificN-nitrosamine (TSNA),N'-
nitrosonornicotine (NNN),and4(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) beingthe mostimportant.
NNN andNNKare formedfromnicotine duringcuring,aging,andespeciallyduringfermentationof tobacco.
Oral swabbingof alowconcentrationof a mixture of NNN plusNNKinwaterinducesoral tumorsinrats. The
concentrationof the stronglycarcinogenicTSNA is higherinsnuff thaninother StreetSmokingproducts.](https://image.slidesharecdn.com/b2163fb6-73f1-4c98-b672-cbd150b92a9f-150323053811-conversion-gate01/85/Tobacco123-3-320.jpg)
Tobacco123
- 1. Substance Abuse/Drug Abuse Editor Dr.Afsar Karim (PharmD) TABACCO/ALCOHOL
- 2. FIRST EDITION 2014/ first series Publication in collaboration with Aga khan youth & Sports Board / Aga Khan Social Welfare Board for Skardu/EFHCA. Thisis greathonor forme to write aninformative literaturecoveringTobaccoandAlcohol onrequesting AkYSBand ASWB forSkardu. This bookis informative forall Youthwantstoknow about the Tobacco and Alcohol.Also reliable forthe Medical Studentsfortheirinformation. For any query mail to [email protected]
- 3. Tobacco Tobacco isa plantwithinthe genus Nicotianaof the Solanaceae (Nightshade) family.There are more than70 species of tobacco.Productsmanufacturedfromdriedtobacco leaves include cigars,cigarettes, snuff,pipe tobacco, chewingtobacco(Gutka/Pan) andflavored Shishatobacco.Furtherusesof tobaccoare in plant bioengineeringandasornamentals,andchemical componentsof tobaccoare usedinsome pesticidesand medications. Nicotine isthe mainactive ingredientandmostaddictive substance intobacco The plant isdividedintotwo: 1. Nicotianatabaccum 2. Nicotianarustica- thisisnotusedcommercially Composition. Polycyclicaromatichydrocarbons(PAHs) are one class of chemical compoundsthat are presentatlowto trace levelsinunburnedcigarette filler, andare predominantlygeneratedduringcombustion.Accordingtoa recent reportof the International AgencyforResearchonCancer,10 carcinogenicPAHstogetherwith53 otherknown carcinogensare presentincigarette smoke. Cigarette smoke isacomplex mixture of variousclassesof compounds,includingnumerousPAHs. The PAH levelsvariedamongthe differentcommercial cigarettebrands,withthe amountof total mainstream smoke PAHsrangingfrom1 to 1.6 microgper cigarette.Undermachine smokingconditions,the mainstream smoke fromdomesticcigaretteshadindividual PAHsrangingfrombenzo[k]fluoranthene atlevelsbelow10 ng/cigarette tonaphthaleneatlevelsof around500 ng/cigarette. solanesol, a45-carbon,trisesquiterpenoidalcohol anaturallyoccurringcomponentintobaccothat isdeposited duringsmokinginthe cigarette filterbutt. Nicotine andcarbonmonoxide,whichare only2 of the more than4,000 differentchemicalspresentincigarette smoke. Several carcinogenshave beenidentifiedinCigerateSmoke,the tobacco-specificN-nitrosamine (TSNA),N'- nitrosonornicotine (NNN),and4(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) beingthe mostimportant. NNN andNNKare formedfromnicotine duringcuring,aging,andespeciallyduringfermentationof tobacco. Oral swabbingof alowconcentrationof a mixture of NNN plusNNKinwaterinducesoral tumorsinrats. The concentrationof the stronglycarcinogenicTSNA is higherinsnuff thaninother StreetSmokingproducts.
- 4. What is'tar'? Cigarette smoke containstinyparticles,whichcanbe collectedona filterpadina laboratorywhena cigarette is smokedbya machine. Tar is usuallydefinedasthe weightof particulate mattercollectedinthisway,after waterand nicotine are subtracted. Tar isa complex mixture of substances,whichincludessubstanceswhichin sufficientquantitiesare thoughtcapable of initiatingand promotingcancerand Emphysema(Chronic obstructive pulmonarydisease(COPD) isone of the mostcommonlungdiseases.Itmakesitdifficulttobreathe). What isnicotine? Nicotine occursnaturallyinthe tobaccoplantand isa constituentof tobaccosmoke. Nicotine hasunusual pharmacological properties;ithasbotha mildstimulanteffect,thoughlessthanthatof caffeine,andamild relaxingeffect. Athighlevels,farhigher thaninthe smoke froma cigarette,nicotineistoxic. . Nicotine isalso an addictive drug,though,andsmokerscharacteristicallydisplayastrongtendencytorelapse afterhaving successfullystoppedsmokingforatime.Wheningestedinlargerdoses,nicotine isahighlytoxicpoisonthat causesvomitingandnausea,headaches,stomachpains,and,insevere cases,convulsions,paralysis,anddeath Studies show nicotine has powerful side effects on the cardiovascular(Heart and its vessels) system. Nicotine: Increasesepinephrine (adrenaline),whichraisesbloodpressure,heartrate andrespiration,andglucose levels. Narrows(constricts) yourbloodvessels,makingitharderforthe heart to pumpbloodthrough constrictedarteries. May cause yourbodyto release storedfatandcholesterol intothe bloodstream. Damagessmoothmuscle cells,promotingthe formationof hardplaqueswhichleadto arthrosclerosis (hardeningof the arteries). What iscarbon monoxide? Carbonmonoxide isagas formedwhenplantmaterialsburn. Itcan combine withhemoglobininblood, reducingthe blood’scapacitytocarry oxygen. Carbonmonoxide intobaccosmoke isthoughttobe associated withthe increasedrisk of heartdisease fromsmoking; Highlevelsof carbonmonoxide canleadtobraindamage and unconsciousness.
- 5. Effects. Smokers die an average of 14 years soonerthan nonsmokers. Smokingisa significantindependentriskfactorforcardiovasculardiseaseandisa leadingcause of structural and functional alterationsof the cardiovascular system.Cigarette smokingcausesinjurytothe vascular endothelium, producessuperoxideanions,reducesproductionandbioavailabilityof nitricoxide(NO),increases productionandrelease of endothelin,causesendothelial dysfunction,thrombosis,atherosclerosis, infarction(localizedDeathof livingCellsresultingfromobstructionof bloodSupply),coronaryarterydisease (atherosclerosis),stroke(SuddenLossof Consciousness)anddeath While the effectof cigarette smokingonthe progressionof atheroscleroticdiseasesisestablishedandwell studied,the role of cigarette smokingoncardiacarrhythmiaislessclearlydefined.Infactthe pathphysiological mechanismof cigarette smoking-inducedcardiacarrhythmiaisverylikelyacomplex one where the pro-fibrotic effectof nicotine on myocardial (Heart) tissue withconsequentincreasedsusceptibilitytocatecholaminemight playa role.Moreover,otherconstituentsof cigarette smoking,suchascarbonmonoxide andoxidative stress, are likelytocontribute tothe generationof arrhythmias.Finally,cigarette smokingmayinduce coronaryartery disease andchronicobstructive pulmonarydisease,whichalsomightcause arrhythmia(anabnormal rate of Muscle contractionsinthe Heart) independently. Tobacco smokingisa majorrisk factorof the developmentof atherosclerosisandthrombosis.Components of tobacco smoke induce changesinthe functionof thrombocytes(BloodPlatelets),endothelium, macrophages (bodyDefenderCells)andsmoothmuscle cellsof bloodvessels.Smokingcauseschangesinactivityof enzymes of antioxidantsystembyinducingproductionof reactive oxygenspecies.Alterationsof cell functionandenzyme activitymayaccelerate formationof atheroscleroticplaques.The compoundsof tobaccosmoke alsopromote atherogenesisbyaffectinggene expression.Nicotine mightpromote aproatheroscleroticstate inhuman coronary endothelialcells(HCAECs),studyingthe role of 3-hydroxy-3-methylglutaryl coenzymeA (HMG-CoA) reductase inhibitorsinpreventingthese phenomena:nicotine inducedexpressionof functionallyactive VCAM- 1/ICAM-1, (vascularcellularadhesionmolecule-1(VCAM-1)/intercellularadhesionmolecule-1(ICAM-1)),since theyincreasedleukocyte adherence toHCAECs.Oxygenfreeradicals,RhoA andnuclearfactor kappaB(NF- kappaB) playa pivotal role inmodulatingtheseeffects.Indeed,nicotine causedoxygenfreeradical production as well asactivationof Rho A and NF-kappaBpathways.Superoxide dimutase, RhoA (Y-27639) and NF-kappaB inhibitors(pyrrolidine dithiocarbamateammonium, Bay11-7082) suppressednicotineeffectsonCAM expression.HMG-CoA reductase inhibitorspreventedthese nicotine-mediatedeffectsbyinhibitingfree radical generationandby modulatingactivationof RhoA andNF-kappaBpathways. Tobacco smokingduringpregnancyincreasedthe concentrationsinmaternal bloodlead.The level of leadin plasmaand whole bloodcorrelatedwiththe degreeof intensityof cigarette smokinginthe pregnantwomen studied.Itmaybe a resultof influencingthe mobilizationof calciumfromthe bone withsimultaneousrelease of leaddepositedinthe bone.Furtherstudiesare requiredtocharacterize the effectof higherleadlevelinthe bloodof mothersonthe riskof premature labor,low birthweightof newbornsandtheirinferiordevelopment. Tobacco smokingduringpregnancyreducedserumnitricoxide concentrationsinmothersandtheirchildrenand correlatedwithnumberof cigarettesdaily consumed. Chewingof tobaccoisassociatedwithanincreasedrisk for oral (Month) cancer. Snuff dippingiscausallyandspecificallyassociatedwithcancerof the cheek,gum,and pharynx causescancersof the lung,esophagus,larynx (voice box),mouth,throat,kidney,bladder,pancreas, stomach,and cervix,aswell asacute myeloidleukemia(Proliferationof white BloodCells). federal lawisrestrictingthe words“light,”“low,”and“mild”fromtobacco productsnow on the market,as healthofficialslaunchacampaign to informsmokersthatthere’snosuchthingas a safe cigarette.Studies clearly showthattheconsumer cangetjustas muchnicotineand tar fromthesecigarettes as‘regular’cigarettes.”
- 7. Heart and heart vessels showing atherosclerosis causing Heart attack. SHEESHA Shisha/Hookah/Waterpipe smoke are more dangerthenthe cigarette Smoke,containsnicotine, carbonmonoxide,andcarcinogensandmaycontain evengreateramountsof tar and heavymetalsthancigarette smoke.It contains11 timesmore Carbonmonoxide thanCigarettes. The WorldHealth Organizationhassaidthat hookahuse isequivalenttosmoking100 cigarettes ina 200-puff session. The researcherssay,Waterpipe smoke hasbeenlinked to oral andlungcancer, heartdisease,infectiousdiseases,and pregnancy- relatedcomplications. Increaseschance of gettingtuberculosis Darkenslips,fingertipsandteeth Coats the tongue andtaste buds andleadsto lossof appetite.
- 8. Alcohol Low risk drinking: One drinkfor female and2 drinksformale. One drinkis defined as:as354ml of bear.148ml of wine or 44 ml of 80 proof distilled. Note:1 literequal to34 oz. 1liter=1000ml. 1 oz = 30ml. Livercan process 7.5ml (.25 oz )of alcohol perhour BloodAlcohol Content(BAC) decreasesbyabout.015% per hour *********************************************** Bloodalcohol level (BAL)dependson: / Weight / Amountof foodand waterin stomach / Carbonatedalcoholicbeverages / Gender BloodAlcohol Level Calculations BAL = (150/bodyweight) x (%alcohol/50)x (ouncesconsumed) x (0.025)
- 9. For example / 175 poundmandrinksfour12-ounce cans of beerwith4% alcohol content / BAL = (150/175) x (4/50) x (48) x (0.025) / =.86 x .08 x 48 x .025 / = .08% Effects : BAL 0.35 to .50 or BloodAlcohol concentrationGreaterthen400mg/dl can cause respiratory depressionand cause comaand Death. Low –Moderate concentration. ApparentStimulant;depressionof cortical functioncauseslossof judgment, emotional liability,Visual impairment,SlurredSpeech, Ataxia(Uncoordinatedmovementisdue toa muscle control problemthatcausesan inabilitytocoordinate movements.). Hangovereffectsmayinclude Nausea, Headache,Dizziness,andtremor.DepressesMedullaryAction; Lethargy,amnesia, Hypothermia(dangerously lowbodytemperature),hypoglycemia{lowsugarlevel inblood)(Esp.inChildren’s)},Stupor(lackof critical cognitive functionand level of consciousness),Coma,Respiratory Depression,Cardiomypathy(Heart Disease),Hypertension(HighBlood Pressure) orhypotension(Low BloodPressure) andcardiovascularcollapse may occur. Chronic Excessive Consumption:damage Brain,liver,Braindamage leadstoWernicke-korsakoff Syndrome (inflammatorydegenerative braindisorderdue tothiamine (vitaminB1) deficiency thatisusuallyassociated withAlcoholism).Pancreatitis(pancreatitisisswellingandinflammationof the pancreas),increase CardiovascularRisk. Fatdepositionmayoccurin liverandthere maybe a reductioninvariousBloodCell Counts and increase Typesof Cancer. Effect on fetus of Pregnant Human.
- 11. Conclusive overviewof Alcohol effectsonHumanbody List of preventable causes of death Leadingcausesof preventabledeathworldwide asof the year2001, accordingto researchersworkingwiththe Disease Control PrioritiesNetwork(DCPN) andthe WorldHealthOrganization (WHO). Cause Numberof deaths resulting(millionsper year) Hypertension 7.8 Smokingtobacco 5.0 Malnutrition 3.8 Sexuallytransmitteddiseases 3.0 Poordiet 2.8 Overweightandobesity 2.5 Physical inactivity 2.0 Alcohol 1.9 Indoorair pollution fromsolidfuels 1.8 Unsafe waterand poor sanitation 1.6 Sources: Martindale 33 edition. Basic & Clinical Pharmacology10EditionbyKatzung. WWW.pubmed.com www.fda.gov/consumer www.wikipedia.com PREPERED BY Dr.AfsarKarim Pharmacist(Doctorof Pharmacy)