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Discover in American and spread to Europe Smokeless tobacco: moist snuff, powder snuff & loose-leaf Absorbed by mucosal in the mouth and nise Nicotine/Tobacco Pharmacology Nicotine is the most important ingredient Average cigarette contains 10 mg of nicotine Central Nervous system stimulant that disrupts the balance of neurotransmitters Dopamine Endorphins epinephrine, Acetylcholine Constricts blood vessels Raises heart rate Depresses appetite Produces mild euphoria Deadens senses Nicotine/Tobacco Two most important reasons people smoke tobacco is: Weight loss Craving One must keep a certain level in blood stream to avoid withdrawal Tolerance develops quickly Withdrawal causes: Headaches Nervousness Fatigue Severe irritability Intense craving Poor concentration Sense of relaxation from smoking a cigarette is actually a withdrawal symptom being subdued Nicotine/Tobacco Addiction Tobacco is pure example of addiction process 80% want to quit & 10% want to cut down May have a genetic predisposition to nicotine addiction Side Effects Tobacco & smoke contain more than 4,000 other chemicals of which 400 are classified as toxic 43 are known as carcinogens Nicotine/Tobacco 1997: 3.5 million premature deaths In U.S

Option 2: Discontinuous use of patches and gradual decrease in the number of tablets in 1 mg

Epub 2010 Feb 13