The Painless Stop Smoking Cure

Quit Smoking Magic

Quit Smoking Magic is the first and Only program of its type that literally can Force You to easily kick the habit in just days even if you have a shoestring budget and absolutely no will power. Benefits: Helps You to successfully quit smoking in as little as just days. Its as easy as taking candy from a Sleeping baby. This system takes just minutes to administer. This system can be done on a shoestring budget. Absolutely no chance of Any negative side effects. Works for almost Everyone 98% success rate thus far. You will never relapse with this program. Theres no Will-power necessary with Quit Smoking Magic. Powerful concept based on Real-life experiences rather than just theories. Quit Smoking Magic Teaches You: How to quit smoking cigarettes super-fast. How to stop your Cravings dead in their tracks. How to Never relapse with this nasty habit. How to avoid spending a ton of Money in your quest for quitting. How to quit smoking Now rather than later. How to Automatically kick this habit even without will-power. How to keep from having withdrawal symptoms and nasty mood swings. How to refrain from having Insomnia after quitting. How to avoid restlessness as well as changes in appetite. More here...

Quit Smoking Magic Overview

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Aerosol Delivery To Treat Lung Cancer

To date, reports of aerosolized chemotherapy for the treatment of lung cancer and pulmonary metastases have been quite limited. Table 1 summarizes all known studies that have investigated local lung delivery of anticancer agents including cytotoxics, gene therapy, chemopreventative agents, immunomodulating agents, or any combination of these treatments. In almost all instances of in vitro, in vivo, or human clinical trials, inhaled chemotherapy resulted in positive outcomes relative to controls. Several broad generalizations may be garnered from a review of these studies performed over the course of nearly 40 years. First, while several different therapeutic agents have been investigated, very few studies have focused on chemotherapy agents that would currently be considered effective in lung cancer. Reasons for this discrepancy may include the relatively poor solubility and stability of many frontline chemotherapy agents readily available for aqueous systems. Also, these studies have...

Smoking In The Movies Does it influence teen smokers

Julia Roberts chain-smoked throughout My Best Friend's Wedding in 1997. Leonardo DiCaprio polluted the skies over Thailand in 2000 with cigarette after cigarette in The Beach. Even the adorable little green aliens from Men in Black II puffed on cigarettes in 2002. Experts fear that Hollywood blockbuster movies are sending the wrong message to teens by showing some of the most famous actors and actresses lighting up cigarettes. The writers, directors, and studios that produce these movies claim they are merely imitating real-life trends and attitudes toward smoking. The use of cigarettes on screen did not decline over the decades, even though the number of American smokers dwindled from 42.4 in 1964 to 25.5 in 1994. The researchers involved in the Dartmouth study concluded that there is a direct association between seeing tobacco use in movies and trying cigarettes, a finding that supports the hypothesis that smoking in movies influences teen trends and attitudes toward smoking. Smoke...

Interaction Between Cannabinoids and Nicotine

The consumption of cannabis is highly associated with tobacco, which contains nicotine, an important psychoactive compound (Nemeth-Coslett et al. 1986 Mc-Cambridge and Strang 2004). The administration of THC and nicotine in rodents produces multiple common pharmacological responses including analgesia, hypothermia, impairment of locomotor activity and addiction (Hildebrand et al. 1997 Ameri 1999 Maldonado and Rodriguez de Fonseca 2002). Nicotine responses are mediated by the activation of nicotinic acetylcholine receptors, which have a pentameric structure consisting of different receptor subunits (Grutter and Changeux 2001 Le Novere et al. 2002). and nicotinic systems. The specific behavioural and biochemical consequences of such an interaction are poorly documented in animal models in spite of the high frequency of association of these two substances in humans. Nicotine facilitated THC-induced acute pharmacological and biochemical responses in mice, including hypothermia,...

Neurochemistry of Nicotine Dependence

2.2 Neurochemical Systems That Support Nicotine 2.2.1 Nicotine 2.2.1.3 Beyond the Role of DA in Nicotine 2.3 Nicotine-Associated Changes in Intracellular Tobacco use is the leading preventable cause of death in North America and a growing medical problem in developing countries throughout the world. In the Western world, the rising cost of cigarettes, social mores, and public policy against smoking have led to appreciable decreases in cigarette use over the last 25 years.12 In recent years, however, smoking prevalence has appeared to reach asymptote at approximately 25 .34 Those with schizophrenia, a history of depression, alcoholism or polydrug use, and those who have difficulty quitting with the help of currently available cessation methods continue to smoke.3,5 Until recently, there were only two FDA-approved treatments for tobacco cessation nicotine replacement therapy and bupropion. In May 2006, the FDA approved the use of a nicotinic receptor partial agonist, varenicline, for...

Individual Differences In The Metabolism Of Nicotine To Cotinine

By simultaneously infusing labeled nicotine-d2 and cotinine-d4, and by measuring levels of cotinine-d2 generated from nicotine-d2, the fractional conversion of nicotine to cotinine can be determined (Benowitz and Jacob 1994). An example of data generated by such a study is shown in figures 6a and 6b. Using this approach in 20 smokers, it was determined that on average 72 percent of nicotine is converted to cotinine (range 55 to 92 percent) (figure 7). No differences in the clearances of nicotine or cotinine or the percentage of nicotine conversion to cotinine were seen when comparing data from men and women. As expected, clearances did vary among individuals, with coefficients of variation of 25 percent and 27 percent for clearances of nicotine and cotinine, respectively. The extent of individual variability and the percentage of nicotine conversion to cotinine was less, with a coefficient of variation of 12 percent. Data on the fractional conversion of nicotine to cotinine and the...

Enzymes in snicotine metabolism and detoxication

Application Enzymes Diagnosis

( -Nicotine1 is one of the most widely used psychoactive drugs in the world. Almost 25 percent of adult Americans smoke despite convincing evidence of the health hazards of smoking (Surgeon General 1988). Nicotine causes complex CNS, behavioral, cardiovascular, and endocrine neuromuscular effects in humans (Benowitz 1988). Most notably, nicotine is the primary cause of tobacco addiction in humans (Surgeon General 1988). The molecular basis for tobacco addiction is unknown but it is possible that a biologically active metabolite of nicotine plays a role in nicotine tolerance and dependence, and individual differences in the metabolism and disposition of nicotine may explain why some humans become highly dependent on nicotine and others do not. Clearly, a full appreciation of the role of human enzymes in nicotine metabolism and detoxication could provide much insight into the interindividual variation in the biological responses to smoking and the variation in the pharmacological...

Pharmacological Action of Nicotine

Nicotine binds selectively to the nicotinic receptors that are present in the adrenal medulla, brain, autonomic ganglia, and neuromuscular junctions. It causes the release of several neurotransmitters and hormones such as acetylcholine, norepinephrine, dopamine, serotonin, arginine vasopressin, j3-endorphin, adrenocorticotropic hormone, and cortisol (187). This neuro-regulatory effect of nicotine is dose-dependent and occurs as plasma nicotine level rises when tobacco is smoked. The neurotransmitters released in the brain medi ate the behavior modulating effects and positive reinforcing effects of nicotine and other habit-forming drugs. 7.2.1.1 Neurological Basis of Nicotine Dependence. In the brain, nicotine exerts a multitude of psychological and behavioral effects. At low doses, it exerts a predominantly stimulating effect, which occurs in the cortex through locus ceruleus and is mediated by norepinephrine. At high doses, a dopaminergic reward effect predominates (184, 188). The...

Smoking Cessation Agents

Although smoking cessation is a lifestyle decision, the ability to quit is usually hindered by nicotine chemical dependence. According to the Surgeon General report on smoking in 2000 (163), Tobacco dependence is in fact best viewed as a chronic disease with remission and relapse. Even though both minimal and intensive interventions increase smoking cessation, most people who quit smoking with the aid of such interventions will eventually relapse. It is estimated that 24.7 of all adults who lived in the United States in 1997 were smokers (164). This is only slightly lower than the 25.5 prevalence in 1994 (165). Statistics show that over 70 of smokers express a strong desire to quit and about 20 actually try to stop smoking. However, only 3-5 of smokers who attempt to quit smoking on their own achieve a successful abstinence after 1 year (165, 166). The agency for Health Care Policy and Research (AHCPR) in its Clinical Practice Guidelines on Smoking Cessation released in April 1996...

Drug Treatments for Nicotine Dependence

Nicotine resembles other addictive drugs in that it induces similar addictive behavior patterns (such as inability to control consumption) and similar neuroadaptive changes (e.g., tolerance). Nicotine intoxication and withdrawal are not associated with the acutely harmful behavior that other drugs of abuse cause but the health consequences of nicotine make it the most important drug of abuse. Withdrawal symptoms associated with nicotine addiction include anxiety, restlessness, difficulty concentrating, and irritability. Drug treatment to prevent relapse in individuals with nicotine addiction must reduce these symptoms and in addition decrease craving for nicotine. This must be achieved in an environment with multiple conditional stimuli for nicotine use, such as the morning cup of coffee. Nicotine can be delivered safely and its use gradually reduced using nicotine replacement therapy. By contrast with methadone maintenance, nicotine replacement therapy is not an indefinite...

Tobacco Dependence Syndrome In the

World Health Organization ICD-10 Classification of Mental and Behavioural Disorders F17.2 Tobacco Dependence Syndrome A cluster of physiological, behavioural, and cognitive phenomena in which the use of tobacco takes on a much higher priority for a given individual than other behaviours that once had greater value. A central descriptive characteristic of the dependence syndrome is the desire (often strong, sometimes overpowering) to take tobacco There may be evidence that return to substance use after a period of abstinence leads to a more rapid reappearance of other features of the syndrome than occurs with nondependent individuals. Diagnostic Guidelines (c) a physiological withdrawal state when tobacco use has ceased or been reduced, as evidenced by the characteristic withdrawal syndrome for tobacco, or use of the same (or a closely related) substance with the intention of relieving or avoiding withdrawal symptoms or interests because of tobacco use, increased amount of time...

Immunological Suppression of Alveolar Macrophages in the Lungs of Habitual Marijuana Smokers

The finding that peripheral blood leukocytes collected from marijuana smokers express higher than normal levels of CB1 and CB2 mRNA (65), and that THC mediates distinct immunoregulatory effects when cultured with human leukocytes in vitro (68,86), provide only indirect evidence that marijuana smoking is associated with immunological consequences. The most compelling and direct evidence is provided by studies with AM recovered directly from the lungs of habitual marijuana users (Table 2 refs. 41 and 42). AM are the primary immune cells residing in the distal air spaces of the lung, where they take up and retain large amounts of inhaled tar (39). As previously described, AM recovered from the lungs of marijuana smokers were found to be significantly impaired in their ability to secrete pro-inflammatory cytokines and to phagocytose and kill S. aureus, whereas AM from tobacco smokers performed normally in these studies (41). It is very likely that THC, which is present only in the tar...

Big Tobacco Targets Young Smokers

Lawsuits against big tobacco companies in recent years have made confidential company documents available to the general public. The contents of these documents reveal that tobacco companies have targeted teens and young adults as replacement customers for the more than 400,000 smokers who die each year due to smoking-related diseases. Take a look at just a few of the quotes from these documents If you decide you don't want to be just another statistic in the big tobacco machine, take advantage of the resources listed in this chapter to quit smoking or become an antismoking activist. A nonprofit organization dedicated to providing research, education, advocacy, and service designed to prevent cancer and save lives. Provides information on the health risks associated with tobacco use. Provides materials designed to educate the public about causes of lung disease, including tobacco use. A valuable source of research on the dangers of smoking and on ways to stop. 1740 Broadway, 14th...

HPLC analysis of nicotine in cigarettes

On the packages of cigarettes, the amounts of nicotine and tar are described. The values show the amounts of nicotine and tar being contained in the smoke discharged from a piece of cigarettes, measured under a fixed condition using a smoking machine such a value for nicotine is called nicotine yield. Nowadays, the nicotine and tar yields for Japanese domestic cigarette brands are 0.1-2.4 mg and 1-24 mg, respectively the cigarettes with low nicotine yields are called low nicotine (tar) cigarettes. To minimize the damage to health by smoking, smokers tend to choose low nicotine yield cigarettes. However, actual amounts of nicotine being contained in a piece of cigarettes (nicotine content) are 7-24 mg 2 . Upon smoking the low nico tine cigarettes, the smokers unconsciously inhale the smoke to reach the lungs deeply, because such cigarettes give light feeling to them the deep inhalation results in the absorbed amounts of nicotine to be as large as 2-3 mg per piece, which are similar to...

Prevalence of cigarette smoking

The percentage of Americans who smoke cigarettes has declined steadily since the government first began compiling statistics on smoking in the mid-1960s. In 1965, nearly 45 percent of all adult Americans and more than half of all adult men smoked cigarettes. At that time, antismoking advocates began to voice the first public concerns about the health risks of smoking. The media and tobacco industry, however, portrayed smoking as glamorous, sexy, and sophisticated. Many of the biggest Hollywood stars smoked, and the rugged Marlboro man was one of the best-known cigarette advertising icons. As researchers began to publish more and more reports about the health dangers of smoking, increasing numbers of smokers gave up the habit. By 1980, about 35 percent of American adults were smokers, a reduction of more than 20 percent in 15 years. Ten years later, the figure was down to 25 percent. Since that time, the rate of decrease has slowed somewhat, and use among males has actually risen since...

Children whose mothers smoke cigarettes and use alcohol are more likely to abuse drugs than children whose fathers do so

The Facts The 2001 SAMHSA report Parental Influences of Adolescent Marijuana Use and the Baby Boom Generation declares that cigarette smoking and alcohol use by fathers had no impact on their children's substance use. In contrast, mothers' cigarette smoking and alcohol use had a significant influence. Children whose mothers smoked cigarettes and used alcohol were likely to be lifetime users of marijuana. From an early age, long before they have much exposure to their peers, children pick up on their parents' attitudes toward drugs. They not only observe how their parents use a variety of substances prescribed drugs, over-the-counter medications, nicotine (in cigarettes), alcohol but also listen to the way their parents talk about these substances. They also evaluate the extent to which their parents' actions match their words. Not surprisingly, teens whose parents abuse drugs or alcohol are significantly more likely to abuse drugs or alcohol themselves.

Ethnic differences in nicotine and cotinine metabolism

Ethnic differences in nicotine metabolism have been hypothesized to contribute to differences in health effects and or susceptibility to addiction in blacks versus whites (Henningfield et al. 1990). The intriguing observation has been made that cotinine levels per cigarette smoked were significantly higher in blacks versus whites (Wagenknecht et al. 1990). In contrast, plasma levels of thiocyanate, a marker of exposure to cigarette smoke in general, were similar. There is also evidence that blacks have higher rates of lung cancer for any given level of cigarette smoking compared with whites (Satariona and Swanson 1988). Ethnic differences in the metabolism of nicotine or cotinine could help explain these observations. To examine this issue, dual-labeled nicotine and cotinine infusions were administered to 40 black and 39 white smokers matched for age, gender, and self-reported cigarette consumption (Benowitz et al. 1995a). The clearance of nicotine and percentage of nicotine...

Deficient Coxidation Of Nicotine

While most people metabolize nicotine extensively into cotinine, a few individuals have been identified who generate very little cotinine. One such person, a 57-year-old woman, was identified in a smoking cessation trial. The subject was found to have unexpectedly low plasma concentrations of cotinine, but normal concentrations of nicotine (Benowitz et al. 1995b), both while smoking and while using nicotine patches. This individual was studied using a dual infusion of labeled nicotine and cotinine. As seen in figures 8a and 8b, little cotinine was generated from nicotine. The subject was found to convert only 9 percent of nicotine to cotinine, in contrast to the average 72 percent seen in the study described previously (Benowitz and Jacob 1994). This individual's clearance of nicotine was unusually low (6.5 mL min kg versus 17.2 mL min kg in 20 controls), the halflife was abnormally long (348 versus 138 min), and the formation clearance of cotinine for this individual was exceedingly...

Nicotine Disposition In Smokers And Nonsmokers

Cigarette smoke contains a variety of chemicals, including polycyclic aromatic hydrocarbons, that may affect the metabolism of various other drugs. For example, smokers are well known to have increased metabolic activity of liver CYP 1A2, which results in the accelerated metabolism of caffeine, theophylline, and other drugs (Dawson and Vestal 1982). Earlier research had suggested that smokers metabolize nicotine more rapidly than nonsmokers (Kyerematen et al. 1982, 1990). If true, this might be a significant factor in the natural history of tobacco addiction as a mechanism of metabolic tolerance. That is, the longer a person smoked, the faster nicotine would be metabolized therefore, one would have to smoke more to maintain a desired nicotine level in the body. The stable isotope technique described above was used to compare nicotine kinetics in smokers and nonsmokers (Benowitz and Jacob 1993). Labeled (S)-(-)-nicotine was infused intravenously for 30 minutes, and blood and urine...

Individual variation in nicotine and cotinine kinetics

As expected by analogy to other weak bases that are extensively metabolized, there is considerable individual variability in the clearance of nicotine. Early studies on nicotine kinetics were performed by infusing nicotine in smokers who were abstinent from tobacco (Benowitz et al. 1982 Rosenberg et al. 1980). However, it is most relevant to investigate the disposition kinetics of a drug in the chemical environment where the drug is normally used. Using labeled compounds, one can study the metabolism and kinetics of nicotine in smokers while they are smoking. To do so, deuterium-labeled analogs of nicotine (3',3'-dideuteronicotine, nicotine-d2) and cotinine (2,4,5,6-tetra-deuterocotinine, cotinine-d4), both with the natural (S)-configurations, have been synthesized. Concentrations of natural and labeled nicotine and cotinine, as well as their metabolites, are measured by gas chromatography mass spectrometry (GC MS). Comparing the pharmacokinetics of labeled and natural compounds, the...

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Nicotine is metabolized via cytochrome P450 (CYP 450) to nicotine iminium ion, and then by aldehyde oxidase to cotinine (figure 1). Cotinine is the major proximate metabolite of nicotine, with 70 to 80 percent of nicotine metabolized to cotinine in most smokers (Benowitz and Jacob 1994). Cotinine is, in turn, metabolized to trans-3'-hydroxy-cotine, which is the most abundant nicotine metabolite in the urine of most smokers. Nicotine-N'-oxide is formed via a flavoprotein enzyme and is a minor metabolite, averaging about 4 percent of the systemic nicotine dose (Benowitz et al. 1994). Nicotine, cotinine, and trans-3'-hydroxycotinine are also conjugated (Benowitz et al. 1994 Byrd et al. 1992). Nicotine and cotinine form quaternary N-glucuronides, whereas trans-3'-hydroxycotinine forms an O-glucuronide (figure 1). Figure 2 shows the average pattern of nicotine metabolism and urinary recovery, based on a study in individuals receiving nicotine at steady state via transdermal nicotine...

Individual Differences in Nicotine Kinetics and Metabolism in Humans

Cigarette smoking remains the major preventable cause of premature disability and death in developed countries (Peto et al. 1992). Cigarette smoking is maintained by addiction to nicotine. Nicotine addiction develops in most people before the age of 20 (Department of Health and Human Services 1994). Many youth experiment with cigarettes, but only about 25 percent of high school seniors become addicted smokers (Escobedo et al. 1993). Thus, there appears to be individual variability in susceptibility to nicotine addiction. In support of the idea of individual variability to nicotine addiction are twin studies showing genetic linkages for never smoking, for quitting (i.e., former smoker status), and even for being a light versus a heavy smoker (Carmelli et al. 1992). The basis for individual differences in susceptibility to addiction is unknown. Possible factors include differences in pharmacokinetics and metabolism of nicotine, pharmaco-dynamic differences, and factors related to...

Serotonergic Adaptations In Smokers

Serotonin (5-HT) regulates many bodily functions, including appetite85 and sleep (i.e., modulation of REM latency),86 and may be involved in initiation and maintenance of tobacco smoking. Drugs that enhance 5-HT levels facilitate smoking cessation in highly dependent smokers.87-89 In turn, nicotine has been shown to elevate 5-HT levels by stimulating 5-HT release through binding to the nAChR90 and inhibiting 5-HT reuptake.90,91 5-HT levels are further enhanced in the smoker's brain as a consequence of decreased monoamine oxidase-A (MAO-A the neuronal enzyme that serves to degrade 5-HT) activity.35 Similar decreases in MAO activity have been noted in platelets of smokers92 and support reports of twofold higher platelet 5-HT levels in smokers as compared to nonsmokers.93 In addition, nicotine has been shown to decrease platelet 5-HT release and inhibit 5-HT uptake.94 Active smokers excrete approximately 30 more 5-HT and 5-hydroxyindoleacetic acid (5-HIAA) as compared to never smokers...

Opioidergic Adaptations In Smokers

The endogenous opioid system is believed to be the primary common pathway for all drugs of abuse. However, the role of the opioid system in habitual tobacco smoking has only recently become of interest. Using the short-acting mu-opioid antagonist naloxone, some studies have found decreases in smoking behavior in short-term laboratory paradigms69,70 while others have reported no effect of naloxone on smoking behavior.71 The long-acting mu-opioid antagonist naltrexone has been studied more extensively and has been shown to reduce smoking behavior and craving for cigarettes.7273 When used in combination with the nicotine patch, naltrexone has been shown to reduce smoking behavior and tobacco craving74 and craving in response to cues,75 as well as to block some effects of nicotine.76 Evidence from clinical trials of naltrexone is equivocal with both positive74,77 and negative findings.78,79 Preclinical evidence suggests that the effects of naltrexone on cigarette smoking may be mediated...

GABAergic Adaptations In Smokers

GABA is a major neurotransmitter in the mammalian brain and controls neuronal excitability. It has been implicated in the addictive and withdrawal processes of nicotine dependence. Nicotine stimulates GABA release via modulation of nAChR on GABAergic neurons, which could lead to a decrease in inhibitory tone from GABAergic stimulation of GABAb autoreceptors.50 Alternatively, nicotine-induced alterations in the levels of neurosteroids that regulate GABAa receptors could also potentially lead to altered levels of GABA.51 Changes in GABA might also occur through nicotine's actions at the nAChR, which increases GABA release. Nicotine-induced GABA release is blocked by mecamylamine and dihydro-P-erythroidine and the effect is lost in the P2 knockout mice, suggesting that P2-nAChR mediates GABA release. The a7 nAChR antagonist, alpha bungarotoxin, did not alter release.52,53 Nicotine-induced GABA release has been demonstrated in the thalamus, hippocampus, and throughout the cerebral...

Dopaminergic Adaptations In Smokers

Alterations in dopamine (DA) levels are associated with the rewarding effects of abused substances including cigarettes. Specifically, the mesolimbic DA pathway, which originates in the ventral tegmental area (VTA) and projects to nucleus accumbens, is believed to be the primary reward pathway in the brain.30 nAChRs containing the alpha7 subunit (a7-nAChR) are abundant in the VTA. Stimulation of these receptors by nicotine or by endogenous acetylcholine, whose release was induced by nicotine or other components of cigarette smoke, produces an increase in glutamate concentrations which in turn stimulate N-methyl-D-aspartate receptors (NMDARs) on DA-containing neurons in the VTA, facilitating DA release and enhancing dopaminergic function in this critical brain reward area.31 a7-nAChRs are localized on glutamatergic terminals along with P2-nAChRs on gamma-aminobutyric acid (GABA) nerve terminals postsynaptic to DA neurons within the VTA. Additionally, P2-nAChRs are localized to DA cell...

Cholinergic Adaptations In Smokers

The nicotinic acetylcholine receptor (nAChR) is the initial site of action of nicotine. With the advent of in vivo imaging methods, such as single photon emission computed tomography (SPECT), the amount of nicotine occupying nAChR in brain after smoking a cigarette may be measured. The occupancy of nAChR containing the P2-subunit by nicotine after smoking one and two cigarettes has recently been determined using the nicotinic agonist radioligand 123I 5-IA-85380 and SPECT. Occupancy of P2-nAChR after smoking one cigarette ranged from 34 to 62 , while, after two cigarettes, the range was from 35 to 56 , both in a region-dependent manner. Interestingly, nicotine continually occupied P2-nAChR 1.8 to 6 h after smoking a cigarette even in the presence of continued radiotracer infusion (see Figure 3.1). The long-lasting occupancy of the P2-nAChR by nicotine raises important questions about the frequency of cigarette smoking. Specifically, why do smokers smoke cigarettes every 1 to 2 h if the...

Nicotineassociated Changes In Intracellular Signaling

At the cellular level, nicotine-induced changes in second messenger signaling are thought to support nicotine-associated changes in neurochemistry and behavioral phenotypes. Due to their putative roles in cellular processes underlying learning and memory (for detailed review, see References 112 and113), the extracellular regulated protein kinase (ERK) and cyclic AMP responsive element binding (CREB) signaling pathways have received the most attention for their potential roles in neuroplasticity underlying nicotine dependence (Figure 2.3).114-117 In vitro studies have shown that ERK is activated by nicotine treatment118 and is critical for nicotine-dependent activation of CREB119120 and tyrosine hydroxylase, the rate-limiting enzyme in DA synthesis.121122 In vivo studies show that regulation of ERK by nicotine is region and treatment specific.114116 Although acute administration of nicotine elevates levels of phosphorylated ERK (pERK) in the amygdala and prefrontal cortex,116 chronic...

Beyond the Role of DA in Nicotine Reinforcement

Although the research described thus far supports the tenet that nicotine reinforcement is regulated by the ability of nAChRs to enhance mesolimbic DA release, an accumulation of evidence questions the simplicity of this dogma. Despite treatment with neuroleptics that block DA receptor stimulation, the percentage of people with schizophrenia who smoke is several times greater than the population as a whole.3,5 In rats, the effects of intra-VTA infusion of nicotine on behavior are dose dependent animals display conditioned place aversion at low doses and CPP at steadily increasing doses of nicotine.80 The experimenters found that intra-accumbens and systemic administration of the neuroleptic, a-flupenthixol, reversed the conditioned aversive but not rewarding effects of nicotine, concluding that NAc dopamine regulates nicotine aversion and not reward.80 a-Flupenthixol, however, blocks both Gs-coupled, Dr and Gi-coupled, D2-type DA receptors, which are known to have opposite effects on...

Nicotine

Of the over 500 compounds in tobacco, the alkaloid nicotine is the most powerful, and the only addictive one. In fact, it is one of the most addictive substances known even more addicting than most hard drugs, such as heroin and one of the most toxic drugs known. Precautions Concentrated nicotine can enter the brain within seconds of smoking a cigarette, even faster than heroin injected into the arm. It is extremely addictive, and may contribute to Alzheimer's disease and other forms of dementia it is known to stimulate, and then block, sensory receptors, preventing the neurotransmission of new information. Common side effects of smoking are believed to include persistent cough, shortness of breath, elevated heart rate, increased salivation, irritated and damaged lung tissue, increased bronchial secretions, constriction of blood vessels, increased blood pressure, slightly enlarged pupils, overstimulation of the central nervous system, tremors, stroke, heart damage, visual impairment,...

Tobacco and Nicotine

Tobacco is one of the most powerful stimulant plants known, and nicotine its active principle is one of the most toxic of all drugs. An average cigar contains enough nicotine to kill several people. When tobacco is smoked, most of the nicotine is destroyed by the heat of burning. (To kill people with a cigar, you'd have to soak the cigar in water till it turned dark, then make people drink the liquid.) Nicotine is so strong and dangerous that the body very quickly develops tolerance to it to protect itself. If a person begins smoking regularly, tolerance to the poisonous effects of nicotine develops in a matter of hours (as compared to days or weeks for heroin and months for alcohol). In the form of cigarettes, tobacco is the most addictive drug known. It is harder to break the habit of smoking cigarettes than it is to stop using heroin or alcohol. Moreover, many people learn to use alcohol and heroin in nonaddictive ways, whereas very few cigarette smokers can avoid becoming addicts....

Famous Dead Smokers

A big part of the decision to start smoking has to do with how the smoker looks cool, rebellious, tough. Some very famous people have been smokers, many of whom have died due to smoking-related illnesses. See if you recognize any of the famous smokers below, or the diseases that killed them Lung cancer Lung cancer Tobacco products are widely available and legally sold in grocery stores, 24-hour convenience markets, gas stations, and many other shops to anyone over the age of 18. But it is important to remember that they contain a drug that is highly addictive nicotine. Nicotine can affect the way your body works now and how well it may function in the future. In this book, you will read about teens making decisions about smoking. You will learn more about how nicotine affects the body. You will learn about the legal issues surrounding nicotine and how these laws have changed over the years. You will find out some surprising statistics about nicotine and learn more about the people...

Lung Cancer

Despite the decades of awareness, and the introduction of newer therapies and treatment regimens, overall lung cancer survival rates remain low, and the urgency of replacing conventional approaches with novel or combination therapies exhibiting enhanced anti-cancer efficacy is now being recognized. The most telling statistic regarding lung cancer is that the annual number of deaths attributed to this disease continues to rise with each passing year (Fig. 1). This dual lack of success in both lung cancer treatment and prevention has garnered increasing attention with not only the popular media, but also among policy makers, recently prompting the U.S. Congress to declare lung cancer a national public health priority and eliciting a call for an inter-agency attack on the primary cause of cancer death. Apart from the inexorable increase in overall lung cancer deaths, another consideration is the shift in the frequency among the different types of lung cancer. Adenocarcinoma has emerged...

Tobacco Addiction

Tobacco addiction is complex, and involves behavioral as well as pharmacologic factors. The importance of nicotine in tobacco dependence has been demonstrated in many studies (Benowitz and Jacob 1990 Surgeon General 1988). However, the neurochemical mechanisms of nicotine tolerance and dependence are not known, and the possibility exists that a reactive metabolite may be involved. Thus, identification of nicotine-derived electrophilic metabolites that covalently modify human proteins may provide insight into the fundamental mechanisms underlying tobacco addiction. This is a largely unexplored area of research. Knowledge of the bioactivation as well as detoxication steps in the metabolism of nicotine may help

Nicotine Addiction

Taken in large enough amounts, nicotine can kill you. But the amount of nicotine in the average cigarette is very small only about 8 or 9 milligrams (to understand exactly how small an amount this is, remember that it takes more than 28,000 milligrams to equal 1 ounce). There may be 8 or 9 milligrams of nicotine in the average cigarette, but a smoker inhales even less. The amount of nicotine a smoker actually inhales from the average cigarette is between 1 and 1.5 milligrams. But even in this tiny amount, nicotine goes to work on your body, changing the way your brain and organs function. This is precisely why nicotine is so dangerous. Even in such small amounts, it proves addictive and alters your body's functioning. Nicotine is addictive both physically (your body becomes accustomed to a certain amount of nicotine in your system and suffers when that nicotine is withdrawn) and psychologically. Both addictions are difficult to break. Your body feels...

Teens Who Smoke

You may think you know everything there is to know about teens who smoke. But take a look at these statistics from the Centers for Disease Control and Prevention Early signs of heart disease and stroke can be found in teens who smoke. People who smoke live on average seven years less than those who never smoked. The resting heart rates of young smokers are two to three beats faster than those of nonsmokers. Teenage smokers are more likely to see doctors or other health care workers for emotional or psychological problems. Teens who smoke are three times more likely than non-smokers to use alcohol, eight times more likely to use marijuana, and 22 times more likely to use cocaine. tobacco habit worries you, and you would like to encourage the person to stop. In the next chapter, we will examine the ways in which nicotine addiction can be treated and the resources that are available for help.

A Target Nicotine

At last count 71.5 million people in the United States use some type of tobacco product.24 The effects of nicotine on the brain are complex, but it is well established that the drug stimulates the production of dopamine, a neurotransmitter that produces feelings of pleasure and euphoria. Cigarette smokers enjoy the pleasurable effects of this legal dopamine surge. An increasing number of nicotine users, however, are becoming concerned about the associated health problems each year two out of three cigarette smokers decide to try to quit smoking. For many, quitting smoking does not mean quitting nicotine. The leading products in the smoking cessation market are Nicotine Replacement Therapy (NRT) products, marketed by pharmaceutical company GlaxoSmithKline. NRT products are available in four different forms gum, patch, inhaler, and microtab.25 Products such as Nicorette gum and the NicoDerm CQ patch work by releasing nicotine into the body in a way that is reportedly less harmful than...

Resources That Can Help

Your health care provider, school counselor, or phone book can provide you with a list of local organizations and programs designed to help people stop smoking or give up tobacco products. There are also a number of national organizations that can provide helpful resources or information on quitting smoking. about the impact that their nicotine use is having on their health, both now and in the future. Be specific, but not confrontational, about how their smoking is causing you concern. Make sure to offer your support if they choose to quit. Offer your help in finding the right program to help them stop smoking. Understand that they may need to drastically change their routines to avoid situations that make them want to reach for a cigarette. Remember that a habit like smoking, particularly if it has been habit for many years, may take time to break and may require more than one attempt to stop. Most successful programs designed to help people give up their dependence on nicotine are...

Exploring Additional Resources

We have discussed how nicotine can affect your body. We have learned a bit about the history of tobacco use, particularly in the United States. We have examined some of the legal issues surrounding tobacco products and how those laws have changed. We have read about teens making decisions about tobacco products and learned more about who is likely to smoke or use tobacco and why. We have taken a look at some of the myths surrounding nicotine and discovered how, just like any drug, it can become addictive. We have discussed how nicotine acts in your body and why it is such an addictive drug. Most important, we have talked about what to do if you or a friend or family member would like to stop smoking. If you need assistance, support, or just more information about nicotine, smoking, or tobacco products, you'll find many resources available. Start with the adults you know a parent, a teacher, your school counselor, a minister, or your doctor or nurse may be able to provide support or...

Teenage Trends and Attitudes

Every day, approximately 4,800 young people between the ages of 11 and 17 will smoke their first cigarette. Of these, almost half will become regular smokers. These teens don't start out smoking with the hope that they will become addicted to nicotine. They smoke because they think it will make them more popular or somehow help them to fit in with their friends and peers. They begin smoking because they believe that smoking will somehow make them feel better about themselves. For some, smoking can be a gesture of independence, a way to signal that no adult can make your decisions for you. It may be a way to break the rules. Teens may choose to smoke in response to advertisements. Even though it is illegal to target underage smokers in advertising campaigns, promotional marketing of cigarettes is intended to depict a happier, more glamorous lifestyle for those who smoke. Movies that show popular actors and actresses smoking contribute to this image-building and convey the idea that...

Smoking The Rest of the Story

In a study of 557 high school students 13 to 19 years old, researchers found several important differences between smokers and nonsmokers Smokers were two times more likely to have suffered from daily coughing spells for more than three months. Smokers were three times more likely to have increased amounts of phlegm every day. Smokers were two times more likely to feel shortness of breath when hurrying. Smokers were more likely to have experience wheezing or asthma and to have had a chest cold that lasted for a week than nonsmokers. Besides the direct consequences of smoking, there are other indirect consequences of smoking that should make any teen who is thinking about smoking think again. Research has shown that smoking is a risk factor for other drug use. This means that cigarette smoking is often a first step to other illegal behavior drinking alcohol and using other illegal drugs. Many studies have demonstrated that people who use illegal drugs such as marijuana or cocaine began...

How smoking creates wrinkles continued

Cigarette smoking also causes heart disease and stroke in adults. Although these diseases are less common in younger smokers, studies have shown that young smokers begin the process, with many developing early signs of cardiovascular disease as young adults. Some studies have also indicated that young smokers develop increased levels of cholesterol, leading to a greater risk for developing heart disease. If you are an athlete or enjoy any sport, you need to be aware that smoking affects both your performance and your endurance. When you smoke a cigarette, you reduce the oxygen carrying capacity of your blood. You are also increasing your heart rate and basal metabolic rate in a sense, working against the very benefits of exercise. Studies of teenage runners show that those who smoked were unable to match the times and distances of nonsmokers. For the smoker, this is one time that your heart doesn't lie. The hearts of young smokers are slightly different from those of nonsmokers. On...

How smoking creates wrinkles

A British doctor named Douglas Model coined the term smoker's face in 1985 to describe the wrinkling and premature aging associated with smoking. In fact, the smoker's face phenomenon was so common and distinct that Model was able to identify more than half of the smokers with a 10-year-old habit that he saw in his clinic simply by looking at their faces. The telltale characteristics of smoking that he observed were prune-like facial wrinkles radiating at right angles from the smokers' lips and eyes gaunt, bony facial features and a slightly pigmented, gray appearance to the skin.

Thinking About Smoking

Thinking About Smoking

But smoking is more than just an image, and anyone who has seen a friend or family member struggle with the health problems caused by a lifetime of smoking knows that smokers pay a price for their habit. What we don't see in the movies are the discolored teeth and fingers, the phlegm (mucus)-filled cough, and the rasping voice all of which reveal the true results of smoking. Smoking is more than just a habit, more than just looking good. It is addictive. Cigarette smoking is the leading cause of preventable death. According to the U.S. Centers for Disease Control and Prevention, more than 400,000 people die every year from smoking-related diseases more than the annual deaths caused by alcohol, AIDS, traffic accidents, drug abuse, murder, and suicide combined. And even more people are affected secondhand, suffering health problems caused by exposure to the smoking of others. A cigarette is a thin roll of finely chopped tobacco wrapped in paper. It is also what scientists refer to as a...

[ Further Reading

American Council on Science and Health. Cigarettes What the Warning Label Doesn't Tell You. Amherst, NY Prometheus Books, 1997. MacDonald, Joan V. Tobacco and Nicotine Drug Dangers. Berkeley Heights, NJ Enslow Publishers, 2001. Nicotine Free Kids www.nicotinefreekids.com 38-39, 41-43, 67 and Nader, 33-34 and nicotine level in cigarettes, 38 and secondhand smoke, 56-59 and Surgeon Generals' reports, 32-33, 36, and tax on cigarettes, 29, 32, 33, 35, 36, 60 Cigarettes 24-25, 26 ingredients in, 11-13 as machine-rolled, 26 manufacturers adjusting nicotine content in, 13, 38 smoke from, 11-12, 13 Cigarillos, 14 Cigarito, 24 packs, 33, 36 and list of additives in cigarettes, 38 Coronas, 14 Depressant, nicotine as, campaign Nicotine stopping smoking, 83 Health effects of nicotine and cigarettes in and cigarettes in U.S., and lung cancer, 13, stopping smoking, 82- Kent cigarettes, 32 Koop, C. Everet, 37 Ligett Group, 39, 41 Ligett & Myers, 28 Loews, 39 Lorillard, 39 Lung cancer, 29-31, 32,...

Bibliography

American Council on Science and Health. Cigarettes What the Warning Label Doesn't Tell You. Amherst, NY Prometheus Books, 1997. Lynch, Barbara S. and Bonnie, Richard J., eds. Growing Up Tobacco Free Preventing Nicotine Addiction in Children and Youths. Washington, DC National Academy Press, 1994. Parker-Pope, Tara. Cigarettes Anatomy of an Industry from Seed to Smoke. New York The New Press, 2001. U.S. Dept. of Health and Human Services. Preventing Tobacco Use Among Young People A Report of the Surgeon General. Atlanta, GA U.S. Dept. of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 1994. U.S. Dept. of Health and Human Services. Smoking Cessation. Rockville, MD Public Health Service, Agency for Health Care Policy and Research, 1996. www.nicotine-anonymous.org www.nicotinefreekids.com

Highlights in the History of Cannabis

Humans use nearly every part of the infamous green weed Cannabis sativa. The plant grows quickly in many environments and can reach a height of 20 feet. Few natural pests attack the crop few extremes in weather challenge its growth. The leaves consist of five or more narrow leaflets, each radiating from a slender stem attached to a thick, hollow stalk. The jagged edge of each leaflet resembles the blade of a serrated knife. The species is dioecious, meaning both female and male varieties of the plant exist. The male grows taller, topped by flowers covered with pollen. The shorter female plant, with its larger, pollen-catching flowers, produces seeds and protects them with a sticky resin. The stalks help produce fiber the seeds provide food and oil. The flowers, leaves, and resin appear in medical and intoxicating preparations. Each day, smiling teens buy hemp shirts. Retailers sell snacks made from the seed. Glaucoma patients puff cannabis cigarettes in hope of saving their sight, and...

Introduction

During a job interview, have you ever been asked to piss for your new employer New applicants for many of the Fortune 500 corporations are now being forced to take a drug test. Drug byproducts can be detected in urine, blood, hair, external residue, and even perspiration Drugs aren't the only things they test for employers are using urinalysis to test women for pregnancy. Pregnant women are getting laid off or denied employment after taking such a test. Parents are spying on their children. The DOD Directive requires the military to screen all active duty members annually. If you don't want to be a victim of the drug war, this text will help you. If you are well known, this text may protect your reputation. I strongly recommended that drug users (pot smokers in particular) read this. Other drugs are covered as well, but marijuana is the main focus of this paper.

Gender Differences and Serum Drug Concentrations

Theophylline is metabolized by CYP1A2. In one study involving 24 subjects, it was observed that theophylline metabolism is faster in women than in men (6 h in female non-smoker vs. 9.3 h in male non-smokers) (46). Phenytoin and naproxen are mainly metabolized by CYP2C9. Rugstad et al. (47) reported that there was an increase in plasma naproxen concentrations with age and that females also had higher plasma concentrations of naproxen compared with males. Although women showed slightly lower concentration of phenytoin compared with men when corrected for body weight and height, the difference was not statistically significant (48). The activity of CYP2C19 may be higher in males than in females. The metabolism of mephobarbital was significantly faster in males than in females when compared after a single oral dose of 400 mg of the drug. The sex difference was more significant with the R-enantiomer (49). Clomipramine, which is metabolized by CYP2D6 and CYP2C19, has a higher clearance rate...

Rates Of Teen Drug Abuse

The Monitoring the Future study shows that substance abuse in the United States is a problem as early as eighth grade. According to the survey, 27.7 percent of eighth-grade students had tried illicit drugs, and 10.1 percent had used drugs in the previous 30 days. The study also found abuse of substances other than illegal drugs. Over 70 percent of all 12th graders reported having used alcohol at least once, and 44.4 percent had used it in the previous 30 days. Among eighth graders, 38.9 percent had used alcohol at least once, and 15.9 percent admitted to using it within 30 days of the survey. Almost one-half (46.2 percent) of 12th graders had tried cigarettes, as had 22.1 percent of eighth graders.

Current Findings About Marijuana

Studies have demonstrated that tolerance and withdrawal develop with daily use of large doses of marijuana or THC (Haney et al. 1999a Jones and Benowitz 1976 Kouri and Pope 2000). About 15 percent of people who acknowledge moderate-to-heavy use reported a withdrawal syndrome with symptoms of nervousness, sleep disturbance, and appetite change (Wiesbeck et al. 1996). Many adults who are marijuana dependent report affective (i.e., mood) symptoms and craving during periods of abstinence when they present for treatment (Budney et al. 1999). The contribution of physical dependence to chronic marijuana use is not yet clear, but the existence of a dependence syndrome is fairly certain. An Epidemiological Catchment Area study conducted in Baltimore found that 6 percent of people who used marijuana met Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) (American Psychiatric Association 1994), criteria for dependence and 7 percent met DSM-IV criteria for substance...

Acute adverse effects of cannabis

Undoubtedly those that give the greatest concern in considering its medical uses (7R, 8RS, 10ER). All of the CNS effects of THC, both the desired medical actions and the undesired psychological effects, appear to be mediated through a single type of brain receptor, the CB1 cannabi-noid receptor. This was illustrated, for example, by a well-controlled study in 63 healthy cannabis users, who received either the CB1 receptor antagonist rimonabant (SR141716A) or placebo and smoked either a THC-containing or a placebo marijuana cigarette (12C ). Rimon-abant blocked the acute psychological effects of the active cigarettes, but when given alone (with placebo cigarettes) produced no significant psychological effects. In many of the medical applications that have been assessed to date, unwanted psychological adverse effects have been blamed as the main cause of patients' rejection of the drug as unacceptable. Patients who have had no prior experience with cannabis often find its intoxicant...

Forms Of Cannabis The Plant And The Preparations

Cannabis preparations are primarily derived from the female plant of Cannabis sativa. The plant contains dozens of different cannabinoids (ElSohly, 2002 Iversen, 2007), but the primary psychoactive constituent in cannabis products is delta-9-tetrahydrocannabinol (THC) (Iversen, 2007 Pertwee, 2008). Administration of THC in pure form produces psychological and physical effects that are similar to those users report when they are smoking cannabis (Wachtel et al., 2002), and drugs that block the effects of THC on brain receptors also block the effects of cannabis in animals (Pertwee, 2008) and humans (Heustis et al., 2001). The effects of THC may also be modulated by cannabidiol (CBD), a nonpsychoactive compound that is found in varying amounts in most cannabis products (Iversen, 2007). Cannabis is usually smoked in a joint, the size of a cigarette, or in a water pipe, with tobacco sometimes added to assist with burning. A typical joint contains between 0.25 and 0.75g of cannabis. The...

Stepping Stones Gateways and the Prevention of Drug Problems

Researchers, theorists, politicians, and parents have all expressed concern about marijuana's potential to lead to the use of drugs with worse negative consequences. Proponents of these stepping-stone and gateway theories suggest that even if the adverse effects of marijuana are minimal, the drug can still cause trouble by ushering users toward the consumption of other illicit substances, including heroin and crack. According to this premise, marijuana should remain a primary concern because these other drugs create so many hardships. Comparable arguments appear against underage drinking and cigarette smoking. The gateway and steppingstone theories have generated considerable research and debate for many years. The research remains difficult to evaluate without clear definitions of a stepping-stone and gateway. Interpreting this literature requires a good understanding of causality. Many popular reports confuse the causes of drug use with simple precursors. Confusion about the actual...

Syndromes of Anxiety and Their Treatment

In sodas and chocolate, not just coffee and tea. Although you may feel calmer when you first drink alcohol, it causes a rebound anxiety when it wears off that may last for some days. The act of smoking may be a habit that relaxes you, but the nicotine in tobacco worsens anxiety. Cocaine, hallucinogenics, and amphetamines can make people acutely anxious during the period of intoxication.

Pregnancy Category None

Typically toad venom is harvested, dried, and smoked. One authority says that swallowing enough venom to cause hallucinations would be fatal. Smokers, however, are apparently not automatically poisoned by the product, although reportedly some persons have instantly passed out upon inhaling the smoke. Smokers have reported altered consciousness and hallucinations involving sight, sound, smell, and touch. In research studies volunteers who took bufotenine have experienced psychedelic effects, such as mild visual hallucinations (seeing geometric shapes), distortions of time and space, and intense emotional experiences.

USA Availability Prescription and nonprescription drug also in food Pregnancy Category C

Loss of bone density in older women studies controlling other factors (such as cigarettes and drugs promoting calcium loss) found that caffeine had no tendency to reduce bone density, but one study published in 2000 and tracking almost 35,000 postmenopausal women found a slight correlation of caffeine usage to broken bones a correlation implying loss of density. Coffee drinking is associated with loss of density. In contrast, examination of over 1,200 older women in England showed that tea drinkers were less likely to have osteoporosis, leading investigators to wonder if something in tea, other than caffeine, affects bone density. Drug interactions. Caffeine itself can reduce headache, and an experiment involving hundreds of participants showed caffeine to substantially improve ibuprofen's ability to relieve headache. Phenylpropanolamine is a drug commonly found in remedies for colds. It seems to increase caffeine levels in a person using both drugs, and together the two can produce...

Case Study Aerosol Delivery Of Camptothecin Analogues

This same liposomal 9-NC-DLPC aerosol system was also studied in a phase I trial in patients with advanced pulmonary malignancies (60,61). Patients were eligible if they had primary or metastatic cancer in the lungs, had failed standard chemotherapy regimens for their disease, exhibited normal bone marrow function along with normal hepatic and renal functions, had no known respiratory disease other than cancer, and possessed acceptable pulmonary function. Treatment in the feasibility cohort consisted of 6.7 mg kg day 9-NC in aerosol reservoir (nebulizer) for 60min per day for 5 consecutive days week for 1,2,4, or 6 weeks, followed by observation for 2 weeks. For the phase I portion of the study, doses were increased stepwise from 6.7 up to 26.6 mg kg day for 5 consecutive days for 8 weeks followed by 2 weeks rest. Twenty five patients received treatment. Does-limiting toxicity was chemical induced pharyngitis seen in two of the patients at the highest dosage (26.6 mg kg day). At 20.0...

Potential Effects Of Airway Obstruction And Concurrent Lung Disease

Moreover, tumor masses within the airways are likely to cause changes in airflow patterns. Under these conditions, aerosol deposition in the airways and lungs deviates from that observed in healthy individuals, a scenario that is not unique to aerosol delivery for lung cancer treatment. Most marketed inhaler systems are designed for use in pulmonary diseases with varying degrees of obstruction and abnormal lung function (i.e. asthma, cystic fibrosis, etc.). The presence of airway obstruction and tumors in the airway lumen will lead to increased turbulence and higher resistance to flow. This is generally known to result in the removal of more particles (specifically smaller particles) from the inhaled aerosol. Accordingly, for pulmonary delivery of chemotherapy aerosols, the particle size distributions and breathing parameters will need to be specifically engineered and controlled for these conditions. In fact, breathing parameters may be identified in which tumor targeting...

Long Term Effects Tumorigenicity

A mortality study among workers engaged in producing chromium compounds from chromite, performed using retrospective data (21), showed a significantly increased risk of lung cancer, despite cessation of exposure. The risk of nasal cavity sinus cancer was also significantly increased.

Table 2 Daily smoked dosages

The national average weight of a cannabis cigarette ranges from 0.5 to one gram each, according to NIDA, the federal National Institute on Drug Abuse. Some patients consume small cigarettes to conserve their medicine, but for a patient who consumes one gram cigarettes, an ounce (28.3 grams) offers less than one cigarette per day for a month. Furthermore, stem and possibly seeds must be cleaned out of cannabis before it is used. A patient who gets 24 cleaned grams per ounce can roll 30 cigarettes at 0.8 grams each, one per day for a month. However, many patients must smoke cannabis throughout the day. Three to five average-size cannabis cigarettes per day comes to about one ounce a week, or 3.25 pounds in a year.

Common Use Drugs Alcohol Tobacco and Caffeine

Until recently, tobacco and tobacco-containing products were primarily regulated by taxation. The exceptions were few and far between, such as the execution of tobacco smokers in seventeenth-century Russia and Turkey, mentioned earlier, and, in the New World, the prohibition of public smoking in certain colonial communities of Massachusetts. By and large, however, American tobacco regulation began in earnest with the control of production, eventually shifting to taxation and the generation of revenue, and finally focusing on consumption. Tobacco production was first regulated in the early eighteenth century by the establishment of a staterun warehouse system to enforce inspection. Ostensibly to control quality, the warehouse system served the interests of planters who dominated the economy. Although a federal excise tax was imposed on snuff in the wake of the American Revolution, most tobacco products remained free of taxation until the time of the Civil War, when cigars and...

Summary And Conclusion

Individual differences in susceptibility to nicotine addiction, the likelihood of successful smoking cessation, and the development of adverse health effects of smoking are well recognized. The basis for these individual differences is as yet unknown. This chapter examines individual differences in the metabolism and kinetics of nicotine as a possible factor. Rare individuals appear to be deficient metabolizers of nicotine. Individual differences are described both in the pattern and rates of nicotine metabolism. Ethnic differences in cotinine metabolism have also been observed. However, the enzymes responsible for nicotine metabolism and their genetic regulation have not been fully characterized. Understanding the basis for individual differences in nicotine kinetics and metabolism, and linking these differences to pharmacodynamic studies, may provide important clues for the prevention and treatment of nicotine and possibly other drug addictions.

Self Perpetuating Lies

At the dawn of the 1990s, the most extravagant and ridiculous attacks on the hemp plant drew national media attention - such as a study widely reported by health journals* in 1989 that claimed marijuana smokers put on about a half a pound of weight per day. Now in 1998, they just want to duck the issue.

Withdrawal and dependence

In humans, early uncontrolled and more recently, controlled studies, have also demonstrated dependence and withdrawal symptoms (Compton et al., 1996 Crowley et al., 1998 Haney et al., 1999 Kouri et al., 1999). The fact that a clear abstinence syndrome has only been shown recently, may be related to the generally much higher concentrations of THC found in marijuana cigarettes (joints) (Ashton, 1999 Iversen, 2000).

Rewarding Incentive Effects

The nAChR agonist nicotine acts on dopaminergic pathways (see Fig. 1) implicated in the rewarding or the incentive-motivational effects of stimuli such as food, play, or copulatory opportunity.70,88 Notably, nicotine's action in this incentive approach system and the conditioned effect associated with this action is used to explain the acquisition and maintenance of compulsive tobacco use,44,45,80 and the over 95 relapse rate following abstinence without pharmacotherapy.16,17 Animal models such as self-administration and intracranial self-stimulation have been employed to elucidate the behavioral and neurobiological processes underlying these effects of nicotine.15,46,69,81 For example, rodents and nonhuman primates prepared with an intravenous catheter will press more on a lever that produces contiguous intravenous delivery of nicotine.22,39 The differential increase in responding (self-administration) maintained by nicotine requires normal functioning of the system outline in Figure...

Amazonian Indians as Psychopharmacologists

When properly performed according to the sacred traditions, the entire yaje ritual, from the initial cutting of the vine and the preparation of the drink to the interpretation of the hallucinogenic effects, is highly formalized and circumscribed from beginning to end by a series of ceremonial requirements and taboos. The pottery vessel that will hold the liquid is a ceremonial object symbolizing the maternal womb and the creative process of gestation. The different symbols with which it is decorated represent fertilization and fecundity, including, on its base, a painted vagina and clitoris. Before the vessel can be used it must be ritually purified with tobacco smoke.

Lung Function Parameters

Smoking, ethnicity, weight or height can have a marked impact on lung function (56,57). Patients with diabetes have an unexplained decrease in lung function compared to those subjects without diabetes (58,59). In one study, the forced vital capacity (FVC) and FEV1 were approximately 8 lower in diabetic individuals compared to non-diabetics (58). This difference is similar to the difference seen between smokers and a subject who has never smoked.

EcstasyA Stepping Stone to Other Drugs

The use of Ecstasy may be associated with the use of other drugs for a variety of purposes, particularly to overcome the stimulant effects of Ecstasy and allow for sleep (to come down from the drug) or to prolong and strengthen the stimulant effects and avoid sleep. For the first purpose, benzodiazepines (minor tranquilizers, such as diazepam which is also known as Valium), alcohol, and cannabis often are used. There also has been a rapid rise in smoking heroin for this purpose in the United Kingdom, possibly owing to a massive increase in supply. For the second purpose, amphetamines and cocaine are used. There is a link between taking Ecstasy and a desire to smoke cigarettes excessively, which may be related to the effect of these drugs upon dopamine pleasure systems in the brain.

Effects of Chronic Marijuana Consumption

Acute marijuana intoxication alters thought and memory. Many researchers have investigated the effects of chronic use of marijuana on these cognitive functions, too. If a single dose of the drug leads to impairments, perhaps consistent use would lead to comparable deficits, even after intoxication has worn off. Most human studies compare people who smoked marijuana daily for many years to others who report never using the drug. Although much of this work reveals no gross impairment in chronic users, some studies report lower test scores or deviant brain waves in those who smoke daily for extended periods. Interpretations and critiques of these studies vary with their results. Studies that find that chronic smokers perform as well as others are often criticized for having inadequate samples or insensitive tests. Critics of studies that reveal deficits in chronic smokers also focus on the people studied and the tests employed. A review of these critiques appears first, followed by...

The Context for Motivational Interviewing and Skills Training

It is important for the counselor to show genuine interest in the client's perspectives on and skills for making change. For example, if the client has quit smoking tobacco, lost a lot of weight, or left a destructive relationship, the counselor explores these experiences to reinforce and highlight the client's capacity and desire for self-development. Self-change advice may be in the form of a brief written handout concerning behavioral changes. Sessions 1 and 2 provide several take-home handouts that reinforce motivational advice given by the counselor during the sessions. These handouts are available at the end of this section.

Addictive Drugs Disrupt Neurotransmission

The following sections explain what neuroscientists know about how alcohol, nicotine, and other drugs that people abuse change the brain during intoxication and over time. The text is divided into broad categories with discussions about the commonly abused drugs in each category. Drugs are categorized in a number of different ways. Some categories agonists and antagonists are defined by what drugs do when they bind to receptors. Other categories depressants and stimulants are defined by their overall effect on the nervous system. Still other categories designer drugs are defined by how drugs are made. The category of inhalants is defined by how people take them. Finally, there is phencyclidine, which has such complex actions it does not fit conveniently into any category.

Why Drugs Can Change The Way Neurons Communicate

On first examination, undertaking such an exploration may seem overwhelming. Many of the drugs people abuse have a wide variety of effects. For example, the description of all the effects that opiates exert on the brain and body occupies several pages of very small print in a comprehensive pharmacology textbook. Nicotine and alcohol are just as complex. You might therefore assume that it takes dozens and dozens of different kinds of neurotransmitters and receptors to produce this large assortment of drug effects. But it does not. The diversity of a drug's actions is not necessarily matched by a similar diversity in its synaptic effects. Moreover, the number of specific actions a drug exerts can be entirely unrelated to the number of different kinds of receptors with which the drug interacts. In fact, we need only refer to about a dozen different kinds of receptors to explain almost all of the effects of the commonly abused drugs. Some drugs with numerous effects, such as opiates or...

Insufficient Sample Sizes

The first critique of studies that reveal no changes in cognitive function in chronic marijuana smokers concerns the number of people studied. Some research that fails to show marijuanarelated cognitive deficits may not employ enough participants. Research cannot reveal effects without a sufficient number of data points. Some investigators who report no effect of chronic use assessed as few as 10 people (e.g., Schaeffer, Andrysiak, & Ungerleider, 1981). Detecting large differences between users and nonusers likely requires at least 25 from each group (Cohen, 1990). The obvious solution to this problem is to study more people.

Pharmacokinetic Effects

Absorption of TCAs can be inhibited by cholestyramine, which therefore must be given at different time intervals than the antidepressants. Specific substances reported to increase TCA levels include fluoxetine, antipsychotic medications, methylphenidate, and cimetidine. Methylphenidate has been combined with desipramine to treat attention deficits and depression in children. The combination therapy had a higher incidence of ECG changes (particularly higher ventricular rates), nausea, dry mouth, and tremor. Enzyme inducers that can lower tricyclic agent levels include phenobarbital and carbamazepine. The nicotine from cigarettes can also induce enzyme activity.

Production of Smoke Condensate

The cigarettes to be smoked were first conditioned at 24 1 C and 60 5 relative humidity. The average weight of a marijuana cigarette was 1.1 g. The smoking machine used was designed to automatically load, light, smoke, and eject approx 2000 cigarettes per hour and take a maximum of 10 puffs per cigarette at the rate of Sparacino et al. (3) prepared cigarettes from Mexican marijuana containing 1.3 A9-THC (labeled as low dose) and 4.4 A9-THC (labeled as high dose) using low-porosity street cigarette papers. Standard research tobacco cigarettes were also prepared. Marijuana and tobacco cigarettes were used to generate smoke condensates under constant draft or intermittent puff smoking modes. The evaluation of smoke condensates from these two systems would provide a qualitative and quantitative range within which the various components of the marijuana smoke actually experienced by human smokers might be found. The cigarette smoking was conducted at flow rates of 1200 mL per minute for...

Neuromancing With Neuroscience

Of particular interest to neuropsychologists is the detailed study of the brain (one component of the nervous system) and the way in which the brain's particular neurons function in order to produce thinking and behaviour. Since psychoactive substances are known to effect the way brain neurons process information, neuropsychology has made some headway into understanding the chemistry of the brain and the actual way in which psychoactive substances work. Thus, we now know something about how common psychoactive substances like tea, coffee, nicotine and alcohol interact with the brain's neuronal architecture to cause their desired psychological effects of stimulation or stupor.

Tissue Levels of Anandamide Continued

Wild-type control mice, although Maccarrone, Attina, Bari, et al. (2001) did not find any difference in the amounts of anandamide in the hippocampus and cortex between control and CBj-receptor-knockout mice. Di Marzo, Berrendero, et al. (2000) reported that the levels of anandamide in the limbic forebrain of A9-THC-tolerant rats were higher than those of normal rats, and the levels of anandamide and 2-AG in the striatum of the A9-THC-tolerant rats were lower than those of normal animals. Recently, Gonzalez et al. (2002) also reported changes in the levels of anandamide (increase or decrease) in various brain regions of the rat following chronic exposure to nicotine, ethanol, and cocaine.

See also Benzodiazepines General Information

Diazepam produces less sedation in cigarette smokers, and higher (not lower, as stated in SEDA-20) doses may be required for the same sedative or anxiolytic effect. Owing in part to its continued widespread use, several unusual adverse effects of diazepam continue to be reported. These include cases of urinary retention and compartment syndrome, which are not explicable by its pharmacology. On the other hand, accumulation of diazepam and attendant complications of obtundation and respiratory depression may be understood in terms of its long half-life, particularly in elderly people and medically ill patients. Caution about the intravenous use of diazepam comes from a study that showed cardiac dysrhythmias (mainly ventricular extra beats) in a quarter of oral surgery patients midazolam and lorazepam were much safer (1).

Contaminated Group Membership

Another critique of studies that fail to find differences concerns the validity of the reports of use. Given the social and legal attitudes against the drug, perhaps some users misrepresent themselves as nonusers. If marijuana genuinely caused a deficit, these incorrectly categorized smokers could lower the average score of

Assessment and some comments on the method

The Konig's coloration method seems specific for cyanide, but thiocyanic acid (HSCN) markedly interferes with the above color development 10 . Thiocyanic acid also reacts with chloramine T to produce chlorocyanogen, which is not negligible. When a specimen containing thiocyanic acid is directly color-developed by the pyridine-pyrazolone method without extraction, it suffers from overestimated values of cyanide due to the false-positive reaction. Blood and serum contain much higher concentrations of thiocyanic acid than that of cyanide (> Table 3.1) in saliva, its concentrations are even higher. The concentrations of thiocyanic acid in blood and saliva of smokers are significantly higher than those of non-smokers therefore, thiocyanic acid levels are being used as an indicator of smoking. To avoid such false-positive reaction, pretreatments of specimens, such as distillation, purging and diffusion, are essential to extract cyanide from the matrix. Thiocyanic acid is not volatile...

Understanding legalisation as regulation and control

Can sell and has access to drugs, and when and where they may be consumed. Civil or criminal sanctions would still be incurred when activities occur outside of these legal frameworks, as is the case with, for example, underage sales of alcohol or cigarettes. Public consumption of drugs could remain illegal. Transform recognises that these regulations do not make drug use safe. Drug use can never be risk-free but opportunities to reduce some risks can be created through regulation and control.

Harm Reduction Efforts

A comprehensive harm-minimisation approach must take into account three interacting components the individuals and the communities involved their social, cultural, physical, legal and economic environment and the drug itself. Harm minimisation approaches will vary according to the nature of the problem, the population group, the time and the locality. For example, strategies that aim to reduce harm for under-age drinkers will differ from strategies that target older smokers. Similarly, different strategies may be appropriate to accommodate the needs of injecting drug users living in rural Queensland and those living in metropolitan Sydney.

It Is the Mind of

From the cyberian perspective, that's exactly what's going on so computer programmers must learn not to give any hair or bodily fluids to their employers. The confiscated parts are being analyzed in scientific 'rituals' that look into the employee's past and determine whether she has engaged in her own rituals - like smoking pot - that have been deemed heretical by the dominating religious body. In this case, that dominating body is the defense industry, and the heretics are pot smokers and psychedelics users, who have demonstrated a propensity to question the justifiability of the war machine.

Introduction and background

Aliphatic cyclic tertiary amines constitute a major class of naturally occurring and synthetic drugs directed at central biogenic amine receptors. Microsomal metabolism of these amines is known to be associated with low levels of covalent binding and or suicide inactivation of the pertinent metabolizing P-450 isozymes two of the more notorious examples are phencyclidine (1-(1-phenylcyclohexyl)piperidine) (PCP) (Hoag et al. 1984) and nicotine (Shigenaga et al. 1988). nucleophiles. Also, although nicotine- 1(5)-iminium forms a p-methylthiophenol adduct (Brandange and Lindblom 1979a), the iminium does not bind to nucleophilic polyamino acids except polycysteine, and this only in the presence of O2 (Obach and Van Vunakis 1988). Unpublished studies from the authors' laboratory indicate that simple cyclic iminium species form stable covalent adducts with typical bionucleophiles only under special conditions, and no evidence has been obtained for the persistent binding of iminium species...

Directacting Cholinomimetics

Direct-acting cholinomimetics are drugs that act directly by stimulating cholinergic receptors. These drugs are divided into drugs that stimulate muscarinic (M-cholinoreceptors) or nicotinic (N-cholinoreceptors) receptors. Drugs whose efficacy is primarily connected to stimulation of muscarinic receptors, including choline esters, i.e. acetylcholine and its structural analogues, which are methacholine, carbacholine, betanechol, and natural alkaloids muscarine and pilocarpine. Drugs whose action is based on stimulation of nicotinic receptors include the alkaloids nicotine and lobeline.

Overview of Critiques of Studies That Reveal Deficits in Chronic Users

A review of potential limitations can help the interpretation of studies that reveal deficits in chronic cannabis users. Any deficits found in marijuana smokers may serve as evidence that the drug impairs function, but other explanations remain tenable. Similar to the critiques of studies that find no differences between groups, critics of the research that reveals deficits generally focus on the samples and tests employed. For example, the chronic users may have differed from the nonusers prior to ever smoking marijuana. In addition, the chronic users may have used drugs other than marijuana that might create these impairments. Participants also may have been intoxicated during testing, transforming the study of chronic effects into a study of acute effects. In addition, the

Natural nicotinic alkaloids

Nicotine Nicotine, 1-methyl-2-(3-piridyl)pirrolidine (13.1.27), is an alkaloid that is isolated from the plant Nicotiana (Nicotiana tabacum, Nicotiana rustica, and others) and can be synthesized in various ways 33-36 . In particular, it is proposed to proceed from nicotinic acid ethyl ester, which is condensed with N-methylpyrrolidone, giving 1-methyl-2-nicotinoyl pyrrolidone-2 (13.1.23). Acidic hydrolysis of this compound leads to an opening of the pyrrolidine ring giving the intermediate (13.1.24), which under the reaction conditions is decarboxylated to the -aminoketone (13.1.25). The carbonyl group is reduced to an alcohol and the resulting product (13.1.26) undergoes dehydration to nicotine (13.1.27).

Intoxication During Testing

Despite researchers' requests and financial incentives, chronic daily users may remain unwilling to abstain from cannabis on the day of an experiment. People who smoke marijuana every day for years may be unlikely to stop simply because a scientist wants them to draw lines, arrange blocks, and memorize words. Without this abstinence, the comparison between chronic users and nonusers essentially becomes a study of intoxication. Given the data on acute effects, studies of chronic effects must clearly occur when all participants are no longer under the influence of the drug. Otherwise, any deficits in chronic users could arise from their current intoxication instead of any impact of long-term consumption. Ensuring this abstinence is extremely difficult when studying people who smoke daily. Inpatient stays in a hospital may help solve this problem. Participants would have to agree to remain in the hospital and avoid drugs for a specified period prior to testing. At least one recent study...

Chemistry And The Mind

To be precise, there are 5 principle classes of drugs which effect mood and behaviour, some of which we have already met and discussed. These are depressants like alcohol, barbiturates, valium, and anaesthetics stimulants like amphetamine (speed), cocaine, caffeine, and nicotine opiates like opium, heroin, and morphine antipsychotics like chlorpromazine (thorazine) and last but by absolutely no means least, there are psychedelics or entheogens like psilocybin, mescaline, LSD, and DMT. Also included as psychedelics are cannabis - since it can cause visual hallucinations at high doses - and the synthetic rave-drug Ecstasy (MDMA).

Ionizing Radiation and Angiogenesis Inhibitors

Many years after the fundamental hypotheses about delivery of oxygen and nutrients to malignant tumors via formation of new blood vessels (angiogenesis) were published, drugs developed to inhibit angiogenesis have now entered routine clinical practice, after landmark randomized trials have identified suitable combination regimens in metastatic colorectal cancer and advanced non-squamous non-small cell lung cancer (Table 7.1). Previously, monotherapy, e.g., with matrix metallo-proteinase inhibitors, failed to improve the results. The fundamental principles of anti-angiogenic approaches and their consequences for the devel- MMPI matrix metalloproteinase inhibitor, NSCLC non-small cell lung cancer, 5-FU 5-fluorouracil, LV leucovorin, PFS progression-free survival, OS overall survival Neutralizing antibodies against VEGF or VEGFR2 can reduce the growth rate of tumors and metastases in experimental animals (Kim et al. 1993 Asano et al. 1995 Borgstr m et al. 1996 PrEsta et al. 1997 PrEwEtt...

Motor and physical development

Some evidence suggests that smoking marijuana may result in long-term impairment of the immune system, which is responsible for fighting infections. A 1997 study from the Center for Substance Abuse Prevention titled Effects of Marijuana on the Lung and Its Immune Defenses reported that marijuana may suppress the activity of a variety of immune cells that fight disease. The article cited studies that found that the lungs of habitual marijuana smokers showed a reduced ability to kill fungal and bacterial organisms as well as tumor cells. These findings suggest that marijuana can have significant negative effects on the body's natural defenses, which could have potentially serious health consequences for users with other immune system problems arising from AIDS, cancer, or an organ transplant. Somewhat surprisingly, no conclusive evidence links marijuana with long-term developmental problems with lung function and respiratory health. For example, a 1987 article in the British Medical...

Superior Performance in Users

A couple of other studies revealed the unexpected superior performance of users over nonusers. Results like these have never inspired anyone to recommend cannabis as a way to enhance cognitive abilities, but they do cast doubt on the idea that chronic marijuana use is detrimental. One of the first reports of superior performance came from an examination of 11 nonusers and 11 people who smoked 3 to 5 times per week for an average of 4 years. The groups did not differ on over a dozen cognitive tests. The users performed better on one test of general cognitive functioning, but the large number of analyses suggest cautious interpretation. The same researchers found superior performance by users on 8 of 11 cognitive tests in another sample (Weckowicz, Collier, & Spreng, 1977). of information. These data do not, however, mean marijuana smokers are more creative than others. The groups may have differed in originality prior to use. Polydrug use was rampant among the smokers, raising the...

The Respiratory System

In addition, precancerous cells have been found in the lungs and respiratory tracts of some heavy long-term marijuana smokers. Although no definitive evidence correlates long-term marijuana smoking and cancer, some of the evidence has led researchers to speculate that there may be similar connections between smoking marijuana and smoking-related illnesses after years of even moderate marijuana smoking. Since the prevention of cancer is often at the heart of public and scientific concern, most of the scientific literature is advising more long-term studies on humans to establish whether habitual marijuana smoking does or does not cause cancer. In studying marijuana smoke and its health effects, some researchers directly compared heavy marijuana smokers with tobacco smokers. (Heavy marijuana smokers in this study were defined as those who had been smoking an average of three to four marijuana cigarettes per day for about 15 years.) These studies found that one marijuana cigarette...

Effects on macrophages

Recently, Baldwin et al. (1997) evaluated the function of alveolar macrophages recovered from the lungs of nonsmokers and habitual smokers of tobacco, marijuana, or crack cocaine. Macrophages recovered from marijuana smokers were deficient in the ability to phagocytose Staphylococcus aureus and were severely limited in the capacity to kill bacteria and tumor cells. Experiments in which NG-monomethyl-L-arginine monoacetate, an inhibitor of nitric oxide synthase, was used suggested that macrophages from marijuana smokers were not able to use nitric oxide (NO) as an antibacterial effector molecule. Furthermore, macrophages from marijuana smokers, but not from smokers of tobacco or cocaine, produced lower levels of TNFa, GMC-SF, and IL6 when stimulated with lipopolysaccharide in culture when compared with alveolar macrophages obtained from control subjects. Based on these observations, it was concluded that habitual exposure of the lung to marijuana impaired select functions of alveolar...

Even tRela ted Po ten tia ls

A body of evidence reveals that chronic, heavy marijuana smokers may not perform as well as nonsmokers on complex cognitive tasks. Another technique for assessing changes in information processing involves changes in an electroencephalogram or EEG. One change associated with chronic consumption of marijuana concerns deviant brain waves that appear during a difficult task (Solowij, 1998). Brain waves that occur in response to a particular event (like a light or a tone) are called eventrelated potentials. These alterations in brain waves can reveal information about cognitive processes. A series of studies looked at these brain waves and found deviations in chronic, heavy users of marijuana that suggest they do not process information as accurately or rapidly as nonusers.

Studies reporting minimal effects on immunity and host resistance

A number of human clinical trials in which peripheral blood lymphocytes from healthy individuals and from chronic marijuana smokers were obtained have revealed no differences in mitogen-induced proliferation of rosette formation which was used as a measure of cell-mediated immunity functional competence (Kaklamani et al., 1978 Rachelefsky and Opelz, 1977 Lau et al., 1976). Marijuana use was found to be associated with an increase in the percentage of CD4+ T lymphocytes in the peripheral circulation with a mean CD4 CD8 ratio of 1.95 in marijuana smokers versus one of 1.27 in control subjects (Wallace et al., 1988). However, other immune function tests which were performed, such as proliferation, were found to be normal. In addition, Wallace et al. (1998) examined risk factors and outcomes associated with identification of Aspergillus in respiratory specimens from individuals with HIV disease as part of a study to evaluate pulmonary complications of HIV infection. It was indicated that...

Dependence and Tolerance

AiiecdotaJ evidence suggests that tolerant e to the crtects of cannabis does develop with continued use, although it is possible thai this is due to users adjusting to. and learning to cope with, their inebriated slates. Conversely, experienced smokers are often better able to reel' lower doses of cannabis than inexperienced users.

Review of Neuropsychological and Cognitive Data

In the Jamaican studies (Rubin and Comitas 1975), 19 neuropsy-chological tests were administered to chronic cannabis users and controls with no major significant differences between groups. In fact, ganja smokers scored the highest on Wechsler Adult Intelligence Scale (WAIS) Digit Span performance (p < 0.05). The authors concluded (p. 119), in a wide variety of human abilities, there is no evidence that long-term use of cannabis is related to chronic impairment.

Epidemiology of Smoking and Quitting

In 2000, 23.3 of adults in the United States were current smokers and approximately 70 of them reported the desire to quit smoking completely. Among the estimated 42.4 ever-smokers, 50.6 were former smokers (Centers for Disease Control and Prevention CDC , 2002). In other words, about one-half of U.S. ever-smokers become nonsmokers during their lives (Hughes, Keely, & Naud, 2004). In Germany, the proportion of ex-smokers in the adult population is 24.2 (Augustin, Metz, Heppekausen, & Kraus, 2005). Whereas the highest prevalence of smoking and the lowest number of ex-smokers can be found in the young adult cohort (41.3 current smokers, 6.7 ex-smokers), the number of smokers is decreasing with increases in age, first slowly, then progressively more rapidly. At the same time, the proportion of ex-smokers is continuously increasing (Augustin et al., 2005 Lampert & Burger, 2004). The declining prevalence of smoking is the result both of the elevated mortality rate among smokers...

Clinical Applications

In the recently published book (6), the clinical applications of pharmacogenomics are classified according drug group, specialties, and diseases including opioids, pain management, nicotine addiction, HIV treatment, immunosuppressants, psychiatry, and clinical and forensic toxicology. Another previous publication by Jicinio and Wong (4) offered extensive basic and clinical information for pharmacogenomics. Readers are

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