Addiction is a primary, chronic disease characterised by impaired control over the use of a psychoactive substance and/or behaviour. Clinically, the manifestations occur along biological, psychological, social and spiritual dimensions. Common features of addiction are: change in mood, relief from negative emotions, provision of pleasure, preoccupation with use of substance(s) or ritualistic behaviour(s); and continued use of substance(s) and/or engagement in behaviour(s) despite adverse physical, psychological and/or social consequences. Among highly addictive Tobacco is one of the most widely abused substances in the world. This is sometimes referred to as the brains ‘happy’ chemical.
ALSO READ: Opinion | Gautam Buddha & Guwahati's Party Culture
Nicotiana attenuata (Wild tobacco), Nicotiana glauca (Tree tobacco), Nicotiana longiflora (Cultivated ornamental), Nicotiana rustica, Nicotiana tabacum (Commercial tobacco), Nicotiana trigonophylla (Desert tobacco) are the widely used most common source of Tobacco. By far the commonest source of nicotine poisoning (acute or chronic) results from smoking tobacco in the form of cigarettes. When a cigarette is lit and inhaled, the smoker is exposed to both gaseous and particulate matter. Nicotine and tar are part of the particulate phase of cigarette smoke. When a cigarette is smoked, more than half the nicotine escapes in the sidestream smoke, while a large fraction remains in the butt and filter, and it is only 0.5 to 2 mg (average 1 mg) of nicotine that finally is delivered to the smoker.
In India, "bidis" are very popular, especially among the poorer sections of society, since they are much cheaper than cigarettes. Bidis are small, brown, hand-rolled cigarettes consisting of tobacco wrapped in a tendu or temburni leaf (Diospyros melanoxylon).
After cigarettes, the next common source of nicotine toxicity results from smokeless tobacco which is of two kinds - snuff and chewing tobacco. Because smoking is not involved, people generally believe that snuff is more socially acceptable and less harmful. This is however not true. Snuff is usually available as finely cut tobacco powder which is packaged dry or moist. It contains approximately 14 mg of nicotine per gram of tobacco.
Health consequences of tobacco use:
- Frequent intake of tobacco leads to worst deadly diseases like, Lung cancer.
- Non-pulmonary cancers: Mouth, larynx, oesophagus, stomach, liver, pancreas, bladder, uterine cervix, breast, brain.
- Respiratory diseases: Emphysema, bronchitis, asthma, pneumonia.
- Cardiovascular diseases: Coronary heart disease, hypertension, arterial thrombosis, stroke.
- Obstetric and neonatal conditions: Abortion, abruptio placenta, placenta praevia, preterm labour, pre-eclampsia, growth retardation, congenital malformations, sudden infant death syndrome, foetal or neonatal death. Along with Other severe conditions like Peptic ulcer, osteoporosis, Alzheimer's disease.
Also the Manifestations of nicotine withdrawal can occur within 4 to 8 hours of the last cigarette. In fact most chronic smokers experience some withdrawal symptoms on waking up each morning. Manifestations include changes in mood, insomnia, difficulty concentrating, restlessness, decreased heart rate (average decline is 8 beats per minute), and weight gain (average is 2 to 3 kg).
Toxic symptoms of Tobacco Abuse:
Early effects of Tobacco Toxicity can occur within 30 Minutes to 1 hour with symptoms like Nausea, salivation, vomiting, abdominal pain,achycardia, hypertension,Tachypnoea, bronchorrhoea, Agitation, anxiety, sweating, headache, blurred vision, confusion, vertigo, tremor, ataxia, muscle fasciculations, convulsions. Pupils are at first constricted, but may dilate later. A primary position of upbeat nystagmus is seen following cigarette smoking, chewing of nicotine gum, and ingestion of nicotiana glauca leaves, and is the direct result of nicotine.
Likewise the Delayed effects of tobacco toxicity can occur within 2 hours of ingestion with severe symptoms like Diarrhoea. Bradycardia (heart beat rate slower than normal ) arrhythmias, hypotension, shock. Hypoventilation, apnoea lethargy, weakness, hyporeflexia, hypotonia, paralysis, coma. Death may occur, especially in the case of ingestion of cigarettes, (inadvertently) by children, or exposure to insecticidal nicotine. After all Nicotine dependence is the most widely preva - lent and deadly of all substance dependencies.
Habit & lifestyle changes can prevent Tobacco Abuse, many of the changes can make a radical difference when it comes to lowering the risk of Tobacco Abuse. One must have to quit tobacco intake and smoking which will lower the risk of very fatal diseases. You can reach out to your doctor to create a quit plan.
The World Health Organization (WHO) has a number of initiatives to help reduce tobacco use, including the WHO FCTC treaty and the MPOWER program. The WHO FCTC is an evidence-based treaty that sets standards for compliance and provides legal dimensions for international health cooperation. The MPOWER program includes six measures to help reduce tobacco use:
- Monitoring tobacco use and prevention policies.
- Protecting people from tobacco use. Offering help to quit tobacco use.
- Warning about the dangers of tobacco.
- Enforcing bans on tobacco advertising, promotion, and sponsorship
- Raising taxes on tobacco.
(The author is a Doctor of Pharmacy Scholar. All views and opinions expressed are author’s own)
