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Tobacco 101: A Guide to Working with Nicotine Addicted Patients

Course Number: 534

Physical Addiction

Nicotine was first isolated in 1828 in Heidelberg, Germany. It is a clear liquid and poisonous alkaloid. It is found in tobacco, and to a much lesser concentration, in tomatoes, potatoes and eggplants. It binds to the alpha 4 beta 2 nicotinic receptor sites in the Ventral Tegmental Area of the brain and is believed to cause the release of dopamine at the Nucleus Accumbens region. Scientists state that nicotine is as addictive as heroin and cocaine, with inhaled cigarette smoke affecting the brain in five seconds. It takes approximately 5 cigarettes or 4-6 mg of nicotine to reach the threshold of addiction.46,47 Nicotine is far from a benign chemical as it increases clotting tendencies, causes bronchospasms, alters heart rates, increases blood pressure, causes coronary artery constriction, causes hyperinsulinemia, and insulin resistance amongst other things. In addition to all of this, it initiates feelings of pleasure, helps concentration, reduces anxiety, relieves pain, and curbs one’s appetite, all contributing to why it is so difficult to give up using it.