Addiction

1. Addiction Nicotine

2. According to the Specification you need to be able to : Describe, with reference to heroin and nicotine • Substance misuse • Mode of action • Effects • Tolerance • Physical / psychological dependencies • withdrawal

3. Some startling statistics…Adults • There are about 10 million adults who smoke cigarettes in the UK • This is about a sixth of the total UK population • 22% of adult men and 19% of adult women are smokers • Among men smoking prevalence is highest in the 25-34 age group (32%). • Among women, smoking is highest among 20-24 year olds (29%). • In 1974, 51% of men and 41% of women smoked cigarettes - nearly half the adult population. • Smoking rates are markedly higher among poorer people. • In 2012, 14% of adults in managerial and professional occupations smoked compared with 33% in routine and manual occupations.

4. Some startling statistics…Young people • Two-thirds of smokers start before age 18. • In 2011 it was estimated that more than 200,000 children aged 11- 15 started smoking. • It is illegal to sell cigarettes to any person under the age of 18.

5. Some startling statistics… • About half of all regular cigarette smokers will eventually be killed by their addiction. • Every year, over 100,000 smokers in the UK die from smoking related causes. • Smoking accounts for over one-third of respiratory deaths, over one-quarter of cancer deaths, and about one-seventh of cardiovascular disease deaths.

6. How much? NHS costs are estimated at £2.7 billion each year

7. Tobacco smoke • Contains over 4,000 chemical compounds, present as either gases or as tiny particles. These include carbon monoxide, arsenic, formaldehyde, cyanide, benzene, toluene and acrolein

8. Medical consequences • • Passive or secondary smoke increases risk for many diseases including lung cancer and cardiovascular disease in nonsmokers as well as increasing the severity of asthma in children and incidence of sudden infant death syndrome• Female smokers tend to have earlier menopause• Female smokers who take oral contraceptives - more prone to cardiovascular and cerebrovascular diseases• Pregnant smokers - increased risk of stillborn, premature or low-birth weight infants• Children of women who smoked while pregnant - increased risk for developing conduct disorders

9. What is the difference between biological addiction and psychological addiction? Answer on your white boards

10. Addiction • What is the difference between drug abuse and drug addiction? • When does drug abuse become addiction? • Answer on your white boards

11. Addiction 60% of smokers say they would find it hard to last a whole day without smoking First cigarette of the day. In 2011, 16% of all smokers had their first cigarette within 5 minutes of waking. Among smokers of 20 or more cigarettes a day, 35% smoked their first cigarette of the day within 5 minutes of waking, compared to just 3% of those smoking fewer than 10 a day. .

12. Nicotine Psychological Dependence An important component of the nicotine withdrawal syndrome is craving. This urge for nicotine that has been described as a major obstacle to successful abstinence and may persist for 6 months or longer. While the withdrawal syndrome is related to the pharmacological effects of nicotine, the severity of withdrawal symptoms can also be affected by psychological experiences. For some people, the feel, smell and sight of a cigarette and the ritual of obtaining, handling, lighting and smoking it are all associated with the pleasurable effects of smoking and can make withdrawal or craving worse.

13. Nicotine Nicotine acts as both a stimulant and a sedative The rush of adrenaline stimulates the body, causing a sudden release of glucose as well as an increase in blood pressure, heart rate and respiration

14. Nicotine Nicotine indirectly causes a release of dopamine in the brain regions that control pleasure and motivation. This reaction is similar to that seen with other abused drugs—such as heroin—and is thought to underlie the pleasurable sensations many smokers experience. In contrast, nicotine can also exert a sedative effect, depending on the level of the smoker's nervous system arousal and the dose of nicotine taken.

15. Mode of action - Nicotine Acetylcholine – ACH – is a neurotransmitter located in many different parts of the brain. It has a role in passing on messages from the brain to the muscles It helps control energy levels It plays a role in learning and memory

16. Mode of Action: http://www.youtube.com/watch?v=yd46Hs7pTow http://learn.genetics.utah.edu/content/addiction/abuse/ http://learn.genetics.utah.edu/content/addiction/crossingdivide/

17. ACH is a very useful little critter helping to manage all sorts of neural activity

18. Only small amount of ACH is released usually – the body is very good at keeping ACH under control. • Remember the body likes to stay in balance - it drives towards homeostasis • Nicotine activates the neurones that use ACH in many regions of the brain simultaneously – this leads to massive neural activity with all kinds of knock on effects - it does this by binding to the ACH receptors and activating them even if ACH is not present!

19. ACH is a very useful little critter helping to manage all sorts of neural activity –now its receptors have gone berserk!!!!

20. Recap: • Each neurotransmitter has its own specific family of receptors. • Nicotineworks by docking to a subset of receptors that bind the neurotransmitter acetylcholine. • Acetylcholineis the neurotransmitter that (depending on what region of the brain a neuron is in): • Delivers signals from your brain to your muscles • Controls basic functions like your energy level, the beating of your heart and how you breathe • Acts as a "traffic cop" overseeing the flow of information in your brain • Plays a role in learning and memory

22. The result of this is • Body and brain called into action – increased reaction time – feeling alert  • Dopamine is released – the reward pathway gets stimulated – feeling calm and relaxed  • Endorphines are released – natural pain killers – feeling good  • BUT: changes in neural activity leads to changes in the number of receptors, remember the body tries to get back to homeostasis, this means in the long-term more nicotine is needed to stimulate the now fewer receptors and the drop in neural activity results in feelings of anxiety – hence why smokers need another cigarette just to feel calm and ok 

23. Nicotine Withdrawal Period that may last a month or more Symptoms may begin within a few hours after the last cigarette, and include irritability, sleep disturbances, craving, cognitive and attentional deficits and increased appetite. Symptoms generally peak within the first few days and may subside within a few weeks, though for some people, they may persist for months or longer.

24. HW Look at the Cancer research UK website http://www.cancerresearchuk.org/cancer-info/cancerstats/types/lung/smoking/lung-cancer-and-smoking-statistics http://ash.org.uk/information/facts-and-stats/fact-sheets Do anti drugs adverts work? http://news.bbc.co.uk/1/hi/health/6741707.stm http://www.theguardian.com/commentisfree/poll/2012/dec/28/nhs-anti-smoking-campaign

25. Task – you should be improving your evaluation for this task Describe and evaluate one campaign that has encouraged people not to use drugs (Frank)or to Smoke

26. Describe and Evaluate one study Ennett, Bauman and Koch 1994 • Ennett et al (1994) variability in cigarette smoking within and between adolescent friendship cliques.

27. Aim: To investigate the role of friendship groups and cliques in the smoking behaviour of adolescence.

28. A total of 87 cliques were identified comprised of 461 adolescence. Average clique size was 5 members. 42.2% of the sample participants were in a clique. • What is a clique? • Those not in cliques were called isolates, 28.6% of the total sample. • Liaisons were participants who were friends with other adolescence but not in a clique, which accounted for 29.2% of the sample.

29. Individuals Assessment for group membership

30. What do these results show?PROPORTION OF CURRENT SMOKERS BY FRIENDSHIP PATTERNS BY SCHOOL (N=1092)

31. Results • 414/461 were non smokers (MAJORITY 89%) • 59/87 were totally non-smoking cliques (68% ) • 2/87 cliques contained smoking only members • The smoking rate of clique members was 11.1% • The overall smoking rate in schools was 15.2% • Clique members displayed high levels of homogeneity (similar behaviour) – this was most apparent in all female, all white cliques, and cliques where mothers had a lower standard of education

32. Conclusions – finish that sentence! • Adolescences that smoke tend to associate with ………. • Clique membership contributes more to non-smoking behaviour than……… • Membership of a non-smoking clique supports the maintenance of ……… • This does / does not support the notion of social learning theory as an explanation of substance misuse.

33. A reminder of how nicotine works • http://www.youtube.com/watch?v=HlcIKekEldg

34. Morgan & Grube • Another study that looks at smoking and peer groups • Read the information from your Angles pack • Identify and evaluate the research method that is being used to learn about drug use in humans. – in other words evaluate the methodology • Evaluate the research GRAVE