Tobacco and other drugs

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An association between tobacco and other drug use has been well established. The nature of this association remains unclear. The two main theories, which are not mutually exclusive, are the phenotypic causation (gateway) model and the correlated liabilities model. The causation model argues that smoking is a primary influence on future drug use, while the correlated liabilities model argues that smoking and other drug use are predicated on genetic or environmental factors.


Causation model

A 1994 report from the Center on Addiction and Substance Abuse at Columbia University, found a correlation between the use of cigarettes and alcohol and the subsequent use of cannabis. The report asserted a link between alcohol and cannabis use and the subsequent use of illicit drugs like cocaine. [1] It found that when younger children used, the more often they use them, the more likely they were to use cocaine, heroin, hallucinogens and other illicit drugs. The report concludes that the data is already robust enough to make a strong case to step up efforts to prevent childhood use of cigarettes and to take firm steps to reduce children’s access to these "gateway drugs". [2]

researchers have found that craving nicotine also increases craving for illicit drugs among drug abusers who smoke tobacco, and this suggests that smokers in drug rehabilitation programs may be less successful than nonsmokers in staying off drugs. [3]

In mice, nicotine increased the probability of later consumption of cocaine. the experiments permitted concrete conclusions on the underlying molecular biological alteration in the brain. [4] The biological changes in mice correspond to the epidemiological observations in humans that nicotine consumption is coupled to an increased probability of later use of cocaine. [5]

Correlative model

Smoking may have a genetic predisposing factor; one 1990 study posited that 52% of the variance in smoking behaviour is attributable to heritable factors. [6] [7] The concept received support from a large-scale genetic analysis of 2016 that showed a genetic basis for the connection of the prevalence of cigarette smoking and cannabis use during the life of a person. [8]

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Related Research Articles

Recreational drug use Use of a drug with the primary intention to alter the state of consciousness

Recreational drug use is the use of a psychoactive drug to induce an altered state of consciousness either for pleasure or for some other casual purpose or pastime by modifying the perceptions, feelings, and emotions of the user. When a psychoactive drug enters the user's body, it induces an intoxicating effect. Generally, recreational drugs are divided into three categories: depressants ; stimulants ; and hallucinogens.

Nicotine Mild chemical stimulant naturally found in some plants

Nicotine is a naturally produced alkaloid in the nightshade family of plants and is widely used recreationally as a stimulant and anxiolytic. As a pharmaceutical drug, it is used for smoking cessation to relieve withdrawal symptoms. Nicotine acts as a receptor agonist at most nicotinic acetylcholine receptors (nAChRs), except at two nicotinic receptor subunits where it acts as a receptor antagonist.

Tobacco smoking Practice of burning tobacco and ingesting the resulting smoke

Tobacco smoking is the practice of burning tobacco and ingesting the smoke that is produced. The smoke may be inhaled, as is done with cigarettes, or simply released from the mouth, as is generally done with pipes and cigars. The practice is believed to have begun as early as 5000–3000 BC in Mesoamerica and South America. Tobacco was introduced to Eurasia in the late 17th century by European colonists, where it followed common trade routes. The practice encountered criticism from its first import into the Western world onwards but embedded itself in certain strata of a number of societies before becoming widespread upon the introduction of automated cigarette-rolling apparatus.

Substance abuse Harmful use of drugs

Substance abuse, also known as drug abuse, is the use of a drug in amounts or by methods which are harmful to the individual or others. It is a form of substance-related disorder. Differing definitions of drug abuse are used in public health, medical and criminal justice contexts. In some cases, criminal or anti-social behaviour occurs when the person is under the influence of a drug, and long-term personality changes in individuals may also occur. In addition to possible physical, social, and psychological harm, the use of some drugs may also lead to criminal penalties, although these vary widely depending on the local jurisdiction.

Drug rehabilitation is the process of medical or psychotherapeutic treatment for dependency on psychoactive substances such as alcohol, prescription drugs, and street drugs such as cannabis, cocaine, heroin or amphetamines. The general intent is to enable the patient to confront substance dependence, if present, and stop substance misuse to avoid the psychological, legal, financial, social, and physical consequences that can be caused.

Chain smoking is the practice of smoking several cigarettes in succession, sometimes using the ember of a finished cigarette to light the next. The term chain smoker often also refers to a person who smokes relatively constantly, though not necessarily chaining each cigarette. The term applies primarily to cigarettes, although it can be used to describe incessant cigar and pipe smoking as well as vaping. It is a common indicator of addiction.

The gateway drug effect is a comprehensive catchphrase for the often observed effect that the use of a psychoactive substance is coupled to an increased probability of the use of further substances. Possible causes are biological alterations in the brain due to the earlier substance exposure and similar attitudes of people who use different substances across different substances. In 2020, the National Institute on Drug Abuse released a study backing allegations that marijuana is a "gateway" to more dangerous substance use, though not for the majority of people who use substances.

Cannabis smoking Inhalation of marijuana fumes

Cannabis smoking is the inhalation of smoke or vapor released by heating the flowers, leaves, or extracts of cannabis and releasing the main psychoactive chemical, Δ9-tetrahydrocannabinol (THC), which is absorbed into the bloodstream via the lungs. Archaeological evidence indicates cannabis with high levels of THC was being smoked at least 2,500 years ago.

Nicotine withdrawal Process of withdrawing from nicotine addiction

Nicotine withdrawal is a group of symptoms that occur in the first few weeks after stopping or decreasing use of nicotine. Symptoms include intense cravings for nicotine, anger or irritability, anxiety, depression, impatience, trouble sleeping, restlessness, hunger or weight gain, and difficulty concentrating. Withdrawal symptoms make it harder to quit nicotine products, and most methods for quitting smoking involve reducing nicotine withdrawal. Quit smoking programs can make it easier to quit. Nicotine withdrawal is recognized in both the American Psychiatric Association Diagnostic and Statistical Manual and the WHO International Classification of Diseases.

Smoking Practice of inhaling a burnt substance for psychoactive effects

Smoking is a practice in which a substance is burned and the resulting smoke is typically breathed in to be tasted and absorbed into the bloodstream. Most commonly, the substance used is the dried leaves of the tobacco plant, which have been rolled into a small rectangle of rolling paper to create a small, round cylinder called a cigarette. Smoking is primarily practised as a route of administration for recreational drug use because the combustion of the dried plant leaves vaporizes and delivers active substances into the lungs where they are rapidly absorbed into the bloodstream and reach bodily tissue. In the case of cigarette smoking these substances are contained in a mixture of aerosol particles and gases and include the pharmacologically active alkaloid nicotine; the vaporization creates heated aerosol and gas into a form that allows inhalation and deep penetration into the lungs where absorption into the bloodstream of the active substances occurs. In some cultures, smoking is also carried out as a part of various rituals, where participants use it to help induce trance-like states that, they believe, can lead them to spiritual enlightenment.

Nicotine dependence Chronic disease

Nicotine dependence is a state of dependence upon nicotine. Nicotine dependence is a chronic, relapsing disease defined as a compulsive craving to use the drug, despite social consequences, loss of control over drug intake, and emergence of withdrawal symptoms. Tolerance is another component of drug dependence. Nicotine dependence develops over time as a person continues to use nicotine. The most commonly used tobacco product is cigarettes, but all forms of tobacco use and e-cigarette use can cause dependence. Nicotine dependence is a serious public health problem because it leads to continued tobacco use, which is one of the leading preventable causes of death worldwide, causing more than 8 million deaths per year.

Polysubstance dependence Medical condition

Polysubstance dependence refers to a type of substance use disorder in which an individual uses at least three different classes of substances indiscriminately and does not have a favorite substance that qualifies for dependence on its own. Although any combination of three substances can be used, studies have shown that alcohol is commonly used with another substance. This is supported by one study on polysubstance use that separated participants who used multiple substances into groups based on their preferred substance. The results of a longitudinal study on substance use led the researchers to observe that excessively using or relying on one substance increased the probability of excessively using or relying on another substance.

Substance use disorder Continual use of drugs (including alcohol) despite detrimental consequences

Substance use disorder (SUD) is the persistent use of drugs despite substantial harm and adverse consequences. Substance use disorders are characterized by an array of mental/emotional, physical, and behavioral problems such as chronic guilt; an inability to reduce or stop consuming the substance(s) despite repeated attempts; driving while intoxicated; and physiological withdrawal symptoms. Drug classes that are involved in SUD include: alcohol; cannabis; phencyclidine and other hallucinogens, such as arylcyclohexylamines; inhalants; opioids; sedatives, hypnotics, or anxiolytics; stimulants; tobacco; and other or unknown substances.

Youth smoking Overview article

Smokingamong youth and adolescents is an issue that affects countries worldwide. While the extent to which smoking is viewed as a negative health behavior may vary across different nations, it remains an issue regardless of how it is perceived by different societies. The United States has taken numerous measures, ranging from changes in national policy surrounding youth cigarette access to changes in media campaigns, in attempts to eliminate the use of tobacco products among teenagers. Approximately 90% of smokers begin smoking prior to the age of 18.

Addiction Disease resulting in compulsive engagement in rewarding stimuli despite adverse consequences

Addiction is a neuropsychological disorder characterized by persistent use of a drug despite substantial harm and adverse consequences. Repetitive drug use often alters brain function in ways that perpetuate craving and undermine self-control. This phenomenon—drugs reshaping brain function—has led to an understanding of addiction as a brain disorder with a complex variety of neurobiological and psychosocial factors that are implicated in its development. Classic hallmarks of addiction include compulsive engagement in rewarding stimuli, preoccupation with substances or behavior, and continued use despite adverse consequences. Habits and patterns associated with addiction are typically characterized by immediate gratification, coupled with delayed deleterious effects.

Cannabis use disorder Continued use of cannabis despite clinically significant impairment

Cannabis use disorder (CUD), also known as cannabis addiction or marijuana addiction, is defined in the fifth revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and ICD-10 as the continued use of cannabis despite clinically significant impairment.

Denise Kandel American medical sociologist and epidemiologist

Denise Kandel is an American medical sociologist and epidemiologist, Professor of Sociomedical Sciences and Psychiatry at Columbia University and Head of the Department of Epidemiology of Substance Abuse at the New York State Psychiatric Institute. She is known for her epidemiological longitudinal studies on the sequence of first-time use of various legal and illegal drugs, carried out beginning in the 1970s and continuing until at least 2016.

The use of psychoactive substances is one of the most common human behaviors. Psychoactive drugs can relieve the symptoms of mental disorders or cause harm to individuals and societies when stigmatized, criminalized, and weaponized by repressive, overreaching authoritarian governments. Psychoactive drugs can induce pleasure, increase energy, relieve pain (Aspirin), or can impose a large social burden in the form of chronic illness and be a cause of morbidity.

Usage of electronic cigarettes Overview about the usage of electronic cigarettes

The usage of electronic cigarettes has risen rapidly since their introduction to the market in 2002. The global number of adult e-cigarettes users rose from about 7 million in 2011 to 68 million 2021 and 82 million in 2021. Awareness and use of e-cigarettes greatly increased over the few years leading up to 2014, particularly among young people and women in some parts of the world. Since their introduction vaping has increased in the majority of high-income countries. E-cigarette use in the US and Europe is higher than in other countries, except for China which has the greatest number of e-cigarette users. Growth in the UK as of January 2018 had reportedly slowed since 2013. The growing frequency of e-cigarette use may be due to heavy promotion in youth-driven media channels, their low cost, and the belief that e-cigarettes are safer than traditional cigarettes, according to a 2016 review. E-cigarette use may also be increasing due to the consensus among several scientific organizations that e-cigarettes are safer compared to combustible tobacco products. E-cigarette use also appears to be increasing at the same time as a rapid decrease in cigarette use in many countries, suggesting that e-cigarettes may be displacing traditional cigarettes.

Effects of nicotine on human brain development Effects of electronic cigarettes on the developing human brain

Exposure to nicotine, from conventional or electronic cigarettes during adolescence can impair the developing human brain. E-cigarette use is recognized as a substantial threat to adolescent behavioral health. The use of tobacco products, no matter what type, is almost always started and established during adolescence when the developing brain is most vulnerable to nicotine addiction. Young people's brains build synapses faster than adult brains. Because addiction is a form of learning, adolescents can get addicted more easily than adults. The nicotine in e-cigarettes can also prime the adolescent brain for addiction to other drugs such as cocaine. Exposure to nicotine and its great risk of developing an addiction, are areas of significant concern.


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