Nicotine Related Quotes

Beginning with maternal, fetal, and infant malnutrition, it’s hardly surprising that the enslaved were more susceptible than free people to most infirmities, including crib death, infant mortality of all kinds (including infanticide), death in childbirth, and injuries and deterioration to the mother from repeated childbirth, along with typhoid, cholera, smallpox, tetanus, worms, pellagra, scurvy, beriberi, kwashiorkor, rickets, diphtheria, pneumonia, tuberculosis, dental-related ailments, dysentery, bloody flux, and other bowel complaints. The health conditions of the enslaved were aggravated by overwork, accidents, and work-related illnesses such as “green tobacco sickness,” today known as nicotine poisoning, which plagued tobacco workers.22 The heavy work regimes they endured wore down their bodies and aged them prematurely, with childbirth-related fatalities limiting women’s life spans even more than the men’s.

Outlawing drugs in order to solve drug problems is much like outlawing sex in order to win the war against AIDS. We recognize that people will continue to have sex for nonreproductive reasons despite the laws and mores. Therefore, we try to make sexual practices as safe as possible in order to minimize the spread of the AIDS viruses. In a similar way, we continually try to make our drinking water, foods, and even our pharmaceutical medicines safer. The ubiquity of chemical intoxicants in our lives is undeniable evidence of the continuing universal need for safer medicines with such applications. While use may not always be for an approved medical purpose, or prudent, or even legal, it is fulfilling the relentless drive we all have to change the way we feel, to alter our behavior and consciousness, and, yes, to intoxicate ourselves. We must recognize that intoxicants are medicines, treatments for the human condition. Then we must make them as safe and risk free and as healthy as possible. Dream with me for a moment. What would be wrong if we had perfectly safe intoxicants? I mean drugs that delivered the same effects as our most popular ones but never caused dependency, disease, dysfunction, or death. Imagine an alcohol-type substance that never caused addiction, liver disease, hangovers, impaired driving, or workplace problems. Would you care to inhale a perfumed mist that is as enjoyable as marijuana or tobacco but as harmless as clean air? How would you like a pain-killer as effective as morphine but safer than aspirin, a mood enhancer that dissolves on your tongue and is more appealing than cocaine and less harmful than caffeine, a tranquilizer less addicting than Valium and more relaxing than a martini, or a safe sleeping pill that allows you to choose to dream or not? Perhaps you would like to munch on a user friendly hallucinogen that is as brief and benign as a good movie? This is not science fiction. As described in the following pages, there are such intoxicants available right now that are far safer than the ones we currently use. If smokers can switch from tobacco cigarettes to nicotine gum, why can’t crack users chew a cocaine gum that has already been tested on animals and found to be relatively safe? Even safer substances may be just around the corner. But we must begin by recognizing that there is a legitimate place in our society for intoxication. Then we must join together in building new, perfectly safe intoxicants for a world that will be ready to discard the old ones like the junk they really are. This book is your guide to that future. It is a field guide to that silent spring of intoxicants and all the animals and peoples who have sipped its waters. We can no more stop the flow than we can prevent ourselves from drinking. But, by cleaning up the waters we can leave the morass that has been the endless war on drugs and step onto the shores of a healthy tomorrow. Use this book to find the way.

What, then, is addiction? In the words of a consensus statement by addiction experts in 2001, addiction is a “chronic neurobiological disease… characterized by behaviors that include one or more of the following: impaired control over drug use, compulsive use, continued use despite harm, and craving.” The key features of substance addiction are the use of drugs or alcohol despite negative consequences, and relapse. I’ve heard some people shrug off their addictive tendencies by saying, for example, “I can’t be an alcoholic. I don’t drink that much…” or “I only drink at certain times.” The issue is not the quantity or even the frequency, but the impact. “An addict continues to use a drug when evidence strongly demonstrates the drug is doing significant harm…. If users show the pattern of preoccupation and compulsive use repeatedly over time with relapse, addiction can be identified.” Helpful as such definitions are, we have to take a broader view to understand addiction fully. There is a fundamental addiction process that can express itself in many ways, through many different habits. The use of substances like heroin, cocaine, nicotine and alcohol are only the most obvious examples, the most laden with the risk of physiological and medical consequences. Many behavioural, nonsubstance addictions can also be highly destructive to physical health, psychological balance, and personal and social relationships. Addiction is any repeated behaviour, substance-related or not, in which a person feels compelled to persist, regardless of its negative impact on his life and the lives of others. Addiction involves: 1. compulsive engagement with the behaviour, a preoccupation with it; 2. impaired control over the behaviour; 3. persistence or relapse, despite evidence of harm; and 4. dissatisfaction, irritability or intense craving when the object — be it a drug, activity or other goal — is not immediately available. Compulsion, impaired control, persistence, irritability, relapse and craving — these are the hallmarks of addiction — any addiction. Not all harmful compulsions are addictions, though: an obsessive-compulsive, for example, also has impaired control and persists in a ritualized and psychologically debilitating behaviour such as, say, repeated hand washing. The difference is that he has no craving for it and, unlike the addict, he gets no kick out of his compulsion. How does the addict know she has impaired control? Because she doesn’t stop the behaviour in spite of its ill effects. She makes promises to herself or others to quit, but despite pain, peril and promises, she keeps relapsing. There are exceptions, of course. Some addicts never recognize the harm their behaviours cause and never form resolutions to end them. They stay in denial and rationalization. Others openly accept the risk, resolving to live and die “my way.

Some people, a relatively small minority, are at grave risk for addiction if exposed to certain substances. For this minority, exposure to drugs really will trigger addiction, and the trajectory of drug dependence, once begun, is extremely difficult to stop. In the United States opiate relapse rates of 80 per cent to more than 90 per cent have been recorded among addicts who try to quit their habit. Even after hospital treatment the re-addiction rates are over 70 per cent. Such dismal results have led to the impression that opiates themselves hold the power of addiction over human beings. Similarly, cocaine has been described in the media as “the most addictive drug on earth,” causing “instant addiction.” More recently, crystal methamphetamine (crystal meth) has gained a reputation as the most instantly powerful addiction-inducing drug — a well-deserved notoriety, so long as we keep in mind that the vast majority of people who use it do not become addicted. Statistics Canada reported in 2005, for example, that 4.6 per cent of Canadians have tried crystal meth, but only 0.5 per cent had used it in the past year. If the drug by itself induced addiction, the two figures would have been nearly identical. In one sense certain substances, like narcotics and stimulants, alcohol, nicotine and marijuana, can be said to be addictive, and it’s in that sense that I use the term. These are the drugs for which animals and humans will develop craving and which they will seek compulsively. But this is far from saying that the addiction is caused directly by access to the drug. The reasons are deeply rooted in the neurobiology and psychology of emotions.

SCIENTISTS HAD KNOWN since the late nineteenth century that tobacco smoke contains carbon monoxide. Victorian scientists had even been able to calculate the amount of gas in the smoke: up to 4 percent in cigarette smoke, and in Gettler’s own choice of tobacco, the cigar, between 6 and 8 percent. Gettler’s latest work theorized that chain smokers might suffer from low-level carbon monoxide poisoning. He speculated in a 1933 report that “headaches experienced by heavy smokers are due in part to the inhalation of carbon monoxide.” But his real interest lay less in their symptoms than in how much of the poison had accumulated in their blood, and how that might affect his calculations on cause of death. He approached that problem in his usual, single-minded way. To get a better sense of carbon monoxide contamination from smoking tobacco, Gettler selected three groups of people to compare: persons confined to a state institution in the relatively clean air of the country; street cleaners who worked in a daily, dusty cloud of car exhaust; and heavy smokers. As expected, carboxyhemoglobin blood levels for country dwellers averaged less than 1 percent saturation. The levels for Manhattan street cleaners were triple that amount, a solid 3 percent. But smokers came in the highest, higher than he’d expected, well above the nineteenth-century calculations. Americans were inhaling a lot more tobacco smoke than they had once done, and their saturation levels ranged from 8 to 19 percent. (The latter was from a Bronx cab driver who admitted to smoking six cigarettes on his way to Gettler’s laboratory, lighting one with the stub of another as he went.) It was safe to assume, Gettler wrote with his usual careful precision, that “tobacco smoking appreciably increases the carbon monoxide in the blood and cannot be ignored in the interpretation of laboratory results.”     THE OTHER NOTABLE poison in tobacco smoke was nicotine.

The first hints of this emerged in the early and mid-1990s, at the tail end of the crack epidemic. Suniya Luthar is now sixty-two, with an infectious smile, bright brown eyes, and short snow-white hair. Back then, she was a fledgling psychologist working as an assistant professor and researcher in the department of psychiatry at the Yale School of Medicine. She was studying resiliency among teenagers in low-income urban communities, and one of her early findings was that the most popular kids were also among the most destructive and aggressive at school. Was this a demographic phenomenon, she wondered, or merely an adolescent one, this tendency to look up to peers who acted out? To find out, she needed a comparison group. A research assistant suggested they recruit students from his former high school in an affluent suburb. Luthar’s team ultimately enlisted 488 tenth graders—about half from her assistant’s high school and half from a scruffy urban high school. The affluent community’s median household income was 80 percent higher than the national median, and more than twice that of the low-income community. The rich community also had far fewer families on food stamps (0.3 percent vs. 19 percent) and fewer kids getting free or reduced-price school lunches (1 percent vs. 86 percent). The suburban teens were 82 percent white, while the urban teens were 87 percent nonwhite. Luthar surveyed the kids, asking a series of questions related to depression and anxiety, drug use ranging from alcohol and nicotine to LSD and cocaine, and participation in delinquent acts at home, at school, and in the community. Also examined were grades, “social competence,” and teachers’ assessments of each student. After crunching the numbers, she was floored. The affluent teens fared poorly relative to the low-income teens on “all indicators of substance use, including hard drugs.” This flipped the conventional wisdom on its head. “I was quite taken aback,” Luthar recalls.

I'm a bartender. How can I stop when surrounded by smoke and smokers at every turn?" I recall attempts where I hoped smoking friends would be supportive in not smoking around me, and not leave their packs lying around to tempt me. While most tried, it usually wasn't long before they forgot. I recall thinking them insensitive and uncaring. I recall grinding disappointment and intense brain chatter, that more than once seized upon frustrated support expectations as this addict's excuse for relapse. Instead of expecting them to change their world for me, the smart move would have been for me to want to extinguish my brain's subconscious feeding cues related to being around them and their addiction. The smart move would have been to take back my world, or as much of it as I wanted. As I sit here typing in this room, around me are a number of packs of cigarettes: Camel, Salem, Marlboro Lights and Virginia Slims. I use them during presentations and have had cigarettes within arms reach for years. Don't misconstrue this. It is not a smart move for someone struggling in early recovery to keep cigarettes on hand. But if a family member or best friend smokes or uses tobacco, or our place of employment sells tobacco or allows smoking around us, we have no choice but to work toward extinguishing tobacco product, smoke and smoker cues almost immediately. And we can do it! Millions of comfortable ex-users handle and sell tobacco products as part of their job. You may find this difficult to believe, but I've never craved or wanted to smoke any of the cigarettes that surround me, even when holding packs or handling individual cigarettes during presentations. Worldwide, millions of ex-smokers successfully navigated recovery while working in smoke filled nightclubs, restaurants, bowling alleys, casinos, convenience stores and other businesses historically linked to smoking. And millions broke free while their spouse, partner or best friend smoked like a chimney. Instead of fighting or hiding from the world, take it back. Why allow our circumstances to wear us down? Small steps, just one moment at a time, embrace challenge. Extinguish use cues and claim your prize once you do, another slice of a nicotine-free life. Recovery is about taking back life. Why fear it? Instead, savor and relish reclaiming it. Maybe I'll have a crave tomorrow. But it's been so many years (since 2001) that I'm not sure I'd recognize it. Why fear our circumstances when we can embrace them? They cannot

The Redish model also predicted that drugs would not show Kamin blocking. Kamin blocking is a phenomenon where animals don't learn that a second cue predicts reward if a first clue already predicts it. This phenomenon is well-described by value-prediction error (VPE) - once the animal learns that the first cue predicts the reward, there is no more VPE (because it's predicted!) and the animal does not learn about the second cue. Redish noted that because drugs provided dopamine, and dopamine was hypothesized to be that VPE delta signal, that when drugs were the 'reward', there was always VPE. Thus, drug outcomes should not show Kamin blocking. The first tests of this did not conform to the prediction - animals showed Kamin blocking, even with drug outcomes. However, Jaffe et al. (2014) wondered whether this was related to the subset problem - that only some animals were actually overvaluing the drug. Jaffe et al. tested rats in Kamin blocking for food and nicotine. All rats showed normal Kamin blocking for food. Most rats showed normal Kamin blocking for nicotine. But the subset of rats that were high responders to nicotine did not show Kamin blocking to nicotine, even though they did to food, exactly as predicted by the Redish model.

Nicotine patches are somewhere in between gum and cigarettes. They contain more nicotine than the gum, but since you absorb it slowly through your skin throughout the day, you get sustained focus and energy. When I tried nicotine patches, I’d take the smallest-dose patch I could find and cut it in half (even though it says not to on the label). I’d leave it on for one to two hours, so I would get 1–4 mg of nicotine during that time. Nicotine inhalers are relatively hard to find, but Nicorette makes them, and they have no chemicals at all. It’s just a sponge with nicotine and a little plastic straw that you suck through to get nicotine-scented air. I like these because they’re free of nasty chemicals, but the downside is that the act of sucking on something appears to be addictive. I found myself wanting to take a puff from one when I was sitting at my desk, even when I didn’t need or want the energy from it—so I quit! Nicotine lozenges, like nicotine gum, are full of crappy chemicals and sweeteners such as aspartame, acesulfame potassium (ace-K), and sucralose. The safest one I’ve found is the Nicorette mini lozenge, which is very small and contains no aspartame. You do get a small dose of unsafe sweetener, but it’s so tiny that it’s unlikely to matter much. When I take half of the smallest, 2 mg lozenge, I feel a cognitive shift in about fifteen minutes. These lozenges are easy to find in the United States. And make sure to get the mini lozenges, as the large Nicorette lozenges are full of chemicals you don’t want to put in your body. Nicotine spray is a more recent invention. Each spray of 1 mg of nicotine contains vanishingly small amounts of sucralose. You spray it under your tongue and feel it quickly, making it an excellent option when you want a burst of sustained energy. I’ve done more than one interview while on this, and I find it’s great for jet lag or when you have a heavy day ahead of you and want to maintain focus. If you do decide to try nicotine, treat it carefully. A safe

1 The line separating habits and addictions is often difficult to measure. For instance, the American Society of Addiction Medicine defines addiction as “a primary, chronic disease of brain reward, motivation, memory and related circuitry….Addiction is characterized by impairment in behavioral control, craving, inability to consistently abstain, and diminished relationships.” By that definition, some researchers note, it is difficult to determine why spending fifty dollars a week on cocaine is bad, but fifty dollars a week on coffee is okay. Someone who craves a latte every afternoon may seem clinically addicted to an observer who thinks five dollars for coffee demonstrates an “impairment in behavioral control.” Is someone who would prefer running to having breakfast with his kids addicted to exercise? In general, say many researchers, while addiction is complicated and still poorly understood, many of the behaviors that we associate with it are often driven by habit. Some substances, such as drugs, cigarettes, or alcohol, can create physical dependencies. But these physical cravings often fade quickly after use is discontinued. A physical addiction to nicotine, for instance, lasts only as long as the chemical is in a smoker’s bloodstream—about one hundred hours after the last cigarette. Many of the lingering urges that we think of as nicotine’s addictive twinges are really behavioral habits asserting themselves—we crave a cigarette at breakfast a month later not because we physically need it, but because we remember so fondly the rush it once provided each morning. Attacking the behaviors we think of as addictions by modifying the habits surrounding them has been shown, in clinical studies, to be one of the most effective modes of treatment. (Though it is worth noting that some chemicals, such as opiates, can cause prolonged physical addictions, and some studies indicate that a small group of people seem predisposed to seek out addictive chemicals, regardless of behavioral interventions. The number of chemicals that cause long-term physical addictions, however, is relatively small, and the number of predisposed addicts is estimated to be much less than the number of alcoholics and addicts seeking help.) *

Do you consider yourself valuable? Do you value yourself less than or more than other people? Describe your self-esteem and how you exhibit self-love. Are you vulnerable—either too much or not enough? Do you have issues protecting yourself, and do you become resentful at others’ behaviors? Have you been known for being “bad” or rebellious, or have you been committed to becoming perfect, the good girl or boy in your family or life? How are these behaviors related to and reflected in your spirituality? Does your faith correspond or conflict with them? Are you too dependent on other people or are you too independent? Do you fear you are dependent on other things—substances like food, alcohol, drugs, or nicotine? Do you use shopping/spending or relationships to shape your identity? Do you consider yourself mature or have you struggled with the idea that you are immature? Do you self-punish over loss of control, believing that by managing your life you prove your maturity? Do you have issues with moderation or intimacy—unsure of how to create whole and healthy boundaries in your life? After you have finished this self-concept, set it aside. Much later, you will be revisiting it, seeing the ways in which you have changed, and the new behaviors and messages you will be incorporating in your life to honor that new self.