Ellen Campbell-Grizzle

Cigarettes contain the drug nicotine. This drug stimulates dopamine release and elevates dopamine levels in the brain. Dopamine is known as the master addiction molecule and high levels in the brain reinforce drug abuse.

Nicotine also stimulates the release of another substance called noradrenaline. Nicotine addicts become accustomed to high levels of these substances in the brain. They experience pleasure, elation and alertness as a consequence of drug use. Normally, nicotine is reabsorbed or quickly broken down by the enzyme monoamine oxidase (MAO). However, a cigarette is engineered so that the action of the enzyme is blocked and nicotine is unleashed and unabated. The same chemical reaction occurs with 'beady' which is now commonly used by Jamaican youth.

Triple causes of addiction

Ultimately, nicotine changes the structure and function of the brain. It elevates dopamine levels, smokers have 25 per cent less MAO(A) and 40 per cent less MAO(B) than non-smokers. For the triple whammy, cigarettes are treated with ammonia that increases the absorption of nicotine 100 fold than tobacco in its natural state. Experts agree that it is similar to freebasing.

Symptoms of nicotine dependence begin days to weeks after occasional use, often before the user begins smoking one stick each day. When a person quits smoking, dramatic changes in their brain rival the magnitude and duration of similar changes seen during withdrawal from cocaine, heroin and amphetamines. Many tobacco addicts want to quit but find stopping very difficult. Here are some interesting facts:

70 per cent to 80 per cent of smokers want to quit.

40 per cent of heart attack smokers relapse within days of hospital discharge.

More than 50 per cent of heroin and cocaine users, and alcoholics, rate smoking as harder to give up.

Consequences of tobacco use

A vast amount of human suffering is caused by tobacco use. Cigarettes contain other harmful chemicals including cancer-causing tars. Environmental Tobacco Smoke (ETS) is harmful to non-smokers who share the smoker's environment. Children of parents who smoke show increased incidence of asthma, chronic bronchitis and middle ear infections.

Women who smoke during pregnancy severely damage the foetus. Cigarette smoking is one of the most common causes of erectile dysfunction in men. It increases 10-fold death and illness from cardiovascular diseases among diabetics and hypertensives and women who use oral contraceptives. Ninety-five per cent of all lung cancers are caused by tobacco smoking, whether active or passive.

Time to quit

If you are a smoker, your best investment is to quit. Quitting is a risk-free investment which guarantees both financial and health benefits. The only possible losers are the tobacco companies. There are three main methods of quitting once you have made up your mind to do so. They are:

Cold turkey - stopping abruptly on the appointed day.

Tapering off - set a day for quitting and reduce consumption until the day arrives.

Postponing - set a day for quitting and reduce the hours of smoking by a fixed amount of time each day until the day arrives.

You may need professional help to manage your cravings and other symptoms of withdrawal. However, drink plenty of water, walk briskly for 20 to 30 minutes each day, breathe slowly or deeply for two to three minutes and eat fruits and other low-calorie snacks to curb your appetite.

Nicotine Replacement Therapy is available to help your smoking cessation programme. Remember, a strong desire to quit will co-exist with the feeling to continue. Experts advise that at these times you should pity smokers and not envy them.

Ellen Campbell-Grizzle, president, Caribbean Association of Pharmacists; director, Information & Research, National Council on Drug Abuse; email: yourhealth@gleanerjm.com.