Smoke
Synonyms
Tobacco smoking, nicotine consumption, nicotine abuse
English: tobacco smoking
introduction
Under "Smoke"One understands the inhalation of tobacco smoke, which occurs when tobacco products are burned (Cigarettes, cigars, cigarillos, shisha, pipes) arises.
The term "Passive smoking“Describes the unwanted inhalation of tobacco smoke from the room air only by the nose. There is no smoking here.
Epidemiology
a) Tobacco use
For example, smoke in Germany 27% of the total population (As of 2010), with 61% to male and at 39% are female smokers. The EU average is 32%.
86% of nicotine users in Germany state that they smoke regularly, with 14% of smokers only consuming tobacco irregularly. The highest proportion of smokers is found among 20 to 25 year olds; 15% of all German smokers are young, the starting age being around 13 years.
In 1999, 82% of adults had started tobacco smoking before the age of 20. Each year around 1350 cigarettes are smoked per inhabitant in Germany.
Smoking behavior is more pronounced in the lower social classes than in higher social classes. The occupational group with the highest proportion of smokers are construction workers as well as bus and truck drivers.
b) Mortality (mortality) among active smokers
50% of all smokers die from an illness associated with tobacco use. They also do this on average 10 years earlier than non-smokers.
It is estimated that average life expectancy would be 3 years longer without parts of the population who smoke.
c) Mortality from passive smoking
In Germany around 3300 non-smoking people die of the every year Consequences of secondhand smoke.
d) associated diseases
30% of all Cancers are caused by smoking in Germany Lung cancer it is even more than 80%. In Germany, 60,000 to 80,000 smokers die each year from tobacco-associated cancer.
A first time Heart attack On average, smokers are 10 years more likely than non-smokers.
25% of deaths in Germany Cardiovascular diseases are due to smoking; the risk of stroke increases by 2 to 4 times.
history
Since 16th Century Tobacco is smoked in Europe, which originally was by Columbus was brought back by American Indian tribes. Herbs, however, were already smoked by the Romans, Greeks and Germanic peoples and the Maya are said to have inhaled smoke.
It has been known since the beginning of the 20th century that smoking also has harmful effects.
Ingredients of the smoke
When active Smoke One cigarette absorbs over 4000 different chemical substances. These include, for example nicotine, Arsenic, carbon monoxide or acetone. About 250 of these ingredients inhaled when smoking are toxic, about 70 are carcinogenic (carcinogen). Nicotine itself is not carcinogenic, but it is responsible for it Addiction development (see effect of nicotine).
Smoke, which is inhaled during passive smoking, also contains a variety of chemical substances, among other things Arsenic, carbon monoxide and Acetone.
Effect of nicotine in the central nervous system
The nicotine gets out of the smoke after inhalation lung into the bloodstream and from there into the brain. Here it binds in a certain brain region (ventral tegmentum, Part of Brain stem) to special receptors (nicotinic acetycholineReceptors). As a result, another region of the brain, the im Forebrain lying Nucleus accumbens, Dopamine is released, which is probably responsible for the feeling of reward, calm and satisfaction caused by smoking.
If you now smoke frequently, i.e. consume nicotine regularly, the phenomenon of tolerance arises, a habit of getting used to the amount of nicotine. The number of receptors decreases due to the regular nicotine receptor binding, which is why the responsiveness to nicotine decreases at the same time. In order to achieve the same effect when smoking, a steadily higher nicotine dose is required over time.
If the brain is no longer supplied with nicotine when you stop smoking and the level in the blood decreases, the nicotine bound to the receptors also disappears. Therefore, the release of dopamine dries up and the first symptoms of withdrawal such as irritability and a greater craving for nicotine appear. As a result, the person smokes again and the cycle starts all over again.
In addition to the aforementioned signs of abstinence, irritability and nicotine cravings, there are numerous others that occur during prolonged withdrawal. On the one hand, the mood can change; Anger, frustration, restlessness, impatience, fear or depression can arise. On the other hand, the sleep rhythm may change (sleep disorders, S.insomnia) and the ability to concentrate decreases. Furthermore, the appetite can change; its increase or cravings associated with weight gain and Obesity are also among the symptoms of abstinence. Also the emergence of dizziness and a headache is possible if the person stops smoking and remains abstinent.
diagnosis
The diagnosis "Nicotine abuse“Is based on the anamnese, paying attention to the duration, amount and regularity of smoking. The amount of tobacco consumed is given in packyears, that is, in cigarette packets multiplied by the years. For example, if a person has been smoking 1 packet of cigarettes a day for 15 years, this is calculated as 15 packyears (15 years times 1 packet).
Furthermore, the physical examination provides indications of heavy nicotine consumption: Examples are tobacco smell, color and texture of the skin and teeth or condition of the vessels.
prophylaxis
The prophylaxis of smoking is on the one hand in the hands of society and on the other hand in the hands of the doctor.
Society can make its contribution through constant education through the media or the Non-Smoking Protection Act. Doctors should also educate patients about the consequences of smoking and actively address this issue during preventive medical checkups (youth care, check-up 35).
In order to prevent tobacco-associated diseases, the attending physician should advise his patients if they are aware of nicotine consumption, lead them to a smoking cessation and finally a Weaning therapy initiate.
forecast
a) Start of smoking
If a person starts smoking, there is a risk of developing addiction 32%. The risk of one tobacco-associated disease to die is 50%.
b) Smoking cessation
The success rate after 12 months depends on the type of therapy. At a "cold withdrawal“As well as the alternative methods Acupuncture for smoking and hypnosis, the success rate is 3 to 5%. When performing behavioral therapy, it increases to 13%, and when using nicotine replacement therapy, it increases to 17%. If, however, medication is used, this leads to success in 16 to 23% of cases. A combination of nicotine replacement therapy and behavioral therapy achieves the highest success rate of all forms of therapy, namely 35%.
If you successfully quit smoking, the first benefit can be seen after just 3 months: lung function improves, shortness of breath, to cough and tiredness decrease. If further time elapses in which nicotine consumption is avoided, the risk of the former smoker of developing cardiovascular or tumor diseases decreases: after one year the risk for CHD (coronary heart disease) only 50%, after 15 years it is comparable to that of a non-smoker. After 5 to 15 smoke-free years, that too is stroke - Risk only as high as with a non-smoking person. The Lung cancer - Risk is reduced by 50 to 70% after 10 years if smoking is stopped.
Summary
27% of the German population actively smokes, which means inhaling tobacco smoke. More regular Nicotine consumption In addition to the positive psychological consequences such as a sense of belonging or enjoyment, it has a number of harmful consequences and can be addictive. The effect of nicotine in the brain is responsible for the emergence of addiction to smoking; the numerous chemical substances contained in tobacco products are harmful to health.
Illnesses associated with smoking arise from both active and passive smoking. These include, for example, cardiovascular diseases, cancer or respiratory diseases.
There are several ways to interrupt nicotine abuse and should best be used with professional help. Nicotine replacement therapy, drug therapy, behavior therapy or a combination of the above are the most successful. With successful smoking cessation, the longer the smoking-free period, the lower the risk of contracting the diseases mentioned.
