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Nicotine is the main ingredient in cigarettes and is one of the major causes of death in the U.S. 1 in 5 deaths are attributed to cigarette smoking, annually, and nicotine is the significant cause of heart and lung disease, vascular disease, stroke, high blood pressure, artery constriction, cancer, chronic obstructive pulmonary disease (COPD), emphysema, low birth weight and perinatal mortality. So, why do people continue to smoke? Research shows that smoking behavior is influenced nicotine dependence (both physical and psychological), genetic and environmental factors and psychosocial behavior. Some smokers may be predisposed to nicotine addiction through the effects of a gene responsible for metabolizing nicotine. Non-smokers are twice as likely to carry a mutation in a gene that helps the body dispose of nicotine. Nicotine is highly addictive and is a potent psychoactive drug that induces euphoria, thereby reinforcing its use.
Patients who quit will often experience nicotine withdrawal symptoms. While cigarette manufacturers have publicly denied the addictive effects of nicotine research indicates that smoking is not a habit but, in most cases, is because of the addictive cycle established by nicotine. Like most addictive drugs, Nicotine changes the chemical balance in the brain. It acts as both a stimulant and a relaxant, with a blend of effects that includes increased focus, reduced fatigue reduced anxiety and induced euphoria. It acts on stress hormones and endorphins. The addictive effect of nicotine is linked to the triggered release of dopamine, a chemical in the brain that is associated with feelings of pleasure. Recent research suggests that the long-term use of nicotine depresses the brain’s ability to experience pleasure and therefore requires more nicotine to achieve the same level of satisfaction. Some research indicates that nicotine ranks ahead of alcohol, cocaine, and heroin as an addictive substance. One of the most telling signs of the addictive properties of nicotine is the discrepancy between the desire to quit and the actual number of people who do quit. Studies indicate that about 70% of smokers want to stop smoking, yet 20% or less abstain for as long as a year, and only 3% quit, using will power alone. Most smokers make several attempts to quit before they succeed. Smokers are often reluctant to quit even after undergoing surgery for smoking related diseases. 40% of laryngectomy patients smoke afterwards and 50% of lung cancer patients resume smoking after surgery
What are the symptoms?
Since nicotine is not an illegal substance, it is not difficult to recognize the primary signs of smoking. Just look for the cigarette in the patient’s hand or the pack in their pocket or purse. Secondary symptoms that are less obvious, and may be life threatening include:
How is it diagnosed and treated?
Doctors do not have to look far to diagnose nicotine addiction. Patients are typically willing to admit smoking, though they may downplay the frequency and the number of packs per day they smoke.
The official diagnostic criteria for Nicotine Addiction include any three of the following signs within a one- year period:
Treatment(s) can include:
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The Warning Signs Of An Impending Bipolar Disorder Manic Episode
Bipolar disorder - as the name implies - involves two distinct set of symptoms. One set throws the individual down into the depths of a massive depression. The other places the individual who suffers with bipolar disorder at the top of a peak manic episode.
Most everyone can eventually recognize the warning signs of an impending depressive episode related to bipolar disorder. More likely than not, individuals with bipolar disorder try very hard to avoid it.
However, for many individuals with bipolar disorder, it's more difficult to recognize the signs of an impending manic episode. After all, a manic episode of bipolar disorder can be mistaken in some cases - especially in the very early formation -- for the lifting of the corresponding mood swing of the depression.
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