Adolescent tobacco use and the subsequent

health problems are a major concern today. Tobacco consumption

has been identified as the single most preventable
cause of death and disease in ndia
n view of above, present study was carried out with an aim
to find out the prevalence of tobacco chewing among adolescents
in four villages namely Alia, bada, Vijarakhi and
Theba, rural field practicing areas of Jamnagar district and
influencing factors associated with it.
Adolescence is a critical time for the Health and future development
of boys and girls. Experience and behaviour during
these formative years can influence lifelong health, as well as
put current health at risk. So, present study is an attempt to
identify the habit of addiction among 930 adolescents in rural
area.


Sl.No Content Questions Total
1 Introduction 1,2,3,4,16,19 06
2 Causes 5,6,7,8,9,10 06
3 EIIects oI smoking
(Physiological)
11,12,13,14,15,17,
18,20,21,22,23
11
4 Physical EIIects oI smoking 24 01
5 Mental eIIects oI smoking 25,26 02
6 Treatment 27,28,29,30 04

Forms
Smokeless Tobacco used in India
Pan-betel quid with tobacco
Pan Masala

Tobacco areca nut and slaked lime
preparation

Mainpuri rabacco
Mawa
Tobacco and slaked lime (khaini)
Chewing tobacco
Suns
Mishri
Gul
Bajjar
Gudhaku
Creamy snuII
Tobacco Water

Smoked Tobacco
Beedis
Cigarettes
Cigars
Cheroots
Chuttas
Reverse chutta smoking
Dhumti
Reverse Dhumti smoking
Pipe
Hooklis
Chillum
Hookah

n
Tobacco is responsible for cancer at many sites: ungs, mouth, pharynx, larynx, stomach,
urinary bladder, gall Bladder, penis (and possibly others) In India, total number oI tobacco
related deaths are likely to be between 800,000 to 900,000 per year. Tobacco leads to: Heart
and blood vessel disease, myocardial InIraction (Heart Attack), Angina (Chest Pain), sudden
Cardiac Death (Unheralded sudden death), stroke (Brain Attack), peripheral Vascular Disease
(Gangrene oI legs).

There is 'one' tobacco related death every 8 seconds
O Smokers/tobacco consumers are 2 to 3 times more likely to develop heart disease and
paralysis than non-smokers.
O Smoking causes more than 90 oI lung cancers and other lung diseases (chronic
bronchitis, emphysema).
any other cancers are caused by tobacco: ral cancers (cancer oI the cheek), stomach
cancers, kidney cancers, bladder cancers.

O $moking / tobacco consumption is a cause of impotence in men.
O Smoking / tobacco consumption decreases estrogen levels in women. Menopause occurs
earlier.
O Smoking / tobacco consumption decreases ability oI physical activity and decreases
physical endurance.
O Women who smoke and take birth control pills are at a greatly increased risk oI a stroke.

O Smoking / tobacco suddenly raises the blood pressure and reduces the blood Ilow to the
heart.
O It also decreases the Ilow oI blood to the Ieet and can cause gangrene oI the legs.
O Tobacco damages the lining oI the arteries all over the body.
O Smoking causes health problems Ior children and other Iamily members (due to second-
hand smoke).
O A non-smoker living with two packs per day smoker, smokes passively equivalent oI
three cigarettes per day according to urine nicotine levels.
O It has also been Iound that smoking/tobacco consumption increases the risk oI diabetes.
O Higher the good cholesterol in the blood the better it is. ower the good cholesterol in the
blood higher is the threat. Tobacco lowers the good cholesterol in the blood.

Why Give up tob
Tobacco is a heart breaker and a body breaker as tobacco mainly kills through heart disease and
cancers.
Nicotine addiction ensures liIe-long customers not long-liIe customers
t's never too late to give it up!
Stopping smoking/tobacco even in middle age beIore having cancer or some other serious
disease avoids most oI the later excess risk oI death Irom tobacco. The beneIits oI stopping at
earlier ages are even greater.nce you give up tobacco the risk oI heart attacks normalized to
that oI a non-smoker in 3 years.
Benefits of Quitting Tobacco
Quitting smoking lowers many health risks very quickly. II you quit, here are only a Iew oI the
beneIits:
The Physical benefits of quitting tobacco:
1. our risk oI cancer and heart disease will go down.
2. Stress on your heart will be reduced.
3. our loved ones will not be harmed by your smoke.
4. our smoker's cough (persistent cough and phlegm) will most probably disappear.
5. our teeth will become whiter and cleaner.
The $ocial benefits of quitting tobacco:
1. ou will be the one in control - cigarettes will no longer control you.
2. our selI-image and selI-conIidence will improve.
3. ou'll be a healthier parent Ior your children, now and in the Iuture.
4. ou'll have more money to spend on other things.
What kind oI drug is tobacco and why does it cause calming?
Answer:
Recreational drugs can be divided into three categories. There are stimulating substances
(uppers), calming/tranquillising substances (downers), and there are psychedelic substances
(psychedelics).
Tobacco is a stimulating substance, although many smokers will say it has a calming eIIect on
them. However, this calming eIIect is not a characteristic oI tobacco. Tobacco is, aIter all, a
stimulating substance that makes people restless.
The calming eIIect is due to the Iact that people have become physically dependent on tobacco.
Because oI habitual smoking, the body has gotten used to a certain level oI nicotine. When this
level goes down the body reacts with withdrawal symptoms. ne oI those withdrawal symptoms
is restlessness. This withdrawal symptom can be temporarily suppressed by increasing the
nicotine level. ou do that by smoking again. The restlessness disappears, and you Ieel calm.
This explains the calming eIIect oI tobacco.
ou think that tobacco calms you down, but you Iorget that the tranquility is in Iact nothing
more than disappeared Ieelings oI restlessness. This restlessness is caused in the Iirst place by
tobacco. Tobacco brings you into a vicious circle. Tobacco causes restlessness which you
temporarily suppress with tobacco. By smoking again, your body gets used to the nicotine,
however, and your Ieelings oI restlessness and your need Ior tobacco will only increase.

ffects of Nicotine
Nicotine changes how your brain and your body Iunction. The net results are somewhat oI a
paradox: Nicotine can both invigorate and relax a smoker, depending on how much and how
oIten they smoke. This biphasic eIIect is not uncommon. Although the actions oI nicotine and
ethanol in the body are quite diIIerent, you also see dose-dependent eIIects when you drink
alcoholic beverages. our Iirst drink may loosen your inhibitions and Iire you up, but aIter
several drinks, you're usually pretty sedate.
Nicotine initially causes a rapid release oI adrenaline, the "Iight-or-Ilight" hormone. II you've
ever jumped in Iright at a scary movie or rushed around the oIIice trying to Iinish a project by
your deadline, you may be Iamiliar with adrenaline's eIIects:
O Rapid heartbeat
O Increased blood pressure
O Rapid, shallow breathing
Adrenaline also tells your body to dump some oI its glucose stores into your blood. This makes
sense iI you remind yourselI that the "Iight-or-Ilight" response is meant to help you either deIend
yourselI Irom a hungry predator or hightail it out oI a dangerous situation -- running or brawling
both require plenty oI energy to Iuel your muscles. (For more inIormation, see How Exercise
Works.)
Nicotine itselI may also block the release oI the hormone insulin. Insulin tells your cells to take
up excess glucose Irom your blood. This means that nicotine makes people somewhat
hyperglycemic, having more sugar than usual in their blood. Some people think that nicotine
also curbs their appetite so that they eat less. This hyperglycemia could be one explanation why:
Their bodies and brain may see the excess sugar and down-regulate the hormones and other
signals that are perceived as hunger.
Nicotine may also increase your basal metabolic rate slightly. This means that you burn more
calories than you usually would when you are just sitting around. (For more inIormation on
metabolism, see How Calories Work.) However, losing weight by smoking doesn't give you any
oI the health beneIits that you'd get iI you were losing weight by exercising -- it actually does the
opposite! ver the long haul, nicotine can increase the level oI the "bad" cholesterol, LDL, that
damages your arteries. This makes it more likely that you could have a heart attack or a stroke
Nicotine is one oI the most heavily used addictive drugs in the United States. Cigarette smoking
has been the most popular method oI taking nicotine since the beginning oI the 20th century.
In 1989, the U.S. Surgeon General issued a report that concluded that cigarettes and other Iorms
oI tobacco, such as cigars, pipe tobacco, and chewing tobacco, are addictive and that nicotine is
the drug in tobacco that causes addiction. In addition, the report determined that smoking was a
major cause oI stroke and the third leading cause oI death in the United States. As a parent or
individual, iI you suspect someone oI using this substance you can get a deIinitive answer by
using a simple, private urine drug testing kit. There are easy-to-use nicotine/cotinine urine drug
testing products at https://www.homedrugtestingkit.com/zshop.
What is nicotine?
Nicotine, one oI more than 4,000 chemicals Iound in the smoke Irom tobacco products such as
cigarettes, cigars, and pipes, is the primary component in tobacco that acts on the brain.
Smokeless tobacco products such as snuII and chewing tobacco also contain many toxins as well
as high levels oI nicotine. Nicotine, recognized as one oI the most Irequently used addictive
drugs, is a naturally occurring colorless liquid that turns brown when burned and acquires the
odor oI tobacco when exposed to air. There are many species oI tobacco plants; the tabacum
species serves as the major source oI tobacco products today. Since nicotine was Iirst identiIied
in the early 1800s, it has been studied extensively and shown to have a number oI complex and
sometimes unpredictable eIIects on the brain and the body. It is very important to get the use oI
this drug stopped. ne oI the ways to do that is to do regular urine drug testing oI the person who
is using this drug. Urine drug testing products are available Ior purchase at
https://www.homedrugtestingkit.com/zshop now.
Cigarette smoking is the most prevalent Iorm oI nicotine addiction in the United States. Most
cigarettes in the U.S. market today contain 10 milligrams (mg) or more oI nicotine. Through
inhaling smoke, the average smoker takes in 1 to 2 mg nicotine per cigarette. There have been
substantial increases in the sale and consumption oI smokeless tobacco products also, and more
recently, in cigar sales.
Nicotine is absorbed through the skin and mucosal lining oI the mouth and nose or by inhalation
in the lungs. Depending on how tobacco is taken, nicotine can reach peak levels in the
bloodstream and brain rapidly. Cigarette smoking, Ior example, results in rapid distribution oI
nicotine throughout the body, reaching the brain within 10 seconds oI inhalation. Cigar and pipe
smokers, on the other hand, typically do not inhale the smoke, so nicotine is absorbed more
slowly through the mucosal membranes oI their mouths. Nicotine Irom smokeless tobacco also is
absorbed through the mucosal membranes.
s nicotine addictive?
es, nicotine is addictive. Most smokers use tobacco regularly because they are addicted to
nicotine. Addiction is characterized by compulsive drug seeking and use, even in the Iace oI
negative health consequences, and tobacco use certainly Iits the description. It is well
documented that most smokers identiIy tobacco as harmIul and express a desire to reduce or stop
using it, and nearly 35 million oI them make a serious attempt to quit each year. UnIortunately,
less than 7 percent oI those who try to quit on their own achieve more than 1 year oI abstinence;
most relapse within a Iew days oI attempting to quit.
ther Iactors to consider besides nicotine's addictive properties include its high level oI
availability, the small number oI legal and social consequences oI tobacco use, and the
sophisticated marketing and advertising methods used by tobacco companies. These Iactors,
combined with nicotine's addictive properties, oIten serve as determinants Ior Iirst use and,
ultimately, addiction. As a parent or individual, iI you suspect someone oI using this substance
you can get a deIinitive answer by using a simple, private urine drug testing kit. There are easy-
to-use nicotine/cotinine urine drug testing products at
https://www.homedrugtestingkit.com/zshop.
Recent research has shown in Iine detail how nicotine acts on the brain to produce a number oI
behavioral eIIects. I primary importance to its addictive nature are Iindings that nicotine
activates the brain circuitry that regulates Ieelings oI pleasure, the so-called reward pathways. A
key brain chemical involved in mediating the desire to consume drugs is the neurotransmitter
dopamine, and research has shown that nicotine increases the levels oI dopamine in the reward
circuits. Nicotine's pharmacokinetic properties have been Iound also to enhance its abuse
potential. Cigarette smoking produces a rapid distribution oI nicotine to the brain, with drug
levels peaking within 10 seconds oI inhalation. The acute eIIects oI nicotine dissipate in a Iew
minutes, causing the smoker to continue dosing Irequently throughout the day to maintain the
drug's pleasurable eIIects and prevent withdrawal.
What people Irequently do not realize is that the cigarette is a very eIIicient and highly
engineered drug-delivery system. By inhaling, the smoker can get nicotine to the brain very
rapidly with every puII. A typical smoker will take 10 puIIs on a cigarette over a period oI 5
minutes that the cigarette is lit. Thus, a person who smokes about 1-1/2 packs (30 cigarettes)
daily, gets 300 "hits" oI nicotine to the brain each day. These Iactors contribute considerably to
nicotine's highly addictive nature.
ScientiIic research is also beginning to show that nicotine may not be the only psychoactive
ingredient in tobacco. Using advanced neuroimaging technology, scientists can see the dramatic
eIIect oI cigarette smoking on the brain and are Iinding a marked decrease in the levels oI
monoamineoxidase (MA), an important enzyme that is responsible Ior breaking down
dopamine. The change in MA must be caused by some tobacco smoke ingredient other than
nicotine, since we know that nicotine itselI does not dramatically alter MA levels. The decrease
in two Iorms oI MA, A and B, then results in higher dopamine levels and may be another
reason that smokers continue to smoke - to sustain the high dopamine levels that result in the
desire Ior repeated drug use. Personal and private nicotine/cotinine drug testing is an important
part oI helping an addict stop their substance abuse. Please visit
https://www.homedrugtestingkit.com/zshop now to purchase your urine drug testing kits today.
What is the extent and impact of tobacco use?
According to the 1999 National Household Survey on Drug Abuse, an estimated 57.0 million
Americans were current smokers and 7.6 million used smokeless tobacco, which means that
nicotine is one oI the most widely abused substances. In addition, in 1998 each day in the United
States more than 2,000 people under the age oI 18 began daily smoking. According to the
Centers Ior Disease Control and Prevention (CDC), the prevalence oI cigarette smoking among
U.S. high school students increased Irom 27.5 percent in 1991 to 36.4 percent in 1997 beIore
declining to 34.8 percent in 1999. NIDA's own Monitoring the Future Study, which annually
surveys drug use and related attitudes oI America's adolescents, also Iound the prevalence rates
Ior smoking among youth declined Irom 1999 to 2000. Since 1975, nicotine in the Iorm oI
cigarettes has consistently been the substance the greatest number oI high school students use
daily.
The impact oI nicotine addiction in terms oI morbidity, mortality, and economic costs to society
is staggering. Tobacco kills more than 430,000 U.S. citizens each year-more than alcohol,
cocaine, heroin, homicide, suicide, car accidents, Iire, and AIDS combined. Tobacco use is the
leading preventable cause oI death in the United States.
Economically, an estimated $80 billion oI total U.S. health care costs each year is attributable to
smoking. However, this cost is well below the total cost to society because it does not include
burn care Irom smoking-related Iires, perinatal care Ior low-birth-weight inIants oI mothers who
smoke, and medical care costs associated with disease caused by secondhand smoke. Taken
together, the direct and indirect costs oI smoking are estimated at $138 billion per year.
ow does nicotine deliver its effect?
Nicotine can act as both a stimulant and a sedative. Immediately aIter exposure to nicotine, there
is a "kick" caused in part by the drug's stimulation oI the adrenal glands and resulting discharge
oI epinephrine (adrenaline). The rush oI adrenaline stimulates the body and causes a sudden
release oI glucose as well as an increase in blood pressure, respiration, and heart rate. Nicotine
also suppresses insulin output Irom the pancreas, which means that smokers are always slightly
hyperglycemic. In addition, nicotine indirectly causes a release oI dopamine in the brain regions
that control pleasure and motivation. This reaction is similar to that seen with other drugs oI
abuse-such as cocaine and heroin- and it is thought to underlie the pleasurable sensations
experienced by many smokers. In contrast, nicotine can also exert a sedative eIIect, depending
on the level oI the smoker's nervous system arousal and the dose oI nicotine taken.
What happens when nicotine is taken for long periods of time?
Chronic exposure to nicotine results in addiction. Research is just beginning to document all oI
the neurological changes that accompany the development and maintenance oI nicotine
addiction. The behavioral consequences oI these changes are well documented, greater than 90
percent oI those smokers who try to quit without seeking treatment Iail, with most relapsing
within a week. In addition, personal and private drug testing will reinIorce the behavior which
leads to discontinuance oI nicotine use. Go to https://www.homedrugtestingkit.com/zshop Ior
purchase oI easy-to-use drug testing kits right now.
Repeated exposure to nicotine results in the development oI tolerance, the condition in which
higher doses oI a drug are required to produce the same initial stimulation. Nicotine is
metabolized Iairly rapidly, disappearing Irom the body in a Iew hours. ThereIore some tolerance
is lost overnight, and smokers oIten report that the Iirst cigarettes oI the day are the strongest
and/or the "best." As the day progresses, acute tolerance develops, and later cigarettes have less
eIIect.
Cessation oI nicotine use is Iollowed by a withdrawal syndrome that may last a month or more; it
includes symptoms that can quickly drive people back to tobacco use. Nicotine withdrawal
symptoms include irritability; craving, cognitive and attentional deIicits sleep disturbances, and
increased appetite and may begin within a Iew hours aIter the last cigarette. Symptoms peak
within the Iirst Iew days and may subside within a Iew weeks. For some people, however,
symptoms may persist Ior months or longer.
An important but poorly understood component oI the nicotine withdrawal syndrome is craving,
an urge Ior nicotine that has been described as a major obstacle to successIul abstinence. High
levels oI craving Ior tobacco may persist Ior 6 months or longer. While the withdrawal syndrome
is related to the pharmacological eIIects oI nicotine, many behavioral Iactors also can aIIect the
severity oI withdrawal symptoms. For some people, the Ieel, smell, and sight oI a cigarette and
the ritual oI obtaining, handling, lighting, and smoking the cigarette are all associated with the
pleasurable eIIects oI smoking and can make withdrawal or craving worse. While nicotine gum
and patches may alleviate the pharmacological aspects oI withdrawal, cravings oIten persist.