Alcohol

Nicotine is both a transient stimulant and a sedative to the central nervous system. Nicotine is physically and psychologically addictive. The ingestion of nicotine results in an almost immediate "kick" because it causes a discharge of epinephrine from the adrenal cortex. This stimulates the central nervous system, as well as other endocrine glands, which causes a sudden release of glucose. Stimulation is then followed by depression and fatigue, leading the abuser to seek more nicotine.

There are three principal ways to consume tobacco: smoking, chewing and dipping, and snuffing. All three ways produce approximately equal blood nicotine levels in tobacco users. Cigarette smoking has been the most popular method of taking nicotine since the beginning of the 20th century. In 1989 the U.S. Surgeon General issued a report that concluded that cigarettes and other forms of 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 of stroke and the third leading cause of death in the United States. Despite this warning, the National Household Survey on Drug Abuse shows that more than 61 million Americans were current cigarette smokers in 1996, making nicotine one of the most heavily used addictive drugs in the United States.

Smoking has been identified as the single most preventable cause of death and disease in the United States. Approximately 50 million Americans smoke. They consume about 540 billion cigarettes each year, and each year approximately 390,000 people die from smoking-related causes. Cigarette smoke contains more than 300 known poisons, including such deadly substances as nicotine, arsenic, cyanide, carbon monoxide, phenol and formaldehyde. Cigarette smoking is such an enticing habit that few smokers realize they are addicted - until they are hooked.

Chewing looseleaf tobacco and "dipping" moist, ground snuff tobacco are two common ways to use tobacco without smoking. There are as many as 12 million chewers and dippers in the United States who consume smokeless tobacco - many under the mistaken impression that it is safer than cigarette smoking. Smokeless tobacco contains powerful chemicals, including nicotine, nitrosamines, polycyclic aromatic hydrocarbons, and dozens of other carcinogens, that can injure tissues in the mouth and throat.

Despite users' erroneous impressions about differing health risks in cigarettes and smokeless tobacco, the health risks presented by smokeless tobacco use are substantial, and cigarettes and smokeless tobacco cannot be meaningfully compared. The Surgeon General has concluded that "the oral use of smokeless tobacco represents a significant health risk. It is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous oral conditions and can lead to nicotine addiction and dependence."

Snuffing is a method of tobacco administration rarely employed in the United States today. In snuffing, a dry powdered tobacco is "snorted" and brought into contact with the nasal passageways, and the nicotine is absorbed through the epithelium in the upper nasal passages.

Smokeless tobacco use has short-term physical effects and consequences including:

Rapid absorption of the stimulant nicotine through the mouth into the bloodstream.

Increased heart rate and blood pressure.

Constricted blood vessels.

Addiction to nicotine.

Reduced physical performance and/or productivity.

Smokeless tobacco use has other physical consequences:

Chemicals in the tobacco produce three carcinogens (cancer-causing agents); when combined with saliva, additional carcinogens are produced.

Application of these carcinogens can produce white, thick patches called leukoplakia on the lining of the mouth; these lesions are considered to be precancerous.

Extensive studies conclude there is a positive correlation between smokeless tobacco use and cancers of the oral cavity, pharynx, larynx, and esophagus. In an Arkansas study, 91% of patients with oral cancers had used smokeless tobacco.

Damage to gum tissue.

Increased sensitivity to cold and heat.

Loosened teeth which can eventually fall out.

Reduced sense of taste and ability to smell.

Not using smokeless tobacco has many social benefits including: Breath does not smell like tobacco; unstained teeth; approval by most people. The following are some tips for quitting cigarettes and smokeless tobacco:

* Make a list of all the reasons you want to quit; keep it with you and look at it often.

* Be assertive; Announce your plan to quit; Tell others clearly why you are quitting tobacco; Ask for help from friends and family members who will offer encouragement.

* Make it difficult to use tobacco; Wet down and throw out all cigarettes and smokeless tobacco.

* When the urge to use tobacco hits, take a deep breath. Hold it for ten seconds, then release slowly. Deep, rhythmic breaths are similar to smoking, only you inhale clean air instead of poisonous gases.

* Stock up on low-calorie "nibbles": sugarless gum, hard candy, carrots, sunflower seeds, fresh fruit, popcorn.

* Avoid situations where you usually use tobacco: the "smoking area" at school, the convenience store or mall, riding with friends who smoke or chew, etc.; Avoid "triggers" -- those certain times, places and situations that make you want to use tobacco.

* Keep busy. Plan alternatives to tobacco use for coping with stress; Acquire some new hobbies: write a letter, play an instrument, take a walk, call a friend.

* Get rid of "tobacco mouth" by brushing your teeth several times.

* Figure out how much money you will save by not using tobacco.

* Reward yourself frequently. Quitting is hard; you deserve credit for your efforts. Plan to reward yourself with each success; buy a new record or tape, a new pair of jeans, or do something nice for yourself; Reward yourself for each week and month you stay off the tobacco.

* Be patient with yourself; Be positive; Don't be defeated.

Alcohol

Marijuana

To obtain information on another of the topics in this section, click on the highlighted words:

Trends in Youth Substance Abuse.

Warning Signs for Youth Substance Abuse.