70.3 million Americans above 12 years reported current use of tobacco (59.9 million were cigarette smokers, 13.7 million smoked cigars, 7.2 million used smokeless tobacco, 1.8 million smoked pipes).
In the past month, 4 million American adolescents have used a tobacco product.
· Mental Illness (including depression, PTSD, bipolar, and schizophrenia)
· Low SES
· Low educational status
[...] Risk Factors Mental Illness (including depression, PTSD, bipolar, and schizophrenia) Low SES Low educational status Genetics Mutation in the a4 subunit of nicotinic acetylcholine receptors (nAChRs) expressed by neurons lowers the threshold for the induction of nicotine dependence. variant gene associated with decreased activity of CYP2B6 (enzyme that breaks down nicotine in the brain) may lead to increased craving during smoking cessation, these patients are also 1.5 times more likely to resume smoking during treatment. Pathophysiology Mechanism by which nicotine binds to nAChR and how this leads to dependence is still poorly understood. [...]
[...] - Nicotine lozenge (Commit): For patients who have 1st cigarette within 30 min after waking mg lozenge PO q1-2h for 6 weeks; 1st cigarette >30 min after waking mg lozenge PO q1-2h for 6 weeks; decrease dosing by q1-2h for 3 weeks. - Nicotine nasal (Nicotrol 1-2 sprays ( 0.5 mg/spray) each nostril q1h for 8 weeks then taper; maximum 10 sprays/h and 80 sprays/d. - Nicotine inhaled (Nicotrol Inhaler): 6-16 cartridges inhaled mg/cartridge) per day for 6-12 weeks then taper. [...]
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