Free Base Nicotine Makes Cigarettes More Addictive
On
October 1, 2003, Connecticut joined six other states in the country that ban
smoking in restaurants. As of that
date, all restaurants with more than 5 employees are required to be smoke
free. A similar prohibition in bars
and taverns will begin on April 1, 2004.
Even
though the decision to smoke is an individual choice, the ramifications have
societal impact. According to the Centers
for Disease Control, smoking alone is responsible for more than 400,000 deaths
each year, and accounts for over $50 billion in annual medical costs. The CDC estimates that 1/3 of all new
smokers will eventually die from tobacco use. Smoking kills more people than
drugs, alcohol, AIDS, fires, homicide, suicide, and automobile accidents
combined each year, yet, tobacco use remains the most preventable cause of death
in this country.
Further,
the decision to smoke jeopardizes not only the smoker’s health, but also the
health of those around him or her. Second-hand smoke (environmental tobacco
smoke)
is more
dangerous than mainstream smoke, because bystanders are exposed to unfiltered
smoke continuously. This
“side-stream smoke” contains over 4000 chemicals, including at least 200 known
poisons; 43 of those are known to cause cancer. No-smoking legislation and
policies have been adopted in response to the growing recognition that
environmental tobacco smoke (ETS) poses a major health threat. In fact, the Environmental Protection
Agency estimates that 3000-4000 lung cancer deaths occur each year as a result
of exposure to ETS. In addition,
such smoke is responsible for many deaths from heart disease, as well as the
development of coronary disease, impaired circulation, and
asthma.
In
addition to instituting smoking bans, tobacco
advertising and sales have been limited by legal restrictions during the past 20
years, but tobacco companies continuously develop new methods to promote the use
of tobacco products. One such
strategy used by tobacco companies has been the use of additives designed to
make cigarettes more addictive. A
study just recently published revealed that the addition of ammonia, urea, and
other ammonia-forming compounds serves to increase the level of nicotine in the
smoker’s body. Nicotine is an
addictive drug that reaches the brain faster when inhaled than drugs that enter
the body intravenously do. The added ammonia mixes with nicotine salts to
produce liquid tobacco smoke particles comprised of free-base nicotine.
This
type of nicotine resides in both the particle phase and the gas phase of
smoking. In the particle phase,
free-base nicotine diffuses out of the particles and into the respiratory tract
and adjacent tissues more rapidly than in its non-free base form. Further, in the gas phase, free-base
nicotine “deposits more efficiently” in the respiratory tract, and is deposited
in lung tissue and diffuses into the body immediately. Any increase in the free-base form of
nicotine will increase the amount of available nicotine and allows for more
rapid absorption into the body. Research has shown that a drug becomes more
addictive when “it is delivered to the brain more rapidly.” A nicotine expert at the University of
California states “the rate of absorption of nicotine . . . into the blood
stream influences the addictiveness of the product, and the rate of absorption
of nicotine from cigarette smoke is dependent on how much of the nicotine is in
the free-base form.” The addition
of ammonia in tobacco smoke is likened to what occurs when cocaine is free-based
in “crack” form. When the
free-based cocaine is smoked, it is aerosolized and is quickly absorbed into the
body, “leading to an immediate and intense high that is said to be comparable to
that obtained with the intravenous injection of cocaine.” How quickly nicotine is absorbed by the
body is determined by the amount of free-base nicotine in the tobacco product –
this determines how addictive the product is.
Given
that the public has been bombarded with information about the detrimental
effects of both mainstream and second hand smoke for decades, one might expect
that great strides have been made in preventing people from smoking in the first
place, and in quitting smoking in the second. Yet, approximately
1/3 of the population of the U.S. continues to smoke, illustrating how addictive
this habit truly is. In fact, the
addictive nature of cigarettes is responsible for the long-term success and
continuation of the tobacco industry, which was the first to recognize that
marketing cigarettes was
a means to deliver an addictive drug. As a document from the Phillip Morris
Company explained,
The cigarette should be conceived
not as a product but as a package.
The product is nicotine.
Think of the cigarette pack as a
storage container for a day's supply of nicotine.... Think of
the
cigarette as the dispenser
for a dose unit of nicotine.
Whether
or not tobacco companies should be required to disclose the amount and types of
additives used is currently being debated.
But there is no debate about the serious nature of the long-term effects
of smoking. That is why public
education about the hazards of cigarette smoke, both mainstream and second-hand,
must continue in an effort to prevent people from beginning to smoke. Further, various strategies to help
smokers quit the habit need to be discovered and employed.
For
the past 25 years, the American Cancer Society has encouraged smokers to quit for a day (or for much longer)
by sponsoring the Great American Smoke Out on the 3rd Thursday of
November. This event
has evolved from a single day devoted to encouraging individuals to quit smoking
to becoming the kick-off point to a yearlong effort to promote strategies to
protect our children from the harmful effects of tobacco use. It is also a good starting point to
learn about the addictive nature of nicotine and the use of additives designed
to increase the concentration of nicotine in each cigarette. Additionally, it is an appropriate time
to inform the public that no Food
and Drug Administration guidelines
exist in this country to determine an acceptable, or allowable, amount of
free-base nicotine that a cigarette may contain.
For
further information about the harmful effects of cigarette smoke or the Great
American Smoke Out, contact the American Cancer Society at 1 800 ACS-2345 or on
line at http://www.cancer.org/,
or the American Lung Association at http://www.lungusa.org/.