Scientific Evidence for the Addictiveness of Tobacco and Smoking Cessation in Tobacco Litigation
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.
Abstract
Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others’. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one’s choice by free will.
참고문헌 (23)
- Lim SS, "A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010", Lancet, 380(9859), pp.2224~2260 (2012)[DOI]
- "Tobacco"[URL]
- Suh GH, "Addictiveness of tobacco and smoker's ability to quit smoking", pp.4~23 (2016)
- American Psychiatric Association, "Diagnostic and statistical manual of mental disorders", pp.571~577 (2013), American Psychiatric Publishing
- Heatherton TF, "The Fagerstrom Test for Nicotine Dependence: a revision of the Fagerstrom Tolerance Questionnaire", Br J Addict, 86(9), pp.1119~1127 (1991)[DOI]
- Han ES, "Characteristics and smoking cessation outcomes of patients returning for repeat tobacco dependence treatment", Int J Clin Pract, 60(9), pp.1068~1074 (2006)[DOI]
- Cosgrove KP, "<TEX>${\beta}2$<", TEX>-nicotinic acetylcholine receptor availability during acute and prolonged abstinence from tobacco smoking, 2009, pp.66(6), 666~676
- Perry DC, "Increased nicotinic receptors in brains from smokers: membrane binding and autoradiography studies", J Pharmacol Exp Ther, 289(3), pp.1545~1552 (1999)
- Karama S, "Cigarette smoking and thinning of the brain's cortex", Mol Psychiatry, 20(6), pp.778~785 (2015)[DOI]
- Kuhn S, "Reduced thickness of medial orbitofrontal cortex in smokers", Biol Psychiatry, 68(11), pp.1061~1065 (2010)[DOI]
- Durazzo TC, "A comprehensive assessment of neurocognition in middle-aged chronic cigarette smokers", Drug Alcohol Depend, 122(1-2), pp.105~111 (2012)[DOI]
- Nutt D, "Development of a rational scale to assess the harm of drugs of potential misuse", Lancet, 369(9566), pp.1047~1053 (2007)[DOI]
- Lopez-Quintero C, "Probability and predictors of transition from first use to dependence on nicotine, alcohol, cannabis, and cocaine: results of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC)", Drug Alcohol Depend, 115(1-2), pp.120~130 (2011)[DOI]
- Lopez-Quintero C, "Probability and predictors of remission from life-time nicotine, alcohol, cannabis or cocaine dependence: results from the National Epidemiologic Survey on Alcohol and Related Conditions", Addiction, 106(3), pp.657~669 (2011)[DOI]
- Statistics Korea, "Report on the social survey: health, education, safety, family, and environment", pp.94~ (2016), Gangmun Publisher
- clinical psychiatry, "Kaplan and Sadock's synopsis of psychiatry: behavioral sciences", pp.2015, Sadock BJ
- Gonzales D, "Varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs sustained-release bupropion and placebo for smoking cessation: a randomized controlled trial", JAMA, 296(1), pp.47~55 (2006)[DOI]
- Jorenby DE, "Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial", JAMA, 296(1), pp.56~63 (2006)[DOI]
- Rosenbaum P, "Large-scale study of freedom from smoking clinics--factors in quitting", Public Health Rep, 107(2), pp.150~155 (1992)
- Kaprio J, "A prospective study of psychological and socioeconomic characteristics, health behavior and morbidity in cigarette smokers prior to quitting compared to persistent smokers and non-smokers", J Clin Epidemiol, 41(2), pp.139~150 (1988)[DOI]
- Farkas AJ, "Addiction versus stages of change models in predicting smoking cessation", Addiction, 91(9), pp.1271~1280 (1996)[DOI]
- Borland R, "The reliability and predictive validity of the Heaviness of Smoking Index and its two components: findings from the International Tobacco Control Four Country study", Nicotine Tob Res, 12(Suppl), pp.S45~S50 (2010)[DOI]
- Babor TF, "Evidence-based alcohol policy in the Americas: strengths, weaknesses, and future challenges", Rev Panam Salud Publica, 18(4-5), pp.327~337 (2005)