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Module 1.3b

1. Arouses the brain to
a state of increased
alertness

2. Increases heart rate
and blood pressure
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4. Reduces circulation
to extremities

FIGURE 1.3-8
3. At high levels, relaxes
muscles and triggers Physiological effects of
the release of nicotine
neurotransmitters Nicotine reaches the brain
that may reduce within 7 seconds, twice as fast
stress as intravenous heroin. Within
5. Suppresses appetite minutes, the amount in the blood
for carbohydrates soars.

Cigarette smoking is the leading cause of preventable death in the United States, killing
480,000 people each year (CDC, 2020b). Although 3 in 4 smokers wish they could stop, each
year fewer than 1 in 7 will be successful (Newport, 2013). Even those who know they are
speeding up their own death may be unable to stop (Saad, 2002).
Nevertheless, repeated attempts seem to pay off. The worldwide smoking rate —
25 percent among men and 5 percent among women — is down about 30 percent since
1990 (GBD, 2017). The U.S. smoking rate has plummeted from 45 percent in 1955 to
15 percent in 2019 (Saad, 2019b). Half of all Americans who have ever smoked have quit,
sometimes aided by a nicotine replacement drug and with encouragement from a coun-
selor or support group. Some researchers argue that it is best to quit abruptly — to go
“cold turkey” (Lindson-Hawley et al., 2016). Others suggest that success is equally likely
whether smokers quit abruptly or gradually (Fiore et al., 2008; Lichtenstein et al., 2010).
The point to remember: If you want to quit using tobacco, there is hope regardless of how
you choose to quit.
For those who endure, the acute craving and withdrawal symptoms slowly dissipate
over the following 6 months (Ward et al., 1997). After a year’s abstinence, only 10 percent
will relapse in the next year (Hughes, 2010). These nonsmokers may live not only healthier
but also happier lives. Smoking correlates with higher rates of depression, chronic disabil-
ities, and divorce (Doherty & Doherty, 1998; Edwards & Kendler, 2012; Vita et al., 1998).
Healthy living seems to add both years to life and life to years. Awareness of nonsmokers’
better health and happiness has contributed to 87 percent of U.S. twelfth graders disapprov-
ing of smoking a pack or more a day, as well as to a plunge in their daily smoking rate, from
25 percent in 1997 to 2 percent in 2021 (Johnston et al., 2021).

The Neuron and Neural Firing: Substance Use Disorders and Psychoactive Drugs Module 1.3b 47

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