Nicotine is the drug in tobacco leaves. It a poisonous volatile alkaloid derived from tobacco (Nicotiana spp.) and responsible for many of the effects of tobacco. It first stimulates (small doses), then depresses (large doses) at autonomic ganglia and myoneural junctions.
Nicotine in inhaled tobacco smoke or in smokeless tobacco applied to buccal or nasal mucosa enters the circulation within seconds, causing an increase in heart rate, ventricular stroke volume, and myocardial oxygen consumption, as well as euphoria, heightened alertness, and a sense of relaxation. Nicotine use is powerfully addictive, readily leading to habituation, tolerance, and dependency. Withdrawal from nicotine causes restlessness, irritability, anxiety, difficulty concentrating, and craving for nicotine. Addiction to nicotine is the reason for most tobacco use and is thus directly responsible for the resulting morbidity and mortality.
Nicotine: Tobacco smoking, chewing, and dipping.
Effect of Substance:
Mild euphoria, feeling of relaxation, anorexia, hypertension, tachycardia
Effect of Withdrawal:
Restlessness, irritability, difficulty in concentrating, depression, insomnia, increased appetite, weight gain
Treatment:
- Detoxification
- Drugs: nicotine gum, nicotine nasal sprays, and nicotine patches.
- Behavior therapy
- Psychotherapy
- Support groups
Nursing Intervention:
- Maintain safety
- Monitor vital sign and neurologic status and report to physician if any abnormal readings
- Provide support to patient, family, and significant others
- Encourage patient to express fears and anxiety
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