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Smoke Brake - Tobacco Tradition, Not Addiction — Transcript

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0:19welcome to smoke break
0:22a production of native american medical
0:25educational services
0:42welcome
0:44this program is created to help you put
0:47the brake on tobacco addiction
0:50the information presented is designed to
0:53give you the knowledge and power to help
0:55you break the habit
0:57of smoking cigarettes or using smokeless
1:00tobacco
1:01the following are chapters in a unique
1:04tobacco cessation program
1:07intro to tobacco
1:09statistics
1:11tobacco companies
1:13diseases of tobacco
1:15brain domain
1:16brain drain
1:18medication
1:20education
1:21and tradition not addiction
1:27intro to tobacco
1:30tobacco
1:32one of the wonders of plant life
1:34native peoples of the americas grew and
1:37harvested the tobacco plant
1:40the resulting product was used for
1:42medicinal purposes and in religious
1:45ceremonies
1:48here's some raw tobacco
1:51smoking the leaves in a pipe
1:54or rolled in corn chucks has been a part
1:56of
1:57ancient ceremonial practices for
1:59centuries
2:01the ancestors believed that their
2:03prayers rose with the tobacco smoke
2:06toward the heavens where the creator
2:07dwelled
2:09and these ancient beliefs and practices
2:11are still upheld in indian country today
2:14but respect for this sacred plant has
2:16been lost
2:17by the habitual use of smoking or
2:20chewing commercial tobacco laced with
2:23chemical additives
2:25tobacco is an amazing drug
2:28you don't have to wait at the pharmacy
2:30you don't have to see a doctor for a
2:31prescription
2:33you can get it
2:34anywhere it is an antidepressant
2:38but on the other hand it will suck the
2:41life out of you
2:45there are reasons why we smoke dip and
2:47snort tobacco they are sociological
2:49psychological and biological
2:52sociological reasons include family
2:55friends society and culture like tobacco
2:58company advertising peer pressure and
3:00role models in movies and sports
3:04psychological factors untreated
3:07depression anxiety schizophrenia
3:09attention deficit disorder and bipolar
3:12disorder may invite the need for tobacco
3:15biological reasons nicotine may disturb
3:18the cells in the brain causing an
3:20addiction an addiction to nicotine may
3:22also be passed down genetically
3:26nicotine in tobacco stimulates the brain
3:29activating the
3:30chemicals serotonin norepinephrine
3:34dopamine and endorphins
3:38the norepinephrine and dopamine
3:40chemicals may be restored in the brain
3:42by the medication bupropion also known
3:45as welbutrin and zyban these are all the
3:47same antidepressant medications
3:50zyban is the marketing name for the
3:52smoking cessation medication
3:57norepinephrine calms down the withdrawal
4:00dopamine feeds the craving together they
4:03help in smoking cessation
4:05and treating depression
4:12so smokers and dippers stop practicing
4:14neuropharmacology
4:16stop writing your own prescriptions for
4:18one to two cigarettes every hour to
4:20treat anxiety
4:22therefore stop smoking your
4:24antidepressants in your anti-and anxiety
4:27medications take the seeds out here
4:30and start taking the pill form after all
4:33that's what it's all about a healthier
4:35approach
4:40if one has a diagnosis of high blood
4:43pressure then the treatment is
4:44medication and education with diet and
4:47exercise
4:52a diagnosis of diabetes includes the
4:54treatment of medication and education
5:02physicians don't tell a patient who has
5:04uncontrollable blood pressure or
5:06diabetes to just stop it to get over it
5:09no
5:10likewise with a nicotine or drug
5:12addiction it requires medication and or
5:15education
5:17basic education for tobacco termination
5:20it takes me to be tobacco-free
5:22medication and or education
5:27medication includes bupropion clonidine
5:31nortriptyline and nicotine replacement
5:34therapy such as the patch
5:37heel
5:38health education a men's life
5:41healing begins with selecting a program
5:44setting your stop date preparing a first
5:47aid kit
5:48get freed protocol and a fall protocol
5:56statistics
5:58this chapter on statistics or numerical
6:01data will reveal the startling number of
6:03americans who have lost their lives to
6:05diseases caused by tobacco abuse
6:09there is an immediate concern to address
6:12the numerous diseases and death from
6:14tobacco abuse
6:17one human has just died from a
6:19tobacco-related disease by the time you
6:21have read this
6:23one death
6:24every 10 seconds
6:30the united states public health service
6:32has eight agencies
6:34let's go to the cdc for statistics
6:38cdc data life loss from tobacco abuse
6:41for males 13.2 years for females 14.5
6:46normal life expectancy for males 73
6:50years and for females 79 years
6:55here are some calculations for minutes
6:57of life loss per cigarette let's take a
6:5916 year old female smoking two packs a
7:01day
7:02that's a total of 6.8 million minutes of
7:05life lost
7:06730 000 cigarettes smoked in 50 years
7:10therefore about 10 minutes of life lost
7:13per cigarette that comes to six hours of
7:16life per day
7:20one year of being sick during a lifetime
7:23of work that means six days of lost work
7:26per year
7:32when lifelong smokers are over 50 years
7:35old
7:36one out of six will die from
7:39tobacco-related diseases
7:46if for the first time somebody brought
7:48to the american shores tobacco
7:51containing nicotine and we had a package
7:53insert that told us everything that we
7:55know about it the government would take
7:57steps to ban it today and if they didn't
7:59it'd be a revolution in the country
8:03these figures represent american lives
8:06lost in all the wars and armed conflicts
8:09in our nation's history
8:11it represents over 624
8:14000 combat deaths
8:23from 200 years of wars and conflict over
8:26624 thousand american lives lost
8:30but
8:31from two years of tobacco diseases over
8:34860 000 american lives lost
8:40comes to over 1 000 american lives lost
8:44per day
8:47we lost over 47 000 in combat deaths in
8:50vietnam between 1964 and 1975
8:55yet we lose over fifty thousand
8:57americans every year from second hand
9:00smoke
9:02there's a big debate about smoking in
9:04restaurants and bars some people argue
9:06that separate sections and filtration
9:08are enough to keep non-smokers safe from
9:10the harmful effects of secondhand smoke
9:13it would be like having separate
9:14sections in a pool peeing and non-peeing
9:17would you feel safe jumping
9:21pretty in but so are heart and lung
9:23diseases caused by second-hand smoke
9:25this is not against personal rights it's
9:27for public health show your support to
9:30regulate smoking in public places
9:33there are more deaths from tobacco per
9:35year then from hiv alcohol motor vehicle
9:39accidents homicide suicide and drug
9:42abuse combined
9:53tobacco companies
9:56once european colonies were established
9:58in america commercial trade with the
10:01indians soon began
10:03metal goods farming supplies furs and
10:06tobacco became the trade goods of
10:09colonial america
10:10but the history of tobacco trade has
10:12proven that commercial tobacco companies
10:15are more concerned about their profits
10:17than the health and well-being of
10:19tobacco consumers
10:23imagine a business that made a product
10:25that killed up to one half of their best
10:27customers
10:29it wouldn't kill its users suddenly but
10:31slowly and insidiously through poisons
10:33that cause or exacerbate cancer heart
10:35disease strokes and lung disease
10:40imagine that the companies knew their
10:41product was deadly and addictive but
10:43kept manufacturing it anyway
10:47imagine that the company spent billions
10:48of dollars every year dying customers
10:50through advertising campaigns that hook
10:52new users especially young ones by
10:55making the product look fun sexy and
10:57inviting
11:05the allegation that smoking cigarettes
11:07is addictive is part of a growing and
11:10disturbing trend that has destroyed the
11:13meaning of the term by characterizing
11:16virtually any enjoyable activity as
11:19addictive whether it's eating sweets
11:21drinking coffee playing video games
11:24or watching tv
11:25of course the industry said that smoking
11:27is more dangerous than eating twinkies
11:28well you read the back of the label of
11:30twinkies guess what you see
11:32what coloring is used
11:34flowers starch sugars turn over your
11:36pack of cigarettes what do you see
11:38you'll see any of it need some labeling
11:40we need some clear technical
11:42understanding that you're just the same
11:44thing you would find on the back of your
11:45twinkies
11:47this morning in your
11:48written statement and your oral
11:50statement you compared cigarettes to
11:52coffee tea sweets sugar warm milk cheese
11:56chocolate and twinkies that's quite a
11:58list
11:59i'm struck by what i think is a
12:02calculated attempt to trivialize the
12:05devastating health impacts of your
12:07product the difference between
12:09cigarettes and twinkies and the other
12:10products you mentioned is death
12:13we're now entering the marlborough
12:15country and the cowboy
12:17hey what's up doing we're here to see
12:19the cowboys who's that the mob roommate
12:22marble man
12:24he passed away some time ago he's dead
12:26he passed away yeah is his heart still
12:28alive or anything
12:29no no cowboys no no no just give us
12:32directions maybe to the graveyard
12:40i wonder what killed him yeah
12:43i know what you've done and i know what
12:45you're doing you sell a product that
12:47contains addictive chemicals so your
12:49customers stand little or no chance of
12:51ever being able to stop using it slowly
12:53over time it kills one-third of them to
12:56replace those dead customers you tried
12:58to market your product to kids as young
13:00as 13. the fact is you get 89 of your
13:04new business from teens i've seen the
13:06proof it's in your own words on your own
13:09letterhead stamp top secret you screwed
13:11up when you tried to hide the documents
13:13and now they're on the web they're on
13:14the web i lost my grandfather my
13:16grandmother was manipulated by your lies
13:18for years my grandfather died because of
13:20your product was the money you made
13:22worth it you've gotten rich selling a
13:24product that kills over 1200 people a
13:26day every day so while you're lounging
13:28around your comfortable house watching
13:30this message look into my eyes
13:33i know what you did and i know what
13:34you're doing and that's why i got
13:36involved and i won't stop until everyone
13:38else knows what you're doing too
13:43all of you touch on it and just yes or
13:44no do you believe nicotine is not
13:46addictive
13:47i believe nicodeen is not addictive yet
13:49mr johnson
13:51uh congressman
13:53cigarettes and nicotine clearly do not
13:56meet the classic definitions of
13:58addiction there is no intoxication we'll
14:00take that as a no and again time is
14:02short if you could just i think each of
14:04you believe nicotine is not addictive we
14:06just would like to have this for the
14:07record
14:08i don't believe that nicotine for our
14:10products are addictive
14:14the tobacco companies hire scientists to
14:16design the most addictive product on
14:18this planet tobacco when abused is more
14:21addictive than methamphetamines heroin
14:24cocaine or alcohol
14:26cigarettes are designed to deliver just
14:28the right dosage of the addictive drug
14:30nicotine to make it difficult to quit
14:33then they take the tobacco and make it
14:35more addictive by adding chemicals
14:38although some of these chemicals were
14:39found to be dangerous and cancerous
14:42these additives were not removed by
14:44order of the company executives
14:46they were concerned that it would impact
14:48sales as their product would release its
14:51grip on some consumers
14:53these companies want to hold their
14:54customers captive even though they will
14:57suffer and die sooner
15:03lead ammonia a household arsenic used in
15:06rat pool benzene chain gas used in
15:08carbon monoxide a poisonous gas ddt
15:11abandoned colonium 210 a cancer-causing
15:14radioactive element
15:17other additives laced into tobacco are
15:19coumarin a rat poison nitrosamines
15:22aldehydes cyanide arsenic formaldehyde
15:27along with
15:28all of these chemical additives
15:31is it possible to make these chemical
15:33recipes
15:34design these additives to make users
15:37only addicted to tobacco and not other
15:39drugs
15:41these additives would most likely be
15:43programmed to alter your brain chemistry
15:45to give you an overall addictive
15:47behavior and possible mental disturbance
15:52these companies may be setting off a
15:54cascade of psychiatric illnesses an
15:57addiction beyond nicotine into crank
16:00heroin cocaine marijuana or alcohol
16:03thus
16:04tobacco may be the gateway drug to poly
16:07substance abuse
16:09if you're planning to quit and for those
16:11who are not consider changing to a
16:13non-additive tobacco
16:16get through the additive withdrawals
16:18first some say the other brands taste
16:21bad this bad experience may be from the
16:24withdrawals of additives
16:27one of the executives from rj reynolds
16:28came over and said what are you doing
16:30and i said well i'm smoking they said
16:31well you're still smoking that stuff and
16:33i said yeah i said how come you guys
16:34from rj reynolds don't smoke
16:36and he turned to me and he said we don't
16:38smoked it we just sell it we reserve the
16:40right to smoke for the young the poor
16:41the black and the stupid
16:44the tobacco company's profits are more
16:46important to them than your life and
16:49health
17:04diseases of tobacco
17:06this chapter will take a look at the
17:08changes in your body after smoking or
17:11chewing tobacco
17:12the resulting diseases are caused by
17:15changes in dna
17:17oxygen flow
17:18and blood flow
17:21dna
17:22the dna molecules transmit special
17:25information needed for living organisms
17:27to develop correctly
17:31dna is the who when where how and why we
17:34are what we are
17:36deep within the nucleus of every cell is
17:38the dna telling the cell what to be when
17:40it grows up
17:42dna and addiction
17:47some of these genes are expressed as
17:49physical and mental problems and
17:50diseases
17:53just as one may be a diabetic from
17:55genetic expression likewise some may be
17:58addicted to tobacco or other drugs
18:02dna and cancer
18:04some of the tobacco chemical additives
18:05are carcinogens or cause cancer
18:12these carcinogens added to the tobacco
18:14and the nicotine alter the dna cell
18:17expression resulting in cancer
18:28additives also cause other devastating
18:30cellular changes that destroy life
18:35oxygen flow
18:40when smoke is inhaled the oxygen level
18:43is lowered and the tar nicotine and
18:45additives are delivered to the lungs
18:52here we have the normal lung anatomy
18:54with the bronchiole the avular sac and
18:57the bronchial wall
19:02copd chronic obstructed pulmonary
19:05disease
19:10smoking tobacco causes copd comprised
19:13primarily of chronic bronchitis and
19:15emphysema
19:19chronic bronchitis a productive mucus
19:22cough for over three months caused by
19:24lung pollution such as tobacco smoke
19:33this illustration of chronic bronchitis
19:35shows the thickened wall a narrow airway
19:38and the mucous plug
19:43plugged up bronchioles cause poor oxygen
19:46flow into the air sacs
19:49increased mucus decreases the oxygen
19:51exchange into the blood
19:55smoking tobacco causes copd comprised
19:59primarily of chronic bronchitis and
20:01emphysema
20:04here is an illustration of the lung with
20:06emphysema
20:08it shows a narrowed airway and an
20:11enlarged air sac
20:15air sacs are enlarged and have lost
20:17their elasticity or expandability this
20:20loss in elasticity causes poor air
20:23exchange a decrease in oxygen flow
20:28emphysema is permanent and may cause
20:31difficulty breathing
20:35medical treatment for copd includes
20:38albuterol
20:39epitropium inhaled steroids and finally
20:43oxygen
20:45smoking tobacco causes copd comprised
20:48primarily of chronic bronchitis and
20:50emphysema this leads to lung infections
20:53and difficulty breathing
21:12foreign
21:34here is a graph showing the health
21:36benefits of living smoke-free
21:38it shows that lung capacity or the
21:40ability to breathe freely decreases as a
21:43person grows older
21:45copd in a smoker's lungs dramatically
21:48decreases their lung capacity and
21:50shortens their lifespan
21:55so if one stops smoking at 45 years old
21:59the lung capacity becomes stable
22:05even if one has reached the point of
22:07disability with severe shortness of
22:09breath and being on oxygen when they
22:12stop smoking the lungs can become stable
22:16expanding their life expectancy for
22:18several more years
22:28this is part of an aorta the main artery
22:30from the heart
22:32smoking makes out to all sticky and
22:34collect dangerous fatty deposits this
22:36much was found stuck to the aorta wall
22:38of a smoker age 32
22:44nicotine and other chemicals cause
22:47cholesterol or fat to collect in the
22:49walls of the arteries
22:51this clogging causes heart attacks and
22:54strokes
22:59here we have a model of the heart
23:07arteries provide blood flow to the heart
23:10muscle
23:12when an artery through which blood flows
23:14to the heart is blocked off
23:16the muscle starts to die
23:19this is called a heart attack
23:23this model of the heart muscle shows on
23:26the left the red area of a good heart
23:28and on the right after a heart attack
23:30the black area showing heart damage
23:36a stroke sometimes called a brain attack
23:39occurs when blood flow to the brain is
23:42interrupted
23:43that can happen if a blood vessel breaks
23:46or gets blocked by a clot
23:48when someone has a stroke brain cells in
23:51the immediate area begin to die because
23:53they stop getting the oxygen and
23:54nutrients they need
23:56somehow we have to get the hopeful
23:59message out that there is something you
24:01can do it's not hopeless and i think
24:04four or five years ago that was pretty
24:06much true but now it's changed vastly
24:10and the change is that now you can do
24:12something i have to get there early to
24:14get the best treatment they need to be
24:16examined by doctors close their eyes
24:18they need brain scans like cat scans to
24:21know what the best therapy is
24:29if one is having a heart or brain attack
24:32get to the hospital
24:34stat
24:37nicotine constricts or narrows the
24:39arteries this dangerously reduces the
24:42blood flow to the organs extremities and
24:44skin
24:46to measure how smoking might already be
24:48making them different from one another
24:50the twins volunteered to be tested at
24:52lutheran medical center in denver
24:54colorado they were tested for lung
24:56capacity karen as you might guess since
24:59you have been a non-smoker and you're
25:00young your tests are
25:02unequivocally normal blast it out becca
25:05your tests are technically within the
25:07normal range but they do show some signs
25:11of early
25:12small airways disease then becca got a
25:15chance to see how smoking just one
25:18cigarette affects her body that will
25:21cause the skin temperature to drop with
25:24each drag the nicotine in the cigarette
25:26begins to constrict becca's circulation
25:29infrared pictures of her hand show the
25:32changes instantly you see the blueness
25:35occurring up in her
25:36index finger now
25:38that temperature drop is quite
25:40significant already in the time it takes
25:42to smoke one cigarette becca's hand
25:45turns from a healthy red to an icy blue
25:47notice we're even getting a little
25:49purple in the tips of your fingers
25:51which is now near the bottom of our
25:53scale
25:54now the non-smoker if they would wiggle
25:56their hands
25:57and we know who it is
25:59your oxygen level has been dramatically
26:01reduced
26:05and that's going to affect your entire
26:08body
26:09yeah we're real tight together
26:24tobacco or nicotine abuse causes or is
26:27thought to cause the following diseases
26:30adverse reactions and side effects
26:39cancer of the lung mouth
26:41throat bladder
26:43kidney stomach pancreas cervix prostate
26:48colon and rectum
26:51and also causes copd
26:54shortness of breath
26:55halitosis respiratory infection chest
26:58pain enlarged heart a heart attack
27:01irregular heartbeat clogged artery
27:04wrinkling of the skin psoriasis delayed
27:07wound healing poor fracture healing
27:09osteoporosis osteoarthritis ulcerative
27:12colitis indigestion peptic ulcer disease
27:16worsening of gi reflux ear infections
27:19impotence infertility decreased sperm
27:22ability mini strokes a stroke depression
27:25anxiety snoring
27:27cataracts hearing loss gum disease optic
27:31neuropathy macular degeneration blood
27:33sugar abnormalities and impaired
27:35immunity
27:37babies exposed to second-hand smoke may
27:39have intellectual impairment prematurity
27:42birth defects fetal growth retardation
27:45and sudden infant death syndrome and
27:48mothers may experience stillbirth and
27:50miscarriages
27:58for pregnant and breastfeeding mothers
28:00we support your efforts to be smoke-free
28:02for your baby
28:04we want this program to be a
28:05non-condemning eye-opening experience
28:08encouraging you to nurture your baby's
28:10health
28:10thankfully we have the smoking cessation
28:13medication and other supportive programs
28:16to help you quit
28:20brain domain
28:22dr daniel ayman and the amen clinic work
28:25with a revolutionary brain imaging
28:26technique called spect that allows them
28:29to accurately see how the brain works
28:33there are many people who are anxious or
28:36depressed or obsessive prone to anger
28:40they have attentional problems and they
28:42thought their problems were all in their
28:44head purely psychological in the
28:46research that i've done with spec
28:49what we found is that these and many
28:51other problems are brain-based problems
28:54and that when we
28:55optimize the brain
28:57their lives become better
29:00we often say you know change your brain
29:02change your life and that's what we've
29:03seen
29:09spec scans allow doctors to look at the
29:11brain in three dimensions
29:13this is a brain of a long-time drug
29:15addict when compared with a healthy
29:17brain it is obvious where the holes of
29:20altered activity are
29:22and sort of the scalloping appearance
29:23where it looks bumpy across the surface
29:25is what we see in toxic brains
29:39well the scans don't lie what we find is
29:41that people who use drugs who use
29:44alcohol damages brain function what we
29:47see is this overall decreased activity
29:50in the brain from from substance abuse
29:52well the good news is that if you stop
29:54using your brain may get better
29:58we've seen a lot of healing take place
30:00in brains that have been damaged with
30:02drugs and alcohol
30:12when a smoker inhales a puff of tobacco
30:14smoke a bolus of nicotine is delivered
30:17to the lungs
30:19it rapidly traverses the alveolar
30:21capillary membrane passing through the
30:23pulmonary veins the left atrium the left
30:26ventricle to the aorta
30:29from here it is distributed in high
30:31concentration to the entire body but
30:33especially to the coronary arteries and
30:36straight up the carotid arteries to the
30:38brain
30:39in the nicotine addicted individual
30:42nicotine particularly with the high and
30:44rapid dosing which the tobacco cigarette
30:47provides produces beneficial pleasurable
30:50and cognitive central nervous system
30:53effects
30:54the sudden elimination of tobacco and
30:56hence nicotine produces a wide range of
30:59unpleasant nicotine withdrawal signs and
31:02symptoms how is it
31:05that nicotine can have this profound an
31:08effect on the brain
31:09on human behavior emotions
31:12thought and intellectual functioning
31:16to understand how nicotine has such an
31:18effect on the brain we must explore
31:22the brain drain
31:26different parts of the brain have
31:27special jobs to perform
31:30such jobs as movement sensation judgment
31:34pain memory vision and coordination
31:40and we see the reward pathway
31:44when nicotine is absorbed several areas
31:47of the brain are increased in chemical
31:49activity thus a reward response
31:53a reward pathway is one of the locations
31:56of the brain's drug craving and
31:59addiction
32:00one of the chemicals that activates the
32:02reward pathway is called dopamine
32:07here we have an illustration of the
32:09smoker's brain before
32:12and after a dose of nicotine
32:16when the smoker or dipper absorbs
32:17nicotine the reward pathway is increased
32:21in activity
32:25now zoom in microscopically to see the
32:28synapse in action
32:33the brain has axons that transmit
32:36messages to different parts of the brain
32:38like telephone lines
32:45these phone lines travel to different
32:47parts of the brain giving them messages
32:49that stimulate thoughts and actions such
32:52as eat walk and smoke
32:56these are the neurons or nerve cells of
32:59the reward pathway
33:01a neuron has a special connection a gap
33:04called synapse
33:12the synapse of the brain is like the
33:14kitchen sink that holds the chemicals
33:16together such as
33:18serotonin norepinephrine and dopamine
33:29this is a model of a balanced synapse
33:32with all the chemicals together with an
33:34equal amount of serotonin norepinephrine
33:37and dopamine
33:42within seconds of inhaling cigarette
33:44smoke a rush of nicotine travels into
33:47the brain increasing chemical activity
33:52this activity releases the
33:54norepinephrine and serotonin systems
33:57together they enhance memory and
34:00concentration and decrease anxiety
34:04then the dopamine system is energized
34:07that calms down the withdrawal feelings
34:09and increases reward activity the
34:12released endorphins provide the
34:14pleasurable sensations
34:22the neurons in the brain need the right
34:24amount of chemicals to work properly
34:27if there are not enough chemicals in the
34:29receptor sites such as serotonin
34:32norepinephrine dopamine and endorphins
34:36then the brain does not work correctly
34:39the drain determines how much water
34:41stays in the sink
34:46we need the right amount of water in the
34:48sink not overflowing or dry
34:52just as an engine needs oil to lubricate
34:56gasoline to run and water to cool the
34:58motor
35:01consider the brain needs
35:03serotonin to lubricate norepinephrine to
35:06run and dopamine to cool the mind
35:13the brain works great with the right
35:15amount of chemicals in the receptor
35:17sites
35:18just as some have problems with their
35:20genetics causing diabetes or obesity
35:23some may be low on these chemicals
35:25causing depression and anxiety
35:29some receptor sites may be normal in
35:31chemical activity
35:33then when one starts abusing tobacco the
35:35nicotine agitates the neurons causing
35:38the feeling of being low on the needed
35:40chemicals
35:41this is the origin of addiction
35:45if the receptor site is low on serotonin
35:48norepinephrine and dopamine then one may
35:51have problems with depression anxiety or
35:54drug seeking behavior
35:56this is called a chemical imbalance
36:01depression is feeling unhappy sad gloomy
36:05disappointed dissatisfied with life or
36:08heavy-hearted
36:16anxiety is the feeling of worry dread
36:20fear tension or stress
36:25imbalances in neurotransmitters loss of
36:27production and changes in receptor
36:30numbers and binding affinity are key to
36:32mood and addiction to make a long story
36:34short and simple consider the following
36:37synapse models to get a visual of the
36:39brain in action
36:43this graphic shows a balanced synapse
36:46with equal amounts of serotonin
36:48norepinephrine and dopamine
36:54this graphic shows a synapse out of
36:56balance
36:57low on serotonin can cause problems with
37:00anxiety and or depression
37:10medicines that increase serotonin in the
37:13synapse one way or another are prozac
37:16paxil lexapro zoloft effexor among
37:20others
37:22medicines that increase serotonin may
37:25help in the treatment of depression and
37:27or anxiety
37:31this graphic shows a synapse also out of
37:33balance low on norepinephrine and
37:36dopamine
37:40this synapse imbalance causes problems
37:43with addiction and or depression
37:50low on norepinephrine one may feel lazy
37:53and less alert
37:54normal levels may increase energy and
37:57alertness
38:00when low on dopamine one may have
38:02problems with attention motivation
38:05pleasure and reward activity
38:10the dopamine surge is one of the
38:12promoters of drug seeking behavior this
38:15is the reward pathway
38:20some are missing the neurochemistry for
38:22peace of mind this chemical imbalance
38:25may be restored with the right
38:26medication and or education
38:30to chemically increase the
38:31norepinephrine and dopamine in the
38:34synapses of a nicotine addicted
38:36individual the drug of choice is
38:39bupropion wellbutrin or zyban they're
38:42all the same medication
38:46pretend it is safe to smoke and very
38:48dangerous to take antidepressant pills
38:52now tell someone to stop his or her
38:54antidepressant because if they don't
38:57they can expect to die in 40 years when
38:59they could have lived 50 years
39:01what would be an acceptable response to
39:03this order
39:05one might say i would rather be happy
39:07for 40 years than depressed for 50.
39:12in a laboratory experiment 20 subjects
39:14were tested 10 received iv normal saline
39:18and it had no effect the other 10
39:20received iv cocaine
39:24half enjoyed the cocaine wanting lots
39:27more the other half did not like it and
39:29wanted to pull out the iv
39:32some people have enough dopamine and do
39:34not want any more while others need and
39:37seek to find their dope to cope
39:40now this illustration presents some
39:42interesting questions which state has
39:44the lowest tobacco usage per capita in
39:46the country
39:48utah
39:54now which state has the highest
39:56antidepressant prescriptions per capita
39:59in the country
40:03yes it is also utah
40:10we will get our dope to cope
40:17medication
40:20addiction is a disease so medication is
40:23an important part of your effort to
40:24break the habit
40:26this chapter will guide you through the
40:28medications available to treat the
40:30disease
40:31now this is intended as a guide
40:34so make sure that you consult your
40:36pharmacist or medical practitioner
40:38before taking any of these medications
40:42it takes me
40:44medication and or education to be
40:47tobacco-free
40:49first-line medications are the u.s
40:51public health service recommendations
40:53from the clinical practice guideline
40:55book treating tobacco use and dependence
41:00the first line medications include
41:02bupropion and nicotine replacement
41:04therapy
41:09bupropion also known as zyban or
41:11wellbutrin is an antidepressant the
41:14recommended dosage is 150 milligrams
41:17every morning for three days then go to
41:20twice a day once in the morning once in
41:22the evening about eight hours apart
41:24start one to two weeks before the stop
41:26date and take for three to six months or
41:29longer the abstinence rate from smoking
41:31is about 30 percent
41:35when taking bupropion
41:38norepinephrine calms down the withdrawal
41:41dopamine feeds the craving together they
41:44help in smoking cessation and treating
41:46depression
41:49there are contraindications when taking
41:51bupropion
41:53don't ever use this medication when
41:55there's a history of brain disease or
41:57seizure disorder or eating problems such
42:00as bulimia and anorexia
42:04there are precautions when taking
42:06bupropion be careful if there's a
42:08history of seizure risk head injury
42:11brain tumor liver or kidney problems if
42:14so contact your practitioner
42:18if one is seeing a specialist for
42:20bipolar disorder psychosis or some other
42:23type of psychiatric problem contact and
42:25inform your doctor first
42:31if there is heart disease such as
42:33congestive heart failure or a heart
42:36attack inform your provider before you
42:38start any medication
42:43there may be drug interactions when
42:45taking bupropion do not consume
42:48excessive alcohol
42:49do not take with certain psychiatric
42:51drugs or drugs that may cause seizures
42:54do not take with street drugs
42:57you may use it with nicotine replacement
42:59therapy such as the patch but monitor
43:01your blood pressure if taking other
43:03medications ask your pharmacist about
43:06drug interactions
43:11now when taking bupropion there may be
43:14adverse reaction possible side effects
43:18you may experience some of them the most
43:20common being anxiety and insomnia
43:31if one develops the side effect of
43:33anxiety problems with distress or
43:36irritability consider trying a second
43:39line medication such as clonidine or
43:41nortriptyline
43:44you may experience insomnia but that may
43:47be resolved in a couple of weeks now
43:49this may be a side effect of a nicotine
43:51withdrawal or from bupropion
43:54some already have this problem and it
43:56may get better or worse
44:00just take one pill in the morning for
44:02several weeks if the problem continues
44:05take the bupropion dose closer together
44:08say six or four hours apart or consider
44:11clonidine or nortriptyline
44:17nicotine replacement therapy helps to
44:20dampen the withdrawal that comes from
44:21the oral and hands-on habit
44:26some researchers state only about 10
44:29percent abstinence from smoking rate
44:31others up to 30 percent
44:34the dosage depends on the type and
44:36amount of tobacco use start the same day
44:39as the stop date
44:43don't use the nicotine replacement
44:45therapy while smoking dipping or
44:47snorting tobacco
44:52now be careful before starting nicotine
44:54replacement therapy such as the patch if
44:56you have an allergy to tape
44:58and be careful starting any nicotine
45:00replacement therapy after a heart attack
45:02or stroke
45:03if you have any serious diseases or
45:06physical problems consult your physician
45:08or pharmacist first
45:12drug interactions now there are many as
45:15tobacco is a dangerous drug however you
45:18may use the patch with the inhaler or
45:21gum for breakthrough craving when one
45:24has the overwhelming desire to smoke
45:28now there may be adverse reactions such
45:31as strange dreams a fast heartbeat and
45:34high blood pressure so check your blood
45:36pressure one to two times per week and
45:38it must be less than one thirty over
45:40eighty
45:46if you experience withdrawal symptoms
45:48then taper down slowly and if you
45:51experience a skin rash try an
45:54over-the-counter topical steroid or
45:56change the patch site
45:58if your patch falls off
46:00put it in your sock or tape it back on
46:03and keep patches away from children
46:10the u.s public health service
46:11recommendations for second line
46:13medications are quantity and
46:16nortriptyline
46:18it's considered if first-line medication
46:20is not working and or there are problems
46:23with side effects
46:28clonadine is a blood pressure medication
46:31the recommended dosage comes in
46:33transdermal or a patch or in tablet form
46:370.1 milligram to 0.3 milligram in the
46:39morning and the evening start three days
46:42before your stop date and work the dose
46:45up slowly take for three to six months
46:48the abstinence rate is about twenty six
46:50percent
46:53nord triptyline is an antidepressant and
46:55the recommended dosage is 25 milligrams
46:58three to four times per day
47:01work the dose up slowly
47:03start three weeks before the stop date
47:05and take for three to six months the
47:08abstinence rate is about 30 percent
47:30do
47:49if one has started an antidepressant
47:52such as bupropion or nordriptyline for
47:54smoking cessation anne finds this
47:56medication improves his or her quality
47:59of life consider staying on that
48:01medication after tobacco termination
48:10knowledge is power and education is your
48:13key to having the power to terminate
48:15tobacco abuse
48:17this chapter on education will help you
48:19heal yourself and become free from
48:21smoking cigarettes or abusing tobacco
48:26education heals
48:29health education amends life
48:33healing begins with selecting a program
48:37setting your stop date preparing a first
48:39aid kit
48:40get freed protocol and a fall protocol
48:46selecting a program
48:51such as medication
48:53counseling and behavioral therapies
49:00stop pulling over every 30 minutes to
49:02pour water in your radiator if your
49:04radiator is leaking water fix it
49:07so stop pulling out a smoke every 30
49:09minutes to pour norepinephrine and
49:11dopamine into your synapses if you have
49:14a chemical imbalance fix it
49:17the excuse abuse are you having a
49:20problem with a medication side effect
49:23don't make it your excuse to start
49:24smoking and dipping contact your health
49:27practitioner or pharmacist for
49:29medication consultation
49:32counseling
49:35consider the smoking cessation success
49:37rate for individual group and telephone
49:40counseling at 17 14 and 13
49:44respectively
49:48add this success rate to those of the
49:50smoking cessation pill and patch and one
49:53has a better chance of being smoke free
49:56consider this same approach of adding
49:58several programs like medication
50:00consultation and behavior therapies to
50:03be drug-free
50:06behavioral therapies
50:08you might consider going cold turkey
50:11that's when one stops all tobacco at
50:13once and withdrawal symptoms may last up
50:16to two weeks
50:18many people have thoughts of hurting
50:21themselves or others when attempting to
50:23go cold turkey so one should be careful
50:26when stopping their antidepressant
50:30tapering is removing one cigarette from
50:32your daily dose each week or month the
50:35following week or month remove another
50:37cigarette
50:42setting your stop date
50:47plan your stop date as a special event
50:50to be celebrated for life schedule this
50:52date during a low stress time of the
50:54week or month
50:55prepare medication and education for
50:58tobacco cessation
51:01healing begins with preparing a first
51:03aid kit containing oral goods and
51:06paraphernalia to hold off the withdrawal
51:10these are some suggested materials for
51:13your tobacco cessation first aid kit as
51:15you can see some are for extreme
51:18measures
51:29get freed protocol
51:33get family and friends for support
51:35get medication to restore the chemical
51:37balance
51:39exercising and eating healthily
51:43exit plans from the temptations
51:46drinking lots of water
51:50doing something else
51:53take deep breaths and get delayed the
51:56urge will go away
52:11do
52:20fall protocol
52:24the protocol for fall don't fall off the
52:27wagon follow up with your practitioner
52:30assess and address the cause
52:32learn from your fall and look for other
52:35programs and plans it may take several
52:38falls to conquer the withdrawal
52:43for additional information and resources
52:45to supplement the smoke break tobacco
52:48cessation program refer to fresh start
52:51provided by the american cancer society
52:54also
52:55the centers for disease control
52:59and the national tribal tobacco
53:01prevention network
53:10there is a light at the end of the
53:12tunnel search to find the medication and
53:16or education for your tobacco
53:18termination
53:30misuse of tobacco leads to an
53:32astonishing rate of disease and death
53:34among american indians
53:36tribal governments and ceremonial
53:38leaders must demand that we stop the
53:41abuse of tobacco
53:43an indian country is joining a growing
53:45trend in america today to restrict
53:47tobacco and prevent further danger to
53:49health
53:51natural tobacco has been a part of
53:53indian tradition and culture long before
53:55europeans came to america
53:57and commercial interest in tobacco
54:00occurred soon after a contact
54:02but it has evolved into a dangerous
54:05practice that is killing our people
54:08the ceremonial use or sacramental
54:10offering of tobacco should be considered
54:13the only appropriate way
54:36wakanda wakanda zinke our time
54:41again we come here this day we thank you
54:43for all these blessings that you have
54:44given us
54:52ah
55:08grandson
55:11your father started smoking at a young
55:13age
55:14when he was in the service
55:17he began smoking several packs of
55:19cigarettes every day
55:21and became addicted
55:23he knew better when he got older but he
55:25was already hooked
55:27and that led to his early death
55:31smoking cigarettes is not the
55:33traditional way
55:35of using tobacco
55:36what do you mean traditional way
55:39smoking is smoking isn't it
55:42a cigarette is like a peace pipe
55:45no grandson
55:47we have ceremonial ways
55:50of handling and using
55:52tobacco
55:54it is a gift from the creator
55:57i offered tobacco this morning
56:00in a prayer
56:02this was taught to me by my grandfather
56:06we use pure tobacco in our pipe
56:08ceremonies or offer it as a gift
56:12the cigarette companies
56:14they poison their tobacco with chemicals
56:16making it addictive
56:18and deadly grandson
56:21i want you to live longer than your
56:23father ever did so get rid of those
56:25things
56:32i know it's not going to be easy to quit
56:34so i'm going to help you
56:41we use this
56:42tobacco in a powerful way
56:45and we never light it up
56:49these cigarettes have poisoned our
56:51people
56:52for many years now
56:56but our traditional ways have kept our
56:58people around for countless generations
57:02so let's go outside
57:04and practice the ways of our ancestors
57:28if we remember the lesson of tradition
57:30not addiction we will honor the
57:32ancestors respect ourselves and provide
57:35a healthy future for those to come
57:45so
57:55so
58:12do
58:26so
58:51so
59:36you

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