Tobacco Essay -- social issues

Tobacco Tobacco is one of the leading preventable causes of death in the United States. Nicotine, which is an alkaloid derived from the tobacco plant, is a potent chemical that has powerful effects on the human body, especially when administered rapidly or at high doses. Prenatal exposure to nicotine is associated with adverse reproductive outcomes, including altered neural structure and functioning, cognitive deficits, and behavior problems in the offspring (9). At least 20% - 30% of pregnant women are estimated to smoke cigarettes, although smoking is associated with low birth weight, prematurity and infant mortality. In the United States, smoking accounts annually for estimated fetal deaths ranging from 19,000 to 141,000, for 1,900 to 4,800 deaths during or immediately after parturition, and for 1,200 to 2,200 death from Sudden Infant Death Syndrome (7). Maternal smoking has been implicated in long term deficits in infant mental development and adverse behavioral problems in children such as attention disorder. Nicotine crosses the human placenta and has direct effects on the developing fetus. Pre-clinical studies suggest that maternal smoking during pregnancy produces changes on the offspring's neural functioning, including reductions in uptake of serotonin, alterations in dopaminergic systems, alterations in peripheral and central noradrenergic neurons, and changes in DNA and RNA synthesis in the brain (9). Children prenatally exposed to nicotine consistently score lower in the two subcategories of expressive language and conceptual comprehension. Evidence from studies of human neonates suggests that maternal smoking during pregnancy is associated with increased rates of neurobehavioral difficulties. Several studies have linked maternal smoking during pregnancy with childhood inattention, impulsivity, and motor hyperactivity in offspring. Similarly, maternal smoking during pregnancy has been associated with parent-teacher ratings of conduct problems in children and a criminal record in young adults. A study by Yousef Tzabi suggested that cigarette smoking during pregnancy may be one of the causes of hyperactivity and learning deficits in children. In a laboratory study with Sprague-Dawley mice, it was shown that hyperactive male pups that were exposed to nicotine prenatally had significantly higher nicotinic receptor concentrations in the... ...ironment is relatively hypoxic, and corresponding cardiac functional deficits would thus contribute to the high incidence of fetal mortality. Just as impaired cardiac function during hypoxia in neonatal rats can account for the increase in mortality with prolonged hypoxia, comparable effects in man would provide a mechanism for cardiovascular collapse and consequent brain damage or death during delivery. The consequences of smoking during pregnancy are very dramatic. If clinicians are able to convince their patients to stop smoking early in their pregnancy, a major impact may be made on the incidence of low birth weight infants, perinatal morbidity and mortality, as well as cognitive deficits and behavioral problems in the offspring. A strong statement has to be made on the issue of tobacco exposure during pregnancy. This could be accomplished by informing women that their infants may not only be "smaller" than their nonsmoking counterparts, but their infants may also have transient or permanent changes in their lung and brain ultrastructure. A patient who is informed of these possible long-term effects of nicotine on her child may be more successful with her smoking cessation.