Izingozi Zempilo Nezingozi Ezifihliwe Zokusebenzisa I-Nicotine

Ikhaya » Izinhlelo zokusebenza ezinhle kakhulu » Izingozi Zempilo Nezingozi Ezifihliwe Zokusebenzisa I-Nicotine

I-Nicotine iphakathi kwenkinga enkulu yezempilo yomphakathi emhlabeni, kodwa izingozi zayo zangempela zivame ukungaqondwa kahle: abantu abaningi bakholelwa ukuthi i-nicotine ngokwayo iyona ebangela umdlavuza, kanti abanye bakholelwa ukuthi i-nicotine ngokwayo ibangela umdlavuza, kanti abanye bakholelwa ukuthi i-nicotine iyingozi kakhulu. Iqiniso licacile: i-nicotine akuyona into ebangela umdlavuza entuthwini kagwayi, kodwa iyisidakamizwa esinamandla, esilutha kakhulu esigcina abantu beluthwe yimikhiqizo ebangela umdlavuza nezinye izifo eziningi ezimbi.

Ukuqonda ukuthi i-nicotine isebenza kanjani emzimbeni, ukuthi kungani ilutha kangaka nokuthi ilimaza kanjani impilo kubalulekile uma ubhema, uphe noma usebenzisa noma yimuphi omunye umkhiqizo kagwayi, noma uma othile oseduze nawe ebhema. Kusukela emvelaphi yayo yezitshalo kanye nokusetshenziswa kwayo emlandweni kuya emthonjeni wayo ebuchosheni, enhliziyweni, emaphashini ngisho nasempilweni yengqondo, indaba ye-nicotine iyinhlanganisela yamakhemikhali, i-biology kanye namashumi eminyaka ethonya lemboni eliye labumba umbono wethu ngengozi.

Iyini ngempela i-nicotine futhi ivelaphi?

I-Nicotine iyikhemikhali equkethe i-nitrogen (i-alkaloid) ebonakala ngokwemvelo ezitshalweni eziningana, njengoba itholakala kakhulu esitshalweni sikagwayi. Ingakhiqizwa futhi ngendlela yokwenziwa emalabhorethri. Indima yayo yemvelo ezitshalweni ikakhulukazi ukusebenza njengendlela yokuzivikela ezinambuzaneni, isebenza njenge-neurotoxin enamandla ezilwaneni eziningi ezincane.

Isitshalo sikagwayi esisetshenziswa kakhulu ukwenza ugwayi, ugwayi kanye neminye imikhiqizo yiNicotiana tabacum, uhlobo olungowomndeni weSolanaceae noma i-nightshade. Lo mndeni wezitshalo omangalisayo uhlanganisa nokudla kwansuku zonke njengotamatisi, amazambane, ama-eggplant kanye nopelepele. Nakuba le mifino iqukethe inani elincane le-nicotine, amazinga mancane uma kuqhathaniswa nemithamo emikhulu ekhishwa yimikhiqizo kagwayi yokubhema noma yokufutha.

Ugwayi ngokwawo ungowokuzalwa eMelika futhi ubusetshenziswa okungenani iminyaka eyizinkulungwane ezimbili njengesitshalo sokwelapha, isakhi sesiko kanye nesikhuthazi ngabantu bomdabu. Esikhathini eside ngaphambi kokuba kube khona ugwayi wezimboni, ugwayi wawubhenywa emapayipini, uhlafunwe, uhogelwe noma usetshenziswe ezimweni ezahlukene zemikhosi. Umphumela wawo ovuselelayo kanye nomuzwa osheshayo wokuqapha kanye nenhlalakahle wawenza waba yinto eyigugu - futhi kamuva yathengiswa kakhulu.

Indlela ugwayi owafika ngayo eYurophu ayibhalwanga ngokugcwele, kodwa izindaba zomlando zivame ukubonga abahloli bamazwe abafana noChristopher Columbus ngokuqala ukuhlangana nokusetshenziswa kukagwayi eMelika futhi kamuva bakwethula emphakathini waseYurophu. Kusukela lapho, ukusetshenziswa kwawo kwasakazeka ngokushesha kulo lonke izwekazi nangale kwalokho, ekugcineni kwaba yimpahla yomhlaba wonke.

Ngekhulu le-17, ukubhema amapayipi nogwayi kwase kusakazeke ezindaweni eziningi zaseYurophu, kwahlukanisa imibono phakathi kodokotela, abaholi benkolo kanye nabezombusazwe. Abanye babebheka ugwayi njengonosizo lwezokwelapha noma lokwelapha, kanti abanye bawubheka njengonobuthi, ongabaza ngokokuziphatha futhi owakha imikhuba. Lokhu kungabaza kwasekuqaleni kwabikezela impikiswano ende neyinkimbinkimbi ngogwayi eqhubekayo nanamuhla.

Kusukela ezitshalweni zendabuko kuya embonini yomhlaba wonke: umlando omfushane we-nicotine nogwayi

Kuyo yonke ikhulu le-18, ukuhweba ngogwayi kwanda kancane kancane, futhi ngasekupheleni kwawo-1700 kwase kuyimboni ebaluleke kakhulu kwezomnotho. Ushintsho olukhulu lwenzeka ngo-1880, lapho umshini wokuqala osebenza kahle wokukhiqiza ugwayi wephepha ngobuningi unelungelo lobunikazi. Ngokungazelelwe, ugwayi wawungenziwa ngokushesha nangokushibhile, okwavula ithuba lokumaketha okunamandla kanye nokukhula kwezinkampani ezinkulu zikagwayi zamazwe ngamazwe.

Ugwayi wathola nokusetshenziswa kwasekuqaleni kwezimboni njengesibulala-zinambuzane, esebenzisa ubuthi be-nicotine ezinambuzaneni. Kusukela ngo-1763, amalungiselelo enziwe ngogwayi asetshenziswa ukubulala izinambuzane, okuwuphawu lokuthi le nhlanganisela isebenza kangakanani ngokwezinto eziphilayo. Okuvikela isitshalo ezinambuzaneni nakho kungalimaza amangqamuzana nezitho zomzimba zabantu, ikakhulukazi ngemithamo kanye nemvamisa ebonwa kwababhemayo.

Ukuhlukaniswa kwamakhemikhali kwe-nicotine esitshalweni sikagwayi kwafezwa ngo-1828 ngudokotela waseJalimane uWilhelm Heinrich Posselt kanye nosokhemisi uKarl Ludwig Reinmann. Ngemva kokuhlukanisa into emsulwa, bayikhomba njengobuthi, beqaphela ukuthi inemiphumela enamandla ohlelweni lwezinzwa. Lo msebenzi wesayensi wokuqala wabeka isisekelo sezifundo zakamuva zobuthi kanye nokuqonda i-nicotine njengomuthi ngokwawo.

Ekupheleni kwekhulu le-19, abenzi bomthetho base bevele beqaphela umthelela omubi we-nicotine nogwayi entsheni, futhi ngo-1890, izifundazwe ezingu-26 zase-US zazinemithetho ezincwadini ezivimbela ukuthengiswa kwemikhiqizo kagwayi kubantwana abangaphansi kweminyaka. Noma kunjalo, ukwamukelwa kabanzi komphakathi kanye nokukhuthazwa okukhulu yimboni kagwayi kwasho ukuthi ukubhema kwaqhubeka nokukhula kuyo yonke ingxenye yokuqala yekhulu lama-20.

Kwaze kwaba ngo-1964 lapho uDokotela Omkhulu wase-US ekhipha khona umbiko obalulekile ohlanganisa ngokusemthethweni ukubhema ugwayi nomdlavuza wamaphaphu nesifo senhliziyo. Lo mbiko washintsha umbono womphakathi futhi waba yitshe lesisekelo sezinqubomgomo zanamuhla zokulawula ugwayi. Kodwa ukuqashelwa komthetho ukuthi i-nicotine ngokwayo iyisidakamizwa esikhiqiza umlutha kwathatha isikhathi eside: i-US Food and Drug Administration (FDA) ayizange ihlukanise i-nicotine ngokusemthethweni njengento ebangela umlutha kwaze kwaba ngo-1994.

Ngisho nangemva kwalokho kuvuma, i-FDA yayingenalo igunya eliphelele lokulawula imikhiqizo kagwayi kwaze kwaba yilapho kuphasiswa uMthetho Wokuvimbela Ukubhema Komndeni Nokulawula Ugwayi ngoJuni 22, 2009. Lo mthetho wanika i-FDA amandla okulawula ukukhiqizwa, ukumaketha kanye nokusatshalaliswa kwemikhiqizo kagwayi, okubeka isisekelo semikhawulo ekukhangiseni, ukufinyelela kwentsha kanye nokulawulwa kamuva kwe-e-cigarettes.

Indlela i-nicotine esebenza ngayo emzimbeni: "umphumela we-nicotine"

I-Nicotine iwumuthi osebenza ngokushesha ongasebenza njengesikhuthazi kanye nesithokozisi, kuye ngomthamo, indlela yokusetshenziswa kanye nesimo sokuqala somsebenzisi. Uma ubhema ugwayi noma uphefumula umhwamuko oqukethe i-nicotine, umuthi ufinyelela ebuchosheni ngemizuzwana embalwa nje, okuyisinye sezizathu ezenza umphumela uzwakale ngokushesha futhi uqina.

Ingxenye ebalulekile yalokho okubizwa ngokuthi “ukushaya kwe-nicotine” ivela ekusebenzeni kwezindlala ze-adrenal, ezisabela ku-nicotine ngokukhulula i-adrenaline (i-epinephrine) egazini. Lokhu kukhuphuka kwe-adrenaline kubangela uchungechunge lwezimpendulo zomzimba: ukushaya kwenhliziyo kuyashesha, ukuphefumula kuyashesha, umfutho wegazi uyakhuphuka futhi umzimba uhambisa ngokushesha i-glucose egazini, ulungiselela umzimba isimo “sokulwa noma sokubaleka”.

I-Nicotine iphinde iphazamise ukukhishwa kwe-insulin kusuka ku-pancreas, okuholela ekukhuphukeni okuncane kwamazinga kashukela egazini. Ngokuhamba kwesikhathi, ukuchayeka ngokuphindaphindiwe kunegalelo ezinguqukweni ze-metabolic ezihlotshaniswa nokwanda kokumelana ne-insulin, okusiza ukuchaza ubudlelwano phakathi kokusetshenziswa kakhulu kukagwayi kanye nengozi ephezulu yesifo sikashukela sohlobo 2.

Ebuchosheni, i-nicotine ikhulisa ngamandla ukukhishwa kwe-dopamine kumasekethe omvuzo kanye nokugqugquzela, kufaka phakathi izindawo ezifana ne-nucleus accumbens. Kwenzeka into efanayo, ngezinga elincane, ngezidakamizwa ezifana ne-cocaine noma i-heroin: umuntu uzwa umuzwa ojabulisayo, isimo sengqondo esithuthukisiwe noma ukukhululeka kwezimpawu zokuhoxa. I-Dopamine iyi-neurotransmitter ehileleke kakhulu emizweni, ekunyakazeni, ekufundeni nasekuboneni injabulo nobuhlungu, ngakho-ke lapho i-nicotine iphinda iqhube i-dopamine phezulu, ubuchopho buqala "ukulindela" leso sikhuthazo.

Kuye ngesimo kanye nomthamo, i-nicotine ingazizwa izolile kunokuba inike amandla, ikakhulukazi kulabo abayisebenzisa njalo. Kumuntu othembele kuyo, ingxenye enkulu "yokuphumula" abakuzwayo ngemva kokubhema empeleni iwukukhululeka ezimpawini zokuhoxa ebezilokhu zanda kusukela kumthamo wokugcina. Ngokwemithi, i-nicotine isasebenza ohlelweni lwezinzwa, kodwa ngokwengqondo ingase ibonakale njengokukhululeka ekucindezelekeni.

Imiphumela ye-nicotine kwezokwelapha nangokwengqondo

Ngokwezinga nje lomzimba, ukuchayeka kwi-nicotine kwandisa ukushaya kwenhliziyo, kuphakamisa inani lomoya-mpilo oludingwa yimisipha yenhliziyo futhi kukhulisa inani legazi inhliziyo ephampa ngalo ngokushaya ngakunye. Lezi yizenzo zemithi ezivamile ezibonwa kubantu, ezincelisayo kanye nezinye izinhlobo eziningi zezilwane ezivezwe kulesi sidakamizwa. Uma ziphindaphindwa kaningi ngosuku eminyakeni eminingi, zibeka ingcindezi engapheli ohlelweni lwenhliziyo nemithambo yegazi.

Ngokwengqondo nangokokuziphatha, i-nicotine ihlotshaniswa nokuqapha okukhulu, injabulo encane kanye nomuzwa wokuzola, yingakho abanye abantu benomuzwa wokuthi iyabasiza ukucabanga kahle noma ukuphatha ukucindezeleka. Abasebenzisi abaningi babika ukuthi ukubhema noma ukubhema ugwayi kubenza bazizwe bekwazi ukugxila emsebenzini noma "abalawula" kakhulu imizwa yabo, okungenani esikhathini esifushane.

Izifundo zithole ukuthi i-nicotine ingathuthukisa okwesikhashana izici ezithile zokugxilisa ingqondo kanye nenkumbulo, umphumela okukholakala ukuthi uhlobene namazinga aphezulu ama-neurotransmitter njenge-acetylcholine kanye ne-norepinephrine. Lawa makhemikhali athuthukisa ukunaka, ukuqapha kanye nokuvuka. Nokho, lokhu kuthuthukiswa kwengqondo yesikhashana kuza nezindleko ezinkulu zesikhathi eside: umlutha, ukulimala kwemithambo yegazi kanye nezinye izinkinga eziningi zempilo.

I-Nicotine iphinde ibangele ukukhishwa kwe-beta-endorphin, into efana ne-opioid yemvelo ekhiqizwa umzimba enciphisa umbono wokucindezeleka nokungakhululeki. Lo mphumela we-biochemical ungaba nomthelela ekutheni kungani abantu bezizwa bengakhathazeki kakhulu ngemva kokubhema noma ukubhema i-vape, okuqinisa indlela yokusebenzisa i-nicotine njengesixazululo esisheshayo noma nini lapho kuvela ukucindezeleka.

Naphezu kwalezi "zinzuzo" zesikhashana, i-nicotine iyalutha kakhulu, futhi uma ubuchopho bujwayela ukuba khona kwayo, ukungayisebenzisi kungazizwa kungakhululekile kakhulu. Abantu abaphuza i-nicotine njalo bese beyeka ngokuzumayo bavame ukuba nezimpawu zokuhoxa njengokuthanda kakhulu, umuzwa wokungabi nalutho, ukukhathazeka, isimo sengqondo sokucindezeleka, ukucasuka kanye nobunzima bokugxilisa ingqondo noma ukunaka.

Umlutha we-Nicotine: kungani kunzima kangaka ukuyeka

I-American Heart Association iyaqaphela ukuthi i-nicotine evela ekubhemeni iphakathi kwezinto okunzima kakhulu ukuziyeka, uma kuqhathaniswa nobunzima bokuyeka ukusebenzisa i-heroin. Ukuqala okusheshayo kwesenzo, ukwanda kwe-dopamine enamandla kanye nemikhuba yokuziphatha ejulile (ukukhanyisa, ukuphefumula, ukushukuma kwesandla emlonyeni) konke kunegalelo ekuthembeleni okunamandla.

Ucwaningo lwango-2013 lubonise ukuthi ukwehlisa okuqukethwe yi-nicotine kusikilidi kunciphisa ukuthi zilutha kangakanani, okuphakamisa ukuthi umthamo we-nicotine uyimbangela eyinhloko yokuphoqelelwa. Kodwa-ke, ngisho nemikhiqizo ene-nicotine ephansi ingaqhubeka nokuthembela ngenxa yokuhlanganiswa kwezimpawu zokuzwa, amasiko kanye namanye amakhemikhali entuthwini kagwayi aguqula umphumela.

Umsebenzi ovela kwi-US National Institute on Drug Abuse uthole ukuthi ukuchayeka kwi-nicotine kungenza ezinye izidakamizwa, njenge-cocaine, zibe umlutha kakhulu, cishe ngokuvuselela uhlelo lomvuzo lobuchopho. Lokhu kubambisana kuphakamisa ukukhathazeka, ikakhulukazi entsheni, ukuthi ukusetshenziswa kwe-nicotine kusenesikhathi kungandisa ubungozi kwezinye izinkinga zokusebenzisa izidakamizwa kamuva.

E-United States, ukubhema ugwayi kusalokhu kuyimbangela ehamba phambili yokufa okungavinjelwa, okubangela ukufa kwabantu abangaba ngu-480,000 minyaka yonke. Abantu baseMelika abangaphezu kwezigidi ezingu-16 njengamanje baphila nesifo esibangelwa ukubhema ngqo. Emhlabeni jikelele, abantu abangaphezu kwezigidi eziyinkulungwane babhema njalo, okubonisa ukuthi umlutha we-nicotine usasakazeke kangakanani naphezu kweminyaka eminingi yemikhankaso yezempilo yomphakathi.

Ngisho naphakathi kwabantu abadala abasebasha, ukubhema nokubhema ugwayi kuhlotshaniswa nempilo embi kanye nekhwalithi yokuphila okubi, okuhlanganisa ukwanda kwezimpawu zokuphefumula, ukuncipha kokukhuthazela ngokomzimba kanye nenhlalakahle engabonakali kahle. Ukuthembela ku-nicotine kuvame ukuqala ebusheni, lapho ubuchopho busakhula futhi busengozini enkulu yezinguquko zesikhathi eside.

Izingozi zempilo zesistimu ngayinye zokusetshenziswa kwe-nicotine nogwayi

I-Nicotine kanye nemikhiqizo kagwayi kuthinta cishe zonke izitho zomzimba, kungaba ngokuqondile ngemiphumela yemithi yomuthi noma ngokungaqondile ngamakhemikhali amaningi anobuthi akhona entuthwini noma e-aerosol. Ngisho noma i-nicotine ngokwayo ingabhekwa njenge-carcinogen yi-International Agency for Research on Cancer, igcina abantu besebenzisa imikhiqizo equkethe izinto eziningi ezibangela umdlavuza.

Esimiso sokujikeleza kwegazi, i-nicotine ingandisa ukuthambekela kwegazi ekujiyileni, okwandisa ingozi yokujiyileka kwegazi okuyingozi okungavimba imithambo yegazi enhliziyweni, ebuchosheni noma emaphashini. Iphinde ibe negalelo ekuqhekekeni kwemithambo yegazi, ukwakheka kwe-plaque ezindongeni zemithambo yegazi, kanye nokwanda kanye nokwenza buthaka kwe-aorta, umthambo oyinhloko ophuma enhliziyweni. Lezi zinguquko ziyimbangela yokuhlaselwa yinhliziyo okuningi, ukushaywa yisifo sohlangothi kanye ne-aneurysms.

Ubuchopho busengozini yemiphumela ye-nicotine, hhayi nje kuphela ngezimpawu ezibukhali ezifana nesiyezi, ikhanda elibuhlungu, ukuphazamiseka kokulala, amaphupho acacile noma aphazamisayo kanye nokwehla okungenzeka kwesikhashana kokugeleza kwegazi, kodwa futhi nangokujwayelana nezifo zengqondo okungapheli. Lapho ukuchayeka kwi-nicotine kuqala ebusheni, kungashintsha ukuthuthukiswa kwezindawo zobuchopho ezihilelekile ekunakeni, ekufundeni, ekulawuleni imizwa kanye nasekulawuleni imizwa.

Uhlelo lokugaya ukudla aluphumi, kanti i-nicotine ivame ukubangela isicanucanu, ukuhlanza, umlomo owomile (xerostomia), ukungagayi kahle kokudla, ukuba kubi kakhulu kwezilonda zesisu, isifo sohudo kanye nokwanda kwesilungulela noma i-acid reflux. Ukusetshenziswa kukagwayi isikhathi eside kuhlotshaniswa nomdlavuza womqala, isisu, i-pancreas kanye ne-colon, yize lokhu kubangelwa kakhulu ezinye izinto ezinobuthi ezitholakala entuthwini kanye nogwayi ongenantuthu.

Inhliziyo isabela ku-nicotine ngokushintsha kwesivinini kanye nesigqi, umfutho wegazi ophakeme kanye nokucinana kwemithambo yenhliziyo, konke okwandisa amathuba okuba nesifo semithambo yenhliziyo kanye nokuhlaselwa yinhliziyo. Izimo zenhliziyo nemithambo yegazi zibangela cishe u-40% wabo bonke abantu abafa ngenxa yokubhema, okugcizelela ukuthi umonakalo wenhliziyo nemithambo yegazi ubaluleke kangakanani emthwalweni ophelele wesifo esihlobene nogwayi.

Kwabesifazane ababhema ngesikhathi sokukhulelwa, i-nicotine kanye nobunye ubuthi bukagwayi kukhulisa izingozi eziningi enganeni ekhulayo, okuhlanganisa amathuba aphezulu okuphuphuma kwesisu, ukuzalwa ngaphambi kwesikhathi, ukuzalwa unesisindo esiphansi kanye nezinkinga zokuphila kamuva njengokukhuluphala ngokweqile, umfutho wegazi ophakeme, isifo sikashukela sohlobo 2, ubunzima bokuphefumula, izinkinga zokuzala, izinkinga ze-neurodevelopmental kanye nokuphazamiseka kokuziphatha.

Eminye imiphumela yomzimba ihlanganisa ukuqaqamba kwamaphaphu, i-pneumonia, ukuthuthumela kwemisipha nobuhlungu, amazinga e-insulin akhuphukayo kanye nokumelana okukhulu kwe-insulin (okubangela ingozi yesifo sikashukela) kanye nobuhlungu bamalunga. Ukubhema kuphazamisa nokusebenza kahle kokuzivikela komzimba, kukhuthaza ukuvuvukala okungapheli futhi kuhlotshaniswa nezifo zamathambo kanye nokuphulukiswa kancane.

Umdlavuza, isifo samaphaphu nesifo senhliziyo: isithombe esikhulu

Nakuba i-nicotine ngokwayo ingeyona imbangela eyinhloko yomdlavuza entuthwini kagwayi, ugwayi uqukethe okungenani amakhemikhali angu-69 aziwa ngokubangela umdlavuza, okuhlanganisa ama-polycyclic aromatic hydrocarbons, ama-nitrosamines kanye nezinsimbi ezisindayo. Ukubhema kubangela okungenani ama-30% abo bonke abantu ababulawa umdlavuza, kanti abantu ababhema kakhulu babhekene namazinga okufa ngenxa yomdlavuza aphakeme cishe ngokuphindwe kane kunalabo abangabhemi nhlobo.

Umdlavuza wamaphaphu umdlavuza odume kakhulu futhi obulalayo ohlotshaniswa nogwayi, obangela u-80-90% wazo zonke izimo zomdlavuza wamaphaphu kanye no-80% wokufa komdlavuza wamaphaphu. Ukubhema kwandisa ingozi yokuba nomdlavuza wamaphaphu ngokuphindwe ka-5 kuya ku-10, kanti ingozi enkulu ibonwa kwababhemayo kakhulu isikhathi eside. Bobabili abesilisa nabesifazane babelana ngale ngozi eyengeziwe, okwenza umdlavuza wamaphaphu ube yimbangela ehamba phambili yokufa komdlavuza kubo bobabili ubulili.

Ugwayi uphinde udlale indima enkulu emdlavuza womlomo, umphimbo, i-larynx, umphimbo, isisu, i-pancreas, umlomo wesibeletho, izinso kanye nesinye, kanye ne-acute myeloid leukemia. Imikhiqizo kagwayi engenantuthu, njengogwayi ohlafunwayo kanye ne-snuff, ihlotshaniswa kakhulu nomdlavuza womlomo kanye nomphimbo, kanye nomdlavuza womphimbo, wesisu, wamaphaphu kanye nomdlavuza we-colorectal.

Ngaphandle komdlavuza, izifo zamaphaphu ezingamahlalakhona zihlobene kakhulu nokubhema, okuhlanganisa i-bronchitis engapheli kanye ne-emphysema, okuhlanganisa ukwakha isifo samaphaphu esingamahlalakhona (i-COPD). Ukubhema ugwayi kuyisici esibaluleke kakhulu sengozi ye-COPD. Nakuba ukuyeka kunganciphisa ukuqhubeka futhi kuthuthukise izimpawu, umonakalo wesakhiwo samaphaphu uma i-COPD isiqalile awunakulungiseka.

Ngokombono wenhliziyo nemithambo yegazi, ukubhema kwandisa kakhulu ingozi yokuhlaselwa yinhliziyo, isifo sohlangothi, isifo semithambo yegazi kanye ne-aortic aneurysm, futhi kuyimbangela ehamba phambili yesifo senhliziyo, okuyimbangela eyinhloko yokufa e-United States. Abantu abasha ababhemayo, ngisho nalabo abaneminyaka ephakathi kuka-26 no-41 ubudala, babika impilo yabo yomzimba kanye nokusebenza kwabo okubi kakhulu uma kuqhathaniswa nabantu abangabhemi abaneminyaka yabo.

Ucwaningo olusanda kuvela luphinde lwaphakamisa ukuxhumana phakathi kokuchayeka kwi-nicotine, ukusebenza kwe-pancreatic kanye nezindawo zobuchopho ezivuselelwa yi-nicotine, okungaba yindlela eyodwa exhumanisa ukubhema ugwayi nengozi eyengeziwe yesifo sikashukela sohlobo 2. Kuhlanganiswe nemiphumela eyaziwayo yokumelana ne-insulin kanye nokulawulwa kwesisindo somzimba, ukusetshenziswa kukagwayi kusobala ukuthi kudlala indima empilweni ye-metabolic.

Izinhlobo zokusetshenziswa kwe-nicotine nogwayi

Iningi labantu lithola i-nicotine yabo ngokubhema ugwayi, kodwa hhayi ukuthi yiyona kuphela indlela esetshenziswayo, i-nicotine ikhona kuma-cigare, amapayipi, imikhiqizo kagwayi engenantuthu kanye nezindlela ezahlukene zokwelapha esikhundleni se-nicotine. Indlela yokulethwa ithonya ukuthi i-nicotine ifinyelela ngokushesha kangakanani ebuchosheni nokuthi kungakanani ukulimala okwengeziwe okuvela kwamanye amakhemikhali okungeziwe ngaphezulu.

Ugwayi usalokhu ungumkhiqizo kagwayi ovame kakhulu emhlabeni wonke, oqukethe ugwayi oqoshiwe kahle ogoqwe ngepayipi lephepha, ngokuvamile onezihlungi kanye nezithasiselo ezishintsha ukunambitheka, izinga lokusha kanye nezici zomusi. Emhlabeni jikelele, abantu abangaphezu kwezigidi eziyinkulungwane babhema njalo, okwenza ugwayi ube umthombo oyinhloko wokulutheka kwe-nicotine kanye nezifo ezihlobene nogwayi.

Ama-cigar namapayipi nawo aletha i-nicotine kanye nemikhiqizo yokusha enobuthi, yize izindlela zokusebenzisa zingahluka. Ama-cigar ahlanganisa ugwayi ogoqwe ngeqabunga likagwayi, kuyilapho amapayipi eshisa ugwayi okhululekile esitsheni. Ngisho noma intuthu ingahogelwa kakhulu njalo, ukuchayeka okukhulu kusenzeka emlonyeni nasemigudwini yomoya ephezulu, okwandisa izingozi zezifo zomlomo, umphimbo kanye namaphaphu.

Ugwayi ongenantuthu uhlanganisa ugwayi ohlafunwayo, isinemfu esimanzi, i-snus kanye nemikhiqizo kagwayi encibilikayo, konke okufakwa emlonyeni noma endebeni engenhla, okuvumela i-nicotine ukuthi imuncwe yi-mucosa. Nakuba igwema intuthu yamaphaphu, le mikhiqizo isaqukethe izinto ezibangela umdlavuza futhi ihlotshaniswa nomdlavuza womlomo, umphimbo, umphimbo, isisu, amaphaphu kanye nomathumbu amakhulu, kanye nesifo sezinsini kanye nokulahlekelwa amazinyo.

Izindlela zokwelapha esikhundleni se-nicotine (NRT) – njengeziqeshana, izinsini, ama-lozenge, izifutho zamakhala kanye nama-inhaler – zenzelwe ukuletha imithamo elawulwayo ye-nicotine ngaphandle kwe-tar, i-carbon monoxide kanye nezinto eziningi ezibangela umdlavuza ezitholakala kusikilidi. Uma zisetshenziswa kahle, zinganciphisa izimpawu zokuhoxa futhi ziphindeke kabili amathuba okuphumelela ukuyeka isikhathi eside, ikakhulukazi uma zihlanganiswa nokwelulekwa.

Ugwayi we-elekthronikhi kanye nokuvayiza: kuphephile, kodwa akulona neze ingozi

Eminyakeni yamuva nje, i-nicotine ewuketshezi ethunyelwa yi-e-cigarettes kanye ne-vaporizers iye yakhuthazwa kakhulu njengendlela ehlukile engenangozi kakhulu kunokubhema, futhi ababhemayo abaningi baye baphendukela kula madivayisi ukuze banciphise noma bayeke ugwayi ovuthayo. Lezi zinhlelo ezisebenzisa amabhethri zifudumeza uketshezi (ngokuvamile oluqukethe i-nicotine, izinongo kanye nezinyibilikisi) ukuze kudalwe i-aerosol umsebenzisi ayiphefumulayo.

Ngokombono we-toxicology kuphela, ukuvayiza kugwema imikhiqizo eminingi yokusha etholakala entuthwini kagwayi, ngakho-ke ubufakazi bamanje busikisela ukuthi, kumuntu obhemayo oshintsha ngokuphelele, ugwayi we-e cishe awunangozi kangako njengokuqhubeka nokubhema. I-Nicotine ngokwayo ayihlukaniswa ngokusemthethweni njenge-carcinogen, futhi ukususa i-tar kanye nobuthi obuningi bomusi kunganciphisa izingozi ezithile.

Kodwa-ke, ama-aerosols e-nicotine ewuketshezi kanye ne-e-cigarette asaqukethe inhlanganisela yamakhemikhali angaba yingozi, okuhlanganisa ama-aldehydes afana ne-formaldehyde, i-benzene kanye nezinye izimo izinto zokunambitha ezifana ne-diacetyl. I-Diacetyl ihlotshaniswa nesifo esibi sokuphefumula esaziwa ngokuthi “i-popcorn lung” kubasebenzi ababhekene nayo emafektri e-microwave popcorn, futhi ukuba khona kwayo kwamanye ama-e-liquids kuphakamisa ukukhathazeka okukhulu ngempilo yamaphaphu yesikhathi eside.

Intsha evape ayigcini nje ngokuphefumula inkungu engenabungozi kodwa iphuza i-nicotine emluthayo kanye namakhemikhali angaphezu kuka-30 angaba yingozi, amanye awo abangela umdlavuza. Izifundo zihlobanise uvape nokukhathazeka okukhulu noma okubi kakhulu kanye nokucindezeleka, ukuncipha kokuqina komzimba, umfutho wegazi ophakeme kanye nobunzima bokugxilisa ingqondo okungaphazamisa ukusebenza kahle kwezemfundo, ezemidlalo kanye nokusebenza kwansuku zonke.

Phakathi kuka-2011 no-2015, ukusetshenziswa kukagwayi kagesi phakathi kwabafundi besikole samabanga aphezulu e-US kwehle kusuka ku-1.5% kuya ku-16%, kanti phakathi kwabafundi besikole samabanga aphakathi kusuka ku-0.6% kuya ku-5.3%. Cishe u-81% wabashushumbisi be-vape abasebasha babike ukuthi uhla olubanzi lwezinongo ezikhangayo kwakuyisizathu esikhulu sokusebenzisa le mikhiqizo. Lokhu kukhanga okubangelwa ukunambitheka kwenze ugwayi kagesi waba yindlela enamandla yokuthembela ku-nicotine entsheni okungenzeka ukuthi ayizange ibheme ugwayi ovamile.

Noma yiluphi uhlobo lwe-nicotine luhlala lumlutha kakhulu, ngakho-ke ama-e-cigarettes nama-vaporizer awafanele izingane, intsha noma abantu abadala abangakasebenzisi ugwayi. Kubantu abangenawo amathuba e-nicotine ngaphambili, ukubhema i-vaping kungasebenza njengesinyathelo sokubhema ugwayi ovuthayo kunokuba ithuluzi lokunciphisa umonakalo. Ngaphezu kwalokho, eminye imikhiqizo ethengiswa ku-inthanethi itholakale inezinga le-nicotine eliphakeme kakhulu.

I-US FDA yaqala ukulawula ugwayi we-e kanye nemikhiqizo ehlobene nayo ngo-2016, futhi kusukela ngo-2018 ibilokhu idinga izixwayiso zokuluthwa yi-nicotine ezintweni zokupakisha nezokumaketha. Kodwa-ke, njengoba ubuchwepheshe busha kakhulu, imiphumela yezempilo yesikhathi eside yokuvapha ayaziwa ngokugcwele. Kunconywa kakhulu ukuqapha, ikakhulukazi kubasebenzisi abasebasha kanye nabangabhemi.

Ukubhema okubhenywa ngabanye abantu, impilo yengqondo kanye nomthelela emphakathini

Ukusetshenziswa kukagwayi akulimazi nje kuphela umuntu odla i-nicotine kodwa nalabo abaseduze naye, ikakhulukazi ngokubhema intuthu kagwayi. Ukuchayeka ngokungazi entuthwini kagwayi kwandisa ingozi yesifo senhliziyo, umdlavuza wamaphaphu kanye nezifo zokuphefumula kubantu abangabhemi, okuhlanganisa nezingane. Ezinsaneni nasezinganeni, ukuhlala nabantu ababhemayo kuhlotshaniswa nokuhlaselwa yi-asthma, izifo zendlebe kanye ne-sudden infant death syndrome (SIDS).

Ukubhema i-vaping kuveza abantu ababukele amakhemikhali afakwe umoya, noma ngabe ukwakheka kwawo kuhlukile kokubhema ugwayi. Nakuba ingozi enkulu iphansi kuneyokubhema ugwayi ovuthayo, izinhlayiya ezincane kakhulu, amakhemikhali e-organic aguquguqukayo, izinsimbi kanye ne-nicotine kusengaphefumulwa abantu abaseduze, ikakhulukazi ezindaweni ezivalekile.

Ngasohlangothini lwezempilo yengqondo, i-nicotine kanye ne-vaping kunobudlelwano obuyinkimbinkimbi nemizwa kanye nokukhathazeka, ikakhulukazi entsheni kanye nabantu abadala abasebasha. Abasebenzisi abaningi babika ukuthi i-vaping ilawula ukucindezeleka, kodwa izifundo zibonisa ukuthi ukusetshenziswa kwe-nicotine empeleni kungandisa noma kubhebhethekise ukukhathazeka kanye nezimpawu zokucindezeleka ngokuhamba kwesikhathi, kudale umbuthano omubi lapho umuthi ukhulula futhi ubhebhethekisa ukucindezeleka ngokomzwelo.

Ngokwezenhlalo, ukubhema sekuyinto ehlazisayo emazweni amaningi, okungaholela emizweni yokuzihlukanisa kanye nesizungu phakathi kwababhemayo. Imikhawulo ezindaweni zokubhema kanye nemibono emibi yomphakathi ingenza abantu ababhemayo bazizwe benganakwa, okwengeza umthwalo wengqondo ngaphezu kwezingozi zempilo yomzimba.

Impilo yomlomo ingenye indawo lapho i-nicotine nogwayi kulimaza khona, okubangela ukushintsha kombala wamazinyo, isifo sezinsini, iphunga elibi lomlomo kanye nomdlavuza womlomo. Le miphumela ayithinti nje ukubukeka kodwa futhi nemisebenzi eyisisekelo yokukhuluma, ukuhlafuna nokunambitha, okunomthelela omkhulu kwikhwalithi yokuphila.

Ukwelashwa kokuthembela ku-nicotine kanye nocwaningo oluvelayo

Ukwelashwa okuhloselwe ukunqamula ukuthembela ku-nicotine, okuvame ukubizwa ngokuthi ukwelashwa kokuyeka ukubhema, kugxile ekunciphiseni izifiso, ukuphatha ukuyeka kanye nokunciphisa izingozi zempilo ezihlobene nokusetshenziswa kukagwayi. Izindlela eziphumelelayo zivame ukuhlanganisa imithi nokusekelwa kokuziphatha.

Izinketho zemithi zokuqala zifaka phakathi izinhlobo eziningana zokwelapha esikhundleni se-nicotine, njengeziqeshana, izinsini, ama-lozenge, ama-spray ekhaleni kanye nama-inhaler. Le mikhiqizo inikeza imithamo ye-nicotine elawulwayo ngaphandle kwentuthu enobuthi, okusiza ekuqedeni ukuhoxa ngenkathi umuntu efunda ukuphila ngaphandle kukagwayi. Nakuba zingaziqedi ngokuphelele izimpawu, ukubuyekezwa okuhlelekile kuthole ukuthi i-NRT ingaphinda kabili amazinga okuyeka isikhathi eside uma kuqhathaniswa nokungathandi ukubhema.

I-Bupropion, eyasungulwa ekuqaleni njengomthi wokucindezeleka, kamuva yatholakala ukuthi inciphisa izifiso ze-nicotine futhi isetshenziswa kabanzi njengosizo lukadokotela lokuyeka. Indlela yayo eqondile yokuncika kwi-nicotine ayiqondakali ngokugcwele, kodwa kubonakala sengathi ilawula izindlela ze-dopamine kanye ne-norepinephrine. Ingabangela ukungakwazi ukulala kubasebenzisi abangu-30-40% futhi inesexwayiso se-FDA esiphathelene nengozi yemicabango yokuzibulala noma yokuziphatha kwabanye abantu abathatha imithi yokucindezeleka.

I-Varenicline (ethengiswa njenge-Chantix kwamanye amazwe) ingenye imithi ephumelelayo yokuthembela kwi-nicotine, esebenza njenge-agonist engaphelele kuma-receptor athile e-nicotinic ebuchosheni. Ivuselela kancane la ma-receptor ukuze kube lula ukuyeka, ngesikhathi esifanayo ivimbela i-nicotine egwayi ukuthi ingawakhuthazi ngokugcwele, ngaleyo ndlela inciphise izifiso kanye nokwaneliseka okutholakala ngokubhema. Isicanucanu siwumphumela waso ovame kakhulu, ngokuvamile omnene futhi owenzeka cishe kubasebenzisi abangu-30%.

Uma ukwelashwa komugqa wokuqala kwehluleka noma kungabekezeleleki, imithi yomugqa wesibili efana ne-clonidine ne-nortriptyline ingacatshangelwa, yize ivame ukuba nemiphumela emibi eminingi. I-Clonidine, umuthi onciphisa umfutho wegazi, ingasiza ekunciphiseni izimpawu zokuhoxa kodwa ingabangela umfutho wegazi ophansi, umlomo owomile, ukuqunjelwa kanye nokushaya kwenhliziyo okuhamba kancane. I-Nortriptyline, umuthi omdala wokucindezeleka we-tricyclic, ingalingisa imiphumela yemizwa ye-nicotine kodwa ihlotshaniswa nemiphumela eminingi engaba mibi futhi ayinalo iphrofayili yokuphepha eqinisekisiwe ngokugcwele yalokhu kusetshenziswa.

Ukwelulekwa kanye nokusekelwa kwengqondo kuthuthukisa kakhulu ukusebenza kahle kwazo zonke lezi zindlela zemithi, kungakhathaliseki ukuthi zilethwa ngeseluleko esifushane esivela kudokotela wokunakekelwa okuyisisekelo, ukwelashwa komuntu ngamunye noma kweqembu okuhleliwe, noma izinhlelo zokusekela ngocingo kanye naku-inthanethi. Ukungenelela kokuziphatha kusiza abantu ukusingatha ukucindezeleka, ukubhekana nezinto ezibangela ukucindezeleka, ukuphatha ukukhathazeka ngesisindo kanye nokwakha imikhuba emisha engagxili ku-nicotine.

Ucwaningo lwamuva luyaqhubeka nokuthuthukisa ukuqonda kwethu ngemiphumela yezempilo ye-nicotine kanye nezindlela ezinhle kakhulu zokuyeka, kusukela ekuhloleni imithi emisha kuya ekuhloleni indima yokuzivocavoca nokudla ekunciphiseni ukuyeka. Ezifundweni zezilwane, isibonelo, amagundane anikezwe ukufinyelela esondweni lokuzivocavoca ngemva kokuchayeka isikhathi eside kwi-nicotine abonise izimpawu ezimbalwa kakhulu zokuhoxa kunamagundane angawuvivinyi umzimba, okubonisa ukuthi umsebenzi womzimba ungaba usizo olukhulu ezinhlelweni zokuyeka.

Ucwaningo lokudla okunempilo luphinde lwasikisela ukuthi ukudla okuthile kungasiza ekulungiseni noma ekuvikeleni ukusebenza kwamaphaphu kulabo ababebhema, kanti olunye ucwaningo olukuyi-European Respiratory Journal luthole ukuthi ukudla okucebile ngotamatisi kungase kunciphise ukwehla kokusebenza kwamaphaphu futhi kusekele ukululama emonakalweni ohlobene nokubhema. Nakuba kungekho ukudla okukodwa okuyisisombululo esimangalisayo, lokhu okutholakele kuqinisa umqondo wokuthi izinguquko zendlela yokuphila zingasekela inqubo yokuphulukiswa ngemva kokuyeka.

Sekukonke, i-nicotine iyisidakamizwa esiyinkimbinkimbi esingalola ukugxila futhi sishintshe isimo sengqondo ngesikhathi esifushane, kodwa amandla ayo okulutha kanye nokulimala okukhulu kokubhema, kanye, ngezinga elincane, ukubhema i-vaping, kuyenza ibe usongo olukhulu empilweni yomphakathi. Ukuqonda ukuthi isebenza kanjani, ukuqaphela ukuthi ngisho nezinye izindlela "eziphephile" zisenezingozi nokwazi ukuthi kukhona ukwelashwa okusebenzayo kanye nokusekelwa kungenza indlela yokuphuma ekusebenziseni i-nicotine icace futhi ifinyeleleke kalula kunoma ubani olungele ukuthatha leso sinyathelo.