Since the 1964 Surgeon General’s Beport, many epidemiological investigations have confirmed that, besides high blood cholesterol and hypertension, cigarette smoking is a main risk factor for the development of coronary heart disease (CHD) (1). Cigarette smoke consists of a mixture of thousands of different compounds, among which nicotine is regarded as the most pharmacologically-active component (2). The pharmacologic and toxicologic effects of nicotine are well-known, and should only be mentioned briefly. The main pharmacological action of nicotine is its stimulation of sympathetic ganglia and of the adrenal medulla, resulting in the release of catecholamines from sympathetic nerves and chromaffine tissues in different organs, thereby influencing fat metabolism, carbohydrate metabolism, thrombocytes, and blood coagulation (3). Furthermore, nicotine is known to release antidiuretic hormone from the pituitary (4) and to increase corticosteroid secretion (5). In higher doses of nicotine, stimulation is followed by paralysis of the central and peripheral nervous system and rapid death (6).
KeywordsSmokeless Tobacco Tobacco User High Blood Cholesterol Serum Cotinine Chewing Tobacco
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