Friday, August 9, 2019

Some definitions related to tobacco and other common addictions

Dr KK Aggarwal

Here is a list of definitions of various terms related to tobacco and other common addictions as to what do they actually mean. This will help to understand the nuances between the various terminologies. You are welcome to add to this list.

·         Smoke is produced as a result of combustion (temperature > 800o C). When combustion occurs, new chemicals are formed via the process of oxidation. Hence, smoke contains several new chemicals different from those initially burned. Smoke can be produced by burning coal, wood, cigarettes, bidis, etc.

·         Smoking is a practice in which a substance is burned and the resulting smoke breathed is absorbed into the bloodstream. The most common form of smoking is cigarette smoking or recreational drug use.

·         Second hand smoke: Smoke that fills restaurants, offices or other enclosed spaces when people burn tobacco products such as cigarettes, bidis and water-pipes.

·         Third hand smoke: It is not exactly smoke, but the “invisible” chemical residual of tobacco smoke contamination that sticks to clothing, wall, furniture, carpet, cushions, hair, skin and other materials in the environment after the cigarette has been extinguished.

·         Vaping: Act of inhaling and exhaling a vapor or an aerosol. E-cigarettes do not produce tobacco smoke, but an aerosol, which is commonly termed as “vapor”.

·         Vapor: When a substance becomes gaseous, at a temperature that is lower than its point of combustion (180-250oC), it is considered as vapor. Unlike smoke, the chemicals in vapor are the same as those found in the vaporized substance.

·         Aerosol: Suspension of tiny particles of liquid, solid or both within a gas.

·         Electronic nicotine delivery systems (ENDS) and Electronic Non-Nicotine Delivery Systems (ENNDS): Products that heat a solution to create an aerosol which frequently contains flavourants, usually dissolved into Propylene Glycol or/and Glycerin; the aerosol is inhaled by the user. Most common example are e-Cigarettes that that do not burn or use tobacco leaves but instead vaporise a solution the user then inhales. All ENDS (but not ENNDS) contain nicotine. 

·         Heated tobacco products: Also known as “Heat-not-Burn” products, they produce aerosols containing nicotine and other chemicals, upon heating of the tobacco, or activation of a device containing the tobacco, which are inhaled by users, through the mouth.

·         Sheesha: Fruit-flavored tobacco, which is roasted in a foil along with charcoal and passed into a small chamber of water through a glass-bottomed pipe. It is then inhaled slowly. 

·         Smokeless tobacco: It is tobacco that is not burned. It is also known as chewing tobacco, oral tobacco, spit or spitting tobacco, dip, chew, and snuff. 

·         Chewing or spit tobacco: Tobacco in the form of loose leaves, plugs, or twists of dried tobacco that may be flavored. It is chewed or placed between the cheek and gum or teeth.

·         Guá¹­kha or pan masala is a chewing tobacco preparation made of crushed areca nut, tobacco, catechu, paraffin wax, catechu, slaked lime, flavoring agents and sweeteners

·         Khaini contains dry tobacco, slaked lime

·         Betel quid or pan: Contains betel leaf, areca nut, catechu, slaked lime and tobacco

·         Snuff or dipping tobacco: Finely ground “smoke-free and spit-free”” tobacco packaged in cans or pouches and may have flavorings added. Dry snuff is sold in a powdered form and is used by sniffing or inhaling the powder up the nose, while moist snuff is put between the lower lip or cheek and gum.

·         Snus: Type of moist snuff first used in Sweden and Norway. It’s often flavored with spices or fruit, and is packaged like small tea bags. Snus is held between the gum and mouth tissues and the juice is swallowed.

·         Standard drink: Definition of standard drink differs in countries: US = 14-15 gm alcohol equivalent to 12 oz beer, 5 oz wine and 1.5 oz 80 proof liquor; UK 8 gm alcohol, Japan 19.75 gm alcohol and India 10 gm alcohol
o     Alcohol content differs in various drinks: Beer 5%; Malt liquor 7%; Table wine 12%; Fortified wine (sherry, port) 17%; Cordial liquor (aperitif) 24%; Brandy (single jigger) 40% and 80 proof gin, Vodka, whisky 40%
o     Moderate drinking means less than 2 drinks per day (women) and less than 3 drinks per day (men) and for people aged more than 65, less than two drinks per day
o     Heavy drinking means more than 7 drinks per week or 3 drinks per occasion (women) or more than 14 drinks per week or 4 drinks per occasion (men).
o     Binge drinking means 4 or more drinks at one time (women) or 5 or more at one time (men)

·         Charas, hashish, ganja and bhang: are obtained from the cannabis plant.

o    Marijuana is another name for cannabis obtained from the Cannabis plant
o    Charas is the separated resin from the cannabis plant
o    Ganja is prepared from the flowering or fruiting tops of the cannabis plant
o    Bhang is prepared from the leaves (and seeds) of the cannabis plant.

(The Narcotic Drugs and Psychotropic Substances Act,1985 has banned the production and sale of cannabis resin and flowers, but permits use of leaves and seeds)

Dr KK Aggarwal
Padma Shri Awardee
President Elect Confederation of Medical Associations in Asia and Oceania   (CMAAO)
Group Editor-in-Chief IJCP Publications
President Heart Care Foundation of India
Past National President IMA

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