tobacco psychosis Associations of alcohol and use with psychotic, depressive and developmental disorders revealed via multimodal neuroimaging Tobacco Addiction: Symptoms, Causes, Effects,

consumers do not have reliable product information E-cigarette liquids contain ingredients that may irritate airways and may be harmful when inhaled repeatedly over prolonged periods of time Nicotine delivery with e-cigarettes is highly variable Adverse health effects associated with second-hand vapor exposure cannot be excluded because e-cigarettes emit ultrafine inhalable particles and carcinogens into indoor air Nicotine solutions used in e-cigarettes increase the risk of accidental nicotine poisoning ELECTRONIC CIGARETTES: Summary of Current Evidence, contd E-cigarettes can reduce the desire to smoke (craving) and reduce nicotine withdrawal symptoms Some smokers reduce the number of cigarettes smoked or quit smoking as a result of using e-cigarettes The efficacy of e-cigarettes as an aid for sustained smoking cessation has not been established ELECTRONIC CIGARETTES: Possible Pros and Cons PROS Large proportion of current smokers switch andvaping is less harmful Current smokers completely switch to vaping, then quit vaping CONS Gateway to smoking Dual use (smoking + vaping) Reduced quitting Smoking is normalized ELECTRONIC CIGARETTES: Recommendations for Clinicians E-cigarette use by adolescents and adults who are current non-smokers should be discouraged Until more is known about the potential risks, e-cigarettes should not be promoted as a safe alternative to smoking Until long-term safety and efficacy data are available, recommend evidence-based, FDA-approved treatments (NRT, bupropion SR, varenicline, combination therapy) for cessation ELECTRONIC CIGARETTES: Recommendations for Clinicians, contd For smokers who are unable to quit using proven effective therapies, non-combusted nicotine-containing products (e-cigarettes) may be appropriate after patient-specific discussion of risks and benefits In the absence of sufficient data, support legislative actions that: include e-cigarettes in clean indoor air regulations prohibit advertising that claims or suggests that e-cigarettes are effective smoking cessation devices FORMS of TOBACCO: SUMMARY Cigarettes are, by far, the most common form of tobacco used in the U.S

Guerin MR: Chemical composition of cigarette smoke

David Royce: Gotta distract him with something

- Seeds are extremely small so best started indoors before planting outside

Braconid wasps also are efficient pollinators visiting both ornamental and vegetable flowers transferring pollen for fertilization

The aim is to select visits with clinician-patient interactions where tobacco use assessment and referrals should occur for current smokers