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8 Tobacco Tobacco is made from the dried leaves of the tobacco plant (Nicotiana). It is generally smoked in the form of a cigarette, cigar or pipe, and more rarely taken as snuff or chewed. Users experience tobacco as stimulating (improves concentration) and calming. Nicotine, its most important psychoactive component, is an addictive substance. Regular use is habit forming and increases tolerance. When tobacco smoke is inhaled, various substances are released, such as nicotine, tar and carbon monoxide, as well as number other chemicals that are harmful to the health. 8.1 Recent facts and trends In this chapter, the main facts and trends concerning tobacco are: • Between 2007 and 2008, there was a slight drop in the percentage of (heavy) smokers in the general population. (§ 8.2). • Between 2005 and 2007, average tobacco sales per smoker remained stable, but rose slightly in 2008 (§ 8.2). • The percentage of school-goers in mainstream education that had ever smoked declined between 2003 and 2007. The percentage of current and daily smokers appears to have remained stable in this period. (§ 8.3). • Pupils attending REC-4 schools are more likely to be current smokers and smoke more cigarettes per day on average than pupils in mainstream schools (§ 8.3). • The Netherlands occupies an intermediate position in the EU with regard to smoking among school-goers (§ 8.4). • The use of smoking cessation aids rose between 2006 and 2008 (§ 8.5). • Lung cancer deaths from smoking rose somewhat between 2003 and 2008, particularly among women (§ 8.6). • The slight reduction in total smoking-related deaths between 2000 and 2005 did not continue between 2005 and 2008 (§ 8.6). 8.2 Usage: general population In the 1960s and 1970s smoking was the norm, particularly among men. From the late 1960s until the early 1990s, the percentage of smokers declined sharply. This decline subsequently became less marked. The percentage of smokers in the population has been measured by various surveys. 8 Tobacco 175
• Surveys by the Continuous Survey of Smoking Habits (COR) of STIVORO (Dutch Expertise Centre on Tobacco Control) point to a flattening curve in the number of smokers between 2004 and 2008 (Table 8.1) (STIVORO, 2009a, 2009b). - Between 2007 and 2008 there was a further slight decline in smoking in the population aged 15 plus, from 27.5% to 26.7% - In 2008 32% of the population aged over 15 were ex-smokers whereas 41% had never smoked. - In terms of the number of people aged over 15, there are 3.6 million smokers in the Netherlands. - The gap between male and female smokers has shrunk (Table 8.1). Female smokers now smoke virtually as much as male smokers. - The highest percentage of smokers is found in the age group from 50 to 54. (Figure 8.1). • The NPO (National Prevalence Research) conducted surveys on substance use in 1997, 2001 and 2005) (Rodenburg et al., 2007). - According to the NPO, the percentage of the population aged 15 to 64 that ever smoked dropped from 70% in 1997 to 62% in 2005. The drop was most marked between 2001 and 2005. - The number of daily smokers dropped between 2001 and 2005 from 34% to 27%. These data deviate somewhat from those of the TNS NIPO measurements. 176 Netherlands National Drug Monitor - NDM Annual Report 2009
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Netherlands National Drug Monitor N
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Colophon Project Manager Dr. M.W. v
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Preface This is already the tenth A
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5.4 Problem Use 113 5.5 Usage: Inte
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List of abreviations and acronyms 2
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NEMESIS NFU NIGZ NMG NPO NRI NVIC N
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Summary Below is an outline of the
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The number of hospital admissions c
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GHB. In 2008/2009 4.6 percent of fr
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Deaths In the Netherlands, smoking
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Offences by drug users Drug users c
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Opiates Ecstasy Amphetamine Alcohol
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1 Introduction The National Drug Mo
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use, particularly cannabis, under-r
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information is available, this is b
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2 Cannabis Cannabis (Cannabis Sativ
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Figure 2.1 Cannabis users in the Ne
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Figure 2.2 Cannabis use among secon
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Cannabis and problem behaviour •
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Table 2.4 Cannabis use among pupils
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Table 2.5 Current cannabis use in s
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• The sharp increase in treatment
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Trends It is difficult to determine
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• The role of cannabis in all req
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- misuse or dependence on alcohol a
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At the Ambulance Transport Centre (
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• So far, epidemiological studies
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Quality and price The Trimbos Insti
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3 Cocaine Cocaine works as a stimul
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Age, gender and urbanisation level
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Special groups In certain groups of
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Table 3.3 Cocaine use in special gr
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and 7.7% in the U.K (England and Wa
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Table 3.5 Cocaine use among school-
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Figure 3.2 Number of (outpatient) a
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Figure 3.4 Admissions to general ho
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The Netherlands Cause-of-Death stat
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• Little is known as yet about a
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4.2 Usage: general population Heroi
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• In the province of Gelderland,
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Figure 4.1 Estimates of the number
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and syringes exchanged has been reg
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• Between 2001 and 2004 the numbe
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- misuse of or dependence on alcoho
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same time it should be noted that t
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International comparison The Europe
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The total number of chronic hepatit
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• It is thought that risk behavio
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the ICD-9 classification. Drug deat
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Amsterdam GGD Amsterdam reports the
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Figure 4.9 Number of drug-induced d
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• Pupils attending REC-4 schools
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5.3 Usage: juveniles and young adul
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• In 2008, key observers in Amste
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Table 5.3 Use of Ecstasy and amphet
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Table 5.4a Use of amphetamines and
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Table 5.5a Ecstasy use among school
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Ecstasy • The number of (outpatie
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Figure 5.3 Numbers registered with
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• The same person may be admitted
Page 125 and 126: • The number of requests for info
Page 127 and 128: According to the EMCDDA, in other E
Page 129 and 130: Figure 5.6 Concentration of MDMA in
Page 131 and 132: Table 5.9 Number of samples contain
Page 133 and 134: • Consumers who had drug samples
Page 135 and 136: 6.2 Usage: general population The r
Page 137 and 138: GHB use is more common among juveni
Page 139 and 140: • GHB use among school-goers is l
Page 141 and 142: Table 6.4 GHB incidents registered
Page 143 and 144: • Of the liquid samples sold as G
Page 145 and 146: • Total deaths from alcohol-relat
Page 147 and 148: Figure 7.1 Alcohol consumption amon
Page 149 and 150: Ethnic background • Among seconda
Page 151 and 152: Table 7.3 Percentage of current dri
Page 153 and 154: Table 7.4 Alcohol use in the social
Page 155 and 156: Holiday-makers • Research conduct
Page 157 and 158: Figure 7.3 Heavy drinkers by gender
Page 159 and 160: The countries with the lowest perce
Page 161 and 162: • In France it is more likely tha
Page 163 and 164: Figure 7.6 Age distribution of prim
Page 165 and 166: • In 2008, 337 day-care admission
Page 167 and 168: • In approximately 1,200 admissio
Page 169 and 170: Table 7.9 Estimated number of injur
Page 171 and 172: • On the basis of current researc
Page 173 and 174: Figure 7.10 Deaths from alcohol use
Page 175: • EU member states have different
Page 179 and 180: Figure 8.1 Percentage of smokers in
Page 181 and 182: 8.3 Usage: juveniles and young adul
Page 183 and 184: Special education Table 8.3 shows t
Page 185 and 186: Table 8.4 Smokers in the EU-15 plus
Page 187 and 188: medication, Champix ® , which was
Page 189 and 190: among passive smoking men, the elev
Page 191 and 192: Table 8.6 Deaths from lung cancer a
Page 193 and 194: Since 1 January 2003 it is no longe
Page 195 and 196: Table 8.8 Cigarette prices and taxe
Page 197 and 198: eported. These refer to 2007 in the
Page 199 and 200: Table 9.1 Criminal investigations i
Page 201 and 202: Table 9.2 Number of dismantled prod
Page 203 and 204: Table 9.3 Characteristics of suspec
Page 205 and 206: Figure 9.2 Number of Opium Act case
Page 207 and 208: Table 9.5 Opium Act cases as a perc
Page 209 and 210: Disposals by the courts (in the fir
Page 211 and 212: • Financial orders (Public Prosec
Page 213 and 214: Table 9.9 Prevalence of new crimina
Page 215 and 216: 10.2 Drug use among offenders Drug-
Page 217 and 218: • In some two-thirds of cases opi
Page 219 and 220: I, II Table 10.2 Number of times th
Page 221 and 222: • The ISD has a capacity of 1,000
Page 223 and 224: • Although there are some female
Page 225 and 226: Clinical admission Admission to a h
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Mellow Type of music at raves that
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Secondary diagnosis A secondary or
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Dismissal on policy grounds Decisio
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eintegration and rehabilitation of
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I. Use and problem use Source Targe
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II. Treatment demand and treatment
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IV. Market information Source Targe
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Source Target group/subject Sources
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Appendix C Explanation of ICD-9 and
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Appendix D Websites in the area of
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Ministry for Health, Welfare and Sp
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Appendix E Drug use in a number of
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References Adlaf, E.M., Korf, D.J.,
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Coumans, A.M. (2005). Survival on t
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Ganpat, S., Wits, E., Schoenmakers,
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Knibbe, R.A., Joosten, J., Derickx,
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Monshouwer, K., Smit, F., De Graaf,
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Rigter, H., Van Laar, M. (2002). Ep
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Tweede Kamer der Staten-Generaal (2
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Van Leeuwen, F.E. (1999). Epidemiol
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In the Netherlands various monitori
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