every cigarette is doing you damage

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Every Cigarette Is Every Cigarette Is doing YOU Damage doing YOU Damage Stories Stories Additives Additives Smokeless Products Smokeless Products By By Cory Bendall RRT BHSc.(RT) CCE Cory Bendall RRT BHSc.(RT) CCE IHA Community Respiratory Therapist – North Okanagan IHA Community Respiratory Therapist – North Okanagan B.C. Cancer Agency Cancer Prevention Coordinator - Okanagan B.C. Cancer Agency Cancer Prevention Coordinator - Okanagan

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Every Cigarette Is doing YOU Damage. Stories Additives Smokeless Products By Cory Bendall RRT BHSc.(RT) CCE IHA Community Respiratory Therapist – North Okanagan B.C. Cancer Agency Cancer Prevention Coordinator - Okanagan. Why we are Here. - PowerPoint PPT Presentation

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Page 1: Every Cigarette Is doing YOU Damage

Every Cigarette Is Every Cigarette Is doing YOU Damagedoing YOU Damage

StoriesStories

AdditivesAdditives Smokeless ProductsSmokeless Products

ByByCory Bendall RRT BHSc.(RT) CCECory Bendall RRT BHSc.(RT) CCE

IHA Community Respiratory Therapist – North Okanagan IHA Community Respiratory Therapist – North Okanagan B.C. Cancer Agency Cancer Prevention Coordinator - OkanaganB.C. Cancer Agency Cancer Prevention Coordinator - Okanagan

Page 2: Every Cigarette Is doing YOU Damage
Page 3: Every Cigarette Is doing YOU Damage

Why we are HereWhy we are Here

Between 1988 to 1999 the mortality rate Between 1988 to 1999 the mortality rate among women with COPD has among women with COPD has by by 53%53%

COPD causes more death in Canada than COPD causes more death in Canada than diabetes and renal disease diabetes and renal disease CombinedCombined

Now more women are dying of Lung Now more women are dying of Lung Cancer than Breast Cancer. Mortality rate Cancer than Breast Cancer. Mortality rate of 5.0% compared to 3.5%of 5.0% compared to 3.5%

O’Donnell, D.E. et al. 2003. Canadian Thoracic Society recommendations for management of chronic O’Donnell, D.E. et al. 2003. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease.obstructive pulmonary disease.

Page 4: Every Cigarette Is doing YOU Damage

““Imagine That”Imagine That”

There is one substance that:There is one substance that: Kills ½ the people who use it as the maker Kills ½ the people who use it as the maker

intends.intends. Kills 6000 people a year in B.C. about 500 of Kills 6000 people a year in B.C. about 500 of

whom have never actually used it – just been whom have never actually used it – just been around it. around it.

Makes thousands of people ill every year Makes thousands of people ill every year including children who can do little to including children who can do little to escape exposure to it.escape exposure to it.

Is highly marketed using deceptive Is highly marketed using deceptive marketing.marketing.

Is legal, addictive with no safe level of Is legal, addictive with no safe level of exposure.exposure.

Page 5: Every Cigarette Is doing YOU Damage

From Anonymous:From Anonymous:

““My maternal grandmother My maternal grandmother died in January. She had died in January. She had smoked 3 packs a day for smoked 3 packs a day for 50 years. She came to live 50 years. She came to live with me in November. She with me in November. She couldn’t sleep for more couldn’t sleep for more than an hour before having than an hour before having to wake up to cough.”to wake up to cough.”

““I am quitting because I don’t I am quitting because I don’t want my grandchildren to want my grandchildren to have to change my diapers have to change my diapers and bathe me and dress me and bathe me and dress me like I had to do for her.”like I had to do for her.”

Retrieved June1st from Retrieved June1st from http://www.quitsmokingsupport.com/remembering.htmhttp://www.quitsmokingsupport.com/remembering.htm

Page 6: Every Cigarette Is doing YOU Damage

Tobacco Companies want Tobacco Companies want YOUYOU

Additives are used to influence the effects Additives are used to influence the effects of nicotine – to make the taste more of nicotine – to make the taste more appealing to young smokers – mask the appealing to young smokers – mask the taste & harshness of the smoke.taste & harshness of the smoke.

90% of new smokers are children and 90% of new smokers are children and teenagers – the companies need to replace teenagers – the companies need to replace the smokers who have died prematurely the smokers who have died prematurely from a smoking related disease.from a smoking related disease.

Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14thth, 2007, from , 2007, from http://www.jrusselshealth.com/smokteens.htmlhttp://www.jrusselshealth.com/smokteens.html

Page 7: Every Cigarette Is doing YOU Damage

Cigarette vs. Lip GlossCigarette vs. Lip Gloss

Tobacco companies match:Tobacco companies match: FlavoursFlavours PackagingPackaging Vernon PriceVernon Price - $3.39 compared to $3.32 - $3.39 compared to $3.32

Smoking DOESN’T keep you slim!Smoking DOESN’T keep you slim!McGill University found that teenage girls McGill University found that teenage girls

gain weight at exactly the same rate gain weight at exactly the same rate whether they smoked or not.whether they smoked or not.

Karp, I. et al. (2005) Smoking trajectories of adolescent novice smokers in a longitudinal study of tobacco use [Electronic version]. Ann Karp, I. et al. (2005) Smoking trajectories of adolescent novice smokers in a longitudinal study of tobacco use [Electronic version]. Ann Epidemiol. Jul; 15(6): 445-52. Epidemiol. Jul; 15(6): 445-52.

Page 8: Every Cigarette Is doing YOU Damage

Your LungsYour Lungs

Page 9: Every Cigarette Is doing YOU Damage

From Mike:From Mike:

““My father was a 2 pack a day smoker. My father was a 2 pack a day smoker. He died of lung cancer when I was 12 He died of lung cancer when I was 12 years old, leaving my mother with 3 years old, leaving my mother with 3 teenage boys to raise. Nothing teenage boys to raise. Nothing prepares a 12 year old boy to deal prepares a 12 year old boy to deal with a dying father who is so with a dying father who is so medicated he can’t even remember medicated he can’t even remember your name.”your name.”

Retrieved May 15Retrieved May 15thth, 2007 from http://www.quitsmokingsupport.com/remembering.htm, 2007 from http://www.quitsmokingsupport.com/remembering.htm

Page 10: Every Cigarette Is doing YOU Damage

Almost 5 Million Canadians Almost 5 Million Canadians SmokeSmoke

Smoking is the #1 Smoking is the #1 preventable cause of preventable cause of death in Canada.death in Canada.

22% of all deaths in 22% of all deaths in Canada are as a result Canada are as a result of smoking.of smoking.

More than 45,000 More than 45,000 Canadians die due to Canadians die due to smoking each year.smoking each year.

Based on 1998 dataBased on 1998 data

Health Canada Canadian Tobacco Use Monitoring Survey 2005, Summary Health Canada Canadian Tobacco Use Monitoring Survey 2005, Summary of Annual Resultsof Annual Results

Makomaski, Illing, E.M., Kaiserman. Can J Public Health 2004; 95: 38-44.Makomaski, Illing, E.M., Kaiserman. Can J Public Health 2004; 95: 38-44.

Deathdue toSmoking

OtherDeaths

Page 11: Every Cigarette Is doing YOU Damage

Smoking in Interior HealthSmoking in Interior Health 21% of residents in the IHA are smokers.21% of residents in the IHA are smokers. 119,625 smokers.119,625 smokers. Highest usage is in 20-24 year olds (36%).Highest usage is in 20-24 year olds (36%).

In B.C. 5700 deaths/year: In B.C. 5700 deaths/year: 520 have never 520 have never smokedsmoked

In B.C. 28% of smokers say they are seriously In B.C. 28% of smokers say they are seriously thinking of quitting within the next 30 days and thinking of quitting within the next 30 days and 63% within the next 6 months.63% within the next 6 months.

B.C. Statistics. March 2007.B.C. Statistics. March 2007.

Page 12: Every Cigarette Is doing YOU Damage

Teen’s Smoking in B.C.Teen’s Smoking in B.C.

Teens from disadvantaged households Teens from disadvantaged households most likely to smoke (34%).most likely to smoke (34%).

First cigarette often a result of a desire First cigarette often a result of a desire for status and approval in a peer group.for status and approval in a peer group.

Teens were concerned about protecting Teens were concerned about protecting infants and young children from infants and young children from cigarette smoke but their own exposure cigarette smoke but their own exposure did not appear to be a large concern!did not appear to be a large concern!

Heart & Stroke Foundation of Canada. (Sept., 1997). Executive summary. Retrieved June 4Heart & Stroke Foundation of Canada. (Sept., 1997). Executive summary. Retrieved June 4thth, 2007 from , 2007 from http://www.healthservices.gov.bc.ca/tobacrs/teen/teen1.html#1.2http://www.healthservices.gov.bc.ca/tobacrs/teen/teen1.html#1.2

Page 13: Every Cigarette Is doing YOU Damage

The Psychological SideThe Psychological Side

What’s different about today’s Smokers?What’s different about today’s Smokers? More likely to have depressionMore likely to have depression More likely to have other addictionsMore likely to have other addictions More severely dependentMore severely dependent Often lack effective alternative coping Often lack effective alternative coping

skillsskills

Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.presentation.

Page 14: Every Cigarette Is doing YOU Damage

Cigarettes = TarCigarettes = Tar

Page 15: Every Cigarette Is doing YOU Damage

Low Tar = Safer Cigarette?Low Tar = Safer Cigarette?

Not necessarily…Not necessarily…

Small holes in the filter reduce the tar and Small holes in the filter reduce the tar and nicotine that the smoker inhales.nicotine that the smoker inhales.

The smoker compensates by smoking the The smoker compensates by smoking the cigarette more intensively in order to obtain cigarette more intensively in order to obtain the same satisfying dose of nicotinethe same satisfying dose of nicotine

Thus for the same dose of nicotine the Thus for the same dose of nicotine the smoker is actually consuming more noxious smoker is actually consuming more noxious smoke.smoke.

Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved May 14addiction. Retrieved May 14thth, 2007 from , 2007 from http://www.ash.org.uk/html/regulation/html/additives.htmlhttp://www.ash.org.uk/html/regulation/html/additives.html

Page 16: Every Cigarette Is doing YOU Damage

Cigarette SmokeCigarette Smoke ““According to R J Reynolds tobacco company According to R J Reynolds tobacco company

chemists cigarette smoke is 10,000 times more chemists cigarette smoke is 10,000 times more concentrated than the automobile pollution at rush concentrated than the automobile pollution at rush hour on the freeway.”hour on the freeway.”

Burning of tobacco generates more than 150 Burning of tobacco generates more than 150 billion tar particles /cu.in. = visible portion of the billion tar particles /cu.in. = visible portion of the smoke.smoke.

But the visible portion is only 5-8% of the total But the visible portion is only 5-8% of the total output of a cigarette…output of a cigarette…

Ginzel, K.H.(n.d.). What’s in a cigarette? Retrieved June 5Ginzel, K.H.(n.d.). What’s in a cigarette? Retrieved June 5thth, 2007, from , 2007, from http://www.quitsmokingsupport.com/whatsinit.htmhttp://www.quitsmokingsupport.com/whatsinit.htm

Page 17: Every Cigarette Is doing YOU Damage

Carbon MonoxideCarbon Monoxide Inhaled with every puff of a cigarette odorless, Inhaled with every puff of a cigarette odorless,

colourless.colourless.

Competes with oxygen for the hemoglobin in Competes with oxygen for the hemoglobin in your blood and wins – 210 times better at your blood and wins – 210 times better at binding to the receptors.binding to the receptors.

Attacks artery walls your body uses LDL Attacks artery walls your body uses LDL cholesterol to fix the holes = atherosclerosis cholesterol to fix the holes = atherosclerosis (plaques around artery walls) = heart disease.(plaques around artery walls) = heart disease.

Interior Health Tobacco Cessation & Reduction Programs. Retrieved June 5Interior Health Tobacco Cessation & Reduction Programs. Retrieved June 5thth, 2007, from , 2007, from http://www.quitnow.cahttp://www.quitnow.caKacmarek, R.M., Mack, C.W., & Dimas, S.(1985). The essentials of Respiratory therapy. (2Kacmarek, R.M., Mack, C.W., & Dimas, S.(1985). The essentials of Respiratory therapy. (2ndnd ed.). Chicago, Il: Year Book ed.). Chicago, Il: Year Book

Medical.Medical.

Page 18: Every Cigarette Is doing YOU Damage
Page 19: Every Cigarette Is doing YOU Damage

Cigarettes = Blocked Cigarettes = Blocked ArteriesArteries

Page 20: Every Cigarette Is doing YOU Damage

Cigarette AdditivesCigarette Additives

““At no stage in the 25 year period has the At no stage in the 25 year period has the Dept. of Health been provided with Dept. of Health been provided with information regarding which additive have information regarding which additive have been used in tobacco products.”been used in tobacco products.”

““the 1997 Voluntary agreement requires the the 1997 Voluntary agreement requires the tobacco companies to provide toxicological tobacco companies to provide toxicological data on data on new new additives but this does not additives but this does not include the 600 existing approved additives.”include the 600 existing approved additives.”

Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved May 14addiction. Retrieved May 14thth, 2007 from , 2007 from http://http://www.ash.org.uk/html/regulation/html/additives.htmlwww.ash.org.uk/html/regulation/html/additives.html

Page 21: Every Cigarette Is doing YOU Damage

From Sherma:From Sherma:

““My uncle smoked for as long as I My uncle smoked for as long as I knew him. Later he had to go on knew him. Later he had to go on oxygen 24 hours a day. What a shame oxygen 24 hours a day. What a shame to have to live your life not being able to have to live your life not being able to go anywhere without a tube in to go anywhere without a tube in your nose and an oxygen bottle.”your nose and an oxygen bottle.”

““It seems like all my memories of him It seems like all my memories of him revolve around watching him gasp revolve around watching him gasp for breath.”for breath.”

Page 22: Every Cigarette Is doing YOU Damage

Is this what You want ?Is this what You want ?

Page 23: Every Cigarette Is doing YOU Damage

Nicotine alters Brain Nicotine alters Brain Physiology Physiology

Nicotine binds to receptors in the brain and causes a Nicotine binds to receptors in the brain and causes a release of release of Dopamine = feelings of pleasure and calmness.Dopamine = feelings of pleasure and calmness.

Between cigarettes, Between cigarettes, Dopamine levels drop = feelings of Dopamine levels drop = feelings of stress and irritation. stress and irritation.

The smoker will crave more nicotine to artificially restore The smoker will crave more nicotine to artificially restore the feelings of pleasure and calmness.the feelings of pleasure and calmness.

Chronic exposure to nicotine causes desensitization and Chronic exposure to nicotine causes desensitization and compensatory receptor up-regulation (compensatory receptor up-regulation ( # of receptors # of receptors). ).

Withdrawal symptoms occur with prolonged absence of Withdrawal symptoms occur with prolonged absence of nicotine (4-6hrs), as nicotine levels nicotine (4-6hrs), as nicotine levels this large # of this large # of receptors become receptors become resensitized.resensitized.

Foulds, J. Int J Clin Pract. 2006: 60:571-575.Foulds, J. Int J Clin Pract. 2006: 60:571-575.

Fagerstrom, K. Drugs. 2002;62(suppl2): 1-9.Fagerstrom, K. Drugs. 2002;62(suppl2): 1-9.

Jarvis, M.J. BMJ 2004; 328:277-279.Jarvis, M.J. BMJ 2004; 328:277-279.

Rigotti, N.A. NEngl J Med 2002:346:506-512.Rigotti, N.A. NEngl J Med 2002:346:506-512.

Dani, J.A. De Biasi, M. Pharmacol Biochem Behav. 2001; 70: 439-446Dani, J.A. De Biasi, M. Pharmacol Biochem Behav. 2001; 70: 439-446

Page 24: Every Cigarette Is doing YOU Damage

AmmoniaAmmonia

Adding Ammonia increases the pH of Adding Ammonia increases the pH of the smoke.the smoke.

This allows more nicotine to remain This allows more nicotine to remain unbound in the bloodstream longer.unbound in the bloodstream longer.

So the physiological effect of the So the physiological effect of the nicotine lasts longer.nicotine lasts longer.

Ammonia added to the cigarette Ammonia added to the cigarette delivers 29% more nicotine to the delivers 29% more nicotine to the body.body.

Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved May Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved May 1414thth, 2007 from , 2007 from http://http://www.ash.org.uk/html/regulation/html/additives.htmlwww.ash.org.uk/html/regulation/html/additives.html

Page 25: Every Cigarette Is doing YOU Damage

AcetaldehydeAcetaldehyde Acetaldehyde and Nicotine work together to strengthen Acetaldehyde and Nicotine work together to strengthen

the addictive properties of nicotine.the addictive properties of nicotine.

When sugar is added to the cigarette for flavour – burning When sugar is added to the cigarette for flavour – burning this sugar creates the Acetaldehyde.this sugar creates the Acetaldehyde.

The level of Acetaldehyde in Marlboro cigarettes has The level of Acetaldehyde in Marlboro cigarettes has ↑↑ by by 40 % in 10 years.40 % in 10 years.

↑ ↑ Aging due to destruction of connective tissue in the skin. Aging due to destruction of connective tissue in the skin.

Caused respiratory tract tumors in hamsters when inhaled. Caused respiratory tract tumors in hamsters when inhaled.

Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved Bates, C., Jarvis, M. & Connolly, G. (1999, July). Tobacco additives: Cigarette engineering and nicotine addiction. Retrieved May 14May 14thth, 2007 from , 2007 from http://http://www.ash.org.uk/html/regulation/html/additives.htmlwww.ash.org.uk/html/regulation/html/additives.html

Haas, E.M. (n.d.). In Staying healthy with nutrition: What does nicotine do to your body? Retrieved June 5Haas, E.M. (n.d.). In Staying healthy with nutrition: What does nicotine do to your body? Retrieved June 5thth, 2007, from , 2007, from http://http://www.quitsmokingsupport.com/whatsinit.htmwww.quitsmokingsupport.com/whatsinit.htm

Page 26: Every Cigarette Is doing YOU Damage

Cigarettes = TumorsCigarettes = Tumors

Page 27: Every Cigarette Is doing YOU Damage

Genetic DamageGenetic Damage

““People with the worst DNA damage People with the worst DNA damage weren’t necessarily the ones who weren’t necessarily the ones who had smoked the longest, but those had smoked the longest, but those that began at an early age.”that began at an early age.”

““Smoking while the lungs are still Smoking while the lungs are still developing appears to permanently developing appears to permanently hamper normal cell repair”hamper normal cell repair”

Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14thth, 2007, from , 2007, from http://www.jrusselshealth.com/smokteens.htmlhttp://www.jrusselshealth.com/smokteens.html

Page 28: Every Cigarette Is doing YOU Damage

FormaldehydeFormaldehyde Added by the tobacco companies as a Added by the tobacco companies as a

preservative?preservative? Analysis shows a particularly high Analysis shows a particularly high

concentration of Formaldehyde in the 1concentration of Formaldehyde in the 1stst puff.puff.

Formaldehyde damages the cilia in your Formaldehyde damages the cilia in your airways – stops the cough.airways – stops the cough.

Sidestream smoke contains up to 40 ppm of Sidestream smoke contains up to 40 ppm of Formaldehyde – approx. 15 ppm associated Formaldehyde – approx. 15 ppm associated with cancer of the nose and throat.with cancer of the nose and throat.

MFL Occupational Health Centre. (1999, Sept). Formaldehyde. Retrieved June 5MFL Occupational Health Centre. (1999, Sept). Formaldehyde. Retrieved June 5thth, 2007, from , 2007, from http://www.mflohc.mb.ca/fact_sheets_folder/formaldehyde.htmlhttp://www.mflohc.mb.ca/fact_sheets_folder/formaldehyde.html

Baker, R.R. (2006, June). The generation of formaldehyde in cigarettes – Overview and recent experiments. Food Chem Baker, R.R. (2006, June). The generation of formaldehyde in cigarettes – Overview and recent experiments. Food Chem Toxicol. 44(11): 1799-822. Retrieved June 5Toxicol. 44(11): 1799-822. Retrieved June 5thth, 2007, from , 2007, from http://www.ncbi.nlm.nih.govhttp://www.ncbi.nlm.nih.gov

Page 29: Every Cigarette Is doing YOU Damage

From Laurel :From Laurel :

““My wonderful dad passed just over week My wonderful dad passed just over week ago with COPD after 45 years of smoking. ago with COPD after 45 years of smoking. I loved my Daddy dearly and wish he were I loved my Daddy dearly and wish he were still here, if it weren’t for tobacco and still here, if it weren’t for tobacco and addiction, he still would be.”addiction, he still would be.”

““I’m encouraging everyone out there to I’m encouraging everyone out there to QUIT SMOKING before we lose more QUIT SMOKING before we lose more loved ones to this evil drug.”loved ones to this evil drug.”

Written: Thursday March 29Written: Thursday March 29thth, 2007, 2007Retrieved June 5Retrieved June 5thth, 2007, from , 2007, from http://www.lung.ca/involved-impliquez/share-partagez_e.cfmhttp://www.lung.ca/involved-impliquez/share-partagez_e.cfm

Page 30: Every Cigarette Is doing YOU Damage

PhenolPhenol

Phenol is used to maintain the tobacco Phenol is used to maintain the tobacco moisture content? “↑ mainstream flavour moisture content? “↑ mainstream flavour and side stream aroma.”and side stream aroma.”

Patented process to preserve additives Patented process to preserve additives added to the filter so that the additives added to the filter so that the additives will be released into the smoke once lit.will be released into the smoke once lit.

Registered pesticide corrosive to the eyes.Registered pesticide corrosive to the eyes.

United States Patent Office. (n.d.). Smoking compositions containing a dicarbonate ester flavorant-release additive. Retrieved June 5United States Patent Office. (n.d.). Smoking compositions containing a dicarbonate ester flavorant-release additive. Retrieved June 5thth, , 2007, from http://www.freepatentonline.com/4578486.html2007, from http://www.freepatentonline.com/4578486.html

Runeckles, V.C. (1999, Nov.). BATCo Documents for the Prov. Of B.C.: Project NO. 0331-01. Retrieved June 5Runeckles, V.C. (1999, Nov.). BATCo Documents for the Prov. Of B.C.: Project NO. 0331-01. Retrieved June 5thth, 2007, from , 2007, from http://www.freepatentsonline.com/4578486.htmlhttp://www.freepatentsonline.com/4578486.html

Scorecard: Pollution Information Site. (n.d.). Phenol. Retrieved June 5Scorecard: Pollution Information Site. (n.d.). Phenol. Retrieved June 5thth, 2007, from , 2007, from http://www.scorecard.org/chemical-profiles/html/phenol.htmlhttp://www.scorecard.org/chemical-profiles/html/phenol.html

Page 31: Every Cigarette Is doing YOU Damage

Propylene glycolPropylene glycol

Maintains moisture, prolongs shelf-life.Maintains moisture, prolongs shelf-life. Helps to release other additives into Helps to release other additives into

the smoke to make the smoke less the smoke to make the smoke less irritating.irritating.

Food additive - but remember we don’t Food additive - but remember we don’t have the powerful digestive enzymes have the powerful digestive enzymes and detoxifying metabolic pathways of and detoxifying metabolic pathways of the digestive system in our lungs.the digestive system in our lungs.

Eye and skin irritant, affects your DNA.Eye and skin irritant, affects your DNA.American Legacy Foundation. (1999, July). Tobacco documents online: Propylene gylcol. Retrieved June 5American Legacy Foundation. (1999, July). Tobacco documents online: Propylene gylcol. Retrieved June 5thth, 2007, from , 2007, from

http://www.tobaccodocuments.org/profiles/propylene_gylcol.htmlhttp://www.tobaccodocuments.org/profiles/propylene_gylcol.html

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Cigarettes = Lost VisionCigarettes = Lost Vision

Page 33: Every Cigarette Is doing YOU Damage

From Valerie:From Valerie:

““My father died of COPD April 15My father died of COPD April 15thth, 2007. I , 2007. I watched my strong independent father watched my strong independent father slowly suffocate, he struggled for every slowly suffocate, he struggled for every breath. This is a horrible disease. No one breath. This is a horrible disease. No one deserves to die as my father did. Save deserves to die as my father did. Save yourselves and quit ....”yourselves and quit ....”

““Dad you were the strongest and best Dad to Dad you were the strongest and best Dad to me. And I’ve learned a lot from you. You will me. And I’ve learned a lot from you. You will be forever missed and remembered.”be forever missed and remembered.”

Retrieved June 5Retrieved June 5thth, 2007, from http://www.lung.ca/involved-impliquez/share-partagez_e.cfm, 2007, from http://www.lung.ca/involved-impliquez/share-partagez_e.cfm

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ButaneButane ↑ ↑ pH of the cigarette pH of the cigarette ↓ ↓ its ability to burn but its ability to burn but

cigarettes don’t go out when left alone?cigarettes don’t go out when left alone?

Butane keeps the cigarette burning at a very Butane keeps the cigarette burning at a very hot temperature so that the nicotine will hot temperature so that the nicotine will vaporize – better delivery into your lungs.vaporize – better delivery into your lungs.

Chemicals added to enhance burning are Chemicals added to enhance burning are among the major causes of fire deaths.among the major causes of fire deaths.

Haas, E.M. (n.d.). In Staying healthy with nutrition: What does nicotine do to your body? Retrieved June 5Haas, E.M. (n.d.). In Staying healthy with nutrition: What does nicotine do to your body? Retrieved June 5thth, 2007, from , 2007, from http://www.quitsmokingsupport.com/whatsinit.htmhttp://www.quitsmokingsupport.com/whatsinit.htm

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CadmiumCadmium Carcinogenic metal that is accumulated and Carcinogenic metal that is accumulated and

concentrated by the leaves of the tobacco concentrated by the leaves of the tobacco plant. plant.

Linked to osteoporosis, kidney failure, Linked to osteoporosis, kidney failure, cancer and stoke.cancer and stoke.

38-50% of Cadmium is in second-hand 38-50% of Cadmium is in second-hand smoke – hazard to non-smokers.smoke – hazard to non-smokers.

Cadmium pigments produce intense yellow Cadmium pigments produce intense yellow colour - teethcolour - teeth

Menden, E.E., Elia, V.J., Michael, L.W. & Petering, H.G. (1972) Distribution of cadmium and nickel during cigarette smoking. Menden, E.E., Elia, V.J., Michael, L.W. & Petering, H.G. (1972) Distribution of cadmium and nickel during cigarette smoking. Retrieved June 5Retrieved June 5thth, 2007, from , 2007, from http://pubs.acs.org/cgi-bin/abstract.cgi/esthag/1972/6/i09/f-pdf/f_es60068a008.pdf?http://pubs.acs.org/cgi-bin/abstract.cgi/esthag/1972/6/i09/f-pdf/f_es60068a008.pdf?sessid=6006l3sessid=6006l3

GlaxoSmithKline. (n.d.). Levels of Cadmium in the environment: Cadmium in tobacco smoke. Retrieved June 5GlaxoSmithKline. (n.d.). Levels of Cadmium in the environment: Cadmium in tobacco smoke. Retrieved June 5thth, 2007, from , 2007, from http://www.cadmium.org/env_lev.htmlhttp://www.cadmium.org/env_lev.html

Page 36: Every Cigarette Is doing YOU Damage

From Steve:From Steve:

““Mum had a dense stroke a year ago, and Mum had a dense stroke a year ago, and spent the following year learning how to spent the following year learning how to swallow, how to stand and walk. When she swallow, how to stand and walk. When she was released from hospital, she was mostly was released from hospital, she was mostly confined to a wheelchair, paralysed on the confined to a wheelchair, paralysed on the left side and unable to form coherent left side and unable to form coherent sentences, although she was aware of what sentences, although she was aware of what she wanted to say…”she wanted to say…”

““Tobacco should be criminalized”Tobacco should be criminalized”

Retrieved June 5Retrieved June 5thth, 2007, from http://www.lung.ca/involved-impliquez/share-partagez_e.cfm, 2007, from http://www.lung.ca/involved-impliquez/share-partagez_e.cfm

Page 37: Every Cigarette Is doing YOU Damage

Cigarettes = StrokeCigarettes = Stroke

Page 38: Every Cigarette Is doing YOU Damage

Smokeless TobaccoSmokeless Tobacco

Products include:Products include: Chew – loose leaf, plugs or twists of Chew – loose leaf, plugs or twists of

tobaccotobacco Snuff – dry or moist loose leaf or Snuff – dry or moist loose leaf or

pouches, placed in the cheek or inhaled pouches, placed in the cheek or inhaled in the nose.in the nose.

1 cigarette has 8-11 mg of nicotine. 1 cigarette has 8-11 mg of nicotine. Chew user-pinch of chew contains 13-23 Chew user-pinch of chew contains 13-23

mg of nicotine.mg of nicotine.

Page 39: Every Cigarette Is doing YOU Damage

SUGARS

ABRASIVES

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Dose of NicotineDose of Nicotine

Cigarette – 1.8 mgCigarette – 1.8 mg Moist snuff – 3.6 mgMoist snuff – 3.6 mg Chewing Tobacco – 4.5 mgChewing Tobacco – 4.5 mg

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Marketing to YouthMarketing to Youth

First time users usually get sick First time users usually get sick from stronger brands such as from stronger brands such as Copenhagen or Skoal.Copenhagen or Skoal.

Tobacco companies love the under Tobacco companies love the under 18 age group because they know 18 age group because they know that 90% of tobacco users start that 90% of tobacco users start before the age of 18.before the age of 18.

They call this age range: Sub They call this age range: Sub Culture Urban Marketing. Culture Urban Marketing. SCUM SCUM for shortfor short..

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Chew and sportsChew and sports

Nicotine causes your reaction time Nicotine causes your reaction time to be slowed down although the to be slowed down although the nicotine will also make it seem nicotine will also make it seem faster. Not a good situation for faster. Not a good situation for players. players.

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Health EffectHealth EffectDipper’s PouchDipper’s Pouch

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Health EffectHealth Effect

Black Hairy Black Hairy TongueTongue

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Health EffectHealth Effect

Stained teethStained teeth

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Health EffectHealth Effect

LeukoplakiaLeukoplakia

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Health EffectHealth Effect

Peridontal Peridontal diseasedisease

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Health EffectHealth Effect

Oral cancersOral cancers

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Health EffectHealth Effect

Cancer of the Cancer of the throat, jaw throat, jaw bone, bone, esophagus, esophagus, stomachstomach

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“…the base of our business is the High

School student.”

Sean

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Smokeless does not mean Harmless

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Are We Winning?Are We Winning?Good News:Good News: In 2005 Canadian Smoking rate is down 19% in over 19’sIn 2005 Canadian Smoking rate is down 19% in over 19’s In British Columbia Smoking in the 15 -19 age group is down 18%In British Columbia Smoking in the 15 -19 age group is down 18%

Bad News:Bad News: People with the worst DNA damage weren’t necessarily the ones People with the worst DNA damage weren’t necessarily the ones

who had smoked the longest, but those that began at an early who had smoked the longest, but those that began at an early age.age.

Smoking while the lungs are still developing appears to Smoking while the lungs are still developing appears to permanently hamper normal cell repair.permanently hamper normal cell repair.

1 out of every 3 young smokers will eventually die from tobacco 1 out of every 3 young smokers will eventually die from tobacco related disease.related disease.

2004-2005 data - 60% of Grade 10 boys and girls have tried 2004-2005 data - 60% of Grade 10 boys and girls have tried smoking.smoking.

Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.

Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14Russell, J.(2001). June Russell’s health facts: Smoking – teens. Retrieved May 14 thth, 2007, from http://www.jrusselshealth.com/smokteens.html , 2007, from http://www.jrusselshealth.com/smokteens.html

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Current GuidelinesCurrent Guidelines Ask, Ask and Ask againAsk, Ask and Ask again about tobacco use – How about tobacco use – How

confident are you in your ability to avoid smoking? If confident are you in your ability to avoid smoking? If less than 7/10, brainstorm ideas how to improve less than 7/10, brainstorm ideas how to improve confidence.confidence.

If currently smoking – how ready are you to quit? Is If currently smoking – how ready are you to quit? Is smoking cessation medication appropriate?smoking cessation medication appropriate?

Supportive counseling, continuous encouragement, Supportive counseling, continuous encouragement, relapse is not a stumbling block but a stepping stone.relapse is not a stumbling block but a stepping stone.

Treat smoking like other chronic medical illnesses Treat smoking like other chronic medical illnesses that have psychosocial and behavioural components.that have psychosocial and behavioural components.

Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.

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What Works – What Doesn’tWhat Works – What Doesn’t

Cost / Benefit analysis – (If the benefits Cost / Benefit analysis – (If the benefits outweigh the consequences – I will outweigh the consequences – I will continue).continue).

Unless I find other ways of feeling good – Unless I find other ways of feeling good – I have little choice.I have little choice.

I need support / to be held accountable for I need support / to be held accountable for my actions.my actions.

Addictions are chronic diseases – treat Addictions are chronic diseases – treat like other similar disease.like other similar disease.

Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.Baker, R. (2007). Nicotine dependence: Treatment update. University of British Columbia. Oral presentation.

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What Can You Do?What Can You Do?

@ School@ School

@ Home@ Home

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Thank YouThank You For your time and attentionFor your time and attention

To Alice Domes RN & Maggie Strosher for To Alice Domes RN & Maggie Strosher for the information on Smokeless Tobaccothe information on Smokeless Tobacco

Cameron Bonell BPhSc. PharmacistCameron Bonell BPhSc. Pharmacist

Questions?Questions?

Comments?Comments?