rejecting tobacco
TRANSCRIPT
© 2009 McGraw-Hill Higher Education. All rights reserved.
Chapter Eight Rejecting Tobacco Use
© 2009 McGraw-Hill Higher Education. All rights reserved.
Cigarette Smoking among College Students
College smoking trending upwards Smoking among college students decreased from 1964
to 1995 (from 21% to 14%) Current rates of smoking among college students:
30.6% of full-time students 42.7% of part-time students
Current rates of smoking among general population: Men: 23.9% Women: 18.1%
Direct relationship between alcohol consumption and cigarette smoking
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Demographic Trends in Smoking
Gender Men have higher rates of smoking than women
Race/ethnicity Highest smoking rates among American Indians and Alaska
Natives Lowest smoking rates among Asian Americans
Level of education Higher levels of education are associated with lower rates of
smoking Age
Smoking rates go down as age goes up Geographic residence
Highest smoking rates in Midwest Lowest smoking rates in West
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Demographic Trends in Smoking
Size of the community Large metropolitan areas have lowest smoking rate
Employment status Highest rate of smoking among unemployed
Recent homelessness or incarceration Higher rates
Place of birth Native-born Americans have higher rates of
smoking than foreign-born Americans
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Marketing of Tobacco Products
Controversy about advertising due to industry’s knowledge of the health risks
Restrictions on marketing of all tobacco products, BUT Magazine advertising has increased
Especially in magazines with 15% or more youth readership
Free distribution of cigarettes in bars and restaurants
Luring teens through anti-smoking ads
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Development of Dependence
Dependence: Physical and/or psychological need to continue the use of nicotine
Physical dependence Tolerance Withdrawal Titration
Particular level of a drug within the body Adjusting the level of nicotine by adjusting the rate of
smoking
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Theories of Nicotine Addiction
Genetic influences 60% of initiation and maintenance of initial smoking
is driven by genetic influences
Bolus theory Based on body’s response to the bolus (ball) of
nicotine delivered to the brain
Adrenocorticotropic hormone (ACTH) theory Release of beta endorphins delivers euphoric effect
Self-medication theory Nicotine, through effects on dopamine, “lifts spirits”
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Psychosocial Factors Related to Dependence
Modeling behavior Manipulation
Susceptibility to advertising Use of tobacco products associated with a
better life
Once smoking is initiated, dependence becomes a key factor in use
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Prevention and Intervention
Early childhood intervention Decision making skills Critical thinking and refusal skills Support for smoke-free environments
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Tobacco Smoke
Particulate phase (small suspended particles) Nicotine Water Tar
Phenol, benzo[a]pyrene, DDT, and many other chemicals
Gaseous phase Carbon monoxide Carcinogens
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Health Risks of Tobacco Use
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Illness, Premature Death, and Tobacco Use
Cardiovascular disease and nicotine Myocardial infarction Sudden cardiac death Angina pectoris Increased platelet adhesiveness Unhealthy cholesterol changes
Cardiovascular disease and carbon monoxide Impairment of oxygen transport
Smoking and oral contraceptive (OC) use Linked to clots and heart attacks Women who smoke should NOT use OCs
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Illness, Premature Death, and Tobacco Use
Cancer Respiratory tract cancers (lung, mouth,
larynx Damage to the respiratory lining (mucus, cilia)
brings carcinogens into direct contact with tissues
Other tobacco-enhanced cancers Kidney Gastrointestinal system
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Development of Lung Cancer
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Chronic Obstructive Lung Disease
Chronic bronchitis Persistent inflammation or infection of the
smaller airways within the lungs
Pulmonary emphysema Irreversible disease process in which the
alveoli are destroyed
Significant impact on quality of life
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Additional Health Concerns
Poor nutritional state Reduced insulin
sensitivity Decline in short-term
memory Loss of senses of smell
and hearing Premature wrinkling of
the skin Stroke Loss of bone mass
Impaired recovery from surgery
Gum disease Impaired resistance to
infection Asthma Infertility Impotence Earlier menopause Poor circulation Burns
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Risks from Specific Tobacco Products
Nonmanufactured cigarettes Roll-your-own Bidis Kreteks
Mentholated cigarettes Pipes Cigars Smokeless tobacco
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Nonmanufactured Forms of Cigarettes
Roll-your-own More affordable Equal risk
Bidis High in tar and nicotine High level of carbon monoxide
Kreteks (clove-flavored tobacco) Increased tar and nicotine delivery
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Mentholated Cigarettes
Menthol Unique taste and “cooling” sensation
Heavily marketed to African American smokers
Special health risks still under investigation
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Pipe and Cigar Smoking
Pipe/cigar smokers have the same rates of cancer as cigarette smokers: Mouth Larynx Throat Esophagus
Cigar manufacturers are now required to disclose tobacco content and additives
Warning labels required
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Smokeless Tobacco Use
Types Chewing tobacco Snuff
Risks associated with use Leukoplakia Erythroplakia Periodontal disease Oral cancer Nicotine addiction Other health risks
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Smoking and Reproduction
Infertility Increased risk of ectopic pregnancy Problem pregnancies Breast-feeding
Exposes infants to harmful effects and chemicals
Neonatal health problems Low birth weight Respiratory problems Higher risk of SIDS
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Involuntary (Passive) Smoking
Mainstream smoke Smoke inhaled and then exhaled by smoker
Sidestream smoke Smoke from the burning end of the
cigarette, pipe, or cigar Contains 85% of harmful substances
associated with secondhand smoke
Environmental tobacco smoke Diluted smoke that stays within a common
source of air
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Health Risks of Passive Smoking
Heart disease Cancer Eye irritation Nasal symptoms Headaches Cough In children:
Bronchitis or pneumonia Respiratory symptoms Middle ear infections
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Cost of Smoking
440,000 deaths/year $150 billion/year in health-
related expenditures Reduced life expectancy Loss of independence,
freedom, and social contacts due to addiction
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The Health Benefits of Quitting
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Smoking Cessation
Programs Education Behavior modification Aversive conditioning Hypnosis Acupuncture
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Smoking Cessation
Nicotine substitution products Chewing gum Patch Inhaler Spray
Neurotransmitter-based prescription medications Bupropion (Zyban) Varenicline (Chantix)
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Chapter Eight: Rejecting Tobacco Use