TOBACCO

Tobacco

• 1982 surgeon general said that smoking is the most important health issue of our time

• Identified the effects of cigarette smoking as the chief preventable cause of death in our society

• Medical costs of smoking is 8$/pack • Smoking related illness cost 158 billion/yr• Highest smoking rates in Asia, 50-80% of Asian men

smoked• 500,000 Americans die each year of an illness related

to smoking

Who Smokes?

• 46.5 million Americans smoke• Kentucky has the highest number of

smokers, 31% of population• 22% of American women smoke• 26% of American men smoke• 1500 adolescent girls start smoking each yr• 9% of 8th graders smoke• 20% of 10th graders smoke

History

• 1920’s considered glamorous and sophisticated to smoke

• 1964 first warning came from the surgeon general about smoking, at that time 50% of Americans smoked

• 1970 banned advertisements for tobacco from TV and radio

Why Do People Smoke?

• Social pressure• Peer pressure• Significant other smokes• Susceptibility to advertising• 90% of smokers knew that it was harmful– Underestimated risk of premature death– Men who smoked 25 cigarettes a day thought they

had a 50% chance of reaching 75 yrs but only have a 26% chance

Physical Dependence

• Become dependent on nicotine– Stimulates the brain so that eventually must have

nicotine or it is a state of hypo arousal

• Smoking releases endorphins (opiate like chemical)

• Women use it as an appetite suppressant – Decreases hunger pains– Dulls the taste buds– Causes the liver to release more glycogen to keep

blood sugar levels normal– Smoking moderate amounts it equivalent to

cutting 200 calories per day– One in five people gain 30 lbs within one year of

quitting

Cigarettes

• No such thing as a safe cigarette, even one that is low in tar and nicotine– People just smoke more or inhale deeper

• Cigarette smoke– 43 compounds in smoke carcinogenic– Carbon monoxide most toxic component of

cigarette smoke• Impairs person’s ability to carry oxygen• Found in concentrations 400 times greater then is

considered safe in the workplace• Leads to shortness of breath and decreased endurance

Cigarettes

• Tar, the non-gaseous part of smoke– Residue from burning tobacco– Highly carcinogenic– Smoke one pack of cigarettes per day

collect four ounces of tar in their lungs/yr– Irritant to the lung tissue and may play a

role in COPD

Health Risks

• A lifetime two pack per day smoking habit will shorten your life by 7-8 years

• 1/5 of the world’s population dies of a disease related to smoking

• 60% increase in cataracts• Increased risk of macular degeneration• Twice a likely to get PID• 70% increase chance of developing hearing loss• Four times greater risk for periodontal disease• Increased risk of degenerative disc disease

Health Risks

• Cancer– Significant role in almost all cancers– Single most important factor in the development

of lung cancer– Rate of lung cancer is 23 times higher for men

who smoke– Smokers account for 87% of all lung cancer

deaths– Smoke paralyzes the cilia so the cells have direct

contact with carcinogenic material

Health Risks

• Cancer– Smokers have five times the risk of mouth cancer– Risk of larynx cancer increases 6-9 times– Risk of bladder cancer increases 2-3 times– Twice as likely to get colo-rectal cancer– Women smokers double their risk of cervical

cancer

Health Risks

• Emphysema– Destruction of alveoli – Chronic illness

• Chronic bronchitis– Inflammation of bronchial tube– Excessive mucous production which narrow the

airways– Chronic shortness of breath

• Smokers have higher rates of illness overall as well as their families

Health Risks

• Cardiovascular disease– Smoking doubles your risk of MI– 1/3 of all cardiovascular disease is related to

smoking

– Nicotine increases heart rate and can lead to angina

– Nicotine causes vasoconstriction of peripheral vessels and increases blood pressure

Health Risks

• Cardiovascular– Accelerates atherosclerosis– Increases platlet adhesiveness to form blood

clots and leads to MI and strokes– Increases the LDL and lowers the HDL in blood

Reproduction

• Men– Decreased sperm motility– Decreased fertility– Fewer sperm produced– Contributes to male impotence, decreased blood

flow to the penis

• Women– Early menopause by an average of two years– Low levels of estrogen

Health Risks

• Pregnancy– Smoking during pregnancy kills approx 1000

infants per year– Carbon monoxide means less oxygen to the fetus– Nicotine causes vasoconstriction and less blood

to the fetus– Increased number of miscarriages

Pregnancy

– Small birth weight babies– Premature babies– Twice as likely to have a baby with crossed eyes– Twice as likely to have a cleft palate if the mother

smoked one pack per day during the first trimester

– Nicotine in breast milk decreases fat content and calories

Kids

• Sudden infant death syndrome– 3.5 times the risk of death if both the mother and

father smoke around the child

• Faster respiratory rates, take in more poisons

• Make take the children of smokers up to the age of 11 before they catch up physically, mentally and emotionally

Kids

• Second hand smoke causes– 36,000 cases of bronchitis in kids under 18

months– 3000 cases of new childhood asthma each year– Twice as many respiratory illness in kids who live

with a smoker

Cigars

• Second hand cigar smoke more poisonous then second hand cigarette smoke

• One cigar equals three cigarettes• Cigar smokers are 3-5 times more likely to

die from lung cancer• Large cigars carry nicotine equal to 4-5

cigarettes, absorbed through the mucous membranes of the mouth

Cigars

• Limit cigars to special occasions• Hold cigar between the teeth rather then the

gums and lips• If not actively smoking put it in an ashtray,

not in your mouth• Conduct monthly self exams for irregularities

or bumps in your mouth

Chewing Tobacco

• Chew, snuff, dip• Nicotine absorbed through the mucous

membranes and you become addicted• Cancer of the mouth, tongue, lips• Periodontal disease• Metastasizes easily to the brain• Facial deformities after surgery

Clove Cigarettes

• Bidis• Cloves comprise 40% of cigarette, tobacco is

the rest• Indonesian cigarettes contain 3 times

amount of nicotine and 5 times the tar of regular cigarettes

• Contain a mild anesthetic hides early warning signs

Passive Smoke

• Mainstream smoke– Inhaled and exhaled by the smoker

• Side stream smoke–More dangerous– Not filtered by cigarette filter or the body – Contains more nicotine, carbon monoxide

(3xs) and tar then the smoker takes it

Passive Smoke

• Side stream smoke– Each pack that is smoked, the nonsmoker

takes in 3-4 cigarettes– If you are married to a smoker 3xs more

likely to have a heart attack

Quitting

• Very difficult– Fewer then 5% of those who stopped

smoking can kick the habit for a year– 70% of Americans who smoke want to stop– Ex-heroin addicts say it is easier to quit

drugs then to quit smoking

• Men are more likely to quit then women

Quitting

• Withdrawal symptoms– Nausea– Headache– Hunger– Irritability– Anxious– Hostile– Crave tobacco

Quitting

• Cold turkey• Smoking cessation programs• Filters• Nicotine replacements– Gum– Patch