Toward a Tobacco-Free Society

1. Toward a Tobacco-Free Society Chapter 11

2. Psychoactive Drugs and Changes in Brain Chemistry • Psychoactive drugs produce most of their key effects by acting on brain chemistry in a characteristic fashion • Consider the route of entry for different types of drugs • Ex. Oral drugs dissolve in stomach absorbed into bloodstream liver, heart and lungs heart brain • The more quickly a drug reaches the brain, the more likely the user is to become dependent

3. Psychoactive Drugs and Changes in Brain Chemistry • Once in the brain, psychoactive drugs act on one or more neurotransmitters by increasing/decreasing their concentrations and actions • Ex. Dopamine is thought to play a role in reinforcement • Heroin, nicotine, alcohol, and amphetamines also affect dopamine levels

4. Who Uses Tobacco? • ~15-18% of the U.S. population • ~19% of males and ~15% of females • ~480,000 deaths/year attributable to smoking • On average, smokers die about 10 years earlier than nonsmokers • The more education a person has, the less likely they are to smoke

5. Why People Use Tobacco • Nicotine, • is the powerful psychoactive drug that naturally occurs in tobacco • is considered by many researchers to be the most addictive of all psychoactive drugs • reaches the brain via the bloodstream in seconds

6. Why Start in the First Place? • 90% of all new smokers in this country are children and teenagers • 1,300 children and adolescents start smoking every day • Average age to start smoking • 13 for smoking tobacco • 10 for smokeless tobacco • Reasons why young people start smoking • Rationalizing the dangers • Danger is not immediate • Can feel invincible • Tobacco ads show smoking as exciting, glamorous or safe

7. Why Start Smoking?

8. Why People Use Tobacco • Nicotine Addiction • Nicotine addiction can start after just a few cigarettes • Most smokers who attempt to quit start again w/in a year • Loss of control • Tobacco users live according to a rigid cycle of need and gratification; on avg. smokers cannot go for no more than 40 min. between doses of nicotine • Tolerance and withdrawal • Sudden abstinence from nicotine produces predictable withdrawal symptoms: severe cravings, insomnia, confusion, tremors, difficulty concentrating, fatigue, muscle pains, headache, nausea, etc., increased heart rate and bp

9. Why People Use Tobacco • Social and Psychological Factors • Secondary reinforcers are activities the smoker associates with tobacco use

10. Health Hazards of Smoking Tobacco • What’s in a Cigarette? • Cigarettes contain ~ 600 chemical substances and thousands more are formed as it is burned

11. Carcinogens and Poisons in Tobacco Smoke • 43 chemicals are linked to development of cancer • Benzo(a)pyrene is a carcinogen- research has found that this causes mutations in lung cancer cells identical to those found in many lung cancer patients • Urethane- also a carcinogen (directly causes cancer) • Formaldehyde – kills microbes; causes eye irritation and coughing • Arsenic-interferes with our DNA repair mechanisms • Hydrogen cyanide-damages cilia • Carbon monoxide-Displaces oxygen in red blood cells • Other Additives • Humectants, sugars, bronchodilators, ammonia, things to make sidestream smoke less obvious

12. “Light” and Low-Tar Cigarettes • Low-tar, low-nicotine, or filtered cigarettes • There is no such thing as a safe cigarette • Users often smoke more, inhale more deeply, blocking ventilation holes • Less likely to quit than smokers of regular cigarettes • In 2010, federal law prohibited the use of terms such as “light” and “mild”

13. Menthol Cigarettes • Menthols comprise about 30% of the total cigarette market • Individuals smoking menthols absorb more nicotine and metabolize it slower than other groups • Anesthetizing effect of menthol, means smokers inhale more deeply and hold smoke longer in the lungs, causing more damage.

14. Immediate Effects of Smoking • Nicotine can either Excite or Tranquilize the Nervous System Depending on Dosage and tolerance of the smoker • The beginning smoker often feels dizziness, faintness, rapid pulse, cold, clammy skin, nausea • At low dosages nicotine constricts blood vessels, elevates HR and BP; higher doses can be lethal (esp. for children) (overdoses in adults are rare) • Adrenal glands are stimulated to discharge adrenaline • Can act as a sedative, relieving symptoms of anxiety and irritability • Depresses hunger and dulls taste buds

15. The Long-Term Effects of Smoking • Cardiovascular Disease • Research indicates that the total amount of tobacco smoke inhaled is a key factor contributing to disease • Coronary heart disease (CHD) causes just as many deaths from smoking as lung cancer • Atherosclerosis leading to angina pectoris and heart attack

16. The Long-Term Effects of Smoking • Lung cancer and other cancers • Research has linked smoking to cancers of the trachea, mouth, esophagus, larynx, pancreas, bladder, kidney, breast, cervix, stomach liver, colon and skin • Chronic obstructive pulmonary disease • Emphysema and Chronic bronchitis

18. Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking

19. Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking

20. Additional Health, Cosmetic, and Economic Concerns • Ulcers • Impotence • Reproductive health problems • Dental diseases • Diminished physical senses • Injuries • Cosmetic concerns (crows feet around eyes and lips) • Economic costs

21. Other Forms of Tobacco • Spit (smokeless) tobacco • Contains at least 28 chemicals known to cause cancer • Cigars and pipes • Users do not need to inhale in order to ingest nicotine - its absorbed through gums and mouth • Cigars contain more tobacco than cigarettes more nicotine • E-cigarettes • Contain nicotine, other harmful substances

22. The Effects of Smoking on the Nonsmoker • Environmental Tobacco Smoke (ETS) or Secondhand • ETS consists of mainstream smoke (exhaled by smokers) and sidestream smoke (uninhaled smoke from a burning cigarette, cigar, or pipe) • Sidestream smoke has twice the tar and nicotine,~ 3X the benzo(a)pyrene, CO, and ammonia • EPA designated ETS as a class A carcinogen and Surgeon General has concluded that there is no safe level of exposure to ETS. • ~ 54,000 people die/year from secondhand smoke

23. ETS Effects • Develop cough, headaches, nasal discomfort, eye irritation, breathlessness, and sinus problems • Allergies will be exacerbated • Nonsmokers can be affected by effects of ETS hours after they leave a smoky environment • Carbon monoxide lingers in bloodstream 5 hours later

24. Infants, Children, and ETS • Children exposed to ETS are more likely to have • SIDs and low-birth weight • Bronchitis, pneumonia, and asthma • Reduced lung function • Middle-ear infections • Lung cancer, emphysema, and chronic bronchitis later in life

25. Smoking and Pregnancy • 12-20% of pregnant women smoke • There is increased risk of miscarriage, premature birth, low birth weight, SIDS, and long term impairments in growth and intellectual development

26. How A Tobacco User Can Quit • The best way to avoid all of the added chemicals in cigarettes is to stop smoking right now!! This very minute!! THE BENEFITS OF QUITTING ARE IMMEDIATE! • Action at many levels • CDC-Tips From Former Smokers • Smokefree.gov • Free telephone quit-lines • 1-800-QUITNOW • Individual action -Talk with your friends and family who have quit smoking and see what helped them, 'quit smoking' products

27. Benefits of Quitting Smoking • There are benefits of quitting • 20 minutes after quitting, BP and heart rate drop • After 48 hrs. senses (taste, smell) may improve • Within weeks, circulation improves, less wheezing, wounds may heal faster • Within months, lung function improves, less fatigue • Benefits continue for years after quitting!

28. Toward a Tobacco-Free Society Chapter 11