SMOKING

1. SMOKING باتل الطريقي حسام الحميدي فارس الرحيلي سعد الشمري ياسر بخش عمار الشهري

2. Smoking التدخين

3. Introduction Smoking epidemic is one of the biggest public health threats the world has ever faced. It is the leading preventable cause of death in many countries. Every Day 13,000 people die . It kills nearly six million people each year. more than 5 million are users and ex users and more than 600.000 are nonsmokers exposed to second-hand smoke.

4. Who Smokes ? 1 Billion Man in the world smoke !! About 35% of men in developed countries and 50% of men in developing countries . 250 Million woman in the world smoke !! About 22% of women in developed countries and 9% of woman in developing countries .

5. It caused 100 million deaths in the 20th century. If current trends continue, it will cause up to one billion deaths in the 21st century. Nearly 80% of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest. 95 % of the global population is unprotected by laws banning smoking.

6. WHO statistics :

10. Mechanism of addiction • Nicotine Multiplies the effect of various neurotransmitter • Dopamine • Noradrenaline • Chronic nicotine administration develop tolerance .

11. Causes of the withdrawal symptoms : • State of nicotine deprivation • Altered level of dopamine • Noradrenaline • Other neurotransmitter

12. RISK OF SMOKING Hussam Alhamidi

13. Effects on body system

16. Risk of smoking • Major factor in many diseases and adverse health events .

17. According to the 2004 Surgeon General’s Report • There is sufficient evidence that smoking causes the following conditions : • Cancers : • lung, • oral (laryngeal) • GI (esophageal, stomach, liver, pancreatic) • GU (bladder, kidney, cervical) • hematologic (myeloid leukemia)

18. Cardiovascular disease: • atherosclerosis • cerebrovascular • coronary heart disease(CHD) • abdominal aortic aneurysm

19. Respiratory disease: • chronic obstructive pulmonary disease(COPD) • increased susceptibility to pneumonia • impaired lung growth during childhood and adolescence

20. Reproductive effects: • decreased fertility in women, • complications of pregnancy:such as • premature rupture of the membranes • placenta previa • placental abruption • miscarriage • still birth • low birth weight • reduced lung function in infants • sudden infantdeath syndrome (SIDS)

21. Other: • hip fractures • low bone density • peptic ulcer disease • cataracts • diminished health status

22. 269,000 deaths among men

23. 243,000 deaths among women

24. 8.6 (95% CI 6.9 to 10.5) million people in the United States had disease attributable to smoking.

25. 8.6 (95% CI 6.9 to 10.5) million people in the United States had disease attributable to smoking.

26. Cancer risk • Lung cancer represents the biggest cause of smoking-related cancer mortality. • According to the (CDC), smoking-related lung cancer accounts for more than 10 times the number of years of potential life lost (YLL) in the United States compared with any other smoking-related cancer

27. Smoking cessation and cancer risk • Difference in lung cancer risk between smokers and former smokers is not to be expected before around 2 years after quitting. • Because of the time lag between mutation, and disease detection. • Most of the increased risk is avoided by those who stop smoking before middle age

28. Smoking cessation and cancer risk

29. Smoking cessation and cancer risk

30. Smoking cessation and cancer risk

31. A systematic review found that smoking cessation was associated with a reduction in the risk of all the major histologic types of lung cancer. • the risk for adenocarcinoma and large cell carcinoma fell off less rapidly than for small cell lung cancer and squamous cell carcinoma.

32. evidence of reduced risk for ex-smokers compared with current smokers for squamous cell esophageal cancer and an increased risk was probably maintained for at least 20 years risk among ex-smokers was still twice the risk of never smokers after 10

34. effects of smoking on cancer treatment • smoking was associated with pulmonary complications during and following surgery • poorer wound healing • increased complications from radiation therapy • Other studies have associated smoking cessation with increased survival times in breast cancer and non-small cell lung cancer

35. Cardiovascular risk • Smoking operates at different stages in the development of coronary heart disease (CHD): • reduces the ability of the blood to carry oxygen • causes progressive atherosclerosis • endothelial injury • thrombotic processes acute infarction

36. Cerebrovascular risk • The evidence is less good than for cardiovascular disease . • The RR decreases with cessation and may reach that of never smokers following 5 to 10 years of abstinence, • depends on past smoking habits, with light smokers (< 20 cigarettes/day) reaching the risk of never smokers within 5 years, whereas heavier smokers may never reach it.

37. Peripheral artery risk • Smoking is the dominant risk factor for (PAD). • RR is slower than for cerebrovascular and CHD, with elevated risk observed even after 20 years. • smoking increased graft failure 3.09-fold in people with PAD who were undergoing arterial reconstructive surgery in the lower extremities

38. Chronic obstructive pulmonary disease • The strongest evidence for benefit is in people with mild COPD. • One RCT, the Lung Health Study, which included people with mild to moderate COPD, found : • an increase in FEV1 in the first year following smoking cessation.

39. secondhand tobacco smoke • Is a significant health risk for nonsmokers, especially those with pre-existing respiratory and cardiac conditions. • Is now a recognized carcinogen . • containing over 50 harmful chemicals, such as : • Formaldehyde • benzene • vinyl chloride • arsenic • ammonia • hydrogen cyanide.

40. secondhand tobacco smoke • Concentrations of many harmful chemicals are higher in secondhand smoke than in that inhaled by smokers. • Found to be immediately detrimental to the cardiovascular system. • There is a prothrombotic effect with increased platelet stickiness • decreased coronary flow reserves • Reduced heart rate variability.

41. secondhand tobacco smoke • Pooled evidence has indicated a causal relationship between secondhand smoke and both lung cancer and CHD. • Nonsmokers exposed to secondhand smoke at home or at work have about : • 25% to 30% increased risk of heart disease • 20% to 30% increased risk of lung cancer.

42. secondhand tobacco smoke • Meta-analysis found that : • RR increased on average by 24%, with people in the highest workplace exposure categories being twice as likely to develop lung cancer compared with nonexposed people .

43. secondhand tobacco smoke • Infants and young children are considered especially vulnerable . • Maternal exposure during pregnancy is associated with • Small decrease in birth weight • Persistent adverse effects on lung function throughout childhood.

44. secondhand tobacco smoke • Parental smoke is linked to ever having asthma, • exposure in children has been associated with increased risk for • Sudden infant death syndrome (SIDS) • Acute respiratory infections • Ear problems • Increased severity of asthma.

45. secondhand tobacco smoke • The Surgeon General has concluded that there is no safe level for secondhand smoke Exposure . • Mechanical ventilation or separation of smokers does not fully eliminate the risk. • Air cleaning systems leave behind small particles. • Heating and cooling systems may distribute smoke throughout a building.

46. Last word Smoking is the biggest preventable cause of premature mortality

47. How are you going to help the smoker to quite? Faris Awadallah AlRehaili

48. QUITTING PLAN • Support group vs Self monitoring • Cold turkey vs Nicotine fading • Use of medications vs Non use of medication • Set a quitting day

49. QUIT DAY • Sitting the quit after 7 to 14 days. • Quitting on Saturday vs Quitting Wednesday. • Mark the date on your calendar. • Be determined to quit on that day. • Don’t quit before your Quit Day.

50. PREPARE FOR YOUR QUIT DAY • stop smoking relating to external and internal triggers • wait 10-15 minutes after the trigger is done. • Be consistent. • Don’t try to quit smoking or even cut down yet.