Tobacco

1. Tobacco Prepared by Mr. Shoup 2019

3. Tobacco History • Mayan Indians used tobacco • Huron Indians introduced tobacco to the white man. • Christopher Columbus 1492, brought back to the New World • Jean Nicot 1850 wrote about the effects of nicotine on the human, French Ambassador to Portugal in 1850. • King James the 1st Opposed tobacco use-taxed tobacco 4,000%

4. History Continued • Sir Walter Raleigh • John Rolfe-1612 Jamestown Colony-state of Virginia today-Cash Crop 1614-1620 • 1791 Tobacco account for 1/5th of American Exports • 1871-1stSurgeon General was founded-means Chief Surgeon, Maine Hospital Services. • 1957 Surgeon General Leroy Burney Declared related tobacco smoking to lung cancer.

5. History Continued • 1962-1st General Surgeon Panel-10 people • 1964-First Surgeon Report to Congress-reported on a Saturday so it would not affect the stock market and to maximize report to a Sunday newspaper. • 1967-Air Time for Anti Cigarette Commercials • 1969-Surgeon General Report to Health Consequences of Smoking • 1970-Cigarette advertisements banned on TV and radio. • 1972-Report on Involuntary Smoke Health Risks

6. History Continued • 1977-Great American Smoke Out Day • 1979-Surgeon General-Richmond Healthy People: Report on Health and Disease Prevention • 1980- Surgeon General Report-Health Consequences of Smoking for Women and Pregnancy. • 1980-1986-More reports to health concerns. • 1984-Federal Cigarette labeling and advertising Act was passed by Congress-Known additives in tobacco.

7. History Continued • 1986-Surgeon General-Koop’s Report on Health Consequences of Involuntary Smoke • 1986-1st Warning on chewing tobacco cans and packages. • 1988-Airlines Restrictions to smoking on planes-2hour flights or less no smoking. • 1990-Airlines restrict smoking on planes-6hours or less. • Later no smoking at all on all plane trips.

8. History Continued • 1982-Environmental Protection Agency-placed ETS as a major carcinogen-workplace and federal. • 1982-Nicotine patches • 1993-Tar Labelled as a “CLASS A” carcinogen • 1994-Youth Smoking and Effects • 1996-Nicotine Gum and Patches-OTC approved • 1997-Minimum age to be 18 years of age and with at least two proofs or more to sell. • 1963 The first known person on record to have the idea for an electronic smoking device was Herbert A. Gilbert.

9. History Continued • 1998-46 states of the 50 settle tobacco lawsuit that includes 246 billion dollars. 50 million enforcement fund to ensure compliances with the agreement. • Bans the use of cartoon characters in advertisement for example buses and taxi’s etc. • Prohibits most outdoor brand advertisements, including billboards and signs and placards in arenas stadiums, malls, and video game arcades. • Bans transit advertisement-taxi’s and buses. • Prohibits tobacco companies from paying for products placement in movies, television shows and other performances or video games. • Bans distribution to the general public of merchandise, such as caps, shirts, and backpacks, bearing tobacco brand names and logos • Bans the manufacturers from distributing free samples of tobacco products, except in adult only facilities. • 100 million dollars to Youth Smoking Prevention Program Department.

10. History Continued • 1999Cigarette advertisements toward female smokers • 2000-”03 The Target Market Program-anti smoking programs on TV. • 2001 New National Cancer Institute study on light and low tar cigarettes-”Deceptive” • 2002 NYS increase the taxes on cigarettes to $1.50 a pack. • 2004-NYS receives 37 million from tobacco lawsuit-state is failing to provide tobacco money for education and medical technology. • 2004-CDC most states are failing to put lawsuit money to education use.

11. History Continues • 2002-2004- Tobacco companies increase marketing of tobacco by 66% from 11.45 billion dollars to 31.4 million dollars per day advertisement of tobacco. • 2010 Healthy People –objectives is to reduce tobacco use and disease to school age students and adults. • In 2003 E-Cigarettes become more popular. • 2013 E-Cigarettes take off • 2013-14CVS stops selling tobacco products • 2016-Chautaugua County sale of tobacco only from 21 years of age and older. 2016-E-Cigarettes are regulated. 2018- Catt Co sale of tobacco products 21 years of age or older

12. NYS Tobacco Taxes • New York is the highest net importer of smuggled cigarettes -- illegal smokes account for 56.9 percent of the state's total market. • New York State also imposes an excise tax on tobacco products at the following rates: • 75% of the wholesale price on cigars and tobacco products (other than little cigars and snuff) • $4.35 per twenty little cigars; and • $2 per container of snuff one ounce or less, and $2 per ounce and a proportionate rate on any fractional amount thereof for containers with more than one ounce.

13. New York's cigarettes tax is $4.35 per pack, the country's highest. • New York City to $5.85. • Chapter 59 of the Laws of 2013 (Part O) amended Article 20 of the Tax Law to increase the penalty for possession of unstamped or unlawfully stamped packages of cigarettes. • Indian Nations or others: • Effective June 1, 2013, in addition to any other penalties imposed under the cigarette tax, the Tax Department is authorized to impose a penalty of not more than $600 for each carton (200 cigarettes) or fraction of a carton of unstamped or unlawfully stamped packages of cigarettes in the possession or control of any person. Prior to June 1, 2013, the penalty imposed could not exceed $150 per carton or fraction of a carton.

14. Tobacco Facts 9 out of 10 smokers started before the age of 18. 98% started to smoke by the age of 26. 1 out of 5 adults and teenagers smoke today. Every day 3,200 students under the age of 18 smoke their first cigarette. 2,100 will become regular smokers From 1964 to 2014 adult smokers has declined from 42% to 16-18%.

15. Cost per household taxes $951.00 16 million people already have at least one disease from smoking More than 20 million have died since 1964 from smoking 2.5 million people died from secondhand smoke 8.6 million people live with a serious illness caused by smoking Lobby congress $19.6 million per year Election cycle $1.6 million Smoking caused health costs and productivity losses per pack sold in the USA $19.16 Average retail cost for a pack of cigarettes $6.16 $170 billion Tobacco company advertisement spendage: $9.1 billion per year $25 MILLION DOLLARS PER DAY Productivity Loss per year: $151 billion NYS $5.73-$6.01 billion dollars per year $267-$270 million dollars per day http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf

16. Stats to Smoking • High school students who are current (past month) smokers: 10.8% [Boys: 11.8% Girls: 9.7%]; over 1.8 million • High school males who are current cigar smokers: 14.0% • High school students who are current e-cigarette users: 16.0% • High school students vaping or using e-cigarettes-21-24% • Kids (under 18) who try smoking for the first time each day: 2,500 • Kids (under 18) who become new regular, daily smokers each day: 400+ • Kids (3-11) exposed to secondhand smoke: 40.6% • [Black: 67.9% White: 37.2%] • Adults in the USA who are current smokers: 15.1% • [Men: 16.7% Women: 13.6%]; 36.5 million

17. In the United States, tobacco use kills more than 480,000 people per year(2014) — more than AIDS, alcohol, car accidents, illegal drugs, murders, and suicides combined.  About 50,000 of these deaths result from exposure to secondhand smoke. The tobacco industry’s business model about the importance of youth smoking was never put more succinctly than in this 1984 document from an RJ Reynolds tobacco official: “If younger adults turn away from smoking, the industry will decline, just as a population which does not give birth will eventually dwindle.” (“younger adults” was industry code from the mid 1970s for children and young adults, to be used in all written communications) http://blogs.bmj.com/tc/2015/11/13/e-cigarettes-and-children-advocates-walking-on-both-sides-of-the-street/?q=w_tc_blog_sidetab

18. Tobacco Facts • Tobacco kills more people than: • Alcohol Abuse • HIV/AIDS • Car Accidents • Illegal Drugs • Murders • Suicides • Fires ALL COMBINED Most smokers begin as children, and 580 kids become regular smokers every day. One in three of them will die an early death as a result.  If current rates persist, kids under 18 alive today who will ultimately die from smoking (unless smoking rates decline): 5.6 million prematurely of tobacco-caused diseases. People who die each year from cigarette smoking and exposure to secondhand smoke: approx. 480,000+ People in the USA who currently suffer from smoking-caused illness: 16 million+ http://www.tobaccofreekids.org/research/factsheets/pdf/0072.pdf

19. Tobacco Use • Tobacco comes from the leaves of the Nicotiana Tabacum plant. • Indians and earlier settlers believed that the exhaled tobacco smoke was capable of carrying one’s thoughts to heaven. More as a incent • Types of tobacco: • 1. Cigarettes • 2. Chew/Snuff • 3. Pipe • 4. Cigars http://tobaccocontrol.bmj.com/

20. Why People Start? • Peer Pressure • Social Acceptance-which is decreasing • To Reduce Stress • Mom, Dad or older sibling smokes • Advertisements/Media • To suppress appetite • For pleasure • 3 out of 4 smokers that say they will quit in 5 years DO NOT QUIT! Including pregnant females 2 to 3 out of 10 pregnant mothers will quit smoking during pregnancy. That means 7or 8 out of 10 will still smoke

21. Smoked Tobacco Products Regular Cigarettes 1.2 milligrams of nicotine, 14 milligrams of tar Light Cigarettes-low tar, low nicotine, .06 mg of nicotine and 7mg of tar; mild, light or ultra light brands. Menthol Cigarettes: Mint leaves such as peppermint or spearmint that gives a cooling sensation. Some slang names for cigarettes are: Smokes Cancer sticks Coffin nails

22. Four Main Components of Tobacco • 400 chemicals before tobacco burns • 7,000 chemicals when tobacco burns, use to be 4,000 • 80% of the above chemicals (7,000) are known to cause cancer • 200 poisons • 60-69 Carcinogens (70) • 562-599 additives that could be added to tobacco products so you enjoy their product. • In fact, a pack-a-day smoker consumes about 75,000 doses of these chemicals in a single year. What happens when you light a cigarette? • Thousands of chemicals like methanol, ammonia, formaldehyde, arsenic, cadmium, and many other toxic chemicals are inhaled into your lungs and released into the air around you. This mixture of dangerous chemicals can damage every organ in your body and cause cancer, heart disease, lung diseases, and circulatory diseases. • Some of the ingredients found in tobacco smoke are: acetone-nail polish, arsenic-rat poison, butane-cigarette lighter fluid, Benzene-a solvent found in pesticides and gasoline, cadmium-rechargeable batteries, Formaldehyde-preservative-body tissue, hydrogen cyanide-gas chamber poison, methane-swamp gas, naphthalene-mothballs, nitrobenzene-gas additive, nitrous oxide phenols-disinfectant, stearic acid-candle wax, toluene-industrial solvent, vinyl chloride-makes PVC pipes, methanol-rocket fuel, bees wax, different plant oils, juices, urea-urine, vinegar, and many more

23. Tobacco IngredientsShort Term Effects 1.Nicotine-the only drug of tobacco • a very strong poison. Used in insecticides • Stimulant-a drug that increases the central nervous system • Vaso-Constrictor-blood vessels get smaller • Addiction- could occur with the first cigarette • 250 hits off cigarettes per day-1pack per day ave. • Increase heart rate-16xs+ more per minute. • Increase blood pressure • Increases chances for heart attacks and strokes 4-25xs greater risk. intends.

24. Ingredients continued • Carbon Monoxide (CO1)-colorless, odorless gas • Poisonous gas • Steals oxygen from the blood • Increases carbon dioxide in the blood • Creates a term called-carboxyhemoglobin • Aids in blood clots. • Increases the risk for blood clots, heart attacks and strokes.

25. Tobacco Ingredients Ammonia: • Main irritant • Slows down cilia action-paralyzes the cilia • Tobacco companies add ammonia to the tobacco product to increase nicotine levels inhaled per puff-addiction faster. • Irritant to eyes and nose-itchy eyes, sneeze Tar: 1 pack a day smoker would inhale 1 quart jar of tar per yr. • Dark brown/blackish sticky substance • Tobacco must burn to create • Main carcinogen-cancer causing agent. Class A • Promotes abnormal growth of cells tumors and cancer • Other chemicals radio active components-polonium 210 and radon

26. deeper puffs. Filters only help block the largest tar particles, letting through smaller bits of tar that can travel deeper into your lungs. The inside of the filter is painted white to appear clean. Each individual filter is made of thousands of tiny fibers. During smoking, these fibers can come off into your mouth and be inhaled into your lungs. Charcoal filters are no better. If you smoke a cigarette with a charcoal filter, not only can you get fibers in your body, you can also get tiny bits of charcoal https://www.nysmokefree.com/FactsAndFAQs/Filters

27. Short & Long Term Effects of Tobacco Use • Leading cause of early death-heart attacks and cancer • Money-finance • Bad Breath-Halitosis • Stained teeth, fingers and finger nails • Wrinkles • Tooth Loss/tooth decay-sugar in tobacco and from the chemicals breaking down your gums-periodontal tissue disease • Gum disease • Heart Diseases • Cancers • COPD-bronchitis, emphysema, lung cancer • COPD-Chronic Obstructive Pulmonary Disease • Burnt furniture, car seats, clothing • Prone to more sickness-decreases immune system • Impairs sense of smell and taste • Smokers Cough • Smell of clothing, car, and house

28. Smoking causes:

29. 2nd leading cause of disabilities

31. Long Term Effects of Smoking

32. What is Chronic Obstructive Pulmonary Disease? • COPD is a disease that makes it hard to breathe. It's the result of lung irritants that have caused permanent damage to the lungs. COPD includes two conditions1: • Emphysema • Chronic bronchitis • Or both of these conditions • Smoking is the most common cause of COPD. Some other causes of COPD include: • Secondhand smoke • Air pollution • Chemical fumes • There is no cure for COPD. There are, however, rescue medicines that can help patients breathe better. • People with COPD have symptoms that include: • Having a hard time catching their breath • Chest tightness • Wheezing (a whistling sound when they breathe) • Chronic cough that may produce a lot of mucus (smoker's cough) • http://myproair.com/respiclick/respiratory-conditions/copd/default.aspx

33. Emphysema: Damage in the lungs Emphysema is one type of COPD (chronic obstructive pulmonary disease). Emphysema means that the tiny air sacs in the lungs have been damaged. This damage doesn't happen overnight: Over time, exposure to irritants, most commonly smoke, damages the tiny air sacs—called alveoli—which you need to breathe The walls of these sacs lose their flexibility, and may even break down entirely. Because the sacs can't stretch, they can't push air out. The end result is that the body doesn't get the oxygen it needs. This may make a person with emphysema feel "out of breath" even after mild activity, like walking Chronic bronchitis: Narrowing of the airways in the lungs Chronic bronchitis is another type of COPD (chronic obstructive pulmonary disease). When a person has chronic bronchitis1: The airways in the lungs become inflamed, causing them to thicken or swell. The muscles around the airways also tighten up, making the airways even smaller. Less air is able to flow through the airways Daily coughing often occurs because the airways produce a lot of mucus. Coughing is how the body gets rid of mucus. http://myproair.com/respiclick/respiratory-conditions/copd/default.aspx

34. Smokeless tobacco use during pregnancy increases preeclampsia-high blood pressure, fluid retention, swelling

35. Smokeless Tobacco Products Chew Tobacco-leaf form Snuff, which also can be sniffed if dried Dip, moist snuff Snus, a small pouch of moist snuff Dissolvable products: including lozenges, orbs, sticks and strips

36. Smokeless Tobacco: Snuff/Chew • Chew-made from tobacco leaves mixed with honey and molasses. • Placed in the mouth between the cheek, gum and teeth • Higher levels of nitrosamines-co-carcinogen • Snuff-ground up tobacco leaves in a can • Placed between cheek and gum • 1 can is like smoking 50-60 cigarettes to nicotine consumption • Higher level of nitrosamines-co-carcinogens • NO TAR-not burning • Drug-Nicotine in liquid form, not gas • Nicotine the addictive drug of smokeless tobacco

37. Smokeless Tobacco • 15% of all males between 12-17 use smokeless tobacco products. • 9% of high school students use smokeless tobacco. • 60% of smokeless tobacco users started by the age of 13. • Data shows that men 18-24 and those with a high school average or less are more likely to use smokeless tobacco products. • The nitrosamines in snuff/chew are at a higher concentration than in a cigarette, cigar, or pipe tobacco users. • Smokeless tobacco contains 28 cancer causing agents.

38. Effects of Smokeless Tobacco • Leukoplakia • Gingivitis/gum recession • Oral Cancers-lip, tongue, cheek 50xs greater • Bad breath-Halitosis • Tooth Decay-from the sugar added in the tobacco • Stained teeth • Stomach ulcers • Decrease sense of taste and smell • Digestive Cancers • Increase heart rate and blood pressure from nicotine • Still constricts blood vessels-nicotine vaso-constrictor • Addiction-liquid state now

39. Oral Cancer-Cheek Leukoplakia

40. Leukoplakia Throat cancer Blood Clot Tongue Cancer

42. 7 Warning Signs of Cancer C=Change in bowel or bladder habits A=A sore that does not heal or go away U=Unusual Bleeding T=Thickening of T=Thickening of the breast or a discharge O=Obvious change in wart or mole Color size bleeding N=Nagging cough or hoarseness I=Indigestion or difficulty swallowing

43. Second Hand Smoke 88 million nonsmokers including 54% of children age 3-11 years are exposed to secondhand smoke. An estimated 3,000 nonsmokers will die from lung cancer from exposure to smokers. Second hand smoke: Nonsmokers from home or the work place increase their lung cancer risk by 20%-30%. Increase their heart disease risk by 25%-30%. 33,000 nonsmokers die each year from coronary heart disease from the exposure to secondhand smoke. In babies secondhand smoke is responsible for 150,000-300,000 new cases of bronchitis and or pneumonia per year. 400,000 babies are exposed to chemicals in cigarette smoke before birth because their mothers smoke. More than 100,000 babies whom died from SIDS in the last 50 years has been from smoking.

44. Second hand Smoke for Children 53.6% of children are exposed to secondhand smoke. 18.2% of children lived with someone who smoked inside their home. In children secondhand smoke causes: Ear infections Asthma attacks Respiratory issues including coughing, sneezing, and shortness of breath Respiratory infections-bronchitis, pneumonia SIDS increase risk

47. Benefits to Quitting • 20 minutes after quitting • Your heart rate and blood pressure drop. • (Effect of smoking on arterial stiffness and pulse pressure amplification, Mahmud A, Feely J. Hypertension.2003:41:183) • 12 hours after quitting • The carbon monoxide level in your blood drops to normal. • (US Surgeon General’s Report, 1988, p. 202) • 2 weeks to 3 months after quitting • Your circulation improves and your lung function increases. • (US Surgeon General’s Report, 1990, pp.193, 194,196, 285, 323) • 1 to 9 months after quitting • Coughing and shortness of breath decrease; cilia (tiny hair-like structures that move mucus out of the lungs) start to regain normal function in the lungs, increasing the ability to handle mucus, clean the lungs, and reduce the risk of infection. • (US Surgeon General’s Report, 1990, pp. 285-287, 304) • 1 year after quitting • The excess risk of coronary heart disease is half that of a continuing smoker’s. • (US Surgeon General’s Report, 2010, p. 359) • 5 years after quitting • Risk of cancer of the mouth, throat, esophagus, and bladder are cut in half. Cervical cancer risk falls to that of a non-smoker. • Stroke risk can fall to that of a non-smoker after 2-5 years. • (A Report of the Surgeon General: How Tobacco Smoke Causes Disease - The Biology and Behavioral Basis for Smoking-Attributable Disease Fact Sheet, 2010; and Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007, p 341)

48. Benefits to quitting continued • 10 years after quitting • The risk of dying from lung cancer is about half that of a person who is still smoking. • The risk of cancer of the larynx (voice box) and pancreas decreases. • (A Report of the Surgeon General: How Tobacco Smoke Causes Disease - The Biology and Behavioral Basis for Smoking-Attributable Disease Fact Sheet, 2010; and US Surgeon General’s Report, 1990, pp. vi, 155, 165) • 15 years after quitting • The risk of coronary heart disease is that of a non-smoker’s. • (Tobacco Control: Reversal of Risk After Quitting Smoking. IARC Handbooks of Cancer Prevention, Vol. 11. 2007. p 11) • These are just a few of the benefits of quitting smoking for good. Quitting smoking lowers the risk of diabetes, lets blood vessels work better, and helps the heart and lungs. • Quitting while you are younger will reduce your health risks more, but quitting at any age can give back years of life that would be lost by continuing to smoke.Last Medical Review: 02/06/2014 Last Revised: 02/06/2014 • http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-benefits

49. Why quit smoking now? • No matter how old you are or how long you’ve smoked, quitting can help you live longer and be healthier. • People who stop smoking before age 50 cut their risk of dying in the next 15 years in half compared with those who keep smoking. • Ex-smokers enjoy a higher quality of life – they have fewer illnesses like colds and the flu, lower rates of bronchitis and pneumonia, and feel healthier than people who still smoke. • http://www.cancer.org/healthy/stayawayfromtobacco/guidetoquittingsmoking/guide-to-quitting-smoking-why-quit-now