Chapter 21

1. Chapter 21 Tobacco

2. Tobacco • Tobacco is the #1 cause of preventable disease in the United States • Everyday teens and adults begin to use some form of tobacco and quickly become addicted

3. Smoking Statistics The adverse health effects from cigarette smoking account for an estimated 480,000 deaths, or nearly one of every five deaths, each year in the United States More deaths are caused each year by tobacco use than by all deaths from human immunodeficiency virus (HIV), illegal drug use, alcohol use, motor vehicle injuries, suicides, and murders combined On average, someone who smokes a pack or more of cigarettes a day lives seven years less than someone who never smokes

4. Statistics Cont’d. • Smokers are more likely to develop heart disease, stroke, and lung cancer. • Smoking is estimated to increase the risk— • For coronary heart disease by 2-4 times (leading killer in US) • For stroke by 2-4 times • Of men developing lung cancer by 25 times • Of women developing lung cancer by 26 times • Cancer almost anywhere in your body • If nobody smoked, 1 out of 3 cancer related deaths wouldn’t exist • *According to CDC

5. Secondhand Smoke Secondhand smoke contains about 70 cancer-causing chemicals Secondhand smoke causes an estimated 46,000 premature deaths from heart disease each year in the United States among nonsmokers. Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of developing lung cancer by 20–30%

6. Tobacco users develop an addiction due to nicotine, a substance found in the leaves of tobacco • Nicotine is a stimulant, it increases the action of the central nervous system • Two pronged sword • Raises blood pressure and increases heart rate • Smoking damages blood vessels by: • Vessels grow thicker and grow narrower • Which makes heart rate increase and blood pressure increase • Once addicted, people need to increase consumption to satisfy cravings

7. How does body become addicted to nicotine? • Nicotine increases activity in the brain and CNS • When it enters the brain, dopamine gets released...the “feel good” chemical that causes feelings of calm and pleasure • Also helps you to feel alert • Over time the brain adjusts to this “buzzed” feeling and more nicotine is required to achieve the same buzz • Eventually, the user will need more amounts of nicotine to feel normal

8. Smoke from tobacco is toxic • Classified as a Group A carcinogen, acancer causing agent, in 1992 by EPA • Group A is most dangerous classification • Cigarettes contain 43 known carcinogens • Smoke contains tar • Damages and destroys tissues in the lungs, making them less functional • COPD…Emphysema…Chronic Bronchitis • Smoke contains carbon monoxide • Replaces oxygen in blood, making it less available to body

9. Smoker Healthy

10. Short Term Effects of Tobacco Use • User will experience withdrawal symptoms • Headaches, nervousness, trembling • Can occur within 30 minutes of last use • Increased respiration and heart rate • Dulled taste buds, lack of appetite • Bad breath, smelly hair, clothes and skin

11. Long Term Effects of Tobacco Use • Cancer • Chronic Bronchitis • Cilia in bronchi become virtually worthless • Tar builds up in lungs causing chronic coughing and excessive mucus secretion • Emphysema • Disease that destroys tiny air sacs in the lungs • A person with advanced emphysema uses up to 80% of energy just to breathe • http://www.youtube.com/watch?v=nf7yquCo2Xo

12. Hookah vs. Cigarettes A typical 1-hour-long hookah smoking session involves inhaling 100–200 times the volume of smoke inhaled from a single cigarette Water pipe smoking is at least as addictive as cigarettes Hookah smokers are at risk for the same kinds of diseases as are caused by cigarette smoking, including oral cancer, lung cancer, stomach cancer, cancer of the esophagus, reduced lung function, and decreased fertility Secondhand smoke from hookahs poses a serious risk for nonsmokers, particularly because it contains smoke not only from the tobacco but also from the heat source (charcoal) used in the hookah The charcoal used to heat tobacco in the hookah increases the health risks by producing high levels of carbon monoxide, metals, and cancer-causing chemicals.

13. Types of Smokeless Tobacco • Chewing Tobacco: • coarsely divided tobacco leaf that • mixed with sugar and molasses (amongst other chemicals) • packaged in a pouch • used in a plug or twist • usually chewed or sucked between cheek and jaw • Snuff: • moist, more finely cut tobacco • usually flavored with mint, wintergreen, etc. • sold in short round cans. • “dipped” by placing a pinch between the cheek and gum. • Dry Snuff: • finely ground and snuffed through the nostrils • rarely used in the US

14. Smokeless Tobacco • Smokeless tobacco is either held in the mouth or chewed • Contains nicotine, just like other forms of tobacco • Has 28 known carcinogens, all of which are absorbed into blood stream • Because smokeless tobacco is held in mouth so long, it delivers carcinogens and nicotine to the body at levels 2-3 times the amount delivered by a single cigarette • Someone who chews 8-10 plugs a day, is equivalent to smoking 2 packs a day • Causes leukoplakia, thickened, white, leathery-looking spots on the inside of the mouth that can develop into oral cancer • After 2 years of use, teeth have become stained and recession of gums is clear

15. Found in smokeless tobacco • Polonium 210 (nuclear waste) • Formaldehyde (embalming fluid) • Cadmium (used in car batteries) • Lead (nerve poison) • Nitrosamines (known carcinogens) • Arsenic • Cyanide

19. Cost $$ • Average price of a pack of cigarettes in Indiana is $5.50 • At a pack a day, that equals $2,007.50 a year • Average price of a can of chewing tobacco in Indiana is $5.20 • A can a day equals $1,898.00 a year • States are placing extraordinarily high taxes on tobacco products • Total tax on cigarettes in NY is near $4.50 – just the tax • Tobacco companies are coming up with new forms of product to lower costs and attract new users • Toothpicks, strips, etc.

20. Quitting Tobacco Use • Nicotine withdrawal- process that occurs in the body when nicotine is no longer used • User will have headaches, trembling, shakes, difficulty concentrating • To help stop use, people use nicotine substitutes- a product that delivers small amounts of nicotine into the user’s system while he or she is trying to give up the tobacco habit • Gum, patches, etc. • Most people fail the first time they try to quit • 38,000,000 Americans have been able to quit

21. Quitting Tobacco Use • 1. Set a target date for quitting and throw away all tobacco products • 2. Find someone close to you or a group to provide support • 3. Look for local tobacco cessation programs that might be able to help • Hospitals, clinics, American Lung Association • 4. Replace tobacco with another habit • Gum, hard candy, cinnamon sticks • 5. Change daily routine to avoid tobacco triggers • 6. Engage in healthful behavior • Exercise, healthy nutrition, stress-management techniques