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Toward a Tobacco-Free Society. Chapter 11. Use of Tobacco. Why People use Tobacco 71 Million Americans, including 13.7 million college-aged Americans. 2008, nearly 21% of Americans age 18 describe themselves as current smokers. Nicotine Addiction Powerful psychoactive drug
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Toward a Tobacco-Free Society Chapter 11
Use of Tobacco • Why People use Tobacco • 71 Million Americans, including 13.7 million college-aged Americans. • 2008, nearly 21% of Americans age 18 describe themselves as current smokers. • Nicotine Addiction • Powerful psychoactive drug • Reaches Brain via bloodstream in seconds • Most physically addictive of the psychoactive drugs. • Loss of control • Tolerance and Withdrawal
Figure 11.1 Annual mortality and morbidity among smokers attributable to smoking
Social and Psychological Factors • Established habits or cues to trigger smoking • Secondary reinforcers. • Genetic Factors: • Specific Genes • CYP2A6 – • influences the way in which nicotine is metabolized • People with slow CYP2A6, nicotine remains in the system longer • DRD2 - • Associated with brain chemical dopamine
Why Start in the First Place? • Children and teenagers make-up 90% of all new smokers in this country. • Thousands of children and adolescents (12-17) start smoking everyday. • Average age • 13 for smoking • 10 for spit tobacco
Characteristics which could increase the potential for use. • A parent or sibling uses tobacco • Peers use tobacco • Child comes from blue-collar family • Child comes from low-income home • Single parent. • Performs poorly in school • Child drops out of school • Has positive attitudes towards tobacco
Health Hazards • Tobacco adversely affects nearly every part of the body. • Contains hundreds of damaging chemical substances. • Unfiltered cigarettes = 5 billion particles per cubic MM • 50,000 times more than polluted urban air • Condensed particles in the cigarette produce the tar
Carcinogens and Poisons • 43 chemicals are linked to cancer (Carcinogen) • Benzo(a)pyrene • Urethane • Cocarcinogens • Combine with other chemicals to cause cancer • Poisonous substances • Arsenic • Hydorgen cyanide • Carbon monoxide • 400 times greater than is considered safe in industrial workplaces • Displaces oxygen in red blood cells • Additives • Nearly 600 chemicals
“Light” and Low-Tar Cigarettes • Low-tar, low-nicotine, or filtered cigarettes • No such thing as a safe cigarette • Often smoke more
Menthol Cigarette • 70% of African Americans smoke these • Absorb more nicotine and metabolize it slower • Anesthetizing effect of menthol, inhale more deeply and hold smoke longer in the lungs
Immediate Effects • Acts on the brain either by exciting or tranquilizing the nervous system • Mild nicotine poisoning • Stimulates the cerebral cortex • Stimulates the discharge of adrenaline • Physiological effects on the body
The Long-Term Effects • Cardiovascular Disease • Coronary Heart Disease (CHD) • Atherosclerosis • plaques • Angina pectoris • Myocardial infarction • Stroke • Aortic aneurysm • Pulmonary heart disease • Lung and other cancers • Benzo (a) pyrene • Chronic Obstructive Lung Disease • Emphysema • Chronic Bronchitis • Other Respiratory Damage
Additional Health, Cosmetic, and Economic Concerns • Ulcers • Impotence • Reproductive health problems • Dental diseases • Diminished physical senses • Injuries • Cosmetic concerns • Economic costs
Cumulative Effects • Males before 15 yrs. old are half as likely to live to 75 versus those who did not smoke • Females with similar habits reduce life expectancy by more than 10 years • Female smokers spend 17% more sick days in bed than nonsmokers • Both men and women show a greater rate of acute and chronic diseases
Other Forms of Tobacco • Spit (Smokeless) Tobacco • More than 6.6 million adults • 8% of all high school students • Cigar and Pipes • Cigar smoking has increased by 148% from 1993-2006. • Clover cigarettes and Bidis • Twice the tar, nicotine, and carbon monoxide
Figure 11.5 Tobacco use among middle school and high school students
The Effects of Smoking on the Nonsmoker • Environmental Tobacco smoke (ETS) • EPA designated ETS as a class A carcinogen • Department of Health and Human Services’ National Toxicology Program - “known human carcinogen” • Surgeon General – 2006 – “there is no safe level of exposure to ETS; even brief exposure can cause serious harm”.
Environmental Tobacco Smoke • Mainstream smoke • Smoke exhaled by smokers • Sidestream smoke • Smoke from the burning end of a cigarette, cigar, or pipe. • 85% of smoke in a room is second hand • Twice the tar and nicotine • Three times the benzo(a)pyrene • Three times the ammonia • Smoke from a cigar can be even more dangerous • 30 times more carbon monoxide
ETS Effects • Develop cough, headaches, nasal discomfort, eye irritation, breathlessness and sinus problems • Allergies will be exacerbated • Causes 3,000 deaths due to lung cancer • Contributes to about 35,000 overall deaths each year. • 20% increase in the progression of atherosclerosis. • Contributes to increased Asthma attacks
Infants, Children, and ETS • More likely to develop • Bronchitis, pneumonia,& respiratory infections • More complications from asthma • Increased chance of SIDS • Low-birth weight • Bronchitis • Chemicals from smoking show up in breast milk • Children inhale three times more pollutants per unit of body weight than adults.
Avoiding ETS • Speak up tactfully • Display reminders • Don’t allow smoking in your home or room • Open a window • Sit in the nonsmoking section • Fight for a smoke-free environment • Discuss quitting strategies
Smoking and Pregnancy • Estimated 4600 infant deaths in the U.S. • Miscarriage, premature birth, low birth weight, long term impairments in growth and intellectual development • Possible higher risks of getting cancer • 16% of pregnant women smoke
Cost of Tobacco Use to Society • Lost productivity from sickness, disability, and premature death makes it close to $167 billion per year. • 1998 Master Settlement Agreement (MSA) • Tobacco companies have to pay $206 billion over 25 years. • Limits or bans certain types of advertising, promotions, and lobbying.
What Can Be Done? • Action at the Local level • Action at the State and Federal level • FDA • EPA • OSHA • International Action • WHO • Action in the private sector • Individual Action
How A Tobacco User Can Quit • 50.2 % of all adults who have smoked have quit. • The Benefits of Quitting • Table 11.2 • Options for quitting • Smoking cessation programs • 1-800-QUITNOW • Department of Health and Human Services • Smoking cessation products • Chantix (Varinicline) • Zyban (Bupropion) • Nicotine replacement products • Patches, gums, lozenges, nasal sprays, and inhalers
Toward a Tobacco-Free Society Chapter 11