Toward a Tobacco-Free Society

1. Toward a Tobacco-Free Society Chapter 11

2. Psychoactive Drugs and Changes in Brain Chemistry • Psychoactive drugs act on one or more neurotransmitters in the brain by increasing/decreasing their concentrations and actions • Ex. Dopamine is thought to play a role in reinforcement • Nicotine raises Dopamine levels much in the same way that Alcohol, Heroin, Amphetamines do

3. Nicotine Receptors in the Brain

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 Start in the First Place? • 90% of all new smokers in this country are children and teenagers and 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 • Feel invincible • Social representation of smoking as exciting, glamorous or safe

6. Why Start Smoking?

7. Why People Continue Using Tobacco • Nicotine Addiction • Nicotine = addictive psychoactive drug naturally found in tobacco • Loss of control • On average, smokers can go no longer than 40 min. between doses of nicotine • Tolerance and withdrawal • Symptoms include severe cravings, insomnia, confusion, difficulty concentrating, headache

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

9. Health Hazards of Smoking Tobacco • Cigarettes contain ~ 600 chemical substances and thousands more are formed as it is burned

10. Carcinogens and Poisons in Tobacco Smoke • Benzene – found in gasoline/pesticides • Formaldehyde – used in embalming fluid; causes eye irritation and coughing • Arsenic-interferes with our DNA repair mechanisms • Cadmium – found in batteries; damages kidneys and wall of arteries • Ammonia – enhances addictive nature of nicotine • Hydrogen cyanide -damages cilia • Carbon monoxide -Displaces oxygen in red blood cells • Chromium – makes carcinogens stick to DNA • Tar – particulate, sticky matter that forms when a cigarette is burned • Other Additives • Humectants, sugars, bronchodilators, things to make secondhand smoke less obvious

11. “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”

12. Menthol Cigarettes • Menthols comprise about 30% of the total cigarette market • Anesthetizing effect of menthol, means smokers inhale more deeply and hold smoke longer in the lungs, causing more damage.

13. 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 (mainly for children, overdoses in adults are rare) • Adrenal glands are stimulated to release adrenaline • Can act as a sedative, relieving symptoms of anxiety and irritability • Depresses hunger and dulls taste buds

14. 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

15. 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 (COPD) • Emphysema and Chronic bronchitis

17. Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking

18. Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking

19. 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 ($5.89/pack or ~ $2,150.00/year)

20. 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

21. The Effects of Smoking on the Nonsmoker • Environmental Tobacco Smoke (ETS) or Secondhand • Secondhand smoke consists of mainstream smoke (exhaled by smokers) and sidestream 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. • ~ 41,000 people die/year from secondhand smoke

22. Infants, Children, and Secondhand Smoke • 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

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

24. 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

25. 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!

26. Toward a Tobacco-Free Society Chapter 11