Toward a Tobacco-Free Society Chapter 11

©2008 McGraw-Hill Companies. All Rights Reserved. Use of Tobacco Why People use Tobacco 70 Million Americans, nearly 4 million adolescents 2004, nearly 30% of Americans age 12 and older had used tobacco during the past 30 days Nicotine Addiction Powerful psychoactive drug Reaches Brain via bloodstream in seconds Most physically addictive of the psychoactive drugs. Loss of control Tolerance and Withdrawal Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Why Start in the First Place? Between 2001-2005 high school use has declined. 28.5% to 23% Children and teenagers make-up 90% of all new smokers in this country. Estimated 4000 children and adolescents (12-17) start smoking. Average age 13 for smoking 10 for spit tobacco Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Listening to Advertising 2003, Tobacco spends nearly $15 billion per year. Most heavily advertised brands Marlboro Camel Newport 90% of teens prefer the top three most advertised brands. Joe Camel is more familiar than Mickey Mouse. More than 90% of 6-year-olds recognized the character Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Who Uses 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Health Hazards 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

“Light” and Low-Tar Cigarettes Low-tar, low-nicotine, or filtered cigarettes No such thing as a safe cigarette Often smoke more Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. The Long-Term Effects Cardiovascular Disease Coronary Heart Disease (CHD) Atherosclerosis Angina pectoris Myocardial infarction Stroke Aortic aneurysm Pulmonary heart disease Lung and other cancers Chronic Obstructive Lung Disease Emphysema Chronic Bronchitis Other Respiratory Damage Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Additional Health, Cosmetic, and Economic Concerns Ulcers Impotence Reproductive health problems Dental diseases Diminished physical senses Injuries Cosmetic concerns Economic costs Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Other Forms of Tobacco Spit (Smokeless) Tobacco More than 6.5 million adults Cigar and Pipes Cigar smoking has increased by 50% since 1993 Clover cigarettes and Bidis Twice the tar, nicotine, and carbon monoxide Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

The Effects of Smoking on the Nonsmoker Environmental Tobacco smoke (ETS) EPA - 1993 – Class A Carcinogen Department of Health and Human Services’ National Toxicology Program - 2000 - “known human carcinogen” Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Environmental Tobacco Smoke Second hand smoke Mainstream smoke Sidestream smoke Twice the tar and nicotine Three times the benzo(a)pyrene Three times the ammonia 85% of smoke in a room is second hand Smoke from a cigar can be even more dangerous 30 times more carbon monoxide Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. ETS Effects Develop cough, headaches, nasal discomfort, eye irritation, breathlessness and sinus problems Allergies will be exacerbated 24-50% increase in lung cancer risk Causes 3,000 deaths due to lung cancer Contributes to about 35,000 overall deaths Contributes to increased Asthma attacks Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

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. Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. 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 Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. 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 11% of pregnant women smoke 14% of female smokers quit while pregnant Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Cost of Tobacco Use to Society Health care costs exceed $75 billion per year. Lost productivity from sickness, disability, and premature death makes it closer to $157 Billion per year. 1998 Master Settlement Agreement (MSA) Tobacco companies have to pay $206 billion over 25 years Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. What Can Be Done? Local laws State and Federal laws FDA EPA International Action Marketing efforts and restrictions Private sector Individual Action Controlling the tobacco companies Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

©2008 McGraw-Hill Companies. All Rights Reserved. Quitting Since 1964 - 50% of all adults who have smoked have quit. Benefits of quitting Options for quitting Smoking cessation programs Smoking cessation products Chantix (Varinicline) Zyban (Bupropion) Nicotine replacement products Patches, gums, lozenges, nasal sprays, and inhalers Chapter eleven ©2008 McGraw-Hill Companies. All Rights Reserved.

Toward a Tobacco-Free Society Chapter 11