Toward a Tobacco-Free Society Chapter 11

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

Nicotine Receptors in the Brain

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 Legal age is 18 or older Each day 1000 teenagers become regular smokers; at least 1/3 of them will die prematurely because of tobacco.

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

Why Start Smoking?

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

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

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

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

“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”

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.

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

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

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

Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking Figure 11.1 Annual mortality (# of deaths per year due to smoking) and morbidity (# of people w/ chronic illnesses due to smoking) among smokers

Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking Figure 11.1 Annual mortality (# of deaths per year due to smoking) and morbidity (# of people w/ chronic illnesses due to smoking) among smokers

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)

Other Forms of Tobacco Spit (smokeless) tobacco Cigars and pipes 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

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

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

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 infants of non-smoking mothers have the lowest risk of SIDS. More than 40% of children who go to the emergency room for asthma live with smokers

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 http://www.cdc.gov/tobacco/campaign/tips/ http://smokefree.gov/

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!

Toward a Tobacco-Free Society Chapter 11