Smoking in Jordan Kawkab Shishani, PhD I am an assistant professor at the Hashemite University in Jordan <a href=“http://www.hu.edu.jo”>hu</a> and my specialty is community health nursing. I have done research in several areas such as air pollution, self administration of chronic medications, and smoking behaviors among adolescents. 8/24/2005

Describe effects of smoking on health Objectives Describe effects of smoking on health List reasons for smoking among Jordanian adolescents Describe the ways that assist in fighting smoking at the primary level of prevention 8/24/2005

Worldwide, there are 1.1 billion smokers; of them: Smoking in the World Worldwide, there are 1.1 billion smokers; of them: 800 million live in developing countries 300 million live in developed countries It is known that smoking is associated with: Death of one individual every 8 seconds Death of 12, 000 individuals every day Death of 4 million individuals annually Experimental as well as descriptive studies confirm that smoking causes: Cancers Cardiovascular diseases Smoking consequences are overwhelming both on the individual and national level. Morbidity and mortality associated with smoking means an increase in health expenditure; in addition to the suffering of the affected individuals as well their families 8/24/2005

What is Tobacco Tobacco is a broad-leafed plant of the nightshade family. The plant can grow to a height of 1 to 1.5 meters. Tobacco is smoked in cigars, cigarettes, and hubble- bubble. There are about 4,000 chemicals that the body absorbs from smoking; some of which are: Nicotine Tar Ammonia Hydrogen cyanide Tobacco products, although they come in different forms, are all similar in harmfulness. Many believe that the hubble-bubble (argeelah), which is popular in the Middle East, is harmless. This is certainly false. One session of Argeelah is equivalent to smoking 20-40 cigarettes. 8/24/2005

Cigarette Components: Nicotine Nicotine is an alkaloid, colorless and rapidly absorbed from the lungs Reaches the brain within 8 minutes Highly toxic (50 mg of nicotine can kill an adult if given intravenously) Each cigarette contains between 3-8mg of nicotine Effects of Nicotine: Addiction Constriction in blood vessels (increase in blood pressure) Platelet coagulation (blood clots) Passes through the umbilical cord to fetus’s blood Passes through breast milk <a href=“ http://www.nida.nih.gov/ResearchReports/Nicotine/nicotine2.html#what ”>nida</a> 8/24/2005

Cigarette Components: Tar Carcinogenic, viscid, and brown to black in color 50% of it remains in the lungs and bronchus If swallowed can cause gastrointestinal cancers Causes cell mutation, which leads to lung cancers Experimental studies on mice demonstrated that when tar was rubbed into mice’s skin the mice developed skin cancer 8/24/2005

Cigarette Components: CO (carbon monoxide) Highly toxic gas Binds to the hemoglobin in the blood CO prevents oxygen from binding with hemoglobin. Instead it binds to hemoglobin causing: Hypoxia Shortage in the oxygen supply to body cells especially the brain and the heart Other components of Cigarettes: Ammonia: causes irritation in eyes and upper respiratory tract Hydrogen Cyanide: highly toxic 8/24/2005

Passive Smoking Passive smoking is when a non-smoking person inhales smoke involuntarily; this is also called second hand smoking Passive smoking effects on health is similar to active smoking effects Passive smoking effects on children: Asthma Respiratory infections Acute and chronic otitis media 8/24/2005

How does smoking cause addiction? Nicotine absorbed from the cigarettes binds to receptors located in the brain This binding causes the release of Dopamine, acetylcholine… For detailed information on addiction: <a href=“ http://www.txtwriter.com/Onscience/Articles/addictingkids.html”>txtwriter</a> 8/24/2005

Farming and the manufacture of tobacco in Jordan Tobacco plantations take up 1% of Jordan’s farming land and approximately 1,500 farmers work on these plantations There are six domestic companies in Jordan that manufacture tobacco 8/24/2005

Smoking in Jordan 21% of teenagers that are between the ages 13-15 smoke: 15% female 25% male 25% of teenage smokers smoke in the house 25% of nonsmokers have the potential to smoke 8/24/2005

Reasons for smoking in Jordan Smoking is one of the most negative habits among teenagers and adults in Jordan Why do Jordanian teenagers smoke: They believed that smoking gives attractive appeal especially that the cigarettes advertisements are always about nice looking young man holding cigarettes or smoking Like imitating adults Because tobacco products are easy to get 8/24/2005

Legislations to prohibit selling cigarettes to minors Fighting Smoking Focusing on the early stages of life to ensure that they don’t smoke when they grow older Legislations to prohibit selling cigarettes to minors It is necessary to focus on the early stages of life because: Behaviors originate from values. Therefore, it is important to develop healthy values at younger ages Behavior modification is easier and more effective at early stages compared to later stages of life In addition, smoking can be lessened by: Activating the laws that prohibit smoking in public areas Smoke-free transportations Smoke-free schools Not smoking in homes or in cars 8/24/2005

Fighting Smoking The development of governmental and non- governmental organizations to help those who want to quit smoking In 2003, the Jordanian Ministry of Health established a smoking cessation clinic. This clinic’s functions are: Encouraging smokers to quit smoking Providing smokers with nicotine alternatives (such as nicotine gum and nicotine filters) that aid smokers quit smoking. Form support groups of ex-smokers Provide health education about consequences of smoking In addition, the Jordanian National Anti-Smoking Society, which is a non-governmental organization, is also complementing the Ministry of Health in campaigning against smoking especially at the primary level of prevention 8/24/2005

Fighting Smoking The Jordanian legislative priorities: Public health promotion Anti-smoking general laws in Jordan: Prohibition of cigarette advertisement Cigarette packs must have warning labels on them. Article 64 for the year 1977 calls for: Prohibition of smoking in public areas Prohibition of manufacturing candy that look like cigarettes Minors behavior surveillance law for the year 2003 forbids the minors from: Buying any of tobacco products for self or others Smoking tobacco or argeelah 8/24/2005