Smoking Tobacco Chapter 13

History of Tobacco ► Tobacco - Nicotiana Tabacum and Nicotiana Rustica ► Smoking practiced among the early Mayas, probably in the district of Tabasco, Mexico, as part of their religious ceremonies AD ► Europeans first exposure from Columbus 1492 ► 2Spread throughout Europe during the s ► By Elizabethan times addictive potential was apparent ► 1633 Turkish Sultan mandated death to smokers ► Late 1800s cigarette smoking became popular ► Link to cancer established during 1960s

Tobacco – Drug Administration ► The active psychotropic drug in tobacco is nicotine ► Nicotine is an acetylcholine agonist ► Nicotine in tobacco can be administered into the blood stream via, eating, snorting, contact w/mucous membranes and SMOKING ► Smoking is the most common route of administration  Pipes  Cigars  Cigarettes

Smoking and the Respiratory System

The Respiratory System ► Air flows in through the  nasal passages  pharynx  larynx  trachea  bronchi and bronchioles ► Smoke is drawn through the mouth and into the respiratory system

The Respiratory System ► Diaphragm and intercostal muscles contract to increase volume of chest. ► Resulting loss in pressure causes air to flow in

The Respiratory System ► Gas exchange occurs in the alveoli ► Alveolus A tiny, thin- walled, capillary-rich sac in the lungs where the exchange of oxygen and carbon dioxide takes place. In this sense, also called air sac.

The Respiratory System - Gas Exchange ► Bubbles with thin skin ► Diffusion pressure leads carbon dioxide to move from the blood and oxygen into the blood.

Smoking and Disease ► Cardiovascular Disease ► Cancer ► Chronic Obstructive Pulmonary Disease ► A Host of Other Fun Stuff

Cardiovascular Disease ► Primary cause of smoking related deaths ► Smoking leads to a relative risk of 2.0 for CVD ► Speeds plaque formation (Atherosclerosis) ► Nicotine increase cardiovascular strain

Cancer ► Lung, lip, mouth, pharynx, esophagus, pancreas, esophagus, pancreas, larynx, trachea, bladder and kidney ► 9.0 relative risk for smoking and cancer ► Primary contributor to lung cancer deaths ► Cigarettes contain at least 43 distinct cancer-causing chemicals.

Chronic Obstructive Pulmonary Disease ► COPD  Emphysema  Chronic Bronchitis ► Frequently coexist, thus physicians prefer the term COPD ► Fourth leading cause of death in the U.S.

Chronic Obstructive Pulmonary Disease ► Approx. 80 to 90 % of COPD cases are caused by smoking ► Relative risk = 10.0

Chronic Bronchitis ► Chronic bronchitis is an inflammation and eventual scarring of the lining of the bronchial tubes. ► An estimated 14 million people suffer from chronic bronchitis, the seventh leading chronic condition in America.

Chronic Bronchitis ► Symptoms of chronic bronchitis include:  chronic cough, increased mucus  frequent clearing of the throat  shortness of breath.

EmphysemaEmphysema ► Emphysema causes irreversible lung damage. The walls between the air sacs within the lungs lose their ability to stretch and recoil. They become weakened and break. ► Elasticity of the lung tissue is lost, causing air to be trapped in the air sacs and impairing the exchange of oxygen and carbon dioxide.

EmphysemaEmphysema ► Symptoms of emphysema include cough, shortness of breath and a limited exercise tolerance. ► Diagnosis is made by pulmonary function tests, along with the patient's history, examination and other tests.