1. Young People and Smoking
Public Health, Tobacco Team

2. Aim
To increase young people’s awareness of the harmful effects of smoking/tobacco.

3. Objectives To be more aware of the risks of smoking/tobacco use.
To be aware of the effects of secondhand smoke
To know where to get advice and support.

4. QUIZ

5. Most young people smoke
Ask: Is this true or false?

6. False
False: The percentage of regular smokers aged (in England) was only 3% in 2013.
National research shows that in 2013 around 100,000 children aged were regular smokers; about 20,000 fewer than in 2012.
The annual Government survey of smoking among secondary school pupils in England defines regular smoking as smoking at least one cigarette a week.
The decline in smoking has been most marked among older pupils. The proportion of 14 year olds who smoked regularly fell from 13% in 2006 to 4% in 2012; among 15 year olds, 8% smoked regularly in 2013, compared with 20% in 2006.
In Bradford, recent research shows that smoking experimentation was rare among younger pupils, with 1% of Year 4 and Year 7 children reporting they were a regular smoker. A third of pupils in Year 10 had tried smoking and 10% reported smoking regularly.

7. More girls than boys smoke
Ask: Is this true or false?

8. False
True. But…. in 2013, similar proportions of boys and girls were regular smokers (3% and 4% respectively). In Bradford this is similar with (10% boys and 9% girls – year 10). So although there is a difference, it is negligible. Basically a small difference.

9. Nicotine is the harmful substance in cigarettes
Ask: Is this true or false?

10. False
False: It is not nicotine, but the thousands of toxins present in tobacco and its products that are responsible for the vast majority of diseases linked to smoking.

11. It is illegal to sell cigarettes to any person under the age of 18
Ask: Is this true or false?

12. True
True: It was made illegal in October 2007.

13. National Tobacco Use Epidemiology of tobacco use:
19% of adult population in England smoke
Majority of smokers start in their teens
More men than women smoke, but the gap is narrowing (21% Men 19% Women)
those from a lower social economic group are more likely to smoke
smokeless tobacco is mainly used by South Asian community groups
19% of the adult population in England smoke: In Bradford this is 22%. However, across Bradford district there are wards and communities with significantly higher rates of smoking e.g. Keighley West and Tong 28%, Pakistani men and Bangladeshi men 56%.
Majority of smokers start in their teens: About 80% of smokers started smoking in their teens. Children who live with parents or siblings who smoke are up to 3 times more likely to become smokers themselves than children of non-smoking households. It is estimated that, each year, at least 23,000 young people in England and Wales start smoking by the age of 15 as a result of exposure to smoking in the home.
Smokeless tobacco is mainly used by South Asian community groups. Over 30 different types of products such as paan, zarda, gutkha. These may be sucked or chewed or placed in the mouth. Chewing tobacco is associated with a range of diseases including an increased risk of cardiovascular disease and oral cancer.

14. Young People and Smoking
Every year more than 205,000 children in the UK start smoking.
Among adult smokers, two-thirds took up smoking before the age of 18 and over 80% before the age of 20
Almost two-fifths of adults (40%) had started smoking regularly before the age of 16.
Just to clarify, most people start smoking when they are in their teens!

15. What factors influence young people to smoke?
Parents and siblings smoking.
Ease of obtaining cigarettes.
Friends smoking.
Socio-economic status.
Exposure to tobacco marketing.
Films, television and other media.
Habit, addiction, to cope.
Peer pressure
Socio economic refers to the costs and availability. Political decisions also play a major role in terms of age at which young people can buy cigarettes. Government action including banning tobacco advertising, putting large health warnings on packs and making all enclosed public places smoke-free plays a major role.
Research also suggests that children's attitudes towards smoking are "considerably" healthier than a decade ago.

16. Additives and Chemicals
What’s in a cigarette
Nicotine
Tar
Carbon monoxide
Additives and Chemicals
Nicotine, an alkaloid, is an extremely powerful drug. Nicotine is contained in the moisture of the tobacco leaf:
When the cigarette is lit, it evaporates, attaching itself to minute droplets in the tobacco smoke inhaled by the smoker.
It is absorbed by the body very quickly, reaching the brain within seconds (OR LESS).
“Tar”, also known as total particulate matter, is inhaled when the smoker draws on a lighted
cigarette. In its condensate form, tar is the sticky brown substance which can stain smokers’
fingers and teeth yellow-brown.
Carbon monoxide, the main poisonous gas in car exhausts, is present in all cigarette smoke.
Additives are used to make tobacco products more acceptable to the consumer. They include
humectants (moisturisers) to prolong shelf life; sugars to make the smoke seem milder and
easier to inhale; and flavourings such as chocolate and vanilla. While some of these may
appear to be quite harmless in their natural form they may be toxic in combination with other
substances. Also when additives are burned, new products of combustion are formed and
these may be toxic.

17. Some of the 4000 chemicals
A cigarette may look harmless enough but they contain a dangerous cocktail of about 4,000 chemicals including:
More than 70 cancer causing chemicals
Hundreds of other poisons
Many additives are designed to make cigarettes taste nicer and keep smokers hooked.
The tobacco industry adds hundreds of additives to cigarettes to make it easier to smoke and more appealing.
They vary by brand and can include chocolate, vanilla, menthol, peppermint, sugar, liquorice, herbs and spices.
They may not be harmful themselves but they help to overcome the initial off-putting taste that new smokers often experience.
Some additives have been used to make the smoke less visible, while others mask the smell, including vanilla, cinnamon, coffee extract and nutmeg oil.

18. Smokeless Tobacco Another way to use tobacco
Used mainly by the south Asian communities
Chewing/smokeless tobacco is associated with oral cancer, pancreatic cancer, other pathologies
As mentioned, used mainly by the south Asian community.
40% will have changes in mouth e.g. oral cancer
Used by:
9% Bangladeshi men, 16% women
2% Pakistani men, 1% women
4% Indian men, 1% women

19. Some more examples of smokeless tobacco products used in South Asian Communities
Qiwan
Khaini
20% of high school boys use smokeless tobacco. 2% of high school girls. (Kids Health Website)
Young generation tend to use Ghutka, which is processed tobacco with added sweeteners. Khaini is tobacco, slaked lime paste, sometimes areca nut. Qiwan is another manufactured smokeless tobacco product with various additives such as sweeteners and flavours. Basically tobacco is tobacco and it is harmful.

20. Shisha smoking
Often seen as attractive, cool, trendy or whatever words young people use.

21. Water Pipes Delivers nicotine Addictive
Tobacco leaves, molasses, vegetarian glycerine and flavours are added.
Sessions last longer than cigarette smoking causing increased levels of smoke being inhaled (Equivalent to 100 cigarettes.
Higher levels of cancer causing chemicals and carbon monoxide
Go through slide

22. Shisha Smoking shisha is NOT safer than cigarettes.
Tobacco-free shisha is not safe – smokers can inhale dangerous levels of carbon monoxide.
Shisha smoking can damage your health
Smoking shisha through bubbling water will not filter out dangerous toxins.
1 hour of smoking shisha = inhaling up to 200 times the volume of smoke in 1 cigarette.
Smoking a shisha mouthpiece can spread diseases.
Shisha tobacco contains highly addictive nicotine.
Fruit flavours disguise the harmful tobacco in shisha.
Shisha smoking can damage your health.

23. Risks of smoking/tobacco use
In England in 2011, around 79,100 deaths were estimated to be caused by smoking-related illness. (Among adults aged 35 and over)
Smoking causes about 90% of lung cancers.
Smoking damages your heart and your blood circulation, increasing the risk of conditions such as: coronary heart disease, heart attack, stroke
Smoking damages your lungs, causing conditions such as: chronic bronchitis, emphysema, pneumonia
Smoking can also worsen or prolong the symptoms of respiratory conditions, for example: asthma

24. Smoking and children’s health
The younger the age of uptake of smoking, the greater the harm is likely to be.
Child and adolescent smoking causes serious risks to respiratory health both in the short and long term.
Teenage smokers experience more asthma and respiratory symptoms, suffer poorer health, have more school absences and are less fit.
Smoking will also:
Make your hair smell.
Your teeth and nails turn yellow and disgusting and your breath stinks.
You cannot taste or smell things very well.

25. What is Secondhand smoke?
Also known as environmental tobacco smoke (ETS)
Secondhand smoke is made up of two types of smoke
mainstream smoke is smoke breathed in and out by smokers
side stream smoke comes from the end of a burning cigarette or cigar.

26. Exposure to secondhand smoke
In 2012, two thirds (67%) of pupils reported being exposed to secondhand smoke with 55% experiencing secondhand smoke in other people’s homes and 43% in their own home.
Over a quarter of pupils (26%) experienced secondhand smoke in their family car while 30% of pupils were exposed in other people’s cars
2013 Bradford Health and Lifestyle Survey shows 15% of young people were exposed to secondhand smoke in the home. As high as 24% in year 10.
2010 this was 19%

27. Secondhand smoke affects us all
Secondhand smoke can linger for two and half hours, even with a window open
you never know where it is, because 85% of it is invisible
95% of deaths associated with secondhand smoke are from exposure in the home
Non- smokers exposure to secondhand smoke
In children:
Respiratory Disease
Cot death
Middle ear disease
In adults increase risk of :
Lung cancer by 24%
Heart disease by 25%

29. Images on packets of cigarettes.

31. What are the Benefits of quitting tobacco?

32. Benefits of quitting tobacco
20 minutes blood pressure and pulse return to normal
8 hours blood oxygen levels return to normal
24 hours carbon monoxide leaves your body
48 hours body is nicotine free
72 hours breathing is easier, more energy
2-12 weeks circulation has improved
3-9 months lung efficiency is up by 5-10%
5 years risk of heart attack is halved
10 years chance of getting lung cancer is halved

33. Help
FREE confidential help and advice to stop smoking is available from:
School Nurse
Local NHS stop smoking services e.g. GP, Pharmacy
Bradford District Stop Smoking Service

34. NHS Helpline
NHS Pregnancy Helpline
Bradford District Stop Smoking Service