1. Health Consequences of Tobacco Use Created by the Registered Nurses’ Association of Ontario

2. Smoking-related death rates In Canada more than 47,000 people per year die prematurely due to tobacco use (Health Canada, 2008) The average person who smokes will die about eight years earlier than a similar non-smoker

3. Tobacco-related Cancers Smoking causes cancer of the: ◦Lung (80-85 % of cases), Oral cavity, Pancreas, Larynx, Kidney, Esophagus, Bladder (30-40 % of cases) Smoking linked to cancer of the large intestine & some forms of leukemia Smoking causes 21,000 deaths from cancer per year in Canada (30% of cancer deaths) Smokeless tobacco (chew tobacco, snuff etc.) is a major cause of cancer of the mouth

4. Risk of Developing Cancer Risk of developing cancer increases with: Duration of smoking Number of cigarettes per day Degree of inhalation Risk of lung cancer is significantly reduced with smoking cessation

5. Effects of Smoking on the Cardiovascular System Smoking: Is a dominant cause of heart disease, stroke & diseases of the blood vessels Causes about 30% of all heart disease deaths Accounts for about ¾ of all cases of peripheral vascular disease As a result of smoking, each year in Canada: More than 17,600 cardiovascular deaths More than 2,000 deaths from stroke Many of these deaths occur prematurely (before age 70)

6. Effects of Smoking on the Cardiovascular System Incidence of coronary heart disease (CHD) is 2 to 4 times greater in smokers Smoking is a major risk factor for heart attacks and sudden cardiac death Smoking acts synergistically with other risk factors (ex. high cholesterol & blood pressure) to increase the risk of CHD Quitting smoking substantially reduces the risk of CHD and stroke

7. Pulmonary Diseases related to tobacco use Smoking is responsible for more than 8,000 deaths from respiratory diseases per year in Canada Smoking depresses the body’s immune system & other defense mechanisms Smokers are at increased risk for respiratory infections compared to non- smokers Smoking may increase susceptibility to the common cold

8. COPD Chronic Obstructive Pulmonary Disease (COPD)  Chronic bronchitis  Chronic airway obstruction  Emphysema & related disorders Smoking accounts for 80% – 90% of all COPD deaths

9. Effects of Smoking on Pregnancy, Newborns and Breastfeeding Bleeding during pregnancy Ectopic pregnancy ◦fertilized egg implants outside of uterus Miscarriage Premature delivery Stillbirth Abnormalities of the placenta

10. Effects of Smoking on Pregnancy, Newborns and Breastfeeding Babies born with low birth weight (less than 2500 g) Babies receive nicotine & carbon monoxide from mother’s blood May contribute to Sudden Infant Death Syndrome (SIDS) Nicotine & other chemicals get into breast milk Decreased quantity of breast milk

11. Effects of Smoking on Early Childhood Increased risk of allergies Higher blood pressure in childhood Increased likelihood of obesity Stunted growth Poorer lung function Increased likelihood of asthma

12. Effects of Smoking on Client/Patient Recovery Smoking can effect recovery from illness & surgery Ex. Increased recovery time for patients who smoke Examples:  Smoking increases the risk of recurrence in persons who have survived a heart attack  Ulcers heal less readily and are more likely to recur

13. Other Health Risks Gastrointestinal problems - Ulcers - Chronic Bowel Disease - Crohn’s Disease Type 2 diabetes - 50 % increased likelihood of getting Type 2 diabetes Rheumatologic conditions - Rheumatoid arthritis Cataracts Orthopedic conditions - Osteoporosis Skin conditions - Contact allergies Kidney damage - Worsens kidney problems for patients/clients with diabetes, high blood pressure etc. Tooth and gum problems - Oral cancer - Tooth loss, decay - Periodontal (gum) disease

14. Additional Hazards For men: Erectile dysfunction Fertility may be impaired For women: Risk for cervical cancer Early menopause Increased menstrual disorders Fertility may be impaired Smoking and the use of oral contraceptives greatly increases the risk of stroke, heart attack and other vascular complications

15. Health Risks of Second-hand Smoke Exposure to second-hand smoke causes the following diseases and conditions: ◦In adults:  Heart disease  Lung cancer  Nasal sinus cancer ◦In children:  SIDS  Fetal growth impairment  Bronchitis, pneumonia & other lower respiratory tract infections  Asthma exacerbation  Middle ear disease  Respiratory symptoms

16. Health Risks of Second-hand Smoke Also linked to: ◦In adults:  Stroke  Cervical cancer  Breast cancer  Miscarriages ◦In children: Adverse impact on cognition and behaviour Decreased lung function Asthma induction Exacerbation of cystic fibrosis

17. Strategies to Include Tobacco Use in Health Assessment Expand the area where vital signs are recorded to include tobacco use or use an alternative universal identification system. Example: Simply ask all patients, "Do you smoke or have you ever smoked?, Are you exposed to second hand smoke at home?", and note their response in the chart.

18. Strategies to Include Tobacco Use in Health Assessment Expand the area where vital signs are recorded to include tobacco use or use an alternative universal identification system. ◦ Simply ask all patients, "Do you smoke or have you ever smoked?, Are you exposed to second hand smoke at home?", and note their response in the chart. Example: