1. Chapter 9 Rejecting Tobacco Use
Personal Health
Chapter 9
Rejecting Tobacco Use

2. Advertisement & Prevelance
Do tobacco ads target kids?
Master Settlement Agreement
Table 9.1
Table 9.2

3. Smoking Among College Students
Recent study showed 31.4%
Some studies show a link between heavy smoking and not completing either high school or college.
Is there a link between heavy smoking and dropping out of high school?

4. Other Demographic Factors
Gender, race, ethnicity and education level
Also:
Age – as the age groups go up in age smoking goes down
Region of the country – northcentral 26%, west 20%, south 25.4%, northeast 23.9%
Size of the community – outside metro 30.5%, small metro 27.2, large metro 26.5
Employment status – part-time 31.2%, full-time 25.5%, unemployed 48.2%

5. Marketing of Tobacco Products
Smoking is a learned habit.
Do advertisements act as a source of behavior to be modeled?
They must because they work.
Advertisements entice new smokers in sufficient numbers to replace the 3000 smokers who die each day.
What has changed in the advertising of tobacco products over the last 10 years?

6. Pipe and Cigar Smoking
Many people believe that pipe and cigar smoking is a safe alternative to cigarette smoking.
See Star Box 283
Still fewer people smoke pipes and cigars.
Starting to see an increase in the number of women who smoke cigars.
Any big media advertisements for cigars?

7. Tobacco Use and the Development of Dependence
Dependence – a physical and/or psychological need to continue the use of a drug
Titration – the particular level of a drug within the body; adjusting the level of nicotine by adjusting the rate of smoking
Dependency to tobacco is easily established.
Of the people who experimented, 85% develop various aspects of a dependence relationship
Some people fear the consequences of stopping.

8. Tobacco Use and the Development of Dependence
Full-time smokers
Social smokers or chippers
Part-time smokers – 20% of the smoking population

9. Theories of Nicotine Addiction
Genetic influences – they do exist
Initial smoking is 60% driven by genetic influences
Not so much the genetic predisposition to try smoking, but more of a genetic predisposition to neurohormonally “appreciate” the stimulating effects of nicotine.
Bolus Theory – each inhalation of smoke releases into the blood a concentrated quantity of nicotine that reaches the brain & results in a period of neurohormonal excitement

10. Theories of Nicotine Addiction
Adrenocorticotrpoic Hormone )ACTH) Theory – suggests that nicotine stimulates the release of ACTH from the anterior pituitary gland causing a release of beta endorphins
Self-Medication Theory – through the effects of mood-enhancing dopamine smokers can treat feelings of tiredness, lack of motivation or even depression

11. Acute Effects of Nicotine on Nervous System Function
Nicotine starts out producing a stat of general arousal by causing the release of norepinephrine, dopamine, scetylcholine and serotonin.
Heavy use eventually produces a blocking effect as more and more receptor sites for these neurotransmitters are filled.
The result is a generalized depression of the CNS.

12. Non-Nervous System Acute Effects
Nicotine affects the transmission of nerve signals at the neuromuscluar junction by mimicking the action of the neurotransmitter acetylcholine.
Nicotine prevents the transmission of nerve impulses from nerve cell to muscle cell.
The release of epinephrine results in an increase in respiration rate, heart rate, blood pressure & coronary blood flow.

13. Non-Nervous System Acute Effects
Also, constriction of the blood vessels beneath the skin, reduction in the motility in the bowels, loss of appetite and changes in the sleep patterns.

14. Psychosocial Factors Related to Dependence
Many of these influences support the dependence process before the onset of the physical addiction.
Modeling – susceptible people smoke to emulate smokers whom they admire or with whom they share other types of bonds
Advertisements for tobacco must use models who are 21 years old
Yet they use models who look much younger

15. Psychosocial Factors Related to Dependence
Manipulation – cigarette use may meet the beginning smokers need to manipulate something & at the same time provide the manipulative tool necessary to offset boredom
Susceptibility to Advertising – the media has paired suggestions of a better life with the use of its products
To the users & potential users, the self-reward of power, liberation, affluence, sophistication, or adult status is achieved by using the products that they are told are associated with these desired states.

16. Preventing Teen Smoking
The tobacco industry used to intentionally target youths with its advertising and marketing campaigns.
5 policies aimed at reducing the percentage of adolescent smoking to no more than 16% by 2010, pg 289.
Which of these do you think will have the greatest effect?

17. Early Childhood Intervention
Some people believe that you should start educating your children as preschoolers.
Suggested activities as opposed to facts for preschoolers, K-3, and preteen years pgs

18. Tobacco: The Source of Physiologically Active Compounds
With each puff of smoke, the body is exposed to approx. 4,700 chemical compounds.
An annula 70,000 puffs taken in by the on-pack-a-day cigarette smoker results in an environment that makes the most polluted urban environment seem clean by comparison.
Table 9.3

19. Tobacco: The Source of Physiologically Active Compounds
Particulate Phase – portion of the tobacco smoke composed of small suspended particles
Includes – nicotine, water, and a variety of powerful chemicals collectively known as tar
Gaseous Phase – portion of the tobacco smoke containing carbon monoxide and many other physiologically active gaseous compounds

20. Tobacco: The Source of Physiologically Active Compounds
60 of these compounds have been determined to be carcinogens or co-carcinogenic promoters
Carbon monoxide is the most damaging compound found in this component of tobacco smoke
Carbon monoxide can inactivate red blood cells
Can cause brain function to eventually be reduced, reactions and judgment are dulled and cardiovascular function is impaired

21. Illness, Premature Death & Tobacco Use
Two-pack-a-day smokers can expect to die 7-8 years earlier.
Smoking is responsible for nearly 440,000 premature deaths each year
Table 9.4

22. Illness, Premature Death & Tobacco Use
Cardiovascular Disease
Tobacco use is clearly one of the major contributing factors
Smoking more than doubles the risk of a myocardial infarction
2-4 times more likely to have a sudden cardiac death
Nicotine increases the heart rate, which increases cardiac output, which increases blood pressure.
Nicotine also increases blood platelet Adhesiveness.

23. Illness, Premature Death & Tobacco Use
Cancer – tobacco use is a significant factor in the development of virtually all forms of cancer and the most significant factor in cancers involving the respiratory system
During 2004 an est. 1,372, 910 Americans developed cancer, equally divided between men and women, leading to 570,280 deaths
30% of all cancer cases are heavily influenced by tobacco use.

24. Additional Health Concerns
Poor state of nutrition
Decline in insulin sensitivity
Decline in short-term memory
Gradual loss of the sense of smell
Premature wrinkling of the skin
More likely to experience strokes
Lose bone mass leading to osteoporosis

25. Additional Health Concerns
Experience more back pain and muscle injury
Find that fracture heal more slowly
Spend more time in the recovery room after surgery
Greater risk of developing serious gum disease
May need supplementation for vitamins C and B

26. Smoking and Reproduction
Infertility – smoking reduces the level of fertility in both men and women
Men – sperm degradation and erectile dysfunction
Women – abnormal ovum formation, negatively influences estrogen levels
Problem Pregnancy – problems during the pregnancy are a result of the carbon monoxide and nicotine exposure; hypoxia
Miscarriage, stillborn, premature birth
Low birth weight

27. Smoking and Reproduction
Breast feeding – nicotine will appear in breast milk; will then have the same effects
Neonatal health problems – babies born to mothers who smoked during pregnancy are:
Shorter and have a lower birth weight
Elevated rate of SIDS
More likely to develop chronic respiratory problems
More frequent colic
Be hospitalized and have poorer overall health early
Behavioral issues

28. Oral Contraceptives and Smoking
Women who smoke and use oral contraceptives, particularly after age 35 are placing themselves at a much greater risk of experiencing a fatal cardiovascular accident.
This risk increase further for women over 40.
Women who smoke and use oral contraceptives are 4 times more likely to die from a heart attack.

29. Combining Tobacco and Alcohol Use
Young people are more likely to use other drugs.
Instead of dealing with the negative consequences of one issue you now have to deal with both.

30. Smokeless Tobacco Use
Nicotine is absorbed through the mucous membranes in the mouth.
Chew
Snuff
Major cause of periodontal disease and cancer.
Not just in the mouth but also the throat, stomach and digestive tract.

31. The Risks of Involuntary Smoking
Mainstream smoke – is inhaled and then exhaled by a smoker
Sidestream smoke – comes from the burning end
Sidestream smoke is responsible for 85% of the harmful substances associated with second hand smoke exposure.
Involuntary smoke exposure may be responsible for 35,000 – 40,000 premature deaths per year from heart disease among non-smokers.
Because of this there are new laws.

32. New Product Development
Eclipse – a cigarette that heats rather than burns most of its tobacco
Accord – intended to reduce the production of sidestream smoke
Advance – cigarettes with Trionic filters supposedly capable of extracting more toxins
Omni – advertised to significantly reduce selected carcinogens

33. New Product Development
Quest – intended to lead smokers to nicotine free smoking
Reduced-ignition-propensity – self-extinguishing cigarettes
Flavored cigarettes?

34. Nontobacco Sources of Nicotine
Multiple flavors of nicotine suckers
Nicotine flavored gum
Nicotine straws
Nicotine enhanced water
Inhalers, sprays, drops, lozenges and transdermal patches
Are these products intended to aid smokers in quitting smoking or something else?

35. Stopping What You Started
Knowledge
Recognition
Familiarity
Belief
Certainty
Figure 9-2 and Changing for the Better pg 303
Gum, patches, hypnotism, counseling, exercise, prescription meds

36. Tobacco Use: A Question of Right
Is it your right as a free American, adult, to choose whether you smoke?

37. Tobacco Use: A Question of Right
Is it our right as Americans to have laws to are aimed at protecting minors?

38. Tobacco Use: A Question of Right
Is it our right as Americans to limit where a smoker can smoke?

39. Tobacco Use: A Question of Right
Do we do the same thing with Alcohol?