1. Chapter 9
Rejecting Tobacco Use

2. Tobacco
When burned – produces 4000 chemical compounds, hundreds known to be physiologically active, toxic and carcinogenic…others unknown
Smoking causes 440,000 US deaths per year- 1 out of every 5 deaths.
November 1998 – states settled with tobacco industry to pay $206 billion (over 25 years) to reimburse states for Medicaid expenditures associated with treating smoking related illnesses, PSA and education.
Advertising approaches – now to young, minority males and females (market shares)
Tobacco industry under fire
Pipe and cigar smoking

3. Why is Smoking So Prevalent Among College Students?
Many college smokers do not connect their smoking behaviors with health consequences. Although they knew the long-term risks, 25% of community college students surveyed did not believe their smoking habits affected their health in any way, and 50% thought quitting would bring them little or no health benefit (Allen, 2004)

4. Development of Dependence
Physiological factors
Nicotine as an addictive drug
Physiologically active, dependence-producing drug found in tobacco
Psychosocial factors
Modeling
Manipulation
Susceptibility to advertising

5. Two Phases -
Particulate Phase
Gaseous Phase

6. Particulate phase Two Phases - #1
Portion of the tobacco smoke composed of small suspended particles
Nicotine
Tar
Water

7. Particulate phase Nicotine
Physiologically active, dependence-producing drug found in tobacco.
Stimulant
Increases blood pressure and heart rate
Increases production of adrenalin
Causes blood vessels to narrow
Increases respiration
Causes release of glycogen from liver = “kick”
Blood vessel narrowing causes decreased skin temperature and increased BP

8. Particulate phase Tar Water Sticky brown substance
Contains carcinogens
Interferes with normal cilia function in the lung
Water
Tar contains carcinogenic hydrocarbons known as polycyclic aromatic hydrocarbons (PAH). Benzo (a) pyrene (a PAH) has been inked with specific genes that cause lung cancer.

9. Tar contains carcinogenic hydrocarbons known as polycyclic aromatic hydrocarbons (PAH). Benzo (a) pyrene (a PAH) has been inked with specific genes that cause lung cancer.

10. In healthy lung
Suspended particles trapped in mucus
Cilia sweeps mucus upward
Mucus is then swallowed and digested
In smoker’s lung
Cilia damaged, can’t sweep and tar remains in airway
Tar increases mucus production, hence “smoker’s cough”
Changes in basal cell layer
Increase work for heart – decrease O2 in blood

12. Gaseous phase Two Phases - #2
Portion of the tobacco smoke containing carbon monoxide, carbon dioxide, ammonia, hydrogen cyanide, isoprene, acetaldehyde, and acetone

13. Gaseous phase Gaseous phase Carbon monoxide
Hemoglobin carries O2 in blood from lungs to tissues
Also carries CO2 from tissues to lungs
CO can also attach to hemoglobin
Carboxyhemoglobin for the rest of its 120 day life
Leads to shortness of breath
CO has strong attraction to hemoglobin (120 day life span).
Non-smoker has approximately 0.5 – 1% carboxHb
Smoker has approximately 5-10%
Presence of excessive levels of carboxhemoglobin in the blood of smokers leads to shortness of breath and lowered endurance

14. Illness, Premature Death, and Tobacco Use
Cardiovascular Disease (CVD)
Nicotine and CVD
Increased platelet adhesiveness
Increases possibility of clots/embolisms
Carbon monoxide and CVD
Nicotine
increases HR, increases blood pressure
Increases platelet adhesiveness
Risk for MI increases 2X
Risk for sudden death increases 4X
1/3 of all CVD can be traced to cigarette smoking
Carbonmonoxide
CarboxHB – this hemoglobin is permanently weaker during 120 day life – with increased activity, there is not enough oxygen for the heart.

17. Proven Health Effects of Tobacco Use
Smoking is associated with CHD, stroke, ulcers, respiratory infections, CANCER of the lung-larynx-esophagus-bladder-pancreas-stomach-uterine cervix, bronchitis, emphysema, early menopause, and still-born & premature births. (CDC)
Smokeless tobacco users and pipe/cigar smokers more susceptible to mouth/esophagus/larynx cancer (NIDA)
College students who smoke have higher rates of respiratory infections and asthma and higher rates of bacterial meningitis (Halperin, 2002)
Women smokers with human papilloma virus are at increased risk of progressing to cervical dysplasia or cancer (Halperin, 2002)
Women who smoke and use oral contraceptives are at higher risk for stroke (Halerpin, 2002)

18. 2nd Hand Smoke
2nd hand smoke causes 35,000 heart disease deaths per year in the US
Non-smokers exposed to 2nd hand smoke have 20% increased risk of heart disease
2nd hand smoke has higher concentrations of ammonia, benzene, nicotine and carbon monoxide. Why?

19. Surgeon General’s Warnings
Quitting smoking now greatly reduces serious risks to your health
Cigarette smoke contains carbon monoxide
Smoking by pregnant women may result in fetal injury, premature birth, and low birth weight
Smoking causes lung cancer, heart disease, and emphysema, and may complicate pregnancy

20. Tobacco and Mental Health Issues
Mental health disorders have strongly associated with smoking, especially among young people (NIDA,2002)
25 year study
Heavy smokers= 6 x more likely for anxiety disorder, 15 x more likely for panic disorders
College students who are daily smokers are more than 5 times more likely to seriously contemplated suicide or tried it than non-smokers (Brown, 2004)

21. Tobacco Use and Lower Academic Performance
Smokers have lower GPA than non-smokers
Daily smokers were found to have even lower GPAs than high-risk drinkers (Halperin and Eytan, 2004)

22. What about Tobacco Use and Sexual Behavior?
College students who are smokers are 50% more likely than nonsmokers to have had two or more sexual partners in the last month (Rigotti, 2000)
Even light smokers are over 3 times more likely to participate in high-risk sexual behavior than non-smokers (Halperin and Eytan, 2004)

23. Smokeless tobacco use Warnings: This product may cause mouth cancer
This product may cause gum disease
This product is not a safe alternative to cigarette smoking

24. College Students and Quitting
Most college students want to quit smoking- 2/3 of current college smokers have tried to quit but can’t (Bernardo, 2001)
A national college survey found that 82% of daily smokers tried to quit and 75% of those smokers were still smoking (Wetter, 2004)
College students as “Social Smokers”, many times leads to addiction