1. Tobacco / Nicotine

2. Introduction  Smoking most avoidable cause of death  1,000 Americans die each day due to tobacco related diseases – 1 in 6 deaths smoking related  Tobacco companies spend 50 times more $$ in advertising than the government does in anti-smoking ads  Should advertising be banned?  Why do people begin smoking?

3. Pharmacology  Nicotine is the addictive substance  Administration  Inhalation  Sublingual  Absorption – directly into bloodstream  Affects brain & CNS  Action  Causes a release of norepinephrine – stimulant  Affects catecholamine – affects HR & BP  Nicotine at high levels act as a depressant  50% of nicotine is metabolized in 30 min.

4. Physiological Effects  Physiological effects  Increase heart rate  Increase blood pressure  Increase breathing rate  Increase cardiac output  Increase brain activity – increase concentration, memory  Decrease appetite  Psychological effects?

5. Addiction  Physical  Need to maintain a functional level of nicotine  Psychological  Withdrawal symptoms  Craving, irritability, anxiety, restlessness, difficulty concentrating, change in appetite  Peak at 1-2 days  Negative reinforcement

6. Adverse Effects  Cardiovascular  Most modifiable risk factor for H.D.  Due to carbon monoxide buildup  Atheroscherosis  Respiratory  Damage to cilia  Chronic Obstructive Lung Disease – emphysema, bronchitis  Cancer  Lung cancer  Other cancers

7. Benefits of Quitting  Box 8.8 p. 182  Decrease risk of cancer  Increase life expectancy  Decrease risk of stroke, chronic cough  Save $$$$  Concerns of quitting  Gain weight

8. To Quit Smoking  Knowledge about health risks  Recognition that health risks are applicable  Familiar with steps to quit  Patch/gum  Support/encouragement  Learn to handle stress/urges  Decrease risk factors  Belief that benefits outweigh the pleasure  Certainty that one can start and maintain behavior required to stop

9. Smokers Rights  Environmental tobacco smoke (ETS) – Passive smoke  Class A carcinogen  Mainstream smoke  Sidestream smoke  S/S – stress, discomfort, cough, wheeze, allergy  Is restricting cigarettes (smoking) legal?

10. Smokeless Tobacco  Chewing tobacco & snuff  1.8 million users – mostly young males, athletes  Nicotine w/o exposure to CO & tar  Same physiological effects as smoking  Time-released absorption  Other health problems  Gum disease, damage to enamel  “Leukoplakia”  Risk of oral, gum, & cheek cancers  Smokeless tobacco doesn’t injure others