1. Smoking

2. Smoking…… Tobacco has been known and used for centuries: It can be snuffed; It can be snuffed; It can be chewed; It can be chewed; It can be placed between gum& lips; or It can be placed between gum& lips; or It can be smoked. It can be smoked.

3. Smoking…… The most popular method of tobacco use is smoking → cigarettes became popular in the early 1900s-before this time tobacco was usually chewed or smoked in pipes.

4. Annual Deaths Attributable to Smoking in the United States

5. Tobacco Products Cigarettes Cigarettes Cigars – contains 23 poisons, 43 carcinogens Cigars – contains 23 poisons, 43 carcinogens Bidis – small hand-rolled, flavored cigarettes, contain 3 times more CO and nicotine, and 5 times more tar than cigarettes Bidis – small hand-rolled, flavored cigarettes, contain 3 times more CO and nicotine, and 5 times more tar than cigarettes Smokeless tobacco Smokeless tobacco Chewing tobacco Chewing tobacco Snuff Snuff

6. Effects of tobacco smoking: nicotine. The primary drug in tobacco is nicotine. There is 1-2 mg nicotine in one cigarette and 90% of this amount being absorbed when inhaled. There is 1-2 mg nicotine in one cigarette and 90% of this amount being absorbed when inhaled.

7. Tobacco And Its Effects Smoke contains 4,700 chemical substances Smoke contains 4,700 chemical substances Nicotine – chemical stimulant Nicotine – chemical stimulant nicotine impairs the cleansing function of cilia nicotine impairs the cleansing function of cilia Tar – condensed particulate matter from smoke that accumulates in the lungs Tar – condensed particulate matter from smoke that accumulates in the lungs Phenols – chemical irritant in smoke that may combine with other chemicals to contribute to the development of lung cancer Phenols – chemical irritant in smoke that may combine with other chemicals to contribute to the development of lung cancer Carbon monoxide – tobacco smoke contains 800 times the level considered safe by the U.S.E.P.A Carbon monoxide – tobacco smoke contains 800 times the level considered safe by the U.S.E.P.A

8. Physiological Effects Of Nicotine Nicotine is a powerful central nervous system stimulant Nicotine is a powerful central nervous system stimulant Nicotine increases heart and respiratory rates, constricts blood vessels, and raises blood pressure Nicotine increases heart and respiratory rates, constricts blood vessels, and raises blood pressure Nicotine decreases blood sugar levels and increase hunger Nicotine decreases blood sugar levels and increase hunger Nicotine poisoning symptoms: Nicotine poisoning symptoms: Dizziness Dizziness Lightheadedness Lightheadedness Rapid pulse Rapid pulse Nausea Nausea

9. Health Hazards Of Smoking Cancer Cancer Cardiovascular disease Cardiovascular disease Platelet adhesiveness Platelet adhesiveness Hypertension Hypertension Stroke Stroke Respiratory disorders Respiratory disorders Chronic bronchitis Chronic bronchitis Emphysema Emphysema Sexual dysfunction Sexual dysfunction Gum disease Gum disease

10. 1-Larynx cancer: 1-Larynx cancer: 2-Oesophageal Cancer: 2-Oesophageal Cancer: 3-Oral Cancer: 3-Oral Cancer: 4-Stomach Cancer: 4-Stomach Cancer: 5-Liver Cancer: 5-Liver Cancer: 6-Pancreas Cancer: 6-Pancreas Cancer: 7-Colorectal Cancer: 7-Colorectal Cancer: 8-Kidney Cancer: 8-Kidney Cancer: 9-Blood Cancer: 9-Blood Cancer: Smoking increases the risk of the cancer in the following organs:

11. Chronic Horseness&Laryngeal Polyps: Persistant horse voice&Vocal cord polyps Gum,Dental and Mouth Disease: periodontal disease&poor mouth hygiene Stroke: Atherosclerosis&throbus formation

12. How Cigarette Smoking Damages the Lungs

14. 1-Miscarriage 2-Pre-mature Delivery 3-Stillbirth 4-Low Birth Weight 5-SIDS The nicotine,carbon monoxide&other harmful chemicals enters her blood stream, pass directly into the baby’s body &prevent the baby from getting essential nutrients&Oxygen for growth

15. If the mother smokes, the baby is exposed to the nicotine and other smoke poisons from her breast milk. Nicotine could cause numerous unwanted symptoms in the baby (such as restlessness, a rapid heartbeat, vomiting, or diarrhea). *Smoking affects Oral Contraceptives: Women who are smoking&using oral contraceptives are ten times more at risk of Heart attack&Stroke compared to those who are smoking but not taking contraceptives

16. Environmental Tobacco Smoke (ETS) Mainstream – smoke drawn through tobacco while inhaling Mainstream – smoke drawn through tobacco while inhaling Side stream – smoke from the burning end of a cigarette or exhaled by a smoker Side stream – smoke from the burning end of a cigarette or exhaled by a smoker Involuntary or passive smokers – breath smoke from someone else’s smoking product Involuntary or passive smokers – breath smoke from someone else’s smoking product 9 out 10 nonsmoking Americans are exposed to ETS 9 out 10 nonsmoking Americans are exposed to ETS

17. Risks From ETS Sidestream smoke contains more carcinogenic substances Sidestream smoke contains more carcinogenic substances Sidestream smoke has 2 times more tar and nicotine, 5 times more carbon monoxide, 50 times more ammonia Sidestream smoke has 2 times more tar and nicotine, 5 times more carbon monoxide, 50 times more ammonia ETS is responsible for 3,000 lung cancer deaths, 35,000 CVD deaths, 13,000 deaths from other cancers ETS is responsible for 3,000 lung cancer deaths, 35,000 CVD deaths, 13,000 deaths from other cancers

18. Protecting Yourself and Others from Secondhand Smoke

19. Criteria for Nicotine dependency:  Tolerance Withdrawal symptoms when use discontinued Withdrawal symptoms when use discontinued Used in greater amounts over longer period of time than intended Used in greater amounts over longer period of time than intended A persistent desire or unsuccessful efforts to cut down or quit A persistent desire or unsuccessful efforts to cut down or quit A great deal of time spent using the substance A great deal of time spent using the substance nicotine nicotine

20. Criteria for Nicotine dependency: Giving up important social, occupational, or recreational activities because of use of the substance Giving up important social, occupational, or recreational activities because of use of the substance Continued use despite knowledge of medical problems related to use and/or social& legal problems resulting from use. Continued use despite knowledge of medical problems related to use and/or social& legal problems resulting from use.

21. Withdrawal of nicotine It refers to the cessation of nicotine use by an individual in whom dependence is established. When the use of products containing nicotine is stopped abruptly, within 24 hours the user will likely experience maximal physical and/or psychological withdrawal symptoms. When the use of products containing nicotine is stopped abruptly, within 24 hours the user will likely experience maximal physical and/or psychological withdrawal symptoms. nicotine nicotine

22. Criteria for Nicotine withdrawal syndrome Dysphoric or depressed mood Dysphoric or depressed mood Insomnia Insomnia Irritability, frustration, and anger Irritability, frustration, and anger Anxiety Anxiety Difficulty concentrating Difficulty concentrating Restlessness Restlessness Decreased heart rate Decreased heart rate Increased appetite or weight gain Increased appetite or weight gain Cravings for tobacco Cravings for tobacco nicotine nicotine

23. Criteria for Nicotine withdrawal syndrome A-Duration A-Duration Most symptoms diminish over a few weeks. Most symptoms diminish over a few weeks. Relapse is common within 1 week when the withdrawal symptoms are at peak. Relapse is common within 1 week when the withdrawal symptoms are at peak. Cravings for tobacco, increased appetite, and weight gain may persist for months or years. Cravings for tobacco, increased appetite, and weight gain may persist for months or years. Nicotine

24. Quitting Nicotine replacement products Nicotine replacement products Nicotine gum Nicotine gum Nicotine patch Nicotine patch Nasal spray Nasal spray Nicotine inhaler Nicotine inhaler

25. Recommended Therapies for Smoking Cessation

27. Benefits Of Quitting Many tissues damaged by smoking can repair themselves in the absence of smoke Many tissues damaged by smoking can repair themselves in the absence of smoke Airways are cleared of mucous Airways are cleared of mucous Circulation improves Circulation improves Senses of taste and smell are restored Senses of taste and smell are restored At the end of 10 smoke-free years, the ex-smoker can expect to live a normal life span At the end of 10 smoke-free years, the ex-smoker can expect to live a normal life span