1. Chronic Disease Risk Factors

2. Risk Factors What are the risk factors for chronic disease? #1?? #2?? Others….

3. Tobacco

4. Between 1964 and 2014: Over 20 million American died because of smoking 2.5 million nonsmokers More than 100,000 babies Smoking is still the leading cause of preventable disease and death in the U.S. “The Health Consequences of Smoking: 50 Years of Progress”

5. An evolving process… “If excessive smoking actually plays a role in the production of lung cancer, it seems to be a minor one.” oThe National Cancer Institute, 1954 “Tobacco use imposes enormous public health and financial costs on this nation – costs that are completely avoidable.” Kathleen Sebelius, Secretary of Health & Human Services, 2010

6. Mortality Source: www.cancercontrol.cancer.gov

8. Smoking and chronic disease Responsible for more than heart and lung disease: 13 different types of cancer Smoking and reproduction Diabetes, eye disease, immune system

9. FDA & Tobacco Regulation Regulations Restricting the Sale and Distribution of Cigarettes and Smokeless Tobacco to Protect Children and Adolescents Restricts sale, distribution, and promotion of tobacco products to make them less accessible to youth. Law went into effect June 22, 2010 o(FDA, 2010) http://www.fda.gov/TobaccoProducts/Labeling/CigarettePro ductWarningLabels/ucm2024177.htm http://www.fda.gov/TobaccoProducts/Labeling/CigarettePro ductWarningLabels/ucm2024177.htm

10. Graphic labels coming soon. (Fda.gov, 2011)

11. (FDA.gov, 2011)

12. Thoughts? Warnings were to appear Sept. 2012 but…. (FDA.gov, 2011)

13. Obesity

14. Contributing Factors Portion Sizes Physical Inactivity Genetics Media Technology

15. Contributing Factor: Inactivity What is the recommended amount of daily activity? Schools and PE Sedentary Workplaces Communities “We have engineered activity out of our lives” (TWON, 2012)

16. Contributing Factor: Advertising “Toxic advertising” Health claims on food TV time has increased

17. Obesity & Stigma A lot of bias exists when it comes to those who are overweight or obese. Health care workers Employment opportunities Media Children

18. Alcohol

19. Alcohol and Chronic Disease 3 rd leading lifestyle-related cause of death How does alcohol contribute to chronic disease? Short-term health effects Long-term health effects

20. Other risk factors?

21. SLEEP! Lack of sleep is associated with: Diabetes, cardiovascular disease, obesity, depression and cancer. (CDC, 2009)

22. Prevention  Prevent, prevent, prevent  But how????  Individual education / motivation  Government policy  Built environments