Toward A Tobacco-Free Society

• Why Do People Smoke Tobacco? What is the History of Tobacco Smoking?

• What are the Short-Term and Long-Term Health Risks of Tobacco Use?

• How Does Environmental Smoke Affect Nonsmokers?

• What are Some Methods to Stop Using Tobacco?

When Did Tobacco Use Begin?

• Ancient Mayans –1000 BC were believed to use the tobacco plant for chewing and smoking.

• The first European smoker was in 1452 AD.

Leading Health Indicator

Cigarette smoking is the single most preventable cause of disease and death in the United States.

Smoking results in more deaths each year in the United States than AIDS, alcohol, cocaine, heroin, homicide, suicide, motor vehicle crashes, and fires—combined .

Leading Causes of Death In 1997

What Kind of Drug is Nicotine?

• At low doses it acts as a stimulant, at higher doses it acts as a sedative.

• does not cause a high, but rather, modulates emotions.

• Stimulates the amplified release of three neurotransmitters: dopamine, epinephrine and norepinephrine.

The Synapse

Psychological Factors

• In addition to the physical addiction we know to be associated w/ tobacco use, there are also social forces which help maintain the habit. Smoking a with a cup of coffee or after dinner or as a break or “reward” for studying. These are all considered secondary reinforcers.

Genetic Factors

• Genes play a role in your decision to become a smoker.

• One gene identified-which actually prevents a person from smoking- is CYP2A6

• CYP2A6 causes slow metabolism of nicotine; it stays in bloodstream longer causing nausea and dizziness when the person first experiences cigarette smoke. Hence, they are less likely to have a good experience, less likely to continue to behavior.

Why Continue?

• Pleasure• Dependence

Who Uses Tobacco?• RESEARCH SAYS: that a child or

adolescent will be more likely to use tobacco if:

• A. Parent or sibling uses tobacco****• B. Child comes from a poor family• C. Family is headed by a Single-Parent• D. Child performs poorly in school

These are strongest factors…. others present.

Health Effects of Chewing Tobacco

• Leukoplakia- a condition characterized by leathery white patches inside the mouth produced by contact with irritants in tobacco juice.

• Between 3 and 17% of diagnosed leukoplakia cases develop oral cancer.

Health Hazards of Smoking• Smoke from an unfiltered cigarette contains

50,000 times more damaging chemical substances than polluted urban air.

• Many are carcinogens or cocarcinogens.• Other compounds reduce the ability of the lung’s

capacity to fight infection (macrophages become less effective)

• Tobacco has been found to contain actual poisons-arsenic and hydrogen cyanide.

• Smokers inhale Carbon Monoxide in concentration 400X stronger than considered safe.

• CO displaces Oxygen in RBCs. It also impairs visual acuity, especially at night.

Why Do People Start Smoking?

• Usually “Peer Pressure”• Urge to “grow up”• Parents or friends smoke• Low self-esteem• Status seeking

**MOST PEOPLE START in TEENS

**RARELY do adults start this habit.

Short-term Effects of Smoking

• Dizziness, faintness, rapid pulse, cold and clammy skin, nausea in a new smoker.

• Feelings of tranquility, depending on dosage• Stimulation of the cerebral cortex and adrenal

glands,which release epinephrine; also inhibition of urine formation. Constriction of blood vessels, elevated BP,

• Depression of Hunger, dulling of taste buds;

What are the LONG-TERM Effects of

Smoking?

Normal Vs. Smoker’s LungAfter 25 Years 2 Packs/Day

Long-Term Effects of Smoking

1. CVD- smokers get more plaque accumulation which causes arteriosclerosis. If a clot develops or plaque completely blocks off flow-myocardial infarction.

Review pg. 308 for details of how smoke does this.***

.

Also Causes

1.Stroke

2. Aortic Aneurysm (a bulge in the aorta caused by weakness in its walls) and

3. Pulmonary Heart Disease: A disease on the right side of the heart caused by changes in the blood vessels of the lungs.

Smoking and CVSHarms the CVS in several ways:• Nicotine is a CNS stimulant, thereby increasing blood pressure and heart rate.

• Carbon monoxide in smoke displaces oxygen in the blood and heart and other parts of body.

• Smoking damages linings of arteries• Contributes to unhealthy blood fat levels by reducing high-density lipoproteins (HDLs) and raising triglycerides and LDLs.

• Causes platelets to become sticky and cluster, forming Clots.

Long-term (continued)

• Lung Cancer and other cancers-

• BENZO(a)PYRENE (the carcinogen) and its precise mechanism has been identified for mutation that triggers oncogenesis of lung cancer: It mutates p53 gene.

• Those who smoke 2 or more packs a day have a 12 –25 X greater chance of lung cancer death.

• Smoking has also been linked to cancers of esophagus, larynx, pancreas, bladder, breast cervix, stomach, liver, colon and skin.

Remember How Cancer Develops and The Suppressors

Lung Cancer

Lag Time Between Smoking and Cancer Diagnosis

Gas Exchange in Humans

Oxygen and Carbon Dioxide Transport Via The Alveoli

• Oxygen from the alveolus enters the red blood cells and combines with hemoglobin to form oxyhemoglobin (HbO2)

• Cells give off Carbon Dioxide as a waste product. They release CO2 into the blood. It combine with hemoglobin..and is then released to the alveoli for exhalation.

SO HOW GREAT is the Surface Area of Human Lung Alveoli?

• If the surface area of the human alveoli were spread out flat, it would cover an area of about 60 square meters. ( about the size of two large parking spaces).

Normal Alveoli Vs. Emphysema

Emphysema

• Smoking is the primary cause of this disease.

• The walls of the alveoli (air sacs of the lungs) lose their elasticity and are gradually destroyed. They lose their ability to exchange Oxygen and Carbon Dioxide.

• The heart has to work harder and becomes enlarged (hypertrophy). Death often results from damaged heart.

Smoking: Other Lung Diseases

Chronic Bronchitis

• This is a persistent, recurrent inflammation of the bronchial tubes that leads to excess secretion of mucus chronic cough.

• Smokers with chronic bronchitis face a much greater risk of lung cancer.

Smokers Who Do Not Get Chronic Diseases

• May still have respiratory damage such as:

1. Cilia lining the bronchial tubes no longer functions to sweep mucus to mouth (Causes pronounced smoker’s cough)

2. Smoking makes macrophages less effective…more prone to infections.

3. Erectile dysfunction, diminished physical senses, and dental diseases.

TERATOGEN

• A chemical that causes a birth defects or slow embryonic development

Smoking During Pregnancy

• The more a woman smokes, the greater the risks to her baby.

• On average, a woman who smokes a pack a day during pregnancy will cut about half a pound from her baby's birth weight.

• Low birth weight, stillbirth, miscarriages, brain damage, weak lungs are all possible consequences of smoke to fetus

• Even one or two cigarettes each day aren't safe.

Smoke Jargon

• Mainstream Smoke- smoke directly inhaled from cigarette

• Sidestream Smoke- smoke that results the burning of the end of the cigarette,cigar or pipe.

• Secondhand Smoke or Environmental Tobacco Smoke- Results from the combination of smoke exhaled by smoker and sidestream smoke.

Sidestream Smoke

Sidestream Smoke: Because it is not filtered, this smoke is significantly higher in toxins and carcinogens:

2X as much tar and nicotine 3X as much BENZO(a)PYRENE 3X as much CO, which displaces O2

from

red blood cells,

Other Forms of Tobacco1) Smokeless or Spit Tobacco- allows nicotine or

other carcinogens, to be absorbed through the gums and lining of mouth.

• Health risks include: Oral cancer and CVD as blood nicotine levels also rise.

2) Cigar and Pipes- More tobacco, nicotine and tar than cigarettes! However, because these are not inhaled, lung cancer and CVD risk are much lower than cigarette smokers. Depending on frequency of smoke, oral cancer a risk.

3) Clove Cigarettes- More dangerous than regular. 2X nicotine, tar and CO.

4) Bidis- Inported from India; 4X nicotine, and 2x tar.

Smoking Wrinkles Your Skin

• Smoking causes narrowing of the blood vessels in the outermost layers of your skin. This impairs blood flow to your skin, depleting it of oxygen and important nutrients, such as vitamin A. Smoking also damages collagen and elastin — fibers that give your skin its strength and elasticity. As a result, skin begins to sag and wrinkle prematurely.

How a Tobacco User Can Quit

• Smoking cessation; “Cold turkey”• Behavior Modification: Substitute with a

walk or talk• Nicotine Replacement: Person gets nicotine

be means other than smoking it; Gum, plus counseling.

• Trandermal Nicotine Patch or Nasal Spray..

When A Smoker Quits

Avoiding ETS

• Speak Up Tactfully• Display Reminders• Don’t Allow Smoking in Your Home, Car

or Room.• Sit in Nonsmoking Sections ( Public Areas)• Fight for Smoke-Free Work Environment• Discuss Quitting Strategies