Health Consequences
of Tobacco Use
Created by the Registered Nurses’
Association of Ontario
Smoking-related death rates

In Canada more than 47,000 people per
year die prematurely due to tobacco use
(Health Canada, 2008)

The average person who smokes will die
about eight years earlier than a similar
non-smoker
Tobacco-related Cancers
•
Smoking causes cancer of the:
◦ Lung (80-85 % of cases), Oral cavity, Pancreas,
Larynx, Kidney, Esophagus, Bladder (30-40 %
of cases)
• Smoking linked to cancer of the large intestine &
some forms of leukemia
• Smoking causes 21,000 deaths from cancer per
year in Canada (30% of cancer deaths)
• Smokeless tobacco (chew tobacco, snuff etc.) is
a major cause of cancer of the mouth
Risk of Developing Cancer

Risk of developing cancer increases with:
• Duration of smoking
• Number of cigarettes per day
• Degree of inhalation

Risk of lung cancer is significantly reduced
with smoking cessation
Effects of Smoking on the
Cardiovascular System
•
Smoking:
• Is a dominant cause of heart disease, stroke &
diseases of the blood vessels
• Causes about 30% of all heart disease deaths
• Accounts for about ¾ of all cases of peripheral
vascular disease
•
As a result of smoking, each year in
Canada:
• More than 17,600 cardiovascular deaths
• More than 2,000 deaths from stroke
• Many of these deaths occur prematurely
(before age 70)
Effects of Smoking on the
Cardiovascular System
•
Incidence of coronary heart disease
(CHD) is 2 to 4 times greater in smokers
•
Smoking is a major risk factor for heart attacks and
sudden cardiac death
•
Smoking acts synergistically with other risk factors
(ex. high cholesterol & blood pressure) to increase
the risk of CHD
•
Quitting smoking substantially reduces the risk of
CHD and stroke
Pulmonary Diseases
related to tobacco use
Smoking is responsible for more than
8,000 deaths from respiratory diseases
per year in Canada
 Smoking depresses the body’s immune
system & other defense mechanisms
 Smokers are at increased risk for
respiratory infections compared to nonsmokers
 Smoking may increase susceptibility to the
common cold

COPD

Chronic Obstructive Pulmonary Disease
(COPD)
 Chronic bronchitis
 Chronic airway obstruction
 Emphysema & related disorders

Smoking accounts for 80% – 90% of all
COPD deaths
Effects of Smoking on Pregnancy,
Newborns and Breastfeeding
Bleeding during pregnancy
 Ectopic pregnancy

◦ fertilized egg implants outside of uterus




Miscarriage
Premature delivery
Stillbirth
Abnormalities of the placenta
Effects of Smoking on Pregnancy,
Newborns and Breastfeeding

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
Babies born with low birth weight (less
than 2500 g)
Babies receive nicotine & carbon
monoxide from mother’s blood
May contribute to Sudden Infant Death
Syndrome (SIDS)
Nicotine & other chemicals get into
breast milk
Decreased quantity of breast milk
Effects of Smoking on
Early Childhood


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Increased risk of allergies
Higher blood pressure in childhood
Increased likelihood of obesity
Stunted growth
Poorer lung function
Increased likelihood of asthma
Effects of Smoking on
Client/Patient Recovery

Smoking can effect recovery from illness
& surgery
• Ex. Increased recovery time for patients who
smoke

Examples:
 Smoking increases the risk of recurrence in
persons who have survived a heart attack
 Ulcers heal less readily and are more likely to
recur
Other Health Risks
• Gastrointestinal problems
- Ulcers
- Chronic Bowel Disease
- Crohn’s Disease
• Type 2 diabetes
- 50 % increased
likelihood of getting Type
2 diabetes
• Rheumatologic conditions
- Rheumatoid arthritis
• Cataracts
• Orthopedic conditions
- Osteoporosis
• Skin conditions
- Contact allergies
•Kidney damage
- Worsens kidney
problems for
patients/clients with
diabetes, high blood
pressure etc.
• Tooth and gum problems
- Oral cancer
- Tooth loss, decay
- Periodontal (gum)
disease
Additional Hazards
•
For men:
• Erectile dysfunction
• Fertility may be impaired
•
For women:
•
•
•
•
•
Risk for cervical cancer
Early menopause
Increased menstrual disorders
Fertility may be impaired
Smoking and the use of oral contraceptives
greatly increases the risk of stroke, heart
attack and other vascular complications
Health Risks of
Second-hand Smoke

Exposure to second-hand smoke causes the
following diseases and conditions:
◦ In adults:
 Heart disease
 Lung cancer
 Nasal sinus cancer
◦ In children:
 SIDS
 Fetal growth impairment
 Bronchitis, pneumonia & other lower respiratory tract
infections
 Asthma exacerbation
 Middle ear disease
 Respiratory symptoms
Health Risks of Second-hand
Smoke

Also linked to:
◦ In adults:




Stroke
Cervical cancer
Breast cancer
Miscarriages
◦ In children:
•
•
•
•
Adverse impact on cognition and behaviour
Decreased lung function
Asthma induction
Exacerbation of cystic fibrosis
Strategies to Include Tobacco Use
in Health Assessment
• Expand the area where vital signs are recorded
to include tobacco use or use an alternative
universal identification system.
Example:
• Simply ask all patients, "Do you smoke or have you ever
smoked?, Are you exposed to second hand smoke at home?",
and note their response in the chart.
Strategies to Include Tobacco Use
in Health Assessment

Expand the area where vital signs are
recorded to include tobacco use or use an
alternative universal identification system.
◦ Simply ask all patients, "Do you smoke or have you ever
smoked?, Are you exposed to second hand smoke at
home?", and note their response in the chart.
Example: