Alcohol and Tobacco
Chapter 8
Use of Tobacco
Why People use Tobacco


71 Million Americans, including 13.7 million college-aged
Americans.
2008, nearly 21% of Americans age 18 describe themselves as
current smokers.
 Nicotine Addiction

Powerful psychoactive drug




Reaches Brain via bloodstream in seconds
Most physically addictive of the psychoactive drugs.
Loss of control
Tolerance and Withdrawal
http://www.youtube.com/watch?v=zRQVqlXhN5c
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2
Social and Psychological
Factors
 Established habits or cues to trigger smoking
 Secondary reinforcers.
 Genetic Factors:
 Specific Genes


CYP2A6 –

influences the way in which nicotine is metabolized

People with slow CYP2A6, nicotine remains in the
system longer
DRD2 
Associated with brain chemical dopamine
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Why Start in the First Place?



Children and teenagers make-up 90% of all new smokers in
this country.
Thousands of children and adolescents (12-17) start smoking
everyday.
Average age


13 for smoking
10 for spit tobacco
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Characteristics which could
increase the potential for use.








A parent or sibling uses tobacco
Peers use tobacco
Child comes from blue-collar family
Child comes from low-income home
Single parent.
Performs poorly in school
Child drops out of school
Has positive attitudes towards tobacco
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Health Hazards
 Contains hundreds of damaging chemical substances,
including acetone (nail polish remover), ammonia,
hexamine (lighter fluid), and toluene (industrial
solvent).
 Unfiltered cigarettes = 5 billion particles per cubic mm
 50,000 times more than polluted urban air
 Condensed particles in the cigarette produce the tar
(brown, sticky mass)
Chapter 8
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Health Hazards (cont)
Carcinogens and Poisons
 43 chemicals are linked to cancer (Carcinogen)
 Benzo(a)pyrene (yellowish tar)
 Urethane (ex: solution used in making foams)
 Cocarcinogens
 Combine with other chemicals to cause cancer (e.g., formaldehyde)
 Poisonous substances
 Arsenic (e.g., insectides and weed killers)
 Hydrogen cyanide (e.g., flammable liquid used in dye)
 Carbon monoxide
 400 times greater than is considered safe in industrial workplaces
 Displaces oxygen in red blood cells
 Additives
 Nearly 600 chemicals
Chapter 8
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“Light” and Low-Tar Cigarettes
 Low-tar, low-nicotine, or filtered cigarettes
 No such thing as a safe cigarette
 Often smoke more
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Menthol Cigarette
 70% of African Americans smoke these
 Absorb more nicotine and metabolize it slower
 Anesthetizing effect of menthol, inhale more deeply
and hold smoke longer in the lungs
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Immediate Effects
 Acts on the brain either by exciting or
tranquilizing the nervous system
 Mild nicotine poisoning
 Stimulates the cerebral cortex
 Stimulates the discharge of adrenaline
 Physiological effects on the body
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Figure 8.4 The short term effects of smoking a cigarette
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The Long-Term Effects

Cardiovascular Disease
Coronary Heart Disease (CHD)
Atherosclerosis
plaques
Angina pectoris
Myocardial infarction
Stroke
Aortic aneurysm
Pulmonary heart disease

Lung and other cancers


Benzo (a) pyrene (yellowish tar)
Chronic Obstructive Lung Disease (COLD)
Emphysema
Chronic Bronchitis
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Additional Health, Cosmetic,
and Economic Concerns
 Ulcers
 Impotence
 Reproductive health problems
 Dental diseases
 Diminished physical senses
 Injuries
 Cosmetic concerns
 Economic costs
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Cumulative Effects
 Males before 15 yrs. old are half as likely to live to 75
versus those who did not smoke
 Females with similar habits reduce life expectancy by
more than 10 years
 Female smokers spend 17% more sick days in bed
than nonsmokers
 Both men and women show a greater rate of acute
and chronic diseases
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Other Forms of Tobacco
 Spit (Smokeless) Tobacco
 More than 6.6 million adults
 8% of all high school students
 Cigar and Pipes
 Cigar smoking has increased by 148% from 1993-2006.
 Cigars contain more tobacco than cigarettes.
 Clover cigarettes and Bidis
 Twice the tar, nicotine, and carbon monoxide
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The Effects of Smoking on the
Nonsmoker
 Environmental Tobacco smoke (ETS)
 Environmental Protection Agency (EPA) designated
ETS as a class A carcinogen
 Department of Health and Human Services’ National
Toxicology Program - “known human carcinogen”
 Surgeon General – 2006 – “there is no safe level of
exposure to ETS; even brief exposure can cause serious
harm”.
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Environmental Tobacco Smoke

Mainstream smoke

Smoke exhaled by smokers
 Sidestream smoke
 Smoke from the burning end of a cigarette, cigar, or pipe.
 85% of smoke in a room is second hand
 Twice the tar and nicotine
 Three times the benzo(a)pyrene
 Three times the ammonia
 Smoke from a cigar can be even more dangerous
 30 times more carbon monoxide
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ETS Effects


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
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Develop cough, headaches, nasal discomfort, eye irritation,
breathlessness and sinus problems
Allergies will be exacerbated
Causes 3,000 deaths due to lung cancer
Contributes to about 35,000 overall deaths each year.
20% increase in the progression of atherosclerosis.
Contributes to increased asthma attacks
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Lung Cancer from Tobacco Smoking
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Oral Cancer from Tobacco Smoking
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Oral Cancer from Tobacco Smoking
http://www.youtube.com/w
atch?v=0hySFt8O11A
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Infants, Children, and ETS

More likely to develop
Bronchitis, pneumonia,& respiratory infections
More complications from asthma
Increased chance of SIDS
Low-birth weight
Bronchitis


Chemicals from smoking show up in breast milk
Children inhale three times more pollutants per unit of body
weight than adults.
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Smoking and Pregnancy
 Estimated 4,600 infant deaths in the U.S.
 Miscarriage, premature birth, low birth weight,
long term impairments in growth and intellectual
development
 Possible higher risks of getting cancer
 16% of pregnant women smoke
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Cost of Tobacco Use to Society
 Lost productivity from sickness, disability, and
premature death makes it close to $167 billion per
year.
 1998 Master Settlement Agreement (MSA)
43 states filed suit against tobacco companies to
recoup public health care expenditures
 Tobacco companies have to pay $206 billion over 25
years.
 Limits or bans certain types of advertising,
promotions, and lobbying.

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What Can Be Done?


Action at the Local level
Action at the State and Federal level
Food and Drug Administration (FDA)
 Environmental Protection Agency (EPA)
 Occupational Safety and Health
Administration (OSHA)


International Action



World Health Organization (WHO)
Action in the private sector
Individual Action
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How A Tobacco User Can Quit



50.2 % of all adults who have smoked have quit.
The Benefits of Quitting (See Table 8.5)
Options for quitting
 Smoking cessation programs
 1-800-QUITNOW


Smoking cessation products



Department of Health and Human Services
Chantix (Varinicline)
Zyban (Bupropion)
Nicotine replacement products

Patches, gums, lozenges, nasal sprays, and inhalers
http://www.videojug.com/interview/the-benefits-of-quitting-smoking-2
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Connect Assignment
 Chapter 8 Connect Assignment (Tobacco) Due
Tuesday, March 9th
© 2010 McGraw-Hill Higher Education. All rights reserved.
Alcohol and Tobacco
Chapter 8