Toward a Tobacco-Free
Society
Chapter 11
Use of Tobacco
Why People use Tobacco
71 Million Americans, including 13.7 million collegeaged 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
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Figure 11.1 Annual mortality and
morbidity among smokers
attributable to smoking
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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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Table 11.1 Who Smokes?
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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
Tobacco adversely affects nearly every part of the
body.
Contains hundreds of damaging chemical
substances.
Unfiltered cigarettes = 5 billion particles per
cubic MM
50,000 times more than polluted urban air
Condensed particles in the cigarette produce the
tar
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Carcinogens and Poisons
43 chemicals are linked to cancer (Carcinogen)
Benzo(a)pyrene
Urethane
Cocarcinogens
Combine with other chemicals to cause cancer
Poisonous substances
Arsenic
Hydorgen cyanide
Carbon monoxide
400 times greater than is considered safe in industrial workplaces
Displaces oxygen in red blood cells
Additives
Nearly 600 chemicals
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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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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
Chronic Obstructive Lung Disease
Emphysema
Chronic Bronchitis
Other Respiratory Damage
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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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15
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.
Clover cigarettes and Bidis
Twice the tar, nicotine, and carbon monoxide
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Figure 11.5 Tobacco use among
middle school and high school
students
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The Effects of Smoking on the
Nonsmoker
Environmental Tobacco smoke (ETS)
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
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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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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Avoiding ETS
Speak up tactfully
Display reminders
Don’t allow smoking in your home or room
Open a window
Sit in the nonsmoking section
Fight for a smoke-free environment
Discuss quitting strategies
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Smoking and Pregnancy
Estimated 4600 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)
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
FDA
EPA
OSHA
International Action
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
Table 11.2
Options for quitting
Smoking cessation programs
1-800-QUITNOW
Department of Health and Human Services
Smoking cessation products
Chantix (Varinicline)
Zyban (Bupropion)
Nicotine replacement products
Patches, gums, lozenges, nasal sprays, and inhalers
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Toward a Tobacco-Free
Society
Chapter 11
