Tobacco and Smoking: Health Impacts

Tobacco

• Tobacco use, whether firsthand or secondhand, leads to hypertension, overweight/obesity, metabolic syndrome, cancer, cardiovascular disease, chronic respiratory disease, and diabetes.

Cigarette Contents and Design

• Cigarettes contain:
  • Tar: a sticky, brown substance that collects in the lungs and is cancer-causing.
  • Carbon Monoxide: blocks oxygen receptors in hemoglobin, hindering oxygen transport and increasing heart workload.
  • Nicotine: an addictive substance causing dizziness, rapid pulse, and nausea. It stimulates the cerebral cortex, accelerating heart rate and increasing blood pressure, leading to a surge of endorphins and increased dopamine.
• Changes in cigarette design include filter holes and self-extinguishing paper, which reduces the burn rate and lowers the fire risk if left unattended.

Health Impacts of Smoking

• Smoking affects health by:
  • Damaging DNA
  • Harming the cleaning systems in the airways
  • Affecting the immune system and causing inflammation

Long-Term Health Effects

• Smoking can lead to:
  • Lung and other cancers
  • Chronic Obstructive Pulmonary Disease (COPD)
  • Emphysema
  • Chronic Bronchitis
  • Cardiovascular Disease
  • Other diseases including stroke, aortic aneurysm, pulmonary heart disease, ulcers, reproductive health issues, erectile dysfunction, and dental diseases

Conclusion on Tobacco Use

• No level of tobacco exposure is risk-free.
• Inhaling tobacco leads to cancer, cardiovascular, and pulmonary diseases due to DNA damage and inflammation.
• Health outcome risks and severity correlate with the duration and level of tobacco smoke exposure.
• Tobacco is highly addictive.
• Low-level exposure can rapidly increase endothelial dysfunction and inflammation, potentially causing cardiovascular events and thrombosis.
• Product modification can’t lower emission of toxicants

Indigenous vs Commercial Tobacco

• Indigenous tobacco is used only in rituals and ceremonies for healing and spiritual benefits like smudging. It is not the same as commercial tobacco.

Environmental Impact

• The environmental impacts of tobacco include:
  • Deforestation
  • Toxic litter
  • Pollution

Smoking Trends in Canada

• There was a steady decline in smoking rates from 1965 to 2015.
• In 1965, about 50% of Canadians smoked and by 2015, it dropped to around 15%.
• The decline is similar for both men and women, though historically men smoked more.
• Current smoking rates in Canada- 12% of Canadians aged >15 smoke cigarettes. Of that, 14% are males and 10% are females.
• 1.1% of males in grades 7-9 smoke; a little less than half smoke daily.
• 0.9% of females in grades 7-9 smoke; a little less than half smoke daily.
• 3.1% of kids from 15-19 are smoking

Social Determinants and Inequalities in Smoking (2019)

• Smoking was 3.9x higher in high school than uni
• It was 2.6x higher for unskilled workers, compared to people in professional occupations.
• Smoking was 1.9x higher in low-income groups than high-income groups.

Smoking in Indigenous Populations

• Smoking is 2.4x higher in Inuit populations.
• It is 1.9x higher among First Nations people living off-reserve.
• Smoking is 1.7x higher among Metis populations.

Smokeless Tobacco

• Chewing tobacco: this is loose leaf, plug, or twist tobacco.
• Snuff: this is finely ground tobacco that can be dry, moist, or in a sachet (tea bag).
• In Canada, <1% of Canadians age 15+ chewed tobacco in the last 30 days

Health Effects, Second-Hand Smoke, and Cessation

• Smoking includes:
  • Gingivitis (inflammation)
  • White or red patches that can appear inside the mouth (leukoplakia), which can be indicative of oral cancer.
• Second-Hand Smoke (SHS) Exposure in Canada:
  • Second-hand smoke is still very dangerous.
  • 22% of Canadians are exposed to SHS every day.
  • Living with someone who smokes increases the chance of getting cancer, heart disease, or stroke by 30%.
• Infants/Children SHS:
  • There is a higher risk of respiratory illnesses and ear infections.
  • It causes more severe asthma attacks.
• Smoking Cessation:
  • Smoking has phases.
  • It takes approximately 30 attempts to finally quit.
  • Use the 5 R's to build motivation: Relevance, Risks, Rewards, Roadblocks, and Repetition.

Smoking Cessation Statistics

• 54% of people aged 20-24 have tried to quit.
• 45.5% of people aged 24-34 have tried to quit. . 44.5% of people aged 35-44 have tried to quit.
• 43% of people >45 have tried to quit.

Health Benefits of Quitting Smoking

• In 20 minutes, blood pressure and heart rate decrease.
• In 2 hours, nicotine is eliminated, and heart rate and blood pressure continue to decrease.
• In 12 hours, carbon monoxide levels in the blood decrease, allowing more oxygen to reach organs.
• In 2 weeks to 3 months, circulation improves and lung function increases.
• Within 1 year, the risk of heart disease decreases by half.
• Within 5 years, the risk of stroke decreases to that of a normal person.
• Within 10 years, the risk of lung cancer decreases by half compared to smokers.

Smoking Cessation; International Smoking and Cannabis

• Smoking Cessation products and supports include:
  • Pharmacological support: -Champix (Varenicline) reduces nicotine craving and blocks the receptors, while Zyban Bupropion eases withdrawal symptoms and reduces the urge to smoke.
  • Nicotine Replacement Therapy: options include gum, patches and inhalers.
  • Helpline
• There are cummulative risks from death with lung cancer
• Highlights of International Tobacco use:
  • It is one of the biggest epidemic public health issues the world has ever faced.
  • It kills more than 8 million people each year.
  • 7 million deaths are directly from tobacco use, and 1.3 million are from SHS.
  • 80% of tobacco users live in low to middle-income countries.
• Tobacco Use in China:
  • China has the most smokers in the world with approximately 291 million, which is about 25% of the population aged 15+. 47% are men, 2% are women
• The China National Tobacco Corporation (CNTC)- produces half of the world's cigarettes (2.2M tons) and is the largest tobacco company. -Weak restrictions on smoking and moderate regulations
• Smokeless Tobacco Use in India: -India has the second most tobacco addiction for people age 15+ (24%)
• Leading cause of oral cancer for people age 15+ is smokeless tobacco

Legislation and Bans

• In 2019, India banned e-cigarettes and heated tobacco.
• Decreasing trend among tobacco across the world

Global Tobacco Control

• Most tobacco control measures have expanded globally, but mass media campaigns and taxation efforts have weakened. However, the most effective improvement has been in pack warnings.
• The first country to have a federal policy to ban smoking in bars and restaurants is Ireland.

E-cigarettes/ Vaping

• Heating liquid into an aerosol-> vapour. This is made up of propylene glycol and/or glycerol and other chemicals. Additional chemicals from vaping liquids are heated/come to contact with parts of the vaping device
• E-cigarette use varies across provinces, with some having higher rates of experimentation but lower regular use. Alberta stands out for higher recent use, while BC has the lowest frequent use. These findings suggest potential regional differences in vaping culture, regulations, or awareness.
• The trend of smoking cigarettes has been decreasing though e-cigarette use is increasing
• The reasons why people are choosing e-cigarettes is primarily is due to its perception of quiting smoking, as well as the general belief that this tool reduces overall risk

Conclusion on E-Cigarettes

• Nicotine from e-cigarettes can cause addiction and can harm the developing adolescent brain.
• Nicotine can cross the placenta and has known effects on fetal and postnatal development.
• E-cigarettes contain more than just nicotine, including carbonyl and volatile organic compounds, leading to adverse health effects.
• E-cigarette aerosol is harmful.
• Due to its liquid components, E-cigarettes, are not completely safe.
• Ingestion of liquid e-cigarettes can cause acute toxicity or death if liquid product is oxidized.

Explore the detrimental effects of tobacco use, including hypertension, cancer, and cardiovascular disease. Learn about cigarette contents like tar, carbon monoxide, and nicotine, and their impact on the body. Understand how changes in cigarette design aim to reduce fire risk.