2 - Health Risks of Smoking.docx

PRD 131: Health Risks of Smoking Smoking Leading preventable cause of death in the United States Tobacco smoke constituents Formaldehyde Carbon monoxide Benzopyrene Pack years Pack years = Packs per day x Number of years 2 cigarettes per pack High risk is >20 pack years Multiplicative effect Toba...

PRD 131: Health Risks of Smoking Smoking Leading preventable cause of death in the United States Tobacco smoke constituents Formaldehyde Carbon monoxide Benzopyrene Pack years Pack years = Packs per day x Number of years 2 cigarettes per pack High risk is >20 pack years Multiplicative effect Tobacco and alcohol consumption have a multiplicative effect oral cancer risk Ex: Tobacco = 3x + Alcohol = 2x → Tobacco + Alcohol = 6x Smoking etiology and pathogenesis Benzopyrene product after cytochrome p450 processing combines with guanine Guanine adduct gets added to DNA More p450 in the nasal cavity and in the lungs Cell detects DNA error → Apoptosis Failure of DNA repair → Cancer Smoking and circulation 1/3 of heart attacks associated with smoking Smoking and diabetes Increases the risk of developing type II diabetes Nicotine increases cell threshold response to insulin Smoking and immune system Makes the body less successful at fighting infections and wound healing Smoking and eye disease Vasoconstriction of eye vessels 4x more likely age-related macular degeneration Cause of cataracts Nicotine Addictive alkaloid in tobacco leaves Absorbed in lung and passes to brain Stimulates dopamine Quitting = withdrawal symptoms Teens (developing brain) are more sensitive to nicotine Most current smokers became addicted as teenagers Smoking cessation (FDA-approved) Nicotine replacement therapy (NRT) Bupropion Increases brain levels of dopamine and norepinephrine Simulating the effects of nicotine Ex: Zyban Varenicline Partial agonist of the major receptor involved in nicotine addiction 50% compared to nicotine Relieves nicotine withdrawal symptoms Ex: Chantix Brief provider advice doubles the likelihood of a patient abstaining from smoking E-cigarettes Tobacco use among youth / young adults is not safe Nicotine exposure harms brain development Includes E-cigarettes E-liquid: Solvent (propylene glycol and/or vegetable glycerin) Nicotine Flavoring E-cigarettes work as a modality to quit conventional cigarettes Are the most used tobacco product among youth in the US Effects of E-cigarettes Periodontal and peri-implant clinical and radiographic parameters are worse Proinflammatory cytokine levels are higher 9 different lesions of the oral mucosa were detected with increased prevalence of: Nicotinic stomatitis Hairy tongue Angular cheilitis Component of vapor have known cytotoxic, genotoxic, and carcinogenic properties Users develop a distinct oral microbiome