Tobacco Health Effects PDF

Tobacco 1 Objectives  Describe some of the forms in which tobacco is sold  Identify several major chemicals found in cigarettes  Explain how toxic substances in tobacco products affect the body  Outline health hazards that stem from using tobacco products  Identify some strate...

Tobacco 1 Objectives  Describe some of the forms in which tobacco is sold  Identify several major chemicals found in cigarettes  Explain how toxic substances in tobacco products affect the body  Outline health hazards that stem from using tobacco products  Identify some strategies people use to quit smoking  Examine the policies and programs that influence tobacco use 2  WHAT IS TOBACCO Tobacco is an herb that can be smoked or chewed; the active ingredient found naturally in leaves is nicotine. Colourless 25-30% of nicotine in smoke drawn into the mouth is absorbed in the body NICOTINE Addictive 90% of nicotine in smoke drawn into Regulated the lungs is absorbed in the body 3 FORMS IN WHICH TOBACCO IS SOLD 4  Anatomy of a Cigarette burn rings paper wrap ventilation holes expanded tobacco reconstituted tobacco filter tobacco Reconstituted Tobacco: recycled tobacco fibres, stems, and particles collected during processing; uses additives (e.g., ammonium) to make nicotine more volatile as it burns 5  MAJOR CHEMICALS IN CIGARETTE SMOKE Every time a person smokes, they ingest a toxic mix of > 7,000 chemicals 70 are known carcinogens Source: American Lung Association Carcinogen= causes cancer 6  Tar is generated when tobacco is burned and forms a component of cigarette smoke. It is a sticky yellow-brown substance that contains carcinogens such as polyaromatic hydrocarbons (PAHs). Tar in cigarette smoke paralyzes and / or destroys the cilia in the respiratory tract. Tar (thick sticky fluid) is formed when cigarette smoke cools and condenses, collecting in the lungs. 7 https://www.nhsinform.scot/healthy-living/stopping-smoking/reasons-to-stop/tobacco/  Carbon monoxide is an odourless, colourless gas that is released from burning tobacco. Inhalation of cigarette smoke allows for carbon monoxide to enter the respiratory tract. Carbon monoxide binds with hemoglobin in red blood cells, diminishing oxygen carrying capacity. 8  NICOTINE AND THE BODY  Smoke a cigarette or use a nicotine product 1  Nicotine is absorbed through mucosal lining of nose, mouth 2  Nicotine passes through the lungs into the bloodstream  Reaches the heart and then the brain and rest of body  Stimulates the release of neurotransmitters 3  Adrenaline and dopamine are released  Nicotine is metabolized by the liver 4  Metabolites filtered in the kidneys and excreted in urine 9 This Photo by Unknown Author is licensed under CC BY-NC HEALTH HAZARDS OF TOBACCO SMOKE 10 Health Effects of Cigarette Smoking  cause of ~80% of lung cancer cases CANCER  linked to at least 10 different cancers  accounts for ~30% of all deaths from cancer HEART  signals heart to be faster and harder DISEASE  blood vessels constrict (raises blood pressure) STROKE  increases LDL and decreases HDL cholesterol 11 Health Effects of Cigarette Smoking  cause of chronic obstructive pulmonary disease RESPIRATORY  progressive limitation of airflow in and out of lungs  destruction of air sacs, inflammation of airways  brittle bones, reduces Vitamin D in the blood OTHER  infections, damages cilia in the respiratory tract  gum disease, increases oral bacteria 12 Cigarette Smoking Harms Non-Smokers First-Hand consists of Second-Hand consists most hazardous form of Mainstream indoor air pollution of Sidestream (mostly) and the exhaled mainstream Inhaled by smoker for a total of about 25 seconds per Inhaled by smoker and cigarette bystanders for about 12 minutes per cigarette Contains more: - Nicotine and Tar (2x) - Carbon monoxide (5x) - Ammonia (50x) Incomplete combustion makes smoke chemically different and more dirty and dangerous 13 A hookah pipe is a water pipe used to smoke tobacco; the smoke is passed through water before inhalation. Health risks include: Head  increased heart rate and blood pressure Body Hose  chronic bronchitis and emphysema  reduced or impaired lung function  oral, esophageal, stomach, lung cancer Water Bowl Mouthpiece 14 Hookah smoking is NOT a safe alternative to cigarettes. Smokeless tobacco is not burned; loose tobacco leaves can be chewed or ground tobacco can be sucked. Health risks include:  greater chance of early delivery or stillbirth Chewing Tobacco  gum disease, tooth decay, and tooth loss  oral, esophageal, pancreatic cancer  increased risk for death from heart disease Snuff Tobacco 15 Smokeless tobacco is NOT a safe alternative to cigarettes. Electronic cigarettes heat a liquid that usually contains nicotine which results in a vapour that can be inhaled. Health risks include:  irritation of throat and mouth, dry cough  harm the developing brain (e.g., memory)  increased headaches and nausea  potential increase in lung injury 16 E-cigarettes are less harmful than cigarettes but NOT safe.  REVIEW arsenic carbon monoxide butane lead nicotine tar cadmium  Carcinogenic component(s) of cigarette smoke.  Component(s) of cigarette smoke that paralyze cilia.  Component(s) of cigarette smoke that reduce the amount of oxygen carried in the blood.  Component(s) of cigarette smoke that is/are addictive  T/F: Cigarette smoking affects only the respiratory system  T/F: Second-hand smoke is more dirtier than mainstream smoke.  T/F: E-cigarettes and smokeless tobacco are safe alternatives to cigarettes 17  Genetics Role Stress Models Mental Health Why Do People Experiment Start Smoking? Marketing Education Weight Control 18  Why Do People Start Smoking? Factor Evidence Genetics may account for some behavior but environment equally important, identical twins (same genes) have more similar smoking habits than fraternal twins Parental Role at least one smoker in family then 50% more likely to start smoking – Models predisposing factor Adult curiosity, defy adults, appear grown up or “cool” – misjudge the addictive Experimentation/ power of cigarettes – symptoms of addiction within days of starting and Rebellion after just a few cigarettes Low Education Smoking rates are lower among people with college/university education or higher Weight Control smokers burn ~100 extra calories a day (nicotine increases metabolism), suppress appetite Aggressive TV/radio ads stopped in 1970’s but still marketing to kids … now Marketing focusing in developing countries where regulations are not as tight Mental health about half of smokers report a mental illness (e.g., depression, anxiety, bipolar disorder) 19 Stress Individuals with high stress levels are 15 times more likely to smoke Prevalence of tobacco smoking (daily and non-daily) in Canada, Adults Aged 15+, 1965-2013 20 Prevalence of tobacco smoking (daily and non-daily) by Province, Adults Aged 15+, 2013 21  Public Health Impact of Tobacco Use in Canada Tobacco use is the leading preventable cause of premature death and diseases in Canada. There is no safe level of exposure to tobacco smoke. Every year in Canada, second-hand smoke causes nearly 1000 deaths from lung cancer and heart disease in non-smokers. https://www.canada.ca/en/health-canada/services/smoking-tobacco/health-effects-smoking- second-hand-smoke.html 22 STRATEGIES TO REDUCE TOBACCO USE STRATEGIES TO QUIT SMOKING 23  CANADA TOBACCO CONTROL POLICIES Canada became a Party to the WHO Framework Convention on Tobacco Control on February 27, 2005. Smoke Free Places Tobacco Advertising, Promotion and Sponsorship Smoking restrictions in Most forms of tobacco workplaces and public places advertising, promotion and sponsorship are prohibited, with a few limited exceptions. Tobacco Packaging and Tobacco Taxation and Prices Labeling As of February 7, 2020, plain The WHO recommends raising packaging is required for all tobacco excise taxes to at least tobacco products. 70 percent of retail prices. These taxes in Canada are below these recommendations. 24 https://www.tobaccocontrollaws.org/legislation/policy-fact-sheets/canada/summary  Cigarette Marketing Pre 2000s Source: Stanford University https://tobacco.stanford.edu/cigarettes/womens-cigarettes/virginia-slims-modern-ads/#collection-173 25  CURRENT CIGARETTE PACKAGING IN CANADA Plain Packaging Photographs and Testimonials No Brand Name Logos Toll-Free Quitline 26  Quit Smoking (Smoking Cessation) Quitting smoking often takes several attempts over many years; success increases when combined with group support. Benefits of quitting begin almost immediately: Twenty minutes Heart rate drops Twelve hours Blood level of carbon monoxide drops to normal Two to 12 weeks Heart attack risk drops, lung function improves One to nine Coughing and shortness of breath decrease months One year Coronary heart disease risk is half that of smoker Five to 15 years Risk of stroke reduced to that of non-smoker Ten years Cancer death rate is about half that of a smoker 27 Fifteen years Heart disease risk is that of a non smoker  NICOTINE WITHDRAWAL SYMPTOMS Withdrawal How Long it Reason Why Symptoms Lasts Body is adjusting to getting Dizzy 1 or 2 days more oxygen Lungs are trying to clear out tar Cough, phlegm 3-5 days and toxins trapped in airways Brain is adjusting to new sleep Trouble sleeping 1 week patterns without nicotine Body is still craving the usual Irritable 2- 4 weeks hit of nicotine Body is learning how to stay Tired, low energy 2-4 weeks alert without nicotine  Quit Smoking (Smoking Cessation) Nicotine-Replacement Therapy (NRT) products supply low doses of nicotine allowing smokers to taper their use gradually. BC Pharmacare covers eligible persons. NRT Patch Gum Lozenges Inhaler Non-Prescription Prescription PURPOSE: minimize withdrawal symptoms and intense nicotine cravings 29  Patch  A transdermal-delivery system where nicotine is provided via a patch attached to the skin by an adhesive.  Worn for 16-24 hours every day for 6-16 weeks.  Size and strength of patch is reduced over time. Side Effects: redness at site; dry mouth; nervousness; insomnia 30  Gum  Contains nicotine resin that is released as it is chewed.  Bite and park between gum and cheek for one minute; repeat process for up to around 30 minutes.  Absorbed through mucous membranes; strength of gum is reduced over time. Side Effects: jaw ache, indigestion, nausea, heartburn, stomach ache 31  Lozenges  Start by sucking until strong taste is released.  Rest lozenge between gum and cheek for one minute; repeat process for up to around 30 minutes.  Absorbed through mucous membranes; strength of lozenge is reduced over time. Side Effects: jaw ache, indigestion, nausea, heartburn, stomach ache 32  Inhalers  Nicotine cartridge is inserted into the mouthpiece.  Tapered end is placed in mouth for inhalation; inhale deeply for approximately 20 minutes.  Absorbed through mucous membranes; strength of dosage is reduced over time. Side Effects: throat irritation, runny nose, cough 33 OFFERING SUPPORT- BC PROGRAMS 34