Chpt 15 PH Enemy #1 Tobacco Spr 2023.pdf

CHAPTER 15 Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Public Health Enemy Number One: Tobacco Copyright © 2021 by Jo...

CHAPTER 15 Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Public Health Enemy Number One: Tobacco Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Public Health Enemy #1 Why is Tobacco  Diseases Caused by Smoking § Cardiovascular disease [American Heart Association’s Life Essential 8 https://www.heart.org/en/healthy-living/healthy-lifestyle/lifes-essential-8] Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Lung cancer § Respiratory diseases – Pneumonia, influenza, bronchitis, emphysema, chronic airway obstruction § Other cancers – Laryngeal, oral, esophageal, pancreatic, urinary § Diseases among infants § Burns Biomedical Basis of Smoking’s Harmful Effects § Nicotine is an addictive drug. – Raises blood pressure and heart rate. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com – May cause spasms in blood vessels of the heart. § Tars are the residue from burning tobacco that condenses in lungs. – Damage cilia and irritate the respiratory tract. – Are a major source of carcinogenicity. § Carbon monoxide – Interferes with oxygen carrying capacity of blood. § Other ingredients – Are also carcinogenic (e.g., arsenic and benzene) – Alter clotting properties of blood – Raise blood cholesterol and reduce HDL Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Historical Tobacco Trends § Intensive use began in early 20th century Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § It was distributed free to soldiers in world wars. § Women began smoking during and after World War II. § Smoking peaked in the mid-1960s with over 42% of adults. § Lung cancer trends followed smoking trends about 20 years later. § The Surgeon General’s first report was 1964. – Smoking rates began to decline. Prevalence of Smoking and Cancer § Fallacy of women’s immunity: Women started smoking later than men, women’s lung cancer rates began rising later, and lung cancer among women surpassed Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com breast cancer in the 1980s. § African American men had a higher rate, but it has declined. § American Indians and Alaskan Natives have high rates. § There is a strong association with lack of education. § Now in the U.S., about 14% of adults smoke. Let’s take a look at who smokes…….  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Who uses tobacco? Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Regulatory Restrictions § Federal Trade Commission – Warning labels Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Federal Communications Commission – Fairness Doctrine for counter-advertising § 1971—The industry submitted a total ban on advertising on radio and television. § 1990s—Nonsmokers’ rights movement. § 1992—EPA declared environmental tobacco smoke to be a carcinogen. § 2019—27 states and the District of Columbia had banned or severely restricted smoking in all public places including work sites, restaurants, and most bars. Initial Emphasis on Youth § Tobacco companies must recruit 1 million smokers per year to replace those who die or quit. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Most smokers begin smoking in their teens. § Ads focus on young people. – Joe Camel § Ads focus on young women. – They are attracted by suggestions that smoking will help them lose weight. § Laws prohibit sale of tobacco to minors but are ineffective.  Taxes § Teenagers are especially sensitive to price. https://igentax.com/cigarette-tax-state/#___Cigarette__tobacco_tax_by_state__ Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § California raised cigarette taxes to fund tobacco control programs. § Many states have raised cigarette taxes to close budget shortfalls. – Number one strategy to damage the tobacco industry – Tax increase is effective at reducing the number of smokers. Cost of pack of cigarettes v/s JUUL pod § Depending on where you live, a pack of cigarettes can cost anywhere from $5 to $13. If you live in New York and smoke a pack a day, that routine will cost you nearly $100 per week. Juul pods, the cartridge that contains the nicotine Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com liquid that is vaporized, go for $15.99 per pack, which contains four pods. § JUUL Labs reports each 5% (nicotine-by-weight) cartridge contains approximately 40 mg nicotine per pod and is 'approximately equivalent to about 1 pack of cigarettes. ' In five independent studies, nicotine in the liquid in a JUULpod ranged from 39.3 to 48.3 mg.Mar 24, 2021  Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Do graphic warnings/labels discourage people from smoking? Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com California’s Tobacco Control Program § Program was funded by 1989 tax increase of 25 cents per pack. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Cigarette consumption immediately declined. § Antismoking campaign in 1990 and 1991 simultaneously reduced smoking. – In 1994, smoking was banned in all workplaces except bars, taverns, and casinos. § Cigarette consumption declined to 11% in 2017. § Studies of antismoking messages show which messages are more effective. 1990s Broad Attack on Tobacco § Class-action lawsuits by state attorneys general were filed. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § FDA commissioner Kessler proposed to regulate tobacco. § “Mr. Butts” leaked tobacco company documents. § Tobacco industry was put on the defensive. § Tobacco companies challenged the FDA’s authority to regulate tobacco. Master Settlement Agreement § In 1997–1998, attorneys general and the tobacco industry agreed on a settlement. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Industry agreed to: – Pay $206 billion to 46 states over 25 years – Pay $1.7 billion to American Legacy Foundation “Truth campaign” used lessons from California’s campaign. – Restrict advertising § Disappointingly, states used very little settlement money for tobacco control. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Family Smoking Prevention and Tobacco Control Act Was passed by Congress in 2009 Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Authorizes the FDA to regulate tobacco products and to restrict advertising and promotion Requires larger and more graphic warning labels on cigarette packages Forbids tobacco companies from sponsoring sporting events Requires disclosure of ingredients of cigarettes Electronic Cigarettes: A Brief Historical Perspective § According to CDC, between 2010 and 2013, e-cigarette awareness grew to 80% and use more than doubled among U.S. adults. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § They are heavily marketed on television. § FDA originally did not have the authority to regulate. As of March 2022, The Food and Drug Administration (FDA) has authority to regulate synthetic nicotine under provisions included in the federal omnibus spending bill recently passed by Congress and signed into law by President Joe Biden.Mar 15, 2022 § Initially there was concern for small children due to fruit and candy flavors. The new law bans sales in stores of vape products---with or without nicotine---in any flavor other than tobacco. It also prohibits sales of flavored nicotine pouches, lozenges, smokeless tobacco (including snus), menthol cigarettes and flavored small cigars.Dec 21, 2022 Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Why is Tobacco Public Health Enemy #1? § Cigarette smoking remains the leading cause of preventable disease and death in the United States. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Cigarette smoking kills more than 480,000 Americans each year.1 Cigarette smoking cost the United States more than $600 billion in 2018, including more than $240 billion in healthcare spending and nearly $372 billion in lost productivity.1,2,3,4 Discussion Question 1 § Use the ecological model (see Chapter 14) to design a community program to discourage smoking among teenagers. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com Discussion Question 2 § Do you believe statements by tobacco companies that their advertising is not aimed at getting kids to smoke? Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Explain your response. Discussion Question 3 § Visit the American Legacy Foundation’s truth campaign website, www.thetruth.com. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § Try playing a game. § Check out the T-shirts in the apparel store. § Do you think these messages are effective at discouraging teenagers from smoking? Discussion Question 4 § Visit the CDC’s Smoking and Tobacco Use webpage, www.cdc.gov/tobacco. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com § What is the CDC doing to reduce the prevalence of smoking in the U.S.?