Download Chapter 17: Eliminating Tobacco Use

Chapter 17
Eliminating Tobacco Use
Learning Objectives
1. Describe the hazards of cigarette smoking.
2. Identify and explain the physiological effects of tobacco.
3. Describe the hazards of smokeless tobacco.
4. Discuss the effects of smoke on nonsmokers, including children.
5. Explain why some people smoke.
6. Identify ways to quit smoking.
7. Describe the various ways to limit tobacco’s damage to society.
Key Terms
Alveoli (385)
Bronchitis (385)
Carcinogens (385)
Chewing tobacco (383)
Chronic obstructive pulmonary disease (COPD) (385)
Emphysema (385)
Moist snuff (383)
Nicotine (381)
Nicotine replacement therapy (387)
Quit date (387)
Snuff (383)
Tar (382)
Trachea (385)
Chapter Summary
No public health message is disseminated as widely as the one that appears on every package of
cigarettes and in every cigarette advertisement: “Warning: The Surgeon General has determined
that cigarette smoking is dangerous to your health.” In spite of the overwhelming evidence that
cigarette smoking is associated with higher death rates from cancer, heart disease, and
respiratory disease, approximately 62 million Americans smoke.
Smoking is an acquired habit; it is not a life-sustaining activity. Therefore, the primary
motivation for all smokers is the desire to smoke. For some, the desire comes from the
stimulation they receive from smoking; for others, smoking is a means to increase pleasure or to
decrease stress.
The fact that smoking is a matter of personal choice means that people can stop smoking if they
so choose. Many smoking cessation programs are available to assist the motivated quitter. The
success of any attempt to quit smoking relies on the smoker’s resolve to quit and on replacing the
unhealthy smoking habit with personally rewarding behaviors.
Smokeless tobacco use has become a problem during the last two decades, particularly among
young people. Smokeless tobacco is not safe to use, just as smoking tobacco is not safe.
Smokeless tobacco causes lip and oral cancers.
One of the reasons that people continue to smoke is that the tobacco industry spends millions of
dollars each year for advertising and other promotional activities that encourage people to
smoke. The federal government is also partly to blame. While the Public Health Service
campaigns against smoking, the Department of Agriculture provides tobacco growers with price
supports for their crops.
The war of words will probably continue for a long time. But you need not be confused by the
real issue: Smoking is a serious risk to your health. Anyone who smokes, and anyone who is
thinking of trying it, should keep in mind the dangers and not forget that there is no cure for heart
disease, emphysema, or lung cancer.
Lecture Outline
Eliminating Tobacco Use
•
45 million Americans over age 18 are smokers.
•
10 million Americans have a disease caused or made worse by smoking.
– Chronic obstructive lung disease
– Heart disease
– Stroke
– Type 2 diabetes
– Erection problems
– High blood pressure
– Cancer
Tobacco Use in the United States
•
About 200,000 Americans die each year as a result of smoking (1 in 5 deaths annually).
•
About $35 billion of the $200 billion it costs to care for smokers is covered by smokers in
the form of cigarette taxes, direct costs, and health care insurance; the rest is up to
nonsmokers to cover.
•
The prevalence of adult American smokers has declined in the past 35 years. But it is
accompanied by increased use of other tobacco products.
•
About 20% of college students use tobacco occasionally.
What Is Tobacco?
•
Used for smoking, chewing or snuff, processed from the leaves of Nicotiana tabacum
•
Nicotine is the most familiar constituent of tobacco.
•
When burned, about 4,000 other chemical substances are released and carried in
the smoke.
•
Contains tar, a yellowish-brown residue of smoke; tar is a documented cause of lung
cancer
Physiological Effects of Tobacco
•
Most prominent effects of nicotine are:
– Increased heart rate and release of adrenaline
– Direct stimulatory effect on the brain
– Lowered skin temperature and reduced blood flow
– Nausea and vomiting (beginning smokers)
– Addiction
•
Most harmful effects are attributable to nicotine and carbon monoxide.
•
Radioactive particles are also present.
Smokeless Tobacco
•
Chewing tobacco is processed in three forms:
– Loose leaf
– Firm/moist plug
– Twist/rope
•
Portion is either chewed or placed in the mouth and held between the lower lip and gum.
•
Snuff is made from powered or finely cut tobacco leaves and is available in two forms:
– Dry snuff: In the United States, a “pinch” is placed in the mouth and held between
the cheek and gum, referred to as “snuff dipping.”
– Moist snuff is made from air- and fire-cured tobacco leaves that are processed
into fine particles and packaged in moist form in round, flat containers. Moist
snuff is considered the most dangerous form of smokeless tobacco.
•
Chewing tobacco has been replaced by moist snuff as the most hazardous form.
•
Smokeless tobacco causes:
– Various forms of oral cancer
– Leukoplakia (hard white patches on the gums)
– Gingivitis (inflammation of the gums)
•
Risk of developing oral cancers is much greater among smokeless tobacco users than
nonusers.
•
Other smokeless tobacco health problems include:
– Increased incidence of tooth decay
– Abrasions on teeth
– Halitosis (bad breath)
– Loss of taste and smell
– Yellow or brown stains on teeth and clothing
– Tobacco clinging to teeth, lips, gums, and clothing
– Instead of spitting, some users swallow the juices, which can lead to stomach
disorders
Cigars
•
Compared with nonsmokers
– Cigar smokers who do not inhale have 3 times the risk of dying of lung cancer
– Cigar smokers who do inhale have 11 times the risk of dying of lung cancer
•
Cancers associated with cigar smoking are:
– Lip, tongue, mouth, throat, esophagus, larynx, pancreas, and bladder
•
One cigar may contain as much tobacco as a pack of cigarettes.
Smoking and Disease
•
There is overwhelming evidence that smokers as a group have a greater incidence of
certain diseases than nonsmokers.
•
Smoking decreases a person’s life expectancy by an average of 7 years.
•
Smokers between the ages of 35 and 70 have death rates three times higher than those
who have never smoked.
•
Effects of Parental Smoking on Children
– Spontaneous abortion
– Death among newborns
– SIDS
– Low-birthweight babies
– Bronchitis and respiratory tract infection
•
Health Effects of Tobacco Use
– Smoking kills more people than AIDS, poor diet, and sedentary lifestyle, car
accidents, alcohol, homicides, illegal drugs, suicides, and fires combined
– Contributes substantially to deaths from cancer, cardiovascular disease, lung
disease, burns, and problems in infancy caused by low birthweight.
•
Lung Cancer
– Annually, about 215,000 people are diagnosed.
– Lung cancer kills about 162,000 people yearly.
– Smoking is responsible for almost 90% of lung cancers among men and more
than 70% among women.
– In 1987, lung cancer passed breast cancer as the leading cause of cancer deaths
among women.
– It is the most preventable of all diseases.
– The key is to stop or never even start smoking.
•
Heart Disease
– Number one killer in the United States.
– Cigarette smoking increases the risk of heart disease.
– Smoking can increase tension in the heart muscle walls, speed up the rate of
muscular contraction, and increase the heart rate. As the heart’s workload
increases, so does the need for oxygen and other nutrients.
– Smoking also reduces the amount of high-density lipoprotein (HDL) cholesterol
(the “good” cholesterol), which facilitates:
•
•
Plaque formation
•
Blood clotting
Bronchitis and Emphysema
– Respiratory diseases sometimes classified with chronic obstructive pulmonary
disease (COPD)
– Associated with breathing difficulty caused by obstruction of or destruction of
some part of the respiratory system
•
Bronchitis
– Inflammation of the upper part of the respiratory tract, particularly the trachea
– Characterized by excessive production of mucus, continual cough (smoker’s
cough), and production of large amounts of sputum
– Can be completely reversed by quitting smoking
•
Emphysema
– Results from destruction of the tiny air sacs, called alveoli, deep in the lungs.
– Irreversible, disabling condition in which the walls of the air sacs in the lungs lose
their elasticity and are gradually destroyed.
– The lungs’ ability to obtain oxygen and remove carbon dioxide is impaired.
– The heart has to work harder, which results in the heart becoming enlarged.
•
Tobacco Smoke’s Effect on Nonsmokers
– Nonsmokers who are exposed to environmental tobacco smoke (ETS) run a health
risk.
– About two-thirds of the smoke from burning cigarettes enters the environment.
– Each year, 3,000 nonsmokers die of lung cancer and 50,000 die from heart disease
caused by ETS.
– Secondhand smoke contains more than 4,000 chemicals but in a greater
concentration than smoking because it is unfiltered.
Why People Smoke
•
Emulate parents and others who smoke.
•
Emulate cigarette ad models.
•
Gain peer recognition.
•
Ease peer pressure.
•
According to the American Cancer Society, the motivations of smokers can be grouped
into six general categories: stimulation, handling, pleasurable relaxation, reducing
negative feelings, craving, and habit.
Quitting Smoking
•
Most smoking cessation plans center on a quit date. Prior to the quit date, the smoker
prepares for stopping
•
Twenty minutes after finishing a cigarette, the body begins a series of regenerating
changes
•
One to 9 months after quitting smoking, coughing, sinus congestion, fatigue, and
shortness of breath decrease, and cilia regrow in the lungs
•
Involves breaking both the biological habit, as well as the psychological and social habits
of smoking
•
Involves a lot of planning and is very involved; it takes work to quit
•
There are nicotine replacement therapies such as nicotine gum and the nicotine patch to
help lessen the effects of nicotine withdrawal
The War of Words
•
Each year, the tobacco industry spends hundreds of billions of dollars to portray smoking
as attractive and sexy, and associated with slimness and high social status.
•
To combat this misinformation, antismoking groups advertise their message of the health
consequences of smoking.
•
In 1998, 46 states and 7 tobacco companies settled the states’ lawsuits to recover
tobacco-related health care costs.
Eliminating Tobacco Use
•
If you don’t smoke, are you bothered by smoking in public places? Which are the most
bothersome to you?
•
If you do smoke, are you bothered by the restrictions by which you must smoke? How do
you cope?
•
Do you know anyone who has tried to quit smoking? How has it affected your view of
smoking?
Study Guide and Self-Assessment Workbook
17.1 Why Do I Smoke?
17.2 Am I Addicted to Nicotine?
Additional Resources
Action on Smoking and Health (ASH)
2013 H Street NW
Washington, DC 20006
(202) 659-4310
www.ash.org
American Lung Association
1740 Broadway
New York, NY 10019
(212) 315-8700
www.lungusa.org
Smoke Free
Smokefree.gov
Smoking Hotline
(800) TRY-TO-STOP