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Chapter Nine
Rejecting Tobacco Use
© 2007 McGraw-Hill Higher Education. All rights reserved.
Tobacco Use in American
Society
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Since 1994, the population of smokers has
declined (22.5% of adults smoke daily)
Men (25.2%) smoke more than women
(20%)
College students smoke less than year
2000
Ethnicity, socioeconomics, education, and
demographics are often factors that
influence smoking
© 2007 McGraw-Hill Higher Education. All rights reserved.
Other Demographic Factors
Influencing Tobacco Use
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Age groups
Region of the country
Size of the community
Employment status
© 2007 McGraw-Hill Higher Education. All rights reserved.
Pipe and Cigar Smoking
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Pipe/cigar smokers
have the same rate
of cancer
frequency as
cigarette smokers
with:
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Mouth
Larynx
Throat
Esophagus
© 2007 McGraw-Hill Higher Education. All rights reserved.
Development of Dependence
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Dependence: physical and/or
psychological need to continue the
use of the drug (nicotine)
Physical dependence due to:
• Titration: particular level of a drug
within the body; adjusting the level of
nicotine by adjusting the rate of
smoking
© 2007 McGraw-Hill Higher Education. All rights reserved.
Theories of
Nicotine Addiction
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Genetic theory – 60% of addiction is
based upon genetic influence
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Bolus theory – ball of nicotine reaches
brain, causing excitement
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Adrenocorticotropic hormone theory
(ACTH) – release of beta endorphins
delivers euphoric effect
Self-Medication theory – nicotine via
dopamine “lifts spirits”
© 2007 McGraw-Hill Higher Education. All rights reserved.
Acute Effects of Nicotine on the
CNS
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Arousal of nicotine allows norepinephrine,
dopamine, acetylcholine, serotonin release
CNS is depressed within the brain which
stimulates areas within the heart, lungs,
blood flow
© 2007 McGraw-Hill Higher Education. All rights reserved.
Psychosocial Factors Related to
Dependence
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Modeling
Manipulation
Susceptibility to Advertising
© 2007 McGraw-Hill Higher Education. All rights reserved.
Tobacco Active Components
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Particulate = nicotine, water, tar
(small particles)
Gaseous = carbon monoxide,
ammonia, hydrogen cyanide, etc.
Carcinogens: capable of stimulating the development of cancer
© 2007 McGraw-Hill Higher Education. All rights reserved.
Illness & Premature Death
Due to Tobacco Use
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Cardiovascular disease (nicotine and
carbon monoxide related)
Cancer (30% of all cancer cases
related to tobacco use)
• lung, mouth, throat cancers
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Chronic Obstructive Lung Disease
(COLD)
Mucus and cilia damage compromise the respiratory
tract
© 2007 McGraw-Hill Higher Education. All rights reserved.
Additional Health Concerns
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Strokes
Osteoporosis
Muscle injury/back
pain
Skin changes
Oral health
Brain and behavior
Neurological
disorders
© 2007 McGraw-Hill Higher Education. All rights reserved.
Smoking and Reproduction
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Infertility
Pregnancy problems
Breastfeeding concerns
Neonatal Health Problems
Sperm degradation
Erectile dysfunction
Use of oral contraception with
smoking increases risk factors for
CHD
© 2007 McGraw-Hill Higher Education. All rights reserved.
Smokeless Tobacco
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Not burned, placed in mouth
Chemicals absorbed through mucous
membranes
Risks: leukoplakia, erythroplakia,
periodontal disease, cancer of
digestive tract and mouth
© 2007 McGraw-Hill Higher Education. All rights reserved.
The Risks of Involuntary (Passive)
Smoking
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Mainstream smoke = smoke
inhaled/exhaled by smoker (15%
exposure to non-smoker)
Sidestream = smoke from the
burning product (85% exposure to
non-smoker)
Environmental = smoke from either
method diluted by the air
Partners of smokers are 3 x’s higher for CAD and 30%
higher risk for lung cancer
© 2007 McGraw-Hill Higher Education. All rights reserved.
New Product Development
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Eclipse (cigarette that heats vs. burns
tobacco)
Accord (cigarette that reduces sidestream
smoke)
Advance, Omni, and Quest: cigarettes that
have ‘trionic” filters which reduce
carcinogen exposure
Non-tobacco sources of nicotine products
e.g. suckers, gums, straws, sprays, drops,
etc.
© 2007 McGraw-Hill Higher Education. All rights reserved.
Smoking Cessation
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Nicotine products (patch, gum,
inhaler)
Medications (anti-depressants)
Inhalation sprays
© 2007 McGraw-Hill Higher Education. All rights reserved.
Chapter Nine
Rejecting Tobacco Use
© 2007 McGraw-Hill Higher Education. All rights reserved.