Presentation on theme: "Tobacco Addiction IS Treatable at the Worksite"— Presentation transcript:
1 Tobacco Addiction IS Treatable at the Worksite Barry Sharp, MSHP, MACM, MCHESManagerTobacco Prevention & Control BranchHealth Promotion & Chronic disease prevention SectionTexas Department of State Health Services
2 Tobacco Addiction IS Treatable Session Objectives:Understanding current tobacco threatHHS Policy ChangeResources are there to treat tobacco dependenceHow do I do it?
3 “We don’t smoke that s--t. We just sell it “We don’t smoke that s--t. We just sell it. We reserve the right to smoke for the young, the poor, the black and the stupid.”[R.J. Reynolds executive’s reply when asked why he didn’t smoke according to Dave Goerlitz, lead Winston model for seven years for R.J. Reynolds.] Giovanni, J, “Come to Cancer Country; USA; Focus,” The Times of London, August 2, 1992.Why is this important?
5 Tobacco = ProblemGlobally – One person dies every five seconds from a tobacco related cause.Nationally – One person dies every 72 seconds from a tobacco related cause.Texas – One person dies every 22 minutes from a tobacco related cause.1,140 youth take up smoking every day; one third of them will die from their habit.
7 Human Toll (Texas) Deaths in Texas from smoking: 24,899 adults each year503,000 youth alive today will die prematurely from smoking2,660 to 4,720 adults, children and babies die from diseases caused by secondhand smoke and pregnancy smokingFor every person who dies from a tobacco related cause, 20 more are suffering from the impact of tobacco related diseases.
8 Take home messages: Economic Impact Health Effects It’s Not Your Parents Tobacco Anymore
9 Economic Toll (Texas) $47 million in highway trash cleanup (2012) Texas Economic costs:$1.6 billion in Medicaid$5.83 billion overall health costs$6.44 billion in lost productivity$13.26 million in fire loss (2012)508 Structure Fires in Texas caused by smoking26 civilian injuries, 6 civilian deaths, ~$7 million in property loss. 678 Outside Fires caused by smoking.Most were likely highway right of way or pasture fires caused by improperly discarded smoking materials$47 million in highway trash cleanup (2012)31 percent of all litter is cigarette buttsTobacco constituted the majority of roadside litter – butts, wrappers, lighters
10 Cigarette Health Effects Smoking causes 443,000 deaths (one in five) each year in the United States.Smoking causes an estimated 90 percent of all lung cancer deaths in men and 80 percent of all lung cancer deaths in women.An estimated 90 percent of all deaths from chronic obstructive lung disease caused by smoking.
11 Cigarette Health Effects Compared to nonsmokers, smoking is estimated to increase the risk of:Coronary heart disease by 2 to 4 timesStroke by 2 to 4 timesLung Cancer in men by 23 timesLung Cancer in women by 13 timesDeath by chronic obstructed lung diseases (such as chronic bronchitis and emphysema) by 12 to 13 times
12 Cigarette Health Effects Cardiovascular ImpactsSmoking causes coronary heart diseaseSmoking reduces circulation by narrowing blood vessels and increases risk of developing peripheral vascular diseasesSmoking causes abdominal aortic aneurysmRespiratory ImpactsSmoking causes lung cancerSmoking causes lung diseases by damaging the airways and alveoli of the lungs
13 Cigarette Health Effects Cancers caused by smoking:Acute myeloid leukemiaBladder cancerCancer of the cervixCancer of the esophagusKidney cancerCancer of the larynx (voice box)Lung cancerCancer of the oral cavity (mouth)Cancer of the pharynx (throat)Stomach cancerCancer of the uterus
14 Cigarette Health Effects Adverse Reproductive and Early Childhood effects:InfertilityPreterm deliveryStillbirthLow birth weightSudden Infant Death Syndrome (SIDS)Postmenopausal women who smoke have lower bone density than women who never smokedWomen who smoke have an increased risk for hip fracture than women who never smoked
15 Smokeless Health Effects CancerSmokeless tobacco contains 28 cancer-causing agentsSmokeless tobacco is a known cause of human cancers and increases the risk of developing cancer of the oral cavityOral HealthSmokeless tobacco strongly associated with leukoplakia – a precancerous lesion of the soft tissue in the mouth consisting of a white patch or plaque that can not be scraped offAssociated with recession of the gums, gum disease and tooth decay
16 Smokeless Health Effects Reproductive HealthSmokeless tobacco use during pregnancy increases the risk for preeclampsia, premature birth and low birth weightSmokeless tobacco use by men causes reduced sperm count and abnormal sperm cellsNicotine AddictionSmokeless tobacco use can lead to nicotine addiction and dependenceAdolescents who use smokeless tobacco are more likely to become cigarette smokers
17 Secondhand Smoke Health Effects According to the Surgeon General:Secondhand smoke is the combination of smoke from the burning end of a cigarette and the smoke breathed out by smokers. Secondhand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer.There is no risk-free level of exposure to secondhand smoke.
18 Secondhand Smoke Health Effects Cardiovascular impactsCauses an estimated 46,000 premature deaths from heart disease each year in nonsmokersExposure increases nonsmokers risk of developing heart disease by 25 to 30 percentInterferes with normal functioning of heart, blood and vascular systems in ways that increase risk of a heart attackBrief exposure can damage the lining of blood vessels and cause blood platelets to become stickier – increasing risk of heart attack.
19 Secondhand Smoke Health Effects Lung CancerIncreases nonsmokers risk for developing lung cancer by 20 to 30 percentCauses an estimated 3,400 lung cancer deaths annually among nonsmokersEven brief exposure can damage cells in ways that set the cancer process in motionThe longer the duration and higher the exposure to secondhand smoke, the greater the risk of developing lung cancer
20 Secondhand Smoke Health Effects Sudden Infant Death Syndrome (SIDS)Smoking during pregnancy increases the risk for SIDSInfants exposed to secondhand smoke after birth are also at a greater risk for SIDSChemicals in secondhand smoke appear to effect the brain in ways that interfere with breathing regulationInfants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine (A biological marker for secondhand smoke exposure) than infants who die from other causes
21 Secondhand Smoke Health Effects Children’s health impactsOlder children whose parents smoke get sick more often, their lungs grow less and get more bronchitis and pneumoniaWheezing and coughing are more common in children who breath secondhand smokeSecondhand smoke can trigger an asthma attack in children. Children exposed to secondhand smoke have more severe and frequent asthma attacks, putting a child’s life in danger.Children whose parents smoke get more ear infections. They also have fluid in their ears more often and have more operations to put in ear tubes for drainage.
27 Secondhand Smoke Elimination Health Effects Clean indoor air legislation linked to reduced hospitalizations for Acute Myocardial Infarction (hearth attack)City of Pueblo, Colorado,City passed ordinance making all workplaces and public places smoke free effective July 1, 200318 months prior to ordinance, hospitals reported 257 per 100,000 person-years AMI admissions18 months after the ordinance, hospitals reported 187 per 100,000 person-years AMI admissions (27 percent decline)36 months after the ordinance, hospitals reported 152 per 100,000 person-years AMI admissions (19 percent decline from first study, 41 percent decline from before passage)
28 Secondhand Smoke Elimination Health Effects Smoke-free laws likely reduce heart attack hospitalizations both by reducing secondhand smoke exposure among nonsmokers and by reducing smoking, with the first factor making the larger contribution.Studies have also found that making restaurants and bars smoke-free are associated with rapid improvements in health indicators for workers, including reductions in self-reported respiratory and sensory symptoms and objectively measured improvements in lung function
29 HHS Policy ChangeSeptember 1 – All Austin Health and Human Services agencies go smoke-free campuses.DSHS remained a tobacco-free campus.March 1 – All Health and Human Services agencies to smoke-free statewide.DSHS campuses remain tobacco-free.DSHS Tobacco Quitline added Health and Human Services employees to list of those eligible for free Nicotine Replacement Therapy as part of cessation counseling services.ERS covers cessation prescription medications
30 Treatment Best Practices Current Texas ModelNational ModelsAskAdviceReferFaxOnlineEMR/EHRPhone AppPharmacology5 A’sAsk, Advise, Assess, Assist, Arrange5 R’sRelevance, Risk, Rewards, Roadblocks, RepetitionPharmacology
31 Tobacco use will remain the leading cause of preventable illness and death in this Nation and a growing number of other countries until tobacco prevention and control efforts are commensurate with the harm caused by tobacco use.David Satcher, MD, PhDFormer U.S. Surgeon GeneralReducing Tobacco Use, A ReportOf the Surgeon GeneralTreatment Resources
32 Texas Based Resources www.YesQuit.org www.texmed.inreachce.com Cessation support website by the Department of State Health Services – on line clinician toolkit for treating tobacco dependence, on line training, referral to Quitline, media messagesTobacco cessation treatment CE courses from the Texas Medical AssociationTobacco cessation treatment courses through the Physician Oncology Education Program of the Texas Medical Associationwww2.mdanderson.org/app/tobaccoTobacco Outreach Education Program – up to five hours physician continuing education from MD Anderson Cancer Center
33 Texas Resources Texas Tobacco Websites – youth tobacco prevention– teen tobacco prevention– smokeless tobacco prevention– secondhand smoke exposure– tobacco cessation resources– state tobacco laws relating to access and youth possession- state tobacco program information, research findings, reports
34 Other Stakeholders/Resources – American Cancer Society– American Heart Assoc.– American Lung Assoc.– Campaign for Tobacco Free Kidswww. legacyforhealth.org – American Legacy Foundation (sponsors national cessation campaign)mayoresearch.mayo.edu/mayo/research/center-tobacco-free-living/index.cfm – Mayo Clinic Center for Tobacco Free Living
35 Thank you for playing along. Four million unnecessary deaths per year, 11,000 every day. It is rare – if not impossible – to find examples in history that match tobacco’s programmed trail of death and destruction. I use the word programmed carefully. A cigarette is the only consumer product which when used as directed kills its consumer.Dr. Gro Harlem BrundtlandFormer Director-GeneralWorld Health OrganizationThank you for playing along.Barry Sharp, MSHP, MACM, MCHESManagerTobacco Prevention & Control BranchTexas Department of State Health Services