1. The Health Risks Associated with Tobacco Use and Exposure to Second and Thirdhand smoke NJ Department of Health and Senior Services, Office of Tobacco Control

2. "Tobacco-Free for a Healthy New Jersey" (TFHNJ) is the Office of Tobacco Control’s statewide tobacco control effort. TFHNJ's membership is comprised of community-based organizations with varied areas of expertise in tobacco control, prevention and cessation. TFHNJ partners seek policy and social change regarding tobacco exposure, use and prevention.

3. Tobacco use is the leading preventable cause of death. In the US, tobacco use is responsible for about 1 in 5 deaths annually (about 443,000 deaths per year). Nearly 1,200 people die every day Half of all smokers die from smoking Smoking accounts for 30% of all cancer deaths and 87% of all lung cancer deaths. http://www.cdc.gov/tobacco/data_statistics/sgr/2010/index.htm http://www.tobaccofreekids.org/facts_issues/toll_us/ American Cancer Society

4. NJ Statistics 398,000 kids are exposed to secondhand smoke in the home in NJ. 11,200 Adults die each year from their own smoking in NJ. 168,000 kids now under 18 and alive in NJ who will ultimately die prematurely from smoking. 14.4% of adults in New Jersey identified themselves as current cigarette smokers Campaign for Tobacco Free Kids

5. New Jersey Smoking Prevalence by Region of Residence NJBRFSS, 2008

6. Tobacco Facts Tobacco is #1 preventable cause of death. Tobacco kills more people than all of these causes of death combined: Car crashes AIDS Suicide Homicide Illicit Drug use Alcohol American Cancer Society

7. Cigarette smoke contains more than 7,000 chemicals and compounds. Hundreds are toxic and at least 69 cause cancer. Acetone (nail polish remover) Butane (lighter fluid) Cadmium (rechargeable batteries) Toluene (industrial solvent) Methanol (rocket fuel) Formaldehyde (tissue preservative) Nicotine and DDT (insecticides) Ammonia (toilet bowl cleaner) Naphthalene (mothballs) Hydrogen Cyanide (gas chamber poison) Carbon Monoxide (car exhaust) Methane (swamp gas) Each cigarette contains 2mg of nicotine. Chemicals in Cigarette Smoke American Cancer Society

8. Tobacco use Leads to Disease and Disability Smoking causes cancer, heart disease, stroke, and lung diseases (including emphysema, bronchitis, and chronic airway obstruction). For every person who dies from a smoking-related disease, 20 more people suffer with at least one serious illness from smoking. http://www.cdc.gov/tobacco/data_statistics/sgr/2010/index.htm

9. Smoking & Hypertension Hypertension is a serious condition that can lead to heart disease, heart failure, stroke, kidney failure, and other health problems. Smoking and hypertension may change the flow properties of the blood and the behavior of the arterial wall and this may explain the arterial damage observed in cigarette smokers and hypertensive patients. Arteriosclerosis, Thrombosis, and Vascular Biology, American Heart Assoc. 1987 National Heart Lung and Blood Institute 2011

10. Heart Disease Only 29% of current smokers believe they have a higher than average risk of heart attack. A person’s risk of heart attack greatly increases with the number of cigarettes he or she smokes and the longer a person smokes, the greater their risk of a heart attack. Ayanian & Cleary, JAMA 218:1019

11. How Does Smoking Increase Heart Disease Risk? The nicotine present in tobacco products causes: A decrease in oxygen to the heart. An increase in blood pressure and heart rate. An increase in blood clotting. Damage to cells that line coronary arteries and other blood vessels.

12. Smoking & Atherosclerosis How Does Smoking Affect the Heart and Blood Vessels: National Heart, Lung and Blood Institute March 2010.

13. Smoking & Cancer Lung cancer is the leading cause of cancer death among both men and women in the U.S. and 90% of lung cancer deaths among women are due to smoking. As the proportion of filtered cigarette users has increased, the specific type of lung cancer has evolved likely influenced by deep inhalation. UMDNJ-Tobacco Dependence Program 2010 National Cancer Institute 2011

14. Average Relative Risk of Cancer in Smokers 15-30x risk of lung cancer 10x risk of laryngeal cancer 4-5x risk of oral cancer 3x risk of urinary tract cancer 2-4x risk of pancreatic cancer 2x risk of other cancers (stomach, liver, cervix) UMDNJ Tobacco Dependence Program 2010.

15. Smoking 16 to 25 cigarettes a day increases the risk for Type 2 diabetes to three times that of a non- smoker. The more risk factors a person has, the greater the chances are of developing diabetes. Smoking increases complications for those who have diabetes – Retinopathy – Heart Disease – Stroke – Vascular disease – Nerve damage – Kidney disease The Cleveland Clinic Foundation 2008 Diabetes and Smoking

16. Damage from Tobacco Smoke is Immediate The chemicals in tobacco smoke reach your lungs quickly every time you inhale. Your blood then carries the toxicants to every organ in your body. The chemicals and toxicants in tobacco smoke damage DNA, which can lead to cancer. Exposure to tobacco smoke quickly damages blood vessels throughout the body and makes blood more likely to clot. This damage can cause heart attacks, strokes, and even sudden death. Office of the Surgeon General 2010

17. Damage from Tobacco Smoke is Immediate The chemicals in tobacco smoke inflame the delicate lining of the lungs and can cause permanent damage that reduces the ability of the lungs to exchange air efficiently and leads to chronic obstructive pulmonary disease (COPD), which includes emphysema and chronic bronchitis. Office of the Surgeon General 2010

18. Smoking Risks in Pregnancy Women who smoke prior to pregnancy… are about twice as likely to experience a delay in conception and have approximately 30% higher odds of being infertile. have about 30% higher odds of delivering prematurely. CDC Preventing Smoking and Exposure to Secondhand Smoke Before, During, and After Pregnancy, July 2007

19. Smoking Risks in Pregnancy Infants who are born to women who smoke during pregnancy… weigh an average of 200 gram less than infants born to women who do not smoke. are 1.4 to 3.0 times more likely to die of Sudden Infant Death Syndrome (SIDS). CDC Preventing Smoking and Exposure to Secondhand Smoke Before, During, and After Pregnancy, July 2007

20. The Hazards of Secondhand Smoke In the United States, secondhand smoke exposure causes an estimated 49,000 deaths annually. (CDC, 2010) Secondhand smoke is the combination of smoke from the burning end of the cigarette and the smoke breathed out by smokers. Secondhand smoke contains about 70 cancer- causing chemicals. There is no safe amount of secondhand smoke.

22. Health Consequences of Environmental Tobacco Smoke (ETS) Lung Cancer Nasal Sinus Cancer Heart Disease Stroke Coughing Reduced Lung Function Emphysema Asthma Irritation of eye, nose, throat and lungs Chronic Bronchitis Reproductive effects in women Higher rate of SIDS American Cancer Society Surgeon General’s Report 2006

23. Secondhand Smoke Causes deadly diseases such as heart disease and lung cancer in nonsmokers. Causes hundreds of thousands of children respiratory infections. 168,000 children in NJ will die prematurely from tobacco related disease Even brief secondhand smoke exposure can damage cells in ways that set the cancer process in motion. As with active smoking, the longer the duration and the higher the level of exposure to secondhand smoke, the greater the risk of developing lung cancer. Surgeon General’s Report 2010

24. Third-hand Smoke Thirdhand smoke refers to the toxins from cigarette smoke that stick to soft surfaces. Through thirdhand smoke, people can be exposed to the same toxins found in tobacco smoke. Low levels of toxins can build up to dangerous levels in the body. This can cause learning problems for children. Thirdhand smoke can stay on unwashed surfaces for days, weeks, even months. http://www.cbc..ca/health/story/2009/01/06/smoking-third.html

25. How Nicotine Affects the Brain and Emotions Regulates mood May control anger and anxiety Can act as a stimulant or relax a person depending on situation May provide a sense of control American Cancer Society

26. Why do smokers still smoke? ADDICTION IS POWERFUL Three components of addiction: Physical – A physical craving for tobacco and withdrawal symptoms may be present in the absence of the drug Habit – The use is ritualistic and done without thought Psychological – The belief that the user cannot function without the habit

27. Faced with change, most people are not ready to act. Change is a process, not a single step. Typically, it takes multiple attempts. HOW CAN I LIVE WITHOUT TOBACCO? The (DIFFICULT) Decision to Quit

28. Treatment: A Collaborative Effort Collaborative efforts among all agencies involved in the lives of smokers is necessary for change to occur. Know cessation resources: o NJ Quitline o Mom’s Quit Connection Know your local and state resources. Join an IMAC to help your community decrease exposure to second and thirdhand smoke. Seek training on how to offer advise to smokers about quitting.

29. Courtesy of Mell Lazarus and Creators Syndicate. Copyright 2000, Mell Lazarus.

30. Resources www.snjpc.org www.nj.gov www.njgasp.org www.cancer.org www.njquitline.org www.nj.quitnet.com http://www.cdc.gov/tobacco Mom’s Quit Connection 1-888-545-5191 New Jersey Quitline 1-866-NJ-STOPS