Chapter 9 Rejecting Tobacco Use

Tobacco When burned – produces 4000 chemical compounds, hundreds known to be physiologically active, toxic and carcinogenic…others unknown Smoking causes 440,000 US deaths per year- 1 out of every 5 deaths. November 1998 – states settled with tobacco industry to pay $206 billion (over 25 years) to reimburse states for Medicaid expenditures associated with treating smoking related illnesses, PSA and education. Advertising approaches – now to young, minority males and females (market shares) Tobacco industry under fire Pipe and cigar smoking

Why is Smoking So Prevalent Among College Students? Many college smokers do not connect their smoking behaviors with health consequences. Although they knew the long-term risks, 25% of community college students surveyed did not believe their smoking habits affected their health in any way, and 50% thought quitting would bring them little or no health benefit (Allen, 2004)

Development of Dependence Physiological factors Nicotine as an addictive drug Physiologically active, dependence-producing drug found in tobacco Psychosocial factors Modeling Manipulation Susceptibility to advertising

Two Phases - Particulate Phase Gaseous Phase

Particulate phase Two Phases - #1 Portion of the tobacco smoke composed of small suspended particles Nicotine Tar Water

Particulate phase Nicotine Physiologically active, dependence-producing drug found in tobacco. Stimulant Increases blood pressure and heart rate Increases production of adrenalin Causes blood vessels to narrow Increases respiration Causes release of glycogen from liver = “kick” Blood vessel narrowing causes decreased skin temperature and increased BP

Particulate phase Tar Water Sticky brown substance Contains carcinogens Interferes with normal cilia function in the lung Water Tar contains carcinogenic hydrocarbons known as polycyclic aromatic hydrocarbons (PAH). Benzo (a) pyrene (a PAH) has been inked with specific genes that cause lung cancer.

Tar contains carcinogenic hydrocarbons known as polycyclic aromatic hydrocarbons (PAH). Benzo (a) pyrene (a PAH) has been inked with specific genes that cause lung cancer.

In healthy lung Suspended particles trapped in mucus Cilia sweeps mucus upward Mucus is then swallowed and digested In smoker’s lung Cilia damaged, can’t sweep and tar remains in airway Tar increases mucus production, hence “smoker’s cough” Changes in basal cell layer Increase work for heart – decrease O2 in blood

Gaseous phase Two Phases - #2 Portion of the tobacco smoke containing carbon monoxide, carbon dioxide, ammonia, hydrogen cyanide, isoprene, acetaldehyde, and acetone

Gaseous phase Gaseous phase Carbon monoxide Hemoglobin carries O2 in blood from lungs to tissues Also carries CO2 from tissues to lungs CO can also attach to hemoglobin Carboxyhemoglobin for the rest of its 120 day life Leads to shortness of breath CO has strong attraction to hemoglobin (120 day life span). Non-smoker has approximately 0.5 – 1% carboxHb Smoker has approximately 5-10% Presence of excessive levels of carboxhemoglobin in the blood of smokers leads to shortness of breath and lowered endurance

Illness, Premature Death, and Tobacco Use Cardiovascular Disease (CVD) Nicotine and CVD Increased platelet adhesiveness Increases possibility of clots/embolisms Carbon monoxide and CVD Nicotine increases HR, increases blood pressure Increases platelet adhesiveness Risk for MI increases 2X Risk for sudden death increases 4X 1/3 of all CVD can be traced to cigarette smoking Carbonmonoxide CarboxHB – this hemoglobin is permanently weaker during 120 day life – with increased activity, there is not enough oxygen for the heart.

Proven Health Effects of Tobacco Use Smoking is associated with CHD, stroke, ulcers, respiratory infections, CANCER of the lung-larynx-esophagus-bladder-pancreas-stomach-uterine cervix, bronchitis, emphysema, early menopause, and still-born & premature births. (CDC) Smokeless tobacco users and pipe/cigar smokers more susceptible to mouth/esophagus/larynx cancer (NIDA) College students who smoke have higher rates of respiratory infections and asthma and higher rates of bacterial meningitis (Halperin, 2002) Women smokers with human papilloma virus are at increased risk of progressing to cervical dysplasia or cancer (Halperin, 2002) Women who smoke and use oral contraceptives are at higher risk for stroke (Halerpin, 2002)

2nd Hand Smoke 2nd hand smoke causes 35,000 heart disease deaths per year in the US Non-smokers exposed to 2nd hand smoke have 20% increased risk of heart disease 2nd hand smoke has higher concentrations of ammonia, benzene, nicotine and carbon monoxide. Why?

Surgeon General’s Warnings Quitting smoking now greatly reduces serious risks to your health Cigarette smoke contains carbon monoxide Smoking by pregnant women may result in fetal injury, premature birth, and low birth weight Smoking causes lung cancer, heart disease, and emphysema, and may complicate pregnancy

Tobacco and Mental Health Issues Mental health disorders have strongly associated with smoking, especially among young people (NIDA,2002) 25 year study Heavy smokers= 6 x more likely for anxiety disorder, 15 x more likely for panic disorders College students who are daily smokers are more than 5 times more likely to seriously contemplated suicide or tried it than non-smokers (Brown, 2004)

Tobacco Use and Lower Academic Performance Smokers have lower GPA than non-smokers Daily smokers were found to have even lower GPAs than high-risk drinkers (Halperin and Eytan, 2004)

What about Tobacco Use and Sexual Behavior? College students who are smokers are 50% more likely than nonsmokers to have had two or more sexual partners in the last month (Rigotti, 2000) Even light smokers are over 3 times more likely to participate in high-risk sexual behavior than non-smokers (Halperin and Eytan, 2004)

Smokeless tobacco use Warnings: This product may cause mouth cancer This product may cause gum disease This product is not a safe alternative to cigarette smoking

College Students and Quitting Most college students want to quit smoking- 2/3 of current college smokers have tried to quit but can’t (Bernardo, 2001) A national college survey found that 82% of daily smokers tried to quit and 75% of those smokers were still smoking (Wetter, 2004) College students as “Social Smokers”, many times leads to addiction