2. (c) 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter Nine: Rejecting Tobacco Use

3. Tobacco Use in American Society Since 1994, the population of smokers has declined (22.5% of adults smoke daily) Since 1994, the population of smokers has declined (22.5% of adults smoke daily) Men (25.2%) smoke more than women (20%) Men (25.2%) smoke more than women (20%) College students smoke less than year 2000 College students smoke less than year 2000 Ethnicity, socioeconomics, education, and demographics are often factors that influence smoking Ethnicity, socioeconomics, education, and demographics are often factors that influence smoking

4. Other Demographic Factors Influencing Tobacco Use Age groups Age groups Region of the country Region of the country Size of the community Size of the community Employment status Employment status

5. Pipe and Cigar Smoking Fallacies still exist with regards to pipe/cigar use Fallacies still exist with regards to pipe/cigar use Pipe/cigar smokers have the same rate of cancer frequency as cigarette smokers with: Pipe/cigar smokers have the same rate of cancer frequency as cigarette smokers with: Mouth Mouth Larynx Larynx Throat Throat Esophagus Esophagus

6. Development of Dependence Dependence: physical and/or psychological need to continue the use of the drug Dependence: physical and/or psychological need to continue the use of the drug Physical dependence due to: Physical dependence due to: Titration: particular level of a drug within the body; adjusting the level of nicotine by adjusting the rate of smoking Titration: particular level of a drug within the body; adjusting the level of nicotine by adjusting the rate of smoking

7. Theories of Nicotine Addiction Genetic theory – 60% of addiction is based upon this influence Genetic theory – 60% of addiction is based upon this influence Bolus theory – ball of nicotine reaches brain, causing excitement Bolus theory – ball of nicotine reaches brain, causing excitement Adrenocorticotropic hormone theory (ACTH) – release of beta endorphins delivers euphoric effect Adrenocorticotropic hormone theory (ACTH) – release of beta endorphins delivers euphoric effect Self-Medication theory – nicotine via dopamine “lifts spirits” Self-Medication theory – nicotine via dopamine “lifts spirits”

8. Acute Effects of Nicotine on the CNS Arousal of nicotine allows norepinephrine, dopamine, acetylcholine, serotonin release Arousal of nicotine allows norepinephrine, dopamine, acetylcholine, serotonin release CNS is depressed within the brain which stimulates areas within the heart, lungs, blood flow CNS is depressed within the brain which stimulates areas within the heart, lungs, blood flow

9. Psychosocial Factors Related to Dependence Modeling Modeling Manipulation Manipulation Susceptibility to Advertising Susceptibility to Advertising

10. The Source of Physiologically Active Compounds Particulate phase (small particle compounds) Particulate phase (small particle compounds) nicotine nicotine water water tar (phenol, cresol, benzo pyrene, DDT) tar (phenol, cresol, benzo pyrene, DDT) Many of these chemicals are considered carcinogens

11. Sources of Physiologically Active Compounds, cont’d Gaseous phase (gas compounds) Gaseous phase (gas compounds) carbon monoxide (CO) carbon monoxide (CO) carbon dioxide, ammonia, hydrogen cyanide, isopyrene, acetone, etc. carbon dioxide, ammonia, hydrogen cyanide, isopyrene, acetone, etc. Many of these chemicals are considered carcinogens

12. Selected Health Effects of Cigarette Smoking (Table 9-3) Lung disease Lung disease Cancer risk Cancer risk Heart disease Heart disease Peripheral Vascular disease Peripheral Vascular disease Skin changes Skin changes Orthopedic problems Orthopedic problems Rheumatologic problems Rheumatologic problems Male Infertility Male Infertility Depression Depression Neurological disorders Neurological disorders Endocrine system problems Endocrine system problems GI tract diseases GI tract diseases Immune system Immune system Oral Health Oral Health Complications in OB/GYN Complications in OB/GYN

13. Relationship Between Cigarette Smoking and the Following Conditions Cardiovascular Disease and Carbon Monoxide Cardiovascular Disease and Carbon Monoxide Impairment of oxygen transport Impairment of oxygen transport Cardiovascular Disease and Nicotine Cardiovascular Disease and Nicotine Myocardial infarction risk Myocardial infarction risk Sudden cardiac death risk Sudden cardiac death risk Development of Angina Development of Angina Increase of Platelet Adhesiveness Increase of Platelet Adhesiveness

14. Relationship Between Cigarette Smoking and the Following Conditions, cont. Cancers Cancers Lung Lung Mouth Mouth Throat Throat * Damage to the lining (mucus, cilia) increase compounds that bring direct contact upon the tissues

15. What are COPD’s? Chronic Bronchitis (inflammation/infection of air passageways) Chronic Bronchitis (inflammation/infection of air passageways) Pulmonary Emphysema (destruction of the alveoli) Pulmonary Emphysema (destruction of the alveoli) (Chronic Obstructive Pulmonary Disorders)

16. Smoking and Reproduction Infertility Infertility Problem pregnancies Problem pregnancies Breastfeeding Breastfeeding Oral contraceptive use relationship Oral contraceptive use relationship Gateway drug concept with alcohol use Gateway drug concept with alcohol use

17. Passive Smoke Mainstream (smoke inhaled by smoker) Mainstream (smoke inhaled by smoker) Sidestream (smoke from the burning product) Sidestream (smoke from the burning product) Environmental smoke (diluted smoke in the air) Environmental smoke (diluted smoke in the air) Sidestream smoke contains 85% of harmful substances

18. New Product Development Eclipse (cigarette that heats vs. burns tobacco) Eclipse (cigarette that heats vs. burns tobacco) Accord (cigarette that reduces sidestream smoke) Accord (cigarette that reduces sidestream smoke) Advance, Omni, and Quest: cigarettes that have ‘trionic” filters which reduce carcinogen exposure 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. Non-tobacco sources of nicotine products e.g. suckers, gums, straws, sprays, drops, etc.

19. Smoking Cessation Nicotine Nicotine products (patch, gum, inhaler) Medications Medications (anti-depressants) Inhalation Inhalation sprays Hypnotism Hypnotism

20. (c) 2005 The McGraw-Hill Companies, Inc. All rights reserved. Chapter Nine: Rejecting Tobacco Use