1. Toward a Tobacco-Free Society
Chapter 11

2. Psychoactive Drugs and Changes in Brain Chemistry
Psychoactive drugs act on one or more neurotransmitters in the brain by increasing/decreasing their concentrations and actions
Ex. Dopamine is thought to play a role in reinforcement
Nicotine raises Dopamine levels much in the same way that Alcohol, Heroin, Amphetamines do

3. Nicotine Receptors in the Brain

4. Who Uses Tobacco? ~15-18% of the U.S. population
~19% of males and ~15% of females
~480,000 deaths/year attributable to smoking
On average, smokers die about 10 years earlier than nonsmokers
The more education a person has, the less likely they are to smoke
Legal age is 18 or older
Each day 1000 teenagers become regular smokers; at least 1/3 of them will die prematurely because of tobacco.

5. Why Start in the First Place?
90% of all new smokers in this country are children and teenagers and 1,300 children and adolescents start smoking every day
Average age to start smoking
13 for smoking tobacco
10 for smokeless tobacco
Reasons why young people start smoking
Rationalizing the dangers
Danger is not immediate
Feel invincible
Social representation of smoking as exciting, glamorous or safe

6. Why Start Smoking?

7. Why People Continue Using Tobacco
Nicotine Addiction
Nicotine = addictive psychoactive drug naturally found in tobacco
Loss of control
On average, smokers can go no longer than 40 min. between doses of nicotine
Tolerance and withdrawal
Symptoms include severe cravings, insomnia, confusion, difficulty concentrating, headache

8. Why People Use Tobacco Social and Psychological Factors
Secondary reinforcers are activities the smoker associates with tobacco use

9. Health Hazards of Smoking Tobacco
Cigarettes contain ~ 600 chemical substances and thousands more are formed as it is burned

10. Carcinogens and Poisons in Tobacco Smoke
Benzene – found in gasoline/pesticides
Formaldehyde – used in embalming fluid; causes eye irritation and coughing
Arsenic-interferes with our DNA repair mechanisms
Cadmium – found in batteries; damages kidneys and wall of arteries
Ammonia – enhances addictive nature of nicotine
Hydrogen cyanide -damages cilia
Carbon monoxide -Displaces oxygen in red blood cells
Chromium – makes carcinogens stick to DNA
Tar – particulate, sticky matter that forms when a cigarette is burned
Other Additives
Humectants, sugars, bronchodilators, things to make secondhand smoke less obvious

11. “Light” and Low-Tar Cigarettes
Low-tar, low-nicotine, or filtered cigarettes
There is no such thing as a safe cigarette
Users often smoke more, inhale more deeply, blocking ventilation holes
Less likely to quit than smokers
of regular cigarettes
In 2010, federal law prohibited the use of terms such as “light” and “mild”

12. Menthol Cigarettes
Menthols comprise about 30% of the total cigarette market
Anesthetizing effect of menthol, means smokers inhale more deeply and hold smoke longer in the lungs, causing more damage.

13. Immediate Effects of Smoking
Nicotine can either Excite or Tranquilize the Nervous System Depending on Dosage and tolerance of the smoker
The beginning smoker often feels dizziness, faintness, rapid pulse, cold, clammy skin, nausea
At low dosages nicotine constricts blood vessels, elevates HR and BP; higher doses can be lethal (mainly for children, overdoses in adults are rare)
Adrenal glands are stimulated to release adrenaline
Can act as a sedative, relieving symptoms of anxiety and irritability
Depresses hunger and dulls taste buds

14. The Long-Term Effects of Smoking
Cardiovascular Disease
Research indicates that the total amount of tobacco smoke inhaled is a key factor contributing to disease
Coronary heart disease (CHD) causes just as many deaths from smoking as lung cancer
Atherosclerosis leading to angina pectoris and heart attack

15. The Long-Term Effects of Smoking
Lung Cancer and Other cancers
Research has linked smoking to cancers of the trachea, mouth, esophagus, larynx, pancreas, bladder, kidney, breast, cervix, stomach liver, colon and skin
Chronic obstructive pulmonary disease (COPD)
Emphysema and Chronic bronchitis

17. Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking
Figure 11.1 Annual mortality (# of deaths per year due to smoking) and morbidity (# of people w/ chronic illnesses due to smoking) among smokers

18. Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking
Figure 11.1 Annual mortality (# of deaths per year due to smoking) and morbidity (# of people w/ chronic illnesses due to smoking) among smokers

19. Additional Health, Cosmetic, and Economic Concerns
Ulcers
Impotence
Reproductive health problems
Dental diseases
Diminished physical senses
Injuries
Cosmetic concerns (crows feet around eyes and lips)
Economic costs ($5.89/pack or ~ $2,150.00/year)

20. Other Forms of Tobacco Spit (smokeless) tobacco Cigars and pipes
Contains at least 28 chemicals known to cause cancer
Cigars and pipes
Users do not need to inhale in order to ingest nicotine - its absorbed through gums and mouth
Cigars contain more tobacco than cigarettes more nicotine
E-cigarettes
Contain nicotine, other harmful substances

21. The Effects of Smoking on the Nonsmoker
Environmental Tobacco Smoke (ETS) or Secondhand
Secondhand smoke consists of mainstream smoke (exhaled by smokers) and sidestream smoke (from a burning cigarette, cigar, or pipe)
Sidestream smoke has twice the tar and nicotine,~ 3X the benzo(a)pyrene, CO, and ammonia
EPA designated ETS as a class A carcinogen and Surgeon General has concluded that there is no safe level of exposure to ETS.
~ 41,000 people die/year from secondhand smoke

22. Infants, Children, and Secondhand Smoke
Children exposed to ETS are more likely to have
SIDs and low-birth weight
Bronchitis, pneumonia, and asthma
Reduced lung function
Middle-ear infections
Lung cancer, emphysema, and chronic bronchitis later in life

23. Smoking and Pregnancy 12-20% of pregnant women smoke
There is increased risk of miscarriage, stillbirth, premature birth, low birth weight, SIDS, and long term impairments in growth and intellectual development
infants of non-smoking mothers have the lowest risk of SIDS.
More than 40% of children who go to the emergency room for asthma live with smokers

24. How A Tobacco User Can Quit
The best way to avoid all of the added chemicals in cigarettes is to stop smoking right now!! This very minute!! THE BENEFITS OF QUITTING ARE IMMEDIATE!
Action at many levels
CDC-Tips From Former Smokers
Smokefree.gov
Free telephone quit-lines
1-800-QUITNOW
Individual action -Talk with your friends and family who have quit smoking and see what helped them, 'quit smoking' products

25. Benefits of Quitting Smoking
There are benefits of quitting
20 minutes after quitting, BP and heart rate drop
After 48 hrs. senses (taste, smell) may improve
Within weeks, circulation improves, less wheezing, wounds may heal faster
Within months, lung function improves, less fatigue
Benefits continue for years after quitting!

26. Toward a Tobacco-Free Society
Chapter 11