1. Toward a Tobacco-Free Society
Chapter 11

2. Psychoactive Drugs and Changes in Brain Chemistry
Psychoactive drugs produce most of their key effects by acting on brain chemistry in a characteristic fashion
Consider the route of entry for different types of drugs
Ex. Oral drugs dissolve in stomach absorbed into bloodstream liver, heart and lungs heart brain
The more quickly a drug reaches the brain, the more likely the user is to become dependent

3. Psychoactive Drugs and Changes in Brain Chemistry
Once in the brain, psychoactive drugs act on one or more neurotransmitters by increasing/decreasing their concentrations and actions
Ex. Dopamine is thought to play a role in reinforcement
Heroin, nicotine, alcohol, and amphetamines also affect dopamine levels

4. Who Uses Tobacco? 71 million Americans smoke
24% of men and 18% of women smoke
The more education a person has, the less likely they are to smoke

5. Figure 11.1 Annual Mortality Among Smokers Attributable to Smoking

6. Figure 11.1 Annual Morbidity Among Smokers Attributable to Smoking

7. Why People Use Tobacco A nicotine addiction
Nicotine is a powerful psychoactive drug
Many researchers consider nicotine the most physically addictive of all psychoactive drugs
Reaches the brain via the bloodstream in seconds

8. Why People Use Tobacco Loss of control Tolerance and withdrawal
Tobacco users live according to a rigid cycle of need and gratification; on avg. can go for no more than 40 min. between doses of nicotine
Tolerance and withdrawal
Sudden abstinence from nicotine produces predictable withdrawal symptoms: severe cravings, insomnia, confusion, tremors, difficulty concentrating, fatigue, muscle pains, headache, nausea, etc., increased heart rate and bp

9. Why People Use Tobacco Social and Psychological Factors
Secondary reinforcers are activities the smoker associate with tobacco use
Genetic Factors
CYP2A6
DRD2 (reward gene)

10. Why Start in the First Place?
90% of all new smokers in this country are children and teenagers
1,300 children and adolescents start smoking every day
Average age to start
13 for smoking
10 for spit tobacco
Rationalizing the dangers, invincible
Emulating smoking in the media??

11. Health Hazards Contains hundreds of damaging chemical substances
Unfiltered cigarettes = 5 billion particles per cubic mm
50,000 times more than in an equal volume of smoggy urban air
Condensed particles in the cigarette produce a sticky brown mass called cigarette tar

12. Carcinogens and Poisons in Tobacco Smoke
43 chemicals are linked to development of cancer
Benzo(a)pyrene is a carcinogen- research has found that this causes mutations in lung cancer cells identical to those found in many lung cancer patients
Urethane- also a carcinogen (directly causes cancer)
Cocarcinogens (ex. formaldehyde)
Combine with other chemicals to cause cancer
Poisonous substances
Arsenic
Hydrogen cyanide
Carbon monoxide
Contains amounts 400 times greater than is considered safe in industrial workplaces
Displaces oxygen in red blood cells
Additives
Humectants, sugars, bronchodilators, ammonia, things to make sidestream smoke less obvious

14. “Light” and Low-Tar Cigarettes
Low-tar, low-nicotine, or filtered cigarettes
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
As of June 2010, federal law prohibited the use of terms such as “light” and “mild”

15. Menthol Cigarettes
About 70% of African American smokers smoke menthol cigarettes
These individuals absorb more nicotine and metabolize it slower than other groups
Anesthetizing effect of menthol, means smokers inhale more deeply and hold smoke longer in the lungs

16. Immediate Effects of Smoking
Nicotine can either Excite or Tranquilize the Nervous System Depending on Dosage
Constricts blood vessels, elevates HR and BP
Stimulates adrenal glands to discharge adrenaline
In adults can increase alertness, concentration, information processing, etc.) opposite effect in young people
Can act as a sedative, and relieve symptoms of anxiety and irritability
Depresses hunger

17. The Long-Term Effects of Smoking
Cardiovascular Disease
Coronary heart disease (CHD) causes just as many deaths from smoking as lung cancer
Atherosclerosis leading to angina pectoris and myocardial infarction (heart attack)

18. The Long-Term Effects of Smoking
Lung cancer and other cancers
The risk of developing lung cancer increases w/ number of cigarettes smoked each day and number of years smoking
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
Emphysema and Chronic bronchitis

20. Additional Health, Cosmetic, and Economic Concerns
Ulcers
Impotence
Reproductive health problems
Dental diseases
Diminished physical senses
Injuries
Cosmetic concerns
Economic costs

21. Cumulative Effects
People who smoke before 15 yrs. old and continue to smoke are half as likely to live to 75 versus those who did not smoke
Smokers spend one-third more time away from their jobs because of illness than nonsmokers
Both men and women show a greater rate of acute and chronic diseases

22. 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

23. The Effects of Smoking on the Nonsmoker
Environmental Tobacco smoke (ETS)
Consists of mainstream smoke (exhaled by smokers) and sidestream smoke (smoke from burning end of a 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.

24. ETS Effects
Develop cough, headaches, nasal discomfort, eye irritation, breathlessness, and sinus problems
Allergies will be exacerbated
Causes 3,000 deaths due to lung cancer
Contributes to about 35,000 heart disease deaths each year
Nonsmokers can be affected by effects of ETS hours after they leave a smoky environment
Carbon monoxide lingers in bloodstream 5 hours later

25. Infants, Children, and ETS
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

26. Smoking and Pregnancy Estimated 4600 infant deaths in the U.S.
Increased risk of miscarriage, premature birth, low birth weight, SIDS, and long term impairments in growth and intellectual development

27. What Can Be Done?
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
Individual action-Talk with your friends and family who have quit smoking and see what helped them, 'quit smoking' products

28. How A Tobacco User Can Quit
The benefits of quitting
Options for quitting
“Cold-turkey”
Changes to routines
Over-the-counter prescription products
Support from family and friends
Smoking cessation programs
Free telephone quitlines
1-800-QUITNOW

29. Toward a Tobacco-Free Society
Chapter 11