2. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Nine Rejecting Tobacco Use

3. © 2007 McGraw-Hill Higher Education. All rights reserved. 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. © 2007 McGraw-Hill Higher Education. All rights reserved. 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. © 2007 McGraw-Hill Higher Education. All rights reserved. Pipe and Cigar Smoking 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: MouthMouth LarynxLarynx ThroatThroat EsophagusEsophagus

6. © 2007 McGraw-Hill Higher Education. All rights reserved. Development of Dependence Dependence: physical and/or psychological need to continue the use of the drug (nicotine) Dependence: physical and/or psychological need to continue the use of the drug (nicotine) 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 smokingTitration: particular level of a drug within the body; adjusting the level of nicotine by adjusting the rate of smoking

7. © 2007 McGraw-Hill Higher Education. All rights reserved. Theories of Nicotine Addiction Genetic theory – 60% of addiction is based upon genetic influence Genetic theory – 60% of addiction is based upon genetic 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. © 2007 McGraw-Hill Higher Education. All rights reserved. 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. © 2007 McGraw-Hill Higher Education. All rights reserved. Psychosocial Factors Related to Dependence Modeling Modeling Manipulation Manipulation Susceptibility to Advertising Susceptibility to Advertising

10. © 2007 McGraw-Hill Higher Education. All rights reserved. Tobacco Active Components Particulate = nicotine, water, tar (small particles) Particulate = nicotine, water, tar (small particles) Gaseous = carbon monoxide, ammonia, hydrogen cyanide, etc. Gaseous = carbon monoxide, ammonia, hydrogen cyanide, etc. Carcinogens: capable of stimulating the development of cancer

11. © 2007 McGraw-Hill Higher Education. All rights reserved. Illness & Premature Death Due to Tobacco Use Cardiovascular disease (nicotine and carbon monoxide related) Cardiovascular disease (nicotine and carbon monoxide related) Cancer (30% of all cancer cases related to tobacco use) Cancer (30% of all cancer cases related to tobacco use) lung, mouth, throat cancerslung, mouth, throat cancers Chronic Obstructive Lung Disease (COLD) Chronic Obstructive Lung Disease (COLD) Mucus and cilia damage compromise the respiratory tract

12. © 2007 McGraw-Hill Higher Education. All rights reserved. Additional Health Concerns Strokes Strokes Osteoporosis Osteoporosis Muscle injury/back pain Muscle injury/back pain Skin changes Skin changes Oral health Oral health Brain and behavior Brain and behavior Neurological disorders Neurological disorders

13. © 2007 McGraw-Hill Higher Education. All rights reserved. Smoking and Reproduction Infertility Infertility Pregnancy problems Pregnancy problems Breastfeeding concerns Breastfeeding concerns Neonatal Health Problems Neonatal Health Problems Sperm degradation Sperm degradation Erectile dysfunction Erectile dysfunction Use of oral contraception with smoking increases risk factors for CHD

14. © 2007 McGraw-Hill Higher Education. All rights reserved. Smokeless Tobacco Not burned, placed in mouth Not burned, placed in mouth Chemicals absorbed through mucous membranes Chemicals absorbed through mucous membranes Risks: leukoplakia, erythroplakia, periodontal disease, cancer of digestive tract and mouth Risks: leukoplakia, erythroplakia, periodontal disease, cancer of digestive tract and mouth

15. © 2007 McGraw-Hill Higher Education. All rights reserved. The Risks of Involuntary (Passive) Smoking Mainstream smoke = smoke inhaled/exhaled by smoker (15% exposure to non-smoker) Mainstream smoke = smoke inhaled/exhaled by smoker (15% exposure to non-smoker) Sidestream = smoke from the burning product (85% exposure to non-smoker) Sidestream = smoke from the burning product (85% exposure to non-smoker) Environmental = smoke from either method diluted by the air Environmental = smoke from either method diluted by the air Partners of smokers are 3 x’s higher for CAD and 30% higher risk for lung cancer

16. © 2007 McGraw-Hill Higher Education. All rights reserved. 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.

17. © 2007 McGraw-Hill Higher Education. All rights reserved. Smoking Cessation Nicotine Nicotine products (patch, gum, inhaler) Medications Medications (anti-depressants) Inhalation Inhalation sprays

18. © 2007 McGraw-Hill Higher Education. All rights reserved. Chapter Nine Rejecting Tobacco Use