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Chapter Nine Rejecting Tobacco Use

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

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

Pipe and Cigar Smoking
Pipe/cigar smokers have the same rate of cancer frequency as cigarette smokers with:
Mouth
Larynx
Throat
Esophagus

Tissue changes associated with lung cancer

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

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

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

Psychosocial Factors Related to Dependence
Modeling
Manipulation
Susceptibility to Advertising

Tobacco Active Components
Particulate = nicotine, water, tar (small particles)
Gaseous = carbon monoxide, ammonia, hydrogen cyanide, etc.
Carcinogens: capable of stimulating the development of cancer

Illness & Premature Death Due to Tobacco Use
Cardiovascular disease (nicotine and carbon monoxide related)
Cancer (30% of all cancer cases related to tobacco use)
lung, mouth, throat cancers
Chronic Obstructive Lung Disease (COLD)
Mucus and cilia damage compromise the respiratory tract

Additional Health Concerns
Strokes
Osteoporosis
Muscle injury/back pain
Skin changes
Oral health
Brain and behavior
Neurological disorders

Smoking and Reproduction
Infertility
Pregnancy problems
Breastfeeding concerns
Neonatal Health Problems
Sperm degradation
Erectile dysfunction
Use of oral contraception with smoking increases risk factors for CHD

Smokeless Tobacco
Not burned, placed in mouth
Chemicals absorbed through mucous membranes
Risks: leukoplakia, erythroplakia, periodontal disease, cancer of digestive tract and mouth

The Risks of Involuntary (Passive) Smoking
Mainstream smoke = smoke inhaled/exhaled by smoker (15% exposure to non-smoker)
Sidestream = smoke from the burning product (85% exposure to non-smoker)
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

New Product Development
Eclipse (cigarette that heats vs. burns tobacco)
Accord (cigarette that reduces sidestream smoke)
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.

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

The benefits of quitting smoking

Chapter Nine Rejecting Tobacco Use

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