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Chapter Eight  Rejecting Tobacco Use
Cigarette Smoking among College Students <ul><li>College smoking trending upwards </li></ul><ul><ul><li>Smoking among coll...
Demographic Trends in Smoking <ul><li>Gender </li></ul><ul><ul><li>Men have higher rates of smoking than women </li></ul><...
Demographic Trends in Smoking <ul><li>Size of the community </li></ul><ul><ul><li>Large metropolitan areas have lowest smo...
Marketing of Tobacco Products <ul><li>Controversy about advertising due to industry’s knowledge of the health risks </li><...
Development of Dependence <ul><li>Dependence: Physical and/or psychological need to continue the use of nicotine </li></ul...
Theories of Nicotine Addiction <ul><li>Genetic influences  </li></ul><ul><ul><li>60% of initiation and maintenance of init...
Psychosocial Factors Related to Dependence <ul><li>Modeling behavior </li></ul><ul><li>Manipulation </li></ul><ul><li>Susc...
Prevention and Intervention <ul><li>Early childhood intervention </li></ul><ul><ul><li>Decision making skills </li></ul></...
Tobacco Smoke <ul><li>Particulate phase (small suspended particles) </li></ul><ul><ul><li>Nicotine </li></ul></ul><ul><ul>...
Health Risks of Tobacco Use
Illness, Premature Death, and Tobacco Use <ul><li>Cardiovascular disease and nicotine </li></ul><ul><ul><li>Myocardial inf...
Illness, Premature Death, and Tobacco Use <ul><li>Cancer </li></ul><ul><ul><li>Respiratory tract cancers (lung, mouth, lar...
Development of Lung Cancer
Chronic Obstructive Lung Disease <ul><li>Chronic bronchitis  </li></ul><ul><ul><li>Persistent inflammation or infection of...
Additional Health Concerns <ul><li>Poor nutritional state </li></ul><ul><li>Reduced insulin sensitivity </li></ul><ul><li>...
Risks from Specific Tobacco Products <ul><li>Nonmanufactured cigarettes </li></ul><ul><ul><li>Roll-your-own </li></ul></ul...
Nonmanufactured Forms of Cigarettes <ul><li>Roll-your-own </li></ul><ul><ul><li>More affordable </li></ul></ul><ul><ul><li...
Mentholated Cigarettes <ul><li>Menthol </li></ul><ul><ul><li>Unique taste and “cooling” sensation </li></ul></ul><ul><li>H...
Pipe and Cigar Smoking <ul><li>Pipe/cigar smokers have the same rates of cancer as cigarette smokers: </li></ul><ul><ul><l...
Smokeless Tobacco Use <ul><li>Types </li></ul><ul><ul><li>Chewing tobacco </li></ul></ul><ul><ul><li>Snuff </li></ul></ul>...
Smoking and Reproduction <ul><li>Infertility </li></ul><ul><li>Increased risk of ectopic pregnancy </li></ul><ul><li>Probl...
Involuntary (Passive) Smoking <ul><li>Mainstream smoke  </li></ul><ul><ul><li>Smoke inhaled and then exhaled by smoker </l...
Health Risks of Passive Smoking <ul><li>Heart disease </li></ul><ul><li>Cancer </li></ul><ul><li>Eye irritation </li></ul>...
Cost of Smoking <ul><li>440,000 deaths/year </li></ul><ul><li>$150 billion/year in health-related expenditures </li></ul><...
The Health Benefits of Quitting
Smoking Cessation <ul><li>Programs </li></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Behavior modification </li><...
Smoking Cessation <ul><li>Nicotine substitution products </li></ul><ul><ul><li>Chewing gum </li></ul></ul><ul><ul><li>Patc...
Chapter Eight:  Rejecting Tobacco Use
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Rejecting Tobacco

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  • Image sources: The McGraw-Hill Companies, Inc./Christopher Kerrigan, photographer Royalty-Free/Corbis The McGraw-Hill Companies, Inc./Gary He, photographer
  • Transcript of "Rejecting Tobacco"

    1. 1. Chapter Eight Rejecting Tobacco Use
    2. 2. Cigarette Smoking among College Students <ul><li>College smoking trending upwards </li></ul><ul><ul><li>Smoking among college students decreased from 1964 to 1995 (from 21% to 14%) </li></ul></ul><ul><ul><li>Current rates of smoking among college students: </li></ul></ul><ul><ul><ul><li>30.6% of full-time students </li></ul></ul></ul><ul><ul><ul><li>42.7% of part-time students </li></ul></ul></ul><ul><ul><li>Current rates of smoking among general population: </li></ul></ul><ul><ul><ul><li>Men: 23.9% </li></ul></ul></ul><ul><ul><ul><li>Women: 18.1% </li></ul></ul></ul><ul><ul><li>Direct relationship between alcohol consumption and cigarette smoking </li></ul></ul>
    3. 3. Demographic Trends in Smoking <ul><li>Gender </li></ul><ul><ul><li>Men have higher rates of smoking than women </li></ul></ul><ul><li>Race/ethnicity </li></ul><ul><ul><li>Highest smoking rates among American Indians and Alaska Natives </li></ul></ul><ul><ul><li>Lowest smoking rates among Asian Americans </li></ul></ul><ul><li>Level of education </li></ul><ul><ul><li>Higher levels of education are associated with lower rates of smoking </li></ul></ul><ul><li>Age </li></ul><ul><ul><li>Smoking rates go down as age goes up </li></ul></ul><ul><li>Geographic residence </li></ul><ul><ul><li>Highest smoking rates in Midwest </li></ul></ul><ul><ul><li>Lowest smoking rates in West </li></ul></ul>
    4. 4. Demographic Trends in Smoking <ul><li>Size of the community </li></ul><ul><ul><li>Large metropolitan areas have lowest smoking rate </li></ul></ul><ul><li>Employment status </li></ul><ul><ul><li>Highest rate of smoking among unemployed </li></ul></ul><ul><li>Recent homelessness or incarceration </li></ul><ul><ul><li>Higher rates </li></ul></ul><ul><li>Place of birth </li></ul><ul><ul><li>Native-born Americans have higher rates of smoking than foreign-born Americans </li></ul></ul>
    5. 5. Marketing of Tobacco Products <ul><li>Controversy about advertising due to industry’s knowledge of the health risks </li></ul><ul><li>Restrictions on marketing of all tobacco products, BUT </li></ul><ul><ul><li>Magazine advertising has increased </li></ul></ul><ul><ul><ul><li>Especially in magazines with 15% or more youth readership </li></ul></ul></ul><ul><ul><li>Free distribution of cigarettes in bars and restaurants </li></ul></ul><ul><ul><li>Luring teens through anti-smoking ads </li></ul></ul>
    6. 6. Development of Dependence <ul><li>Dependence: Physical and/or psychological need to continue the use of nicotine </li></ul><ul><li>Physical dependence </li></ul><ul><ul><li>Tolerance </li></ul></ul><ul><ul><li>Withdrawal </li></ul></ul><ul><ul><li>Titration </li></ul></ul><ul><ul><ul><li>Particular level of a drug within the body </li></ul></ul></ul><ul><ul><ul><li>Adjusting the level of nicotine by adjusting the rate of smoking </li></ul></ul></ul>
    7. 7. Theories of Nicotine Addiction <ul><li>Genetic influences </li></ul><ul><ul><li>60% of initiation and maintenance of initial smoking is driven by genetic influences </li></ul></ul><ul><li>Bolus theory </li></ul><ul><ul><li>Based on body’s response to the bolus (ball) of nicotine delivered to the brain </li></ul></ul><ul><li>Adrenocorticotropic hormone (ACTH) theory </li></ul><ul><ul><li>Release of beta endorphins delivers euphoric effect </li></ul></ul><ul><li>Self-medication theory </li></ul><ul><ul><li>Nicotine, through effects on dopamine, “lifts spirits” </li></ul></ul>
    8. 8. Psychosocial Factors Related to Dependence <ul><li>Modeling behavior </li></ul><ul><li>Manipulation </li></ul><ul><li>Susceptibility to advertising </li></ul><ul><ul><li>Use of tobacco products associated with a better life </li></ul></ul><ul><li>Once smoking is initiated, dependence becomes a key factor in use </li></ul>
    9. 9. Prevention and Intervention <ul><li>Early childhood intervention </li></ul><ul><ul><li>Decision making skills </li></ul></ul><ul><ul><li>Critical thinking and refusal skills </li></ul></ul><ul><ul><li>Support for smoke-free environments </li></ul></ul>
    10. 10. Tobacco Smoke <ul><li>Particulate phase (small suspended particles) </li></ul><ul><ul><li>Nicotine </li></ul></ul><ul><ul><li>Water </li></ul></ul><ul><ul><li>Tar </li></ul></ul><ul><ul><ul><li>Phenol, benzo[a]pyrene, DDT, and many other chemicals </li></ul></ul></ul><ul><li>Gaseous phase </li></ul><ul><ul><li>Carbon monoxide </li></ul></ul><ul><ul><li>Carcinogens </li></ul></ul>
    11. 11. Health Risks of Tobacco Use
    12. 12. Illness, Premature Death, and Tobacco Use <ul><li>Cardiovascular disease and nicotine </li></ul><ul><ul><li>Myocardial infarction </li></ul></ul><ul><ul><li>Sudden cardiac death </li></ul></ul><ul><ul><li>Angina pectoris </li></ul></ul><ul><ul><li>Increased platelet adhesiveness </li></ul></ul><ul><ul><li>Unhealthy cholesterol changes </li></ul></ul><ul><li>Cardiovascular disease and carbon monoxide </li></ul><ul><ul><li>Impairment of oxygen transport </li></ul></ul><ul><li>Smoking and oral contraceptive (OC) use </li></ul><ul><ul><li>Linked to clots and heart attacks </li></ul></ul><ul><ul><li>Women who smoke should NOT use OCs </li></ul></ul>
    13. 13. Illness, Premature Death, and Tobacco Use <ul><li>Cancer </li></ul><ul><ul><li>Respiratory tract cancers (lung, mouth, larynx </li></ul></ul><ul><ul><ul><li>Damage to the respiratory lining (mucus, cilia) brings carcinogens into direct contact with tissues </li></ul></ul></ul><ul><ul><li>Other tobacco-enhanced cancers </li></ul></ul><ul><ul><ul><li>Kidney </li></ul></ul></ul><ul><ul><ul><li>Gastrointestinal system </li></ul></ul></ul>
    14. 14. Development of Lung Cancer
    15. 15. Chronic Obstructive Lung Disease <ul><li>Chronic bronchitis </li></ul><ul><ul><li>Persistent inflammation or infection of the smaller airways within the lungs </li></ul></ul><ul><li>Pulmonary emphysema </li></ul><ul><ul><li>Irreversible disease process in which the alveoli are destroyed </li></ul></ul><ul><li>Significant impact on quality of life </li></ul>
    16. 16. Additional Health Concerns <ul><li>Poor nutritional state </li></ul><ul><li>Reduced insulin sensitivity </li></ul><ul><li>Decline in short-term memory </li></ul><ul><li>Loss of senses of smell and hearing </li></ul><ul><li>Premature wrinkling of the skin </li></ul><ul><li>Stroke </li></ul><ul><li>Loss of bone mass </li></ul><ul><li>Impaired recovery from surgery </li></ul><ul><li>Gum disease </li></ul><ul><li>Impaired resistance to infection </li></ul><ul><li>Asthma </li></ul><ul><li>Infertility </li></ul><ul><li>Impotence </li></ul><ul><li>Earlier menopause </li></ul><ul><li>Poor circulation </li></ul><ul><li>Burns </li></ul>
    17. 17. Risks from Specific Tobacco Products <ul><li>Nonmanufactured cigarettes </li></ul><ul><ul><li>Roll-your-own </li></ul></ul><ul><ul><li>Bidis </li></ul></ul><ul><ul><li>Kreteks </li></ul></ul><ul><li>Mentholated cigarettes </li></ul><ul><li>Pipes </li></ul><ul><li>Cigars </li></ul><ul><li>Smokeless tobacco </li></ul>
    18. 18. Nonmanufactured Forms of Cigarettes <ul><li>Roll-your-own </li></ul><ul><ul><li>More affordable </li></ul></ul><ul><ul><li>Equal risk </li></ul></ul><ul><li>Bidis </li></ul><ul><ul><li>High in tar and nicotine </li></ul></ul><ul><ul><li>High level of carbon monoxide </li></ul></ul><ul><li>Kreteks (clove-flavored tobacco) </li></ul><ul><ul><li>Increased tar and nicotine delivery </li></ul></ul>
    19. 19. Mentholated Cigarettes <ul><li>Menthol </li></ul><ul><ul><li>Unique taste and “cooling” sensation </li></ul></ul><ul><li>Heavily marketed to African American smokers </li></ul><ul><li>Special health risks still under investigation </li></ul>
    20. 20. Pipe and Cigar Smoking <ul><li>Pipe/cigar smokers have the same rates of cancer as cigarette smokers: </li></ul><ul><ul><li>Mouth </li></ul></ul><ul><ul><li>Larynx </li></ul></ul><ul><ul><li>Throat </li></ul></ul><ul><ul><li>Esophagus </li></ul></ul><ul><li>Cigar manufacturers are now required to disclose tobacco content and additives </li></ul><ul><li>Warning labels required </li></ul>
    21. 21. Smokeless Tobacco Use <ul><li>Types </li></ul><ul><ul><li>Chewing tobacco </li></ul></ul><ul><ul><li>Snuff </li></ul></ul><ul><li>Risks associated with use </li></ul><ul><ul><li>Leukoplakia </li></ul></ul><ul><ul><li>Erythroplakia </li></ul></ul><ul><ul><li>Periodontal disease </li></ul></ul><ul><ul><li>Oral cancer </li></ul></ul><ul><ul><li>Nicotine addiction </li></ul></ul><ul><ul><li>Other health risks </li></ul></ul>
    22. 22. Smoking and Reproduction <ul><li>Infertility </li></ul><ul><li>Increased risk of ectopic pregnancy </li></ul><ul><li>Problem pregnancies </li></ul><ul><li>Breast-feeding </li></ul><ul><ul><li>Exposes infants to harmful effects and chemicals </li></ul></ul><ul><li>Neonatal health problems </li></ul><ul><ul><li>Low birth weight </li></ul></ul><ul><ul><li>Respiratory problems </li></ul></ul><ul><ul><li>Higher risk of SIDS </li></ul></ul>
    23. 23. Involuntary (Passive) Smoking <ul><li>Mainstream smoke </li></ul><ul><ul><li>Smoke inhaled and then exhaled by smoker </li></ul></ul><ul><li>Sidestream smoke </li></ul><ul><ul><li>Smoke from the burning end of the cigarette, pipe, or cigar </li></ul></ul><ul><ul><li>Contains 85% of harmful substances associated with secondhand smoke </li></ul></ul><ul><li>Environmental tobacco smoke </li></ul><ul><ul><li>Diluted smoke that stays within a common source of air </li></ul></ul>
    24. 24. Health Risks of Passive Smoking <ul><li>Heart disease </li></ul><ul><li>Cancer </li></ul><ul><li>Eye irritation </li></ul><ul><li>Nasal symptoms </li></ul><ul><li>Headaches </li></ul><ul><li>Cough </li></ul><ul><li>In children: </li></ul><ul><ul><li>Bronchitis or pneumonia </li></ul></ul><ul><ul><li>Respiratory symptoms </li></ul></ul><ul><ul><li>Middle ear infections </li></ul></ul>
    25. 25. Cost of Smoking <ul><li>440,000 deaths/year </li></ul><ul><li>$150 billion/year in health-related expenditures </li></ul><ul><li>Reduced life expectancy </li></ul><ul><li>Loss of independence, freedom, and social contacts due to addiction </li></ul>
    26. 26. The Health Benefits of Quitting
    27. 27. Smoking Cessation <ul><li>Programs </li></ul><ul><ul><li>Education </li></ul></ul><ul><ul><li>Behavior modification </li></ul></ul><ul><ul><li>Aversive conditioning </li></ul></ul><ul><ul><li>Hypnosis </li></ul></ul><ul><ul><li>Acupuncture </li></ul></ul>
    28. 28. Smoking Cessation <ul><li>Nicotine substitution products </li></ul><ul><ul><li>Chewing gum </li></ul></ul><ul><ul><li>Patch </li></ul></ul><ul><ul><li>Inhaler </li></ul></ul><ul><ul><li>Spray </li></ul></ul><ul><li>Neurotransmitter-based prescription medications </li></ul><ul><ul><li>Bupropion (Zyban) </li></ul></ul><ul><ul><li>Varenicline (Chantix) </li></ul></ul>
    29. 29. Chapter Eight: Rejecting Tobacco Use
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