health publications : These “basic six” services were: vital statistics, communicable disease control, environmental sanitation, public health laboratory services, maternal and child health services, and public health education

1. Introduction to Public Health
Module # 7A
Lecture # 9
Tobacco consumption/ smoking with impact and its prevention
DR. SHAIKH ABDUS SALAM
Dept. of Public Health
North south University

2. By the end of this lecture you will be able to:
o Conceptualize
• The harmful effects of tobacco consumption.
• Smoking behaviors.
• planning & policies to control smoking tobacco
o Understand the feasibilities of reducing manufacturing and
consumption of tobacco in Bangladesh.
OBJECTIVES OF THE LECTURE
Dr. Shaikh Abdus Salam 1

3. Dr. Shaikh Abdus Salam
Smoking and it’s impacts on health
SMOKING AND IT’S
IMPACTS ON HEALTH
& SOCIETY

4. Tobacco History
• Jean Nicot de Villemain introduces
tobacco to France, promotes importation
and cultivation (1556)
• Chewed recreationally, used for ailments
(e.g. headaches, colds) in Europe
(1500s)
• Tobacco becomes major cash crop of
American colonies, spurring demand for
slave labor (1600s)

5. Tobacco
Dr. Shaikh Abdus Salam

6. Tobacco in Virginia
Dr. Shaikh Abdus Salam

7. Advertising

8. Anti-Smoking Ad Campaigns
Scare tactics

9. 9
There are over 4,000 chemicals in tobacco
smoke
Each puff on a cigarette delivers nicotine to your brain within a few seconds.
However, the Nicotine levels in your blood drop quickly after your cigarette is done.
After 20 or 30 minutes you may feel the urge to smoke again.

10. Dr. Shaikh Abdus Salam

11. Dr. Shaikh Abdus Salam

12. Dr. Shaikh Abdus Salam

13. Who are at risk to get Tobacco?
 Early adolescents age group
 Males are more prone
 Not going to school
 Related with tobacco trades
 Parents are tobacco consumers/traders
 Peer pressure
 Curiosity etc.
Dr. Shaikh Abdus Salam

14. Dr. Shaikh Abdus Salam
• Tobacco Smoking: The Deadliest Habit
• Asbestos exposure
• Family history
• Recurring Inflammation of the lung
• Carcinogens in the workplace
• Marijuana use
• Radon exposure
• Indoor & Outdoor air pollution

15. Why tobacco is more addictive?
The nicotine ( a deadly poison) is having the
following effect on Nervous system :
 Decrease the anxiety/stress.
 Increase the concentration
 Increase the short term memory
 Arousal/ stimulate CNS
 Stabilizing the mood
 Control the daily emotion etc.
Dr. Shaikh Abdus Salam

16. Bangladesh & Tobacco
• Tobacco control is a complex issue in Bangladesh
– Diverse types of tobacco products used
– Large number of user
– Tobacco producing country
– Low income country with limited resource for tobacco
control
16

17. Smoking Tobacco
• Cigarette
• Bidi
• Hukkah
17

18. Smokeless Tobacco
• Chewing tobacco
– Zarda
– Sada pata
– Gul
• Snuff
– Nasshi
18
RM
Davis,
M.D.

19. Commercial Tobacco
Contents
4000 Chemicals
40 Cancer causing agents
500 Poisons
19

20. Chemical Box:
What’s in Tobacco?
 Tar: black sticky substance used to pave roads
 Nicotine: Insecticide
 Carbon Monoxide: Car exhaust
 Acetone: Finger nail polish remover
 Ammonia: Toilet Cleaner
 Cadmium: used batteries
 Ethanol: Alcohol
 Arsenic: Rat poison
 Butane: Lighter Fluid
20

21. Nicotine
Poisonous
More addictive than cocaine and heroine
So powerful that farmers can’t use it to kill insects
Legal addiction
Use results in emotional dependence
 Mood leveler
 Users rely on it to control emotional responses to
everyday life
21

22. Carbon Monoxide
The compound in car exhaust that
causes death
Causes shortness of breath
Reduces the amount of oxygen blood
can carry
22

23. Tar
Sticky Residue that stains the
fingers and teeth.
Contains benzopyrene, one of the
deadliest cancer causing agents
known.
23

24. Chemicals
Acetone: fingernail polish remover
Ammonia: floor/toilet cleaner
Cadmium: batteries
Arsenic: rat poison
Methane: cow manure fumes
Formaldehyde: preserver of dead bodies
24

25. Metals
Aluminum
Magnesium
Zinc
Silicon
Titanium
Silver
Lead
Copper
Mercury
Heavy metals
25

26. What are the tobacco-relateddiseases that
are contributingtoall these deaths?
26

27. Dr. Shaikh Abdus Salam

28. Dr. Shaikh Abdus Salam

29. Dr. Shaikh Abdus Salam

30. Dr. Shaikh Abdus Salam

31. Dr. Shaikh Abdus Salam

32. Dr. Shaikh Abdus Salam

33. Dr. Shaikh Abdus Salam

34. Arteriosclerosis & Atherosclerosis:
34
Healthy artery Damaged artery

35. Peripheral Vascular Disease
35

36. Stroke:
36
This brain shows
stroke damage, which
can cause death or
severe mental or
physical disability

37. Emphysema:
37
Healthy lung Emphysematic lung
Symptoms Include
Shortness of breath
Chronic cough
Wheezing
Anxiety
Weight loss
Ankle, feet and leg swelling
fatigue

38. Lung Cancer:
The uncontrolled growth of abnormal cells in one or both lungs
38
Lung cancer kills more people than any other
type of cancer

39. Fetal Damage:
39
Fetal Smoking Syndrome:
•Birth defects
•Premature stillbirth
•Low birthweight
•Prone to Sudden Infant Death Syndrome
•Lowered immune capacity

40. Dental Problems:
Above:Cavities
Below: Gingivitis
Overall poor oral health
Common
Consequences:
•Stained teeth
•Gum inflammation
•Black hairy tongue
•Oral cancer
•Delayed healing of the
gums

41. Consequences of chewing tobacco:
41
Leukoplakia Oral cancer

42. When You Quit…
Within One Year:
 Risk of coronary heart disease is half that of a smoker
Within Two Years:
 Heart attack risk drops to near normal
Within 5 Years:
 Lung cancer death rate for average pack-a-day smoker decreases
by almost half
 Stroke risk is reduced
 Risk of mouth, throat and esophageal cancer is half that of a smoker
42

43. When You Quit…
Within 10 Years:
 Lung cancer death rate is similar to that of a person who does not
smoke.
 The pre-cancerous cells are replaced.
Within 15 Years:
 Risk of coronary heart disease is the same as a person who has
never smoked.
43

44. The Quit Plan:
• Treat yourself well
• Drink lots of water
• Change your routines
• Reduce stress
• Deep breathing
• Regular exercise
• Do something enjoyable every day
• Increase non-smoking social support
• Other ideas?
44

45. Advertisement:
Using beauty and fame to promote a dirty, devastating habit
45

46. Tobacco control
 Monitoring--- Who affected, How much affected, age group, types of tobacco
products etc.
 Protection of Non smokers
 Warning
 Enforcement
 Support of addicts
 Tax increase for all tobacco products
 Source reduction
 Supply reduction
 Demand reduction
Dr. Shaikh Abdus Salam

47. Smoke-free places in Bangladesh
• Schools, day care center, hospitals are 100%
smoke-free by law but universities, other public
places can identify separate smoking area
• 50 taka fine to smokers in public places; no fine for
manager of places
• Restaurants not included as public places but many
restaurants, bus services, launch services declared
as smoke-free voluntarily
47

48. 48
Declaration of smoking area
in a rural market place
Declaration of smoke free area
in a rural school

49. Warn about the dangers of Tobacco
• WNTD observed regularly through
out the country
• Billboards and no smoking signs are
placed
• Good media coverage of tobacco
control activities (both extensive and
supportive) in newspapers, radio,
sometimes TV
49

50. Pack warnings
• 30% of front and back surface
• Six rotating warnings (only one
warning at a time; warnings
change each six months)
• Black letters on white surface
• Specific diseases mentioned
• Huge improvement over earlier
warnings—but still far from optimal
50

51. Indirect advertisement-
51
Point of sale Brand stretching

52. Raise taxes on tobacco
• Low tax on cigarettes and bidis
• Tax were increased in the last budget on cigarettes
and bidi
• Even lower tax on smokeless products
52

53. Dr. Shaikh Abdus Salam

54. Dr. Shaikh Abdus Salam

55. Dr. Shaikh Abdus Salam
This Photo by Unknown Author is licensed under CC BY-SA

56. Dr. Shaikh Abdus Salam