2. Today we will discuss..
Tobacco Use
Environmental Tobacco Smoke / Secondhand &
Thirdhand Smoke
Health effects of Secondhand & Thirdhand Smoke
for non-smokers
Types of Tobacco
Ingredients/Chemicals
Reasons for Smoking
Reducing Risks of Exposure
Cessation Resources
6. Secondhand Smoke (SHS)
Smoke from the burning end of a lighted cigarette.
Contains more than 7,000 chemicals.
7. Health Effects of SHS for Non-Smokers
Causes 34,000 premature deaths.
Increased risk of developing heart disease by 25–30%.
8. Health Effects of SHS
Interferes with the normal functioning of:
Heart;
Blood; and
Vascular systems in ways that increase the risk of having a
heart attack.
9. SHS Exposure to Pregnant Women & Children
Sudden Infant Death Syndrome (SIDS)
Health problems in children:
Wheezing and coughing..
10. Thirdhand Smoke (THS)
Toxic brew of gases and particles clinging to smoker’s hair
and clothing.
12. Chemicals in SHS and THS
Chemicals in Secondhand Smoke:
Arsenic (used in pesticide)
Toluene (ingredient in paint thinner)
Hydrogen cyanide (production of chemical weapons)
Chemicals in Thirdhand Smoke:
Acrylonitrile aka vinyl cyanide
Acrolein (irritate the eyes and lungs)
13. Types of Tobacco
Cigarettes;
Bidis;
Cigars, Cigarillos, & Little Cigars;
Electronic cigarette or E- cigarette;
Hookah;
Pipe; and
Smokeless tobacco.
39. References
http://www.cdc.gov/tobacco/data_statistics/fact_sheets/secondhand_smoke/health_effects/
https://www.healthypeople.gov/2020/topics-objectives/topic/tobacco-use
http://tobaccopreventionandcontrol.ncdhhs.gov/shs/index.htm
Protano, C., & Vitali, M. (2011). The New Danger of Thirdhand Smoke: Why Passive Smoking Does Not
Stop at Secondhand Smoke. Environmental Health Perspectives, 119(10), a422.
http://doi.org/10.1289/ehp.1103956
Brooks, J., Holditch-Davis, D., Weaver, M. A., Miles, M. S., & Engelke, S. C. (2011). Effects of Secondhand
Smoke Exposure on the Health and Development of African American Premature Infants. International
Journal of Family Medicine, 2011, 165687. http://doi.org/10.1155/2011/165687
http://www.surgeongeneral.gov/library/reports/50-years-of-progress/
Matt, G. E., Quintana, P. J. E., Destaillats, H., Gundel, L. A., Sleiman, M., Singer, B. C., … Hovell, M. F. (2011).
Thirdhand Tobacco Smoke: Emerging Evidence and Arguments for a Multidisciplinary Research Agenda.
Environmental Health Perspectives, 119(9), 1218–1226. http://doi.org/10.1289/ehp.1103500
http://smokefree.gov/health-effects
http://www.mayoclinic.org/healthy-lifestyle/adult-health/expert-answers/third-hand-smoke/faq-20057791
University of Oxford. (2016, March 14). If you want to quit smoking, do it now: Stopping smoking abruptly
is a better strategy than cutting down before quit day. ScienceDaily. Retrieved April 4, 2016 from
www.sciencedaily.com/releases/2016/03/160314211358.htm
USDHHS. (2006).The Health Consequences of Involuntary Exposure to Tobacco Smoke: Report of the
Surgeon General.
Editor's Notes
The leading cause of preventable illness and death in the United States. It causes many different types of cancer as well as chronic lung diseases.
Tobacco use also causes
Cancer
Heart disease
Lung diseases (including emphysema, bronchitis, and chronic airway obstruction)
Pregnancy-related problems (Premature birth, low birth weight, and stillbirth).
Tobacco use leads to disability and harms nearly every single organ of the body. if you think in terms of blood circulation,
It even effects your big toe.
Tobacco use is a known cause of erectile dysfunction in males. (CDC), I was
Tobacco use increases the risk of diabetes, the 7th leading cause of death in the U.S.
Worldwide, tobacco use causes nearly 6 million deaths per year, and current trends show that tobacco use will cause more than 8 million deaths annually by 2030.
Environmental tobacco smoke (ETS) refers to exposure to tobacco smoke. Not from your smoking, but from being exposed to someone else's cigarette, cigar, or pipe smoke.
Breathing in Environmental tobacco smoke is known as passive smoking, second-hand smoke, or involuntary smoking.
Firsthand smoke/Main stream smoke is what a cigarette smoker inhales. Anyone nearby who breathes in pollutants from the air is being exposed to what’s called secondhand smoke. Thirdhand smoke is what still persists in the air many hours later.
The combination of smoke from the burning end of a cigarette and the smoke breathed out by a smoker.
Secondhand smoke contains more than 7,000 chemicals. Hundreds are toxic and about 70 can cause cancer.
Since the 1964 Surgeon General’s Report, 2.5 million adults who were nonsmokers died because they breathed secondhand smoke (CDC, 2014).
Causes 34, 000 premature death From heart disease each year in the United States among nonsmokers.
Among Non-smokers who are exposed to secondhand smoke at home or at work …
Secondhand smoke …Increases risk for coronary heart disease, stroke, and Lung Cancer by 20−30%.
Respiratory
–Asthma induction and exacerbation
–Eye and nasal irritation
–Bronchitis, pneumonia, otitismedia,bruxism in children
–Decreased hearing in teens
Carcinogenic
–Lung cancer
–Nasal sinus cancer
–Breast cancer? (younger, premenopausal women)
Cardiovascular
–Heart disease mortality
–Acute and chronic coronary heart disease morbidity
–Altered vascular
(USDHHS. (2006).The Health Consequences of Involuntary Exposure to Tobacco Smoke: Report of the Surgeon General.)
(CDC): Exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and can cause coronary heart disease and stroke
Last) Secondhand smoke exposure causes more than 8,000 deaths from stroke annually.
CDC
Breathing secondhand smoke can have immediate adverse effects on your blood and blood vessels,.
Even Brief exposure to secondhand smoke can damage the lining of blood vessels and cause your blood platelets to become stickier. These changes can cause a deadly heart attack.
Secondhand smoke causes lung cancer in adults who have never smoked..
It causes more than 7,300 lung cancer deaths among U.S. nonsmokers each year.
Nonsmokers who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers.
CDC
Secondhand Smoke increases the risk of Sudden Infant Death Syndrome (SIDS) in pregnant women. SIDS is the sudden, unexplained, unexpected death of an infant in the first year of life.
Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die from other causes… SIDS is the leading cause of death in otherwise healthy infants.
Secondhand smoke can cause serious health problems in children…
Sick, more often;---lungs grow less than children who do not breathe secondhand smoke; and
SHS can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have more severe and frequent asthma attacks.
Children whose parents smoke around them get more ear infections.
Chemicals in secondhand smoke appear to affect the brain in ways that interfere with its regulation of infants' breathing.. Infants who are exposed to secondhand smoke after birth are also at greater risk for SIDS
Is a relatively new concept, and researchers are still studying its possible dangers.
Invisible yet …..
Not to mention cushions and carpeting. Lingers long after secondhand smoke (SHS) has cleared from a room.
Studies show that thirdhand smoke clings to hair, skin, clothes, furniture, paint, walls, bedding, carpets, dust, vehicles and other surfaces, even long after smoking has stopped.
Thirdhand smoke residue builds up on surfaces over time and resists normal cleaning. Thirdhand smoke can't be eliminated by airing out rooms, opening windows, using fans or air conditioners, or confining smoking to only certain areas of a home (Mayoclinic.com).
The residue that is build up – is thought to react with common indoor pollutants to create a toxic mix. This toxic mix of thirdhand smoke contains cancer-causing substances, posing a potential health hazard to nonsmokers who are exposed to it. (Mayoclinic.com) such as People, especially children and hospitality industry workers, can have considerable exposure to THS
Thirdhand smoke is a danger to
Children;
Infants, children and non-smoking adults may be at risk of tobacco-related health problems when they inhale, ingest or touch substances containing thirdhand smoke.
The American Academy of Pediatrics (AAP) recommends that all children be protected from tobacco smoke.
Among 7,000 chemicals that have been identified in secondhand tobacco smoke, at least 69 of those toxic chemicals in secondhand tobacco smoke cause cancer
Powerful group of toxins. Only 3 of 7000 chemicals
Other chemicals in SHS..
Chromium (a metallic element)
Formaldehyde (used in manufacturing & chemical industries).
Benzene (found in vehicle emissions)
Cadmium: Used in batteries
Benzo pyrene (It is also found in tobacco, oil and gas products, charred or grilled foods, and other sources. It may also be found in water and soil. Benzo(a)pyrene can cause a skin rash, a burning feeling, skin color changes, warts, and bronchitis. It may also cause cancer.)
(Cancer.gov)
THS CHEMICALS:
Acrylonitrile --- known cancer-causing agent. It can be inhaled and absorbed trough the skin. Used in making acrylic fibers and synthetic rubber and as a chemical to kill pests. Risk for toddlers who crawl on the carpet etc.
Acrolein– Clear or yellowy liquid and has an odor that can create a choking sensation. In high conc. It is a known poison. Manufacturers add it in plastics, medicines, and pesticides. . A risk for toddler as they are more likely to put stuff in their mouth.
A combination of cured and finely cut tobacco, reconstituted tobacco and other additives/chemicals rolled or stuffed into a paper wrapped cylinder.
More than 4,000 different chemicals have been found in tobacco and
tobacco smoke. Among these are more than 60 chemicals that are
known to cause cancer. Studies have proven that smoking cigarettes causes cancers of the bladder, oral cavity,
pharynx, larynx (voice box), esophagus, cervix, kidney, lung, pancreas, and stomach, and
causes acute myeloid leukemia. It also causes heart disease and stroke.
Will discuss the ingredients in a little more detail shortly.
Bidis
(Bidis (pronounced "bee-dees") are small, thin hand-rolled cigarettes
Imported to the United States primarily from India and other Southeast Asian countries.)
1) Associated with an increased risk of oral, lung, stomach, and esophageal cancer and increased risk of coronary health disease and heart attacks.
There is no evidence to indicate that Bidis are safer than
conventional cigarettes. They have higher concentrations of nicotine, tar, and carbon
monoxide than conventional cigarettes sold in the United States, so are even more addictive
than cigarettes.
Made up of a single type of air-cured or dried tobacco.
Contain higher level of nicotine than cigarettes.
Most cigars are Cigar tobacco leaves are first aged for about a year and
then fermented in a multi-step process that can take from 3 to 5
months. Fermentation causes chemical and bacterial reactions that
change the tobacco. This is what gives cigars a different taste and
smell from cigarettes.
For those cigar smokers who inhale, the nicotine is absorbed through the
lungs as quickly as it is with cigarettes. For those who do not inhale, the nicotine is
absorbed more slowly through the lining of the mouth.
Studies have shown that cigar smoking is linked to cancers of the mouth, lips, tongue,
throat, larynx, lung, pancreas and bladder cancer. Cigar smoking, like cigarette smoking, is
also linked to gum disease, where the gums shrink away from the teeth. It also raises your
risk that teeth will actually fall out.
A study completed in 2000 found cigar smoking, like cigarette smoking, is linked to sexual
impotence in men (an inability to get an erection, known as erectile dysfunction).
1)E-cigarettes, including e-pens, e-pipes, e-hookah and e-cigars, are known collectively as Electronic Nicotine Delivery system (ENDS),
2) A battery-powered device that contains a cartridge filled with nicotine, flavor and other chemicals.
3) Electronic cigarette or E- cigarette: Electronic cigarettes, or e-cigarettes, are a popular new tobacco product that have still largely unknown public and individual health effects. E-cigarettes are entirely unregulated by the U.S. Food and Drug Administration (FDA). Because of this, there are no safety checks or requirements for what can go into an e-cigarette.
According to the FDA, e-cigarettes are devices that allow users to inhale an aerosol (vapor) containing nicotine or other chemical substances (propylene
Glycol, Glycerol, Propylene Oxide, Benzene, and Toluene. Carbonyl compounds such as Formaldehyde.
there is no tobacco or burning of tobacco involved and the e-cigarette
produces no smoke. It does produce a fine, heated mist called vapors and/or Aerosols. Aldehydes.
This product is often marketed as an alternative to smoking or an aid in quitting but the
World Health Organization claims there are no studies showing that the electronic cigarette
is a safe and effective nicotine replacement therapy and no scientific evidence to confirm
the product's safety. Recent studies by the FDA show that the e-cigarette contains known
carcinogens and toxic chemicals that are harmful to the user
Trending among youth/adolescents… shift from conventional cigarettes to e-cig
Youth are using e-cigarettes at increasing and alarming rates. According to the CDC, e-cigarette use among both high school and middle school students tripled in one year, increasing from 4.5 percent in 2013 to 13.4 percent in 2014 among high school students, and from 1.1 percent in 2013 to 3.9 percent in 2014 among middle school students. Youth use of e-cigarettes has now surpassed youth cigarette smoking.
The tobacco industry aggressively markets e-cigarettes to youth, glamorizing e-cigarette use in advertisements and offering e-cigarettes in candy flavors such as bubble gum and gummy bears. Kids also can easily buy e-cigarettes online, according to a March 2015 study published in the Journal of JAMA Pediatrics. Learn more about youth e-cigarette use. Basic FDA oversight, which would include youth access restrictions, is needed to protect kids from becoming the next generation hooked on nicotine.
Hookah :
Consists of a head, body water bowl and hose.
Is a pipe used to smoke Shisha, a combination of tobacco and fruit or vegetable that is heated (usually heated through charcoal) and the smoke is filtrated through water.
According to a World Health Organization advisory, a typical one-hour
session of hookah smoking exposes the user to 100 to 200 times the
volume of smoke inhaled from a single cigarette. Even after passing
through water, tobacco smoke still contains high levels of toxic compounds,
including carbon monoxide, heavy metals and cancer-causing chemicals (carcinogens).
Hookah smoking also delivers significant levels of nicotine — the addictive substance in
tobacco.
Hookah smoking has been associated with lung, mouth and other cancers, heart disease
and respiratory infections.
The substances used to heat the tobacco also produce carbon monoxide, heavy metals and
cancer causing chemicals, creating it own health hazards.
Also, Sharing the mouthpiece of the Hookah has been associated with mouth and other infections
including herpes, tuberculosis and hepatitis.
Pipe:
Tobacco is placed into the bowl and lit.
The smoke is than drawn through the stem and mouthpiece and inhaled
Pipe smoke has been shown to cause:
Gum disease and tooth loss
Cancer of the mouth, lip, tongue, throat, larynx, lung, pancreas, kidney…
Pipes are often reusable and consist of a chamber or bowl, stem and mouthpiece.
bladder, colon, and cervix as well as leukemia and
diseases such as chronic obstructive lung disease, stroke, and
coronary heart disease.
Pipe smoking can also cause "hairy
tongue," furry-looking bumps on the tongue that can become stained by tobacco, making
the tongue look discolored or black.
Smokeless Tobacco
The two main types of smokeless tobacco in the United States are
chewing tobacco and snuff: then there are snus and spit tobacco. Chewing tobacco comes in the form of
loose leaf, plug, or twist. Snuff is finely ground tobacco that can be
dry, moist, or in sachets (tea bag-like pouches).
Although some forms of snuff can be used by sniffing or inhaling into
the nose, most smokeless tobacco users place the product in their
cheek or between their gum and cheek. Users then suck on the
tobacco and spit out the tobacco juices, which is why smokeless
tobacco is often referred to as spit or spitting tobacco. The nicotine in
this tobacco is absorbed primarily through the skin in the mouth.
Smokeless tobacco is a significant health risk and is not a safe substitute for smoking
cigarettes.
Smokeless tobacco contains 28 cancer-causing agents (carcinogens). It increases the risk of
developing cancer of the oral cavity, is strongly associated with leukoplakia (a lesion of the
soft tissue in the mouth that consists of a white patch or plaque that cannot be scraped off)
and recession of the gums.
Using smokeless tobacco can lead to nicotine addiction and dependence and is not a safe
alternative to smoking.
Harmful and Potentially harmful constituents.
Roll-your-own tobacco is defined “any tobacco product which, because of its appearance, type, packaging, or labeling, is suitable for use and likely to be offered to, or purchased by, consumers as tobacco for making cigarettes.” The term cigarette filler is not defined in the FD&C Act. For purposes of this draft guidance, we intend cigarette filler to mean the cut, ground, powdered, or leaf tobacco that is a component of a cigarette.
** N-nitrosonornicotine
CO – Found in Car exhaust
Arsenic – Frequently used in pesticide
Butane –found in lighter fluid
Ammonia– Cleaning agent.
Toluene- ingredient in paint thinner
Cadmium found in batteries.
Smoking cause different types of cancer.
Cancers
–Bladder and kidney
–Cervical
–Colon, liver, pancreas
–Esophageal
–Gastric
–Laryngeal
–Lung
–Oral cavity and pharyngeal
–Prostate (↓survival)
Pulmonary diseases
–Acute (e.g., pneumonia)
–Chronic (e.g., COPD)
–Tuberculosis
Cardiovascular diseases
–Abdominal aortic aneurysm
–Coronary heart disease
–Cerebro-vascular disease
–Peripheral arterial disease
–Type 2 diabetes mellitus
Reproductive effects
–Reduced fertility in women
–Poor pregnancy outcomes (ectopic pregnancy, congenital anomalies, low birth weight, preterm delivery)
–Infant mortality; childhood obesity
Other effects: cataract; osteoporosis; Crohns; periodontitis,; poor surgical outcomes; Alzheimer ; rheumatoid arthritis; less sleep
U.S. Department of Health and Human Services. The Health Consequences of Smoking: A Report of the Surgeon General,2010.
-- Time since quit date
--2 weeks to 3 months: Circulation improves,
walking becomes easier
Lung function increases up to 30% ----- 1 – 9 months : Lung cilia regain normal function
Ability to clear lungs of mucus increases
Coughing, fatigue, shortness of breath decrease
-- 1 Year: Excess risk of CHD decreases to half that of a continuing smoker 5years: Risk of stroke is reduced to that of people who have never smoked
--10 Years: Lung cancer death rate drops to half that of a continuing smoker After 15 years: Risk of CHD is similar to that of people who have never smoked
Risk of cancer of mouth, throat, esophagus, bladder, kidney, pancreas decrease
Aside from the harmful health effects of tobacco use
Smoking costs the United States billions of dollars each year.
The tobacco industry spends billions of dollars each year on cigarette advertising and promotions. In 2012, $9.17 billion was spent on advertising and promotion of cigarettes—more than $25 million every day, or more than $1 million every hour.
Medical Costs:
Smoking costs Nearly $170 billion in direct medical care for adults.
More than $156 billion in lost productivity due to premature death and exposure to secondhand smoke.
For people not suffering from severe mental illness, cigarettes may still become a form of self-medication. For decades, soldiers have taken up smoking on the battlefield to deal with wartime stress, for example. Many people experiencing much lower levels of stress -- in a high-pressure job, for example -- may start to smoke as a way to manage the tension and nerves associated with the situation.
Adults smoke for other reasons. They may have a lot of stress and pressures because of economic and personal problems. They may be unemployed or working but not making enough money to take care of themselves and their families. They may be homeless, or they may be dealing with alcohol or cocaine/heroin addictions. Some may be in bad marriages or relationships in which there is physical and/or verbal abuse. All these people may smoke to feel relaxed or to give them energy while going through a hard time.
Smoking is something you are more likely to experience when you are younger. Young people smoke a to look mature, to be like their friends, and to experiment. The excitement of experimenting with something that is forbidden. In Massachusetts it is against the law for anyone under 18 years old to smoke. Usually parents do not allow their under age teens to smoke. Therefore, smoking becomes very attractive. It is exciting to get cigarettes and sneak away to smoke without being caught.
Since teens see older people all around them smoking, especially their parents and relatives, they smoke to act older. If their friends or peers smoke, they may feel pressured into doing the same to be accepted
Research has suggested that, worldwide, tobacco advertising plays a role in the number of people who start or stop smoking. This is not news for public health officials, who, in many nations, began fighting smoking-related illness by restricting tobacco advertising. A 1975 ban on tobacco advertising in Norway, for example, helped reduce long-term smoking prevalence in that nation by 9 percent [source: Willemsen].
Many millions of Americans, both children and adults, are still exposed to secondhand smoke in their homes and workplaces despite substantial progress in tobacco control.
Eliminating indoor smoking fully protects nonsmokers from exposure to secondhand smoke. Smoking bans prohibit smoking from indoor areas of public places and workplaces. Studies showed an average reduction in exposure to components of secondhand smoke of 72%.
Separating smokers from nonsmokers, cleaning the air, and ventilating buildings cannot eliminate exposure to secondhand smoke.
You may Create your own rules in home or in your vehicle..;, don't allow smoking in your home. If your guests smoke, ask them to do it outside. 2. If your partner smokes, encourage him or her to quit. 3. Don't allow smoking in your vehicle. 4. Only visit restaurants and other businesses that enforce no-smoking policies. 5. Choose smoke-free care facilities for children and aging loved ones.
THS ---
Do not allow smoking inside your home or car
Do not allow smoking near you, your children, or your pets
Ask anyone who cares for your child or pet to follow these rules- and tell them why
E-cigarette vapor or aerosol also contains chemicals. Do not let anyone use e-cigarettes in your home, car, or near your child or pet
The only way to completely protect against thirdhand smoke is to quit.
What are tobacco Quitlines??
Tobacco cessation counseling that are provided at no cost via telephone to all Americans
by trained specialists
Up to 4–6 personalized sessions (varies by state)
Some state Quitlines offer nicotine replacement therapy at no cost (or reduced cost)
Up to 30% success rate for patients who complete sessions
They may also provide nicotine replacement products such as (nicotine gum, patches, and Lozenge).
