Generic pharmacy talk

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  • 1931
  • 2007
  • July 30, 2008 SF Chron
  • Marin Independent Journal 3 July 2002
  • NYT 11/12/99
  • Generic pharmacy talk

    1. 1. The Pharmacist’s Role in Ending the Tobacco Pandemic<br />Alan Blum, MD<br />Auburn University <br />Harrison School of Pharmacy <br />February 18, 2011<br />
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    3. 3. DEATHS FROM CIGARETTE SMOKING IN US SINCE 1964<br />12,000,000<br />
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    5. 5.
    6. 6. Smoking Prevalence<br />
    7. 7. CAUSES OF DEATH<br />Heart disease<br />Cancer<br />Stroke<br />COPD<br />Accidents<br />Diabetes<br />
    8. 8. MARLBORO’S MYOCARDIAL MAYHEM<br />↑ oxygen demand<br />↓ angina threshold<br />↓ exercise performance<br />↑ recurrent infarction<br />
    9. 9. CAMEL’S CORONARY CONSEQUENCES<br />Adverse lipid profile<br />Altered hematologic factors<br />Direct arterial wall effects<br />Elevated blood pressure<br />
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    12. 12. Cancer Death Rates for Men, US, 1930-2005<br />
    13. 13. Cancer Death Rates for Women, US, 1930-2005<br />
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    15. 15. COPD<br />5% of US population<br />80% caused by smoking<br />4th leading cause of death<br />
    16. 16. DIABETES:<br />3x Cardiovascular Mortality<br />
    17. 17. SMOKING + DIABETES:<br />11x Cardiovascular <br />Mortality<br />
    18. 18. OTHER TOBACCOGENIC PROBLEMS<br />Osteoporosis<br />Hip fractures<br />Early menopause<br />Macular degeneration<br />Peptic ulcer disease<br />
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    20. 20. SECONDHAND SMOKE<br />Lung cancer: 3,000 deaths/year<br />Heart disease: 40,000 deaths/year<br />Asthma: 2 million visits/year<br />
    21. 21. SMOKING IN PREGNANCY<br />Low birthweight<br />Preterm labor<br />Spontaneous abortion<br />Abruptio placenta<br />Placenta praevia<br />Premature rupture of membranes<br />
    22. 22. EFFECTS ON CHILDREN<br />SIDS<br />Asthma<br />Bronchitis<br />Otitis media<br />Pneumonia<br />
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    26. 26. INFLUENCES<br />Peers<br />Parents<br />Propaganda<br />
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    45. 45. SMOKING CESSATION<br />44.5 million smoke<br />77% want to stop<br />40% try each year<br />5% succeed<br />
    46. 46. MARKERS OF ADDICTION<br />>20 Cigarettes /day<br />Smoke upon awakening<br />Psychiatric condition<br />Alcohol dependence<br />
    47. 47. BEHAVIOR MODIFICATION<br />Identify situations<br />Choose oral substitutes<br />Do five-minute plan:<br /> Postpone<br /> Inhale<br /> Reconsider<br />
    48. 48. SMOKING’S MYTHS<br />Relieves stress<br />Keeps weight down<br />Low-tar, filters, are safer<br />
    49. 49. THE PRODUCT<br />Filter<br />Low tar<br />Lights<br />Menthol<br />
    50. 50. MONEY LOST<br />Number of packs/day<br />x Cost/pack<br />x 365 days/year<br />X Number of years smoking<br />Total cash lost (plus interest)<br />
    51. 51. INHALATION COUNT<br />Number of cigarettes/day<br />x 10 inhalations/cigarette<br />x 365 days/year<br />x Number of years smoking<br />Total inhalations<br />
    52. 52. BENEFITS OF STOPPING<br />1 day: ↓ MI risk<br />1 year: ↓ Stroke risk 50%<br />10 years: Stroke risk of non-smoker<br />15 years: CHD risk of non-smoker<br />
    53. 53. COSMETIC BENEFITS<br />Fresher breath, clothing<br />Whiter teeth, nails<br />Endurance<br />
    54. 54. NICOTINE REPLACEMENT THERAPY<br />Gum (Nicorette)<br />Transdermal patch (Nicoderm)<br />Inhaler (Nicotrol)<br />Lozenge (Commit)<br />Electronic cigarette?<br />
    55. 55. ADJUNCTIVE PHARMACOTHERAPY<br />Bupropion<br />Clonidine<br />Nortriptyline<br />Verenicline<br />Rimonabant<br />
    56. 56.
    57. 57. SMOKING PREVENTION<br />Increase cigarette taxes<br />Restrict teen access<br />Clean indoor air laws<br />Ban advertising<br />Educate on TV, radio, internet<br />
    58. 58.
    59. 59. SHIFTING THE FOCUS<br />Substance -> Product<br />Effects -> Promotion<br />User -> Pusher<br />
    60. 60. AMERICAN TOBACCO COMPANIES<br />Philip Morris USA<br />Reynolds-American Inc.<br />Lorillard Inc.<br />United States Smokeless Tobacco<br />Liggett Vector Brands Inc.<br />Swedish Match<br />Imperial Tobacco<br />
    61. 61. CANCER’S 7 WARNING SIGNS<br />Philip Morris USA<br />Reynolds American Inc<br />Lorillard Inc.<br />United States Smokeless Tobacco<br />Liggett Vector Brands Inc.<br />Swedish Match<br />Imperial Tobacco<br />
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    74. 74. Alan Blum, M.D.<br />Professor and Gerald Leon Wallace Endowed Chair in Family Medicine, College of Community Health Sciences, School of Medicine, The University of Alabama<br />Director, The University of Alabama Center for the Study of Tobacco and Society<br />ablum@cchs.ua.edu<br />
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    112. 112. STRATEGIC WEAPONS<br />Map<br />Calendar<br />Camera<br />
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    136. 136. Alan Blum, M.D.<br />Professor and Endowed Chair in Family Medicine, The University of Alabama<br />Director, The University of Alabama Center for the Study of Tobacco and Society<br />ablum@cchs.ua.edu<br />

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