Transcript Chapter 12 Tobacco

Chapter 12
Tobacco
Tobacco Use:
Scope of the Problem




Cigarette smoking is the major, most preventable cause of disease and premature
death in the U.S.
1192 deaths a day and 435,000 annually
related to cigarette smoking
One in four regular smokers will eventually
die from tobacco use
Nicotine dependency is the most common
form of drug addiction
Current tobacco use

In 1995, 61 million Americans smoked
cigarettes
 This represents 29 % among the U.S. population
age 12 and older

An additional 6.9 million Americans use
smokeless tobacco
 This represents 3.3% of the population
Current tobacco use




From 1965 to 1993, smoking among adults
decreased from 42% to 25%
The average age of people who began daily
cigarette use was 19.1 years in 1993
The average age of people who began daily
cigarette use was 16.8 years in 1995
Since 1956, the amount of leaf tobacco in a
cigarette has declined by approximately
25%
Modern government regulation



1964 - the Advisory Committee to the U.S.
Surgeon General reported that cigarette
smoking is related to lung cancer
1965 - Congress passed legislation setting up
the National Clearinghouse of Smoking
and Health
Since 1970 - all cigarette packages and
cartons have had to carry a warning label
Pharmacology of nicotine



Nicotine is the substance in tobacco that
causes dependence
It is a colorless, highly volatile liquid
alkaloid
It initially stimulates and then depresses the
nervous system
Pharmacology of nicotine

Amount of tobacco absorbed depends on:






Exact composition of tobacco
How densely the tobacco is packed
Length of the cigarette smoked
Whether a filter is used and characteristic of filter
The volume of smoke inhaled
The number of cigarettes smoked
Physiological effects


In large doses, nicotine is highly toxic
Symptoms of nicotine poisoning
 Sweating, vomiting, mental confusion,
diminished pulse rate, and breathing difficulty
 Respiratory failure



Stimulus effect - release of norepinephrine
Depression - caused by blocked nerve
activity
Stimulates CVS - by releasing of epinephrine
A costly addiction
Q. How many packages of cigarettes are
purchased annually in the U.S.?
A. 24 billion
Q. Approximately how many deaths are
attributed to cigarette smoking each year?
A. 400,000
Q. In 1993, smoking-attributable costs for
medical care reached ? billion.
A. $50 billion
Mortality Rates



About 10 million people in the U.S. have
died from causes attributed to smoking
since the Surgeon General’s report on
smoking and health in 1964.
The risk of premature death is significantly
higher (70%) for cigarette smokers than
for nonsmokers.
A 35-year-old male who smokes two packs a
day has a life expectancy that is 8.1 years
shorter than his nonsmoking counterpart.
Deaths attributable to cigarette smoking:1990
23,000
80,000
31,000
120,000
65,000
Lung Canc e r
Is c he mic He art
Dis e as e
Chro nic Lung
Dis e as e
Othe r Diag no s e s
S tro ke
Othe r Canc e rs
99,000
Comparative causes of annual deaths
in the U.S.: 1990
450
418
400
350
300
250
200
150
105
Smoking
31
Suicide
9
Illict Drugs
25
Homicide
Fires
4
Alcohol
0
46
30
AIDS
50
Motor
Vehicle
100
Chronic illnesses and smoking
Men and women who smoke have more
chronic illnesses, including:
- emphysema & bronchitis
- cardiovascular disease
- cancer
- bronchopulmonary disease
 Sudden infant death syndrome (SIDS)

Tobacco use without smoking
Snuff
dipping

Tobacco
chewing
How safe are smokeless tobacco products
compared with cigarettes?
 One pinch of snuff has effects equivalent to those
derived from smoking 3 to 4 cigarettes
Secondhand and sidestream smoke




Mainstream smoke - smoke drawn through
the mouthpiece of the cigarette
Sidestream smoke - smoke released into the
air directly from the lighted tip of a
cigarette
Passive smoking - nonsmokers’ inhalation of
tobacco smoke
Environmental tobacco smoke - sidestream
smoke and exhaled mainstream smoke
that is inhaled by the passive smoker
Who smokes?

In 1994, estimated 60 million Americans
 This is 29% of population age 12 and older

Approximately 4.5 million youths aged 1217
 This is about 20% of this population


18-25-year-old age group has the highest rate
of smokers (35%)
Whites have the highest past-month smoking
rate (29.7%), blacks have the 2nd highest
(28.1%)
Quitting smoking

The primary methods for quitting smoking
are:







Step-by-step manuals
Acupuncture
“Cold turkey” techniques
Hypnosis
Nicotine gum
Nicotine patches
Self-help with behavioral modification
Social Issues

Economic interests
 Mickey Mouse vs. Joe Camel







Tobacco as a gateway drug
Smoking prohibition vs. smokers’ rights
Smoke-free indoor air
Youth access to tobacco
Licensing
Advertising
Taxing cigarettes