PSYC 3110 Lecture Notes - Lecture 9: Biopsychosocial Model, Twin Study, Health Canada

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Lecture 9: Tobacco & Smoking
Midterm exam is next week!
- Short answer
- The questions will range in marks from 1-5 marks
- Way to think about answering the question (for every mark you should give one point or
one thing person grading can evaluate)
- Common mistakes is not reading question properly… make sure to answer the question!
- Spend time reading the question when writing the exam! (are you supposed to describe
or explain)
- Need to be able to produce an answer not recognize an answer
- Content only exam
- Lectures good indicator of what you should be studying
Goal of the essay:
Start thinking about topic during reading week
Knowledge related to the material
Skills: work through and grapple with peer-reviewed literature
- Use peer reviewed to answer a normative question not an empirical question
- The essay you are working on is not empirical however you need to take into account
empirical work in answering the question
- Imagine you work for health Canada and have to make decisions on how to regulate
society… empirical evidence should inform your decisions, but the empirical evidence
will not tell you what you should do
* This is the skill professor wants you to develop (use literature to make a case)
* Need to convince professor of your argument
* Whatever position you take you should argue it very well
* Whoever reads the essay should be convinced of the position you have taken
- More you read and integrate what you have the stronger your position will be
- The stuff in class is the baseline information you should take into account (minimum)
Overview
- Historically in many countries, tobacco major contributor to the economy
- Lost of profits, taxes, job creation
- There is a benefit to the community and society
- From the perspective of governments, tax they get from tobacco tends to be more than
what to costs them to pay for smoking related diseases
- Governments have a responsibility to citizens to ensure good health
- There is a clear conflict of interest (governments benefit through profits, but on the
other they have to discourage smoking for better health)
- There is a tension in society as a result
Prevalence
- What is the extent of the problem?
- Who is it a problem for?
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Cigarette consumption in USA
– Doubled in 1920s
Doubled in 1930s
Peaked at 67% in 1940s & 1950s
1965-2004 adults dropped from 42% to 21% 
In UK peak at 80% of men during 1940s & 1950s Since then decline, with
demographic variations 
- Decline is not even
Canada: steady decline over last 20 years 17% currently smoking in 2011
Smoking in many developing countries increasing dramatically, with heavy industry
promotion 
- However, in contrast to these figures in many developing countriesincreasing
Prevalence (2)
• Historically, more men than women smokers
Historical variation with trends in female empowerment
Trends in professional women versus poorer background
• National variation (men):– More than 40%: Austria, Greece, Norway, Portugal Less
than 25%: Belgium, Finland, Hungary, Sweden
• Increasingly smoking associated with low income, unemployment
- Large variation
- More and more especially in developing countries smoking is associated with low
income and unemployment
- This is a paradox because smoking is expensive
Lessons from Observing Prevalence
Dramatic changes in prevalence over time suggest strong social determinants
underlying smoking behaviour 
- Why? If it was just biological we wouldn’t find these changes because genetics
don’t change. There has to be social determinants.
Strong national variation suggests possibility of cultural and political influences 
- Suggests political and cultural influences at play
- Why cultural? Perhaps there are cultural practices
- Why political? Similar to alcohol there is a lot of influence to policy through
political motivations.
- Gives an indicator of where we should be looking to solve problem
Health Effects of Smoking
Cigarette smoking estimated to account for nearly 1 in 5 deaths! (UK and US) 
(More than combined deaths from HIV illegal drugs, alcohol, cars, suicide, murder)
- Smoking is big when it comes to health effects and mortality
Leading preventable cause of death in US 
Causes disease in nearly every organ of the body
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Quitting smoking has immediate & long term benefits (even after age 65, 50% risk
reduction) 
Carcinogenic – 20-30 years delay between exposure and cancer 
- As soon as you quit benefits start accumulating right away
- Long delay between when cancer appears (huge factor in learning theories)
Effects of Passive Smoking
- For a long time controversial
- Why?
Answer: has to do with attributing choice
If the government and anti smoking campaigners say we should restrict people of
smoking, people who smoke and tobacco companies say we have free choice
With second hand smoke you are effecting others not yourself so it adds another
dimension
Consistent inhalation of SHS associated with higher risk of cancer; heart, respiratory
disease 
Sudden infant death syndrome associated with environmental tobacco smoke 
Studies of women (non-smoking) who lived with smokers 
Statistically sig. excess risk of lung cancer 
Dose response relationship to # of cigs smoked and duration of smoking (dose
response relationship means risk starts accumulating with a little bit, this is different
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