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Midterm 2 notes.docx

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Bruce Mc Kay

Tobacco 15/10/2013 6:20:00 PM Tobacco history and advertising:  1942: Christopher Columbus “discovers” tobacco  1900’s: Cigars or cigarettes? Long, think and dark vs. short slender and light  1964: First surgeon general’s report on smoking (book called “smoking-health” Cigars: tightly rolled quantities of dried tobacco leaves Cigarettes: rolls of shredded tobacco wrapped in paper  Active athletes and doctors advertised tobacco  Anti-smoking messages after 1964 (“mind if I smoke?” “mind if I die?”)  As recent as 1994, during testimony to US Congress a slide show stated “cigarette smoking is not addictive” Nicotine Dependence- DSM-IV-TR The usual “substance dependence” criteria must be somewhat modified for tobacco, because tobacco is legal and can be used in many places 1. Tolerance 2. Withdrawal 3. Substance often taken in larger amounts or over a period longer than intended 4. Persistent desire or unsuccessful efforts to cut down or control substance use 5. A great deal of time is spent in obtaining the substance 6. Important activities are given up 7. Continued use despite health issues  2011: 75% of the display space on a cigarette pack must be warnings 2006-Smoke-Free Ontario Act  prohibits smoking in all enclosed public places and workplaces in Ontario effective May 31,2006  Ensures the min. age to purchase cigarettes is 19 (retailer must verify age like lcbo)  Phases out the retail display of tobacco products Average North American was smoking 500 cigarettes per year in 1950 Who is smoking?  1 in 4/5 people smoke  Males smoke slightly more than females  China smokes the most (2/3 people) o No advertising o Less laws/regulations o Lifestyle stressors o Farms need to sell to make money and China is not very educated When does smoking start?  28% of eighth graders have tried cigarettes in their lives  Peak years for smoking begins in grade 6-7  80-90% if regular smokers begin at 18 Are the negative health effects of cigarettes widely known, and if so, why do people start smoking in the first place?  There really aren’t immediate consequences  It is long term Why does smoking start? For teenagers:  Establish feelings of independence and maturity (parental wishes)  Improving self-image, enhancing social acceptance (everyone else was smoking at the party)  Counter-act stress or boredom  Simple curiosity **Nicotine and alcohol makes it more addictive (nicotine increases the addiction in other drugs) Laurier data: Most have never done it, or tried it once. About 7% smoke at least one cigarette a day (predictions are 35% of laurier students) What’s in tobacco smoke? The most important toxic compounds in tobacco smoke is Carbon monoxide (CO)  An odourless, colourless, tasteless toxic gas  Attaches itself to haemoglobin better than oxygen  Produces a slow asphyxiation of the body  A cause of cardiovascular diseases Tar:  Sticky, adheres to cells in the lungs and airways  Impairs ciliary escalator  Permits carcinogenic compounds to settle on pulmonary tissue; origin of metastatic cancers Most important toxic compounds in tobacco smoke Nicotine: - toxic dependence-producing psychoactive drug, found exclusively in tobacco - stimulates CNS receptors (nicotinic) sensitive to acetylcholine - releases adrenaline - inhibits activity in the gastro-intestinal tract - passes blood-brain and blood-placental barrier in 5 seconds -first used as an insect killer Do filtered cigarettes have fewer toxins? Filtered cigarettes have a filter to remove toxins, the filter also decreases the tar (flavour) and nicotine - to compensate, manufacturers increased the tar, effectively negating the filter's purpose - the second hand smoke is worse from a filtered cigarette E-Cigarettes - vaporize nicotine without the tar or carbon monoxide; but you get diethylene glocol instead (anti-freeze) Hookah - large, ornate water pipes imported from Arab country that produce milder, water-filtered tobacco smoke Are Hookahs Safer? - does decrease toxins, but you don't smoke the same way as a cigarette - added coal in hookah adds to the number of toxins - sessions tend to last 20-25 minutes with a person puffing 50-100 times - average smoker does 5-7 minutes between 10-20 puffs - singer session results in the same carbon monoxide and tar intake as smoking 100 cigarettes Short Term Tobacco Effects Central nervous system - increased electrical activity of the cortex (arousal) - given complex task + nicotine = better task Circulatory system effects - increased heart rate and blood pressure - increased oxygen need of the heart - decreased oxygen-carrying ability of blood - shortness of breath - increased platelets adhesiveness (clotting) Reduced hunger - inhibition of hunger contractions - increased blood sugar - deadening of taste buds - average smoker is 8-10 pounds lighter than non-smoker - they often gain 20-50 pounds when they quit Acute Toxic Effects - 60 mg is lethal to an adult - 2.5 dead adults per pack if 100% of nicotine absorbed - death is by acute and severe convulsions (epilepsy) - risk for: children, tobacco workers, laboratory use, insecticides Nicotiine Poisoning Early symptoms: flu like, nausea, abdominal pain, cold sweat, headache, dizziness, mental confusion Later: fainting and prostration, falling blood pressure, breathing impairment, weak pulse, collapse Finally: convulsions, respiratory failure, death Treatment: in swallowed, place absorbent charcoal in the stomach, prove artificial respiration and treat for shock Chronic, Long Term Effects -lung cancer - cardiovascular disease - chronic obstructive lung diseases (emphysema) - various cancers - risk increase for young and long time - cigar smoking is more dangerous than cigarette smoking - can get hairy tongue - smoking is the single greatest avoidable cause of death Top 8 Causes of Death in NA - approx 430 000 US deaths each year - drink whole life/heroin whole life moderately, but smoking is the only one that will kill you 1. Heart disease 2. Cancer 3. Stroke 4. Lung problems (all cigarette) 5. Unintentional injuries 6. Diabetes 7. Pneumonia 8. Alzheimer's Chewing Tobacco - lumps in jaw or neck - colour change inside lips - white spots in mouth - red spots in moth/bleeding Pregnancy and Smoking - increased risk of miscarriage, low birth weight, SIDS - 50-60% of SIDs cases occur in smoking families - lay on back and no tobacco smoke - later effects on physical and intellectual development - poor reading and math - hyperactivity - Effects are of the same type and magnitude as those reported for "crack babies" - many more pregnant women smoke than use cocaine - nurses would adopt the crack baby over the alcohol and tobacco babies Women - Tobacco use increases risk of dying from stroke due to brain hemorrhage - it's not the carbon monoxide, not the tar, but the nicotine - 3x higher than men - Birth control pills: 22x higher than men - Dying from heart attack - 2x higher than men - Birth control pills: 20x higher than men Second Hand Smoke and Third Hand Smoke Mainsteam smoke - smoke exhaled by smoker Sidestream smoke - the smoke rising from the ash of the cigarette Sidesteam is carcinogenic - ¾ of nicotine smoke ends up in the atmosphere - non-smoking wives have 30% increased risk of lung cancer Review: Tobacco increases risk of: Lung cancer Larynx cancer Mouth cancer Lip cancer Bladder cancer Pancreatic cancer Kidney or uterine cancer - about 7% of all health care costs go to treating smoking related problems Ontario Sues Big Tobacco - for $50 billion Fun Fact: July 2008, government reached a 1.7 billion settlement with tobacco companies after they admitted aiding smugglers bringing contraband cigarettes into Canada - was done as tax evasion strategy - the total evaded was $10 billion, so their net profit after fine was $8.3 billion Taxes - for every 10% increase in the retail cost of cigarettes 2-3% reduction in adult smoke
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