Chapter 11 Alcohol, Tobacco and Caffeine Unacknowledged Addictions

1. Chapter 11Alcohol, Tobacco and CaffeineUnacknowledged Addictions Tobacco

2. TOBACCOJanuary 11, 1964: U.S. Surgeon General ReportCigarette smoking is linked to increased morbidity and  mortality Canadian Smokers proportion of smokers decreased in past 25 years - still approximately 30% smoke

3. Smoking…… in Canada • 7 millions Canadians smoke • heavy smokers on the rise • 45,000 Canadians die from tobacco abuse each year • Adolescent females (14-20 yr.) • 1990-1994 # of adolescents smoking increased by 24 % • Health care cost more than $9.6 billion annually

4. Forms of Tobacco Consumption: Snuff: • powdered tobacco • absorbed through mucous membrane of nose • some increase in popularity

5. Chewing Tobacco • tobacco leaves mixed with a variety of flavoring agents (ex. molasses) • tobacco constituents (nicotine) absorbed through mucous membrane in mouth • Snuff and chewing tobacco smokeless tobacco • smokeless tobacco = 11 X the risk of developing cancers mouth and gum as nonusers

6. Pipes-Cigars-Cigarettes:Composition of Tobacco Smoke: • inhaling hot smoke absorbed via the lungs • 65 species of tobacco • over 4000 known compounds in tobacco • smoke in our atmosphere • 1. Mainstream smoke - drawn through cigarette & filter • 2. Side-stream smoke - burning tobacco not inhaled = second-hand smoke

7. Composition of Cigarette Smoke • Condensed particles: Tar (8 % of total volume) • Gases and Vapors (92 % of total volume)

8. Harmful constituents of cigarette smoke Tar • Carcinogenic agents (cancer-producing chemicals) • Co-carcinogenic agents (substances combine with others that cause cancer) • Nicotine • Tar + CO + Nicotine are obtained from burning tobacco in cigarettes, pipes and cigars • Tar - related to  mortality &  morbidity

9. Carcinogens and Co-carcinogens • Carcinogens or tumor initiators, lung, pancreas, kidney, and bladder; • Co-carcinogens or tumor promoters: help maintain process of tumor formation

10. Nicotine: • 50-2500 mg/cigarette • powerful pharmacological agent • stimulates cerebral cortex immediate effects: •  HR •  MAP (vasoconstriction) •  MVO2 •  ventilation •  hunger (dulls taste buds) • 1/2 life of nicotine 30 min - highly addictive

11. Nicotine • regular smokers need to replenish body's nicotine level every 30-min. • major addictive agent • nicotine dependence is a physical and psychological • several “breaks/day”

12. Carbon Monoxide (CO): • CO causes noticeable physiological effects • 1-5 % of smoke • CO interferes with ability of Hb to bind with O2 • CO levels in smoke have been positively correlated with risk of CAD/stroke

13. Benzopyrene: • responsible for lung cancer kills the cancer-protecting cells in the body

14. During Puffing: • temperature in burning cone is between 900 and 1050 °C • these temperatures produce mainstream smoke • the side-stream smoke is generated during smoldering of tobacco at 800 °C • estimated that 55-70 % of tobacco of cigarettes is burned between puffs  source of side-stream smoke

15. Giving Up Smoking! Smoking - powerful immediate satisfaction for individual: • pharmacological • psychological • emotional • social Approximately: • 50 % quit smoking "COLD TURKEY" • 50 % gradual reduction

16. 2 types of withdrawal: Physiological Withdrawal: • physical dependence on nicotine / easiest to deal with Symptoms: • headaches • irritability • sleeplessness • intense cravings • muscle aches • symptoms highest at three days - diminish with time

17. Psychological Withdrawal • breaking patterns / changing behavior • first few months are critical…… • relapses are common • Individual changes in behavior • mood • craving for tobacco

18. Smoking a Learned Behaviour Tobacco industry portrays smoking as positive • a gradual process • peer pressure Promotion of Smoking • helps to shape & reinforce + image • influences amount smoked • negative influence to quit by acting as reassuring cue

19. Don’t Start Smoking…..Best Results from Prevention • Stay Healthy • pursue healthy activities • choose friends who also respect healthy • lifestyles • protect your personal environment……public places, home, car and other places where smoking occurs!