Tobacco: The End is Near

1
Tobacco The End is Near

• Chronic Disease Conference
• Hawaii Island Tobacco-Free Partnership
• August 19, 2004
• Kevin Kunz M.D., M.P.H., FASAM

2
Chronic Diseases

• Heart Disease
• Vascular Disease
• Hypertension
• Diabetes
• Obesity
• Cancer
• Mental Illness

• Lipid Disorders
• Cancer
• Lung Diseases, COPD, asthma
• Arthritis
• Metabolic Syndrome
• Addiction

3
Addiction is a Chronic Disease

• A genetically influenced, bio-psycho-social
  disease with predictable and characteristic signs
  and symptoms, an natural history
• Intoxication, tolerance, self-administration,
  withdrawal, cessation/relapse cycles
• 5 Cs Control, Compulsion, Consequences,
  Continued Use, Cravings
• 33 of nicotine addicted persons will die of
  their addiction

4
Reported Vs Actual Causes of DeathCDC 2000

• Reported
• Heart Disease 30
• Cancer 23
• Stroke 7
• COPD 5
• Injuries 4
• Diabetes 3
• Pneumonia/flu 3
• Alzheimers 2
• Kidney Disease 2

• Actual
• Tobacco 18
• Diet/Inactivity 17
• Alcohol 3.5
• Microbial 3.1
• Toxic Agents 2.3
• Motor Vehicles 1.8
• Firearms 1.2
• Sexual Behavior .8
• Illicit drugs .7

5
Actual Numbers for Actual CausesCDC 2000

• Tobacco 435,000
• Poor Diet/Inactivity 400,000
• Alcohol Consumption 85,000
• Microbial Agents 75,000
• Motor Vehicles 43,000
• Firearms 29,000
• Sexual Behavior 20,000
• Illicit Drugs 17,000

6
Addiction The Leading Cause of Death

• Tobacco 435,000 18
• Alcohol 85,000 3.5
• Illicit Drugs 17,000 .7
• Total 537,000 22.2