Chapter 11 Alcohol, Tobacco and Caffeine Unacknowledged Addictions

1
Chapter 11 Alcohol, 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-CigarettesComposition 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
Dont Start Smoking.. Best Results from
Prevention

• Stay Healthy
• pursue healthy activities
• choose friends who also respect healthy
• lifestyles
• protect your personal environmentpublic places,
  home, car and other places where smoking occurs!