Toward a Tobacco-Free Society

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Toward a Tobacco-Free Society

• Chapter 11

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Psychoactive Drugs and Changes in Brain Chemistry

• Psychoactive drugs produce most of their key
  effects by acting on brain chemistry in a
  characteristic fashion
• Consider the route of entry for different types
  of drugs
• Ex. Oral drugs dissolve in stomach
  absorbed into bloodstream liver, heart and
  lungs
  
  
  
  
  heart brain
• The more quickly a drug reaches the brain, the
  more likely the user is to become dependent

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Psychoactive Drugs and Changes in Brain Chemistry

• Once in the brain, psychoactive drugs act on one
  or more neurotransmitters by increasing/decreasing
  their concentrations and actions
• Ex. Dopamine is thought to play a role in
  reinforcement
• Heroin, nicotine, alcohol, and amphetamines also
  affect dopamine levels

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Who Uses Tobacco?

• 71 million Americans smoke
• 24 of men and 18 of women smoke
• The more education a person has, the less likely
  they are to smoke

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Figure 11.1 Annual Mortality Among Smokers
Attributable to Smoking
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Figure 11.1 Annual Morbidity Among Smokers
Attributable to Smoking
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Why People Use Tobacco

• A nicotine addiction
• Nicotine is a powerful psychoactive drug
• Many researchers consider nicotine the most
  physically addictive of all psychoactive drugs
• Reaches the brain via the bloodstream in seconds

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Why People Use Tobacco

• Loss of control
• Tobacco users live according to a rigid cycle of
  need and gratification on avg. can go for no
  more than 40 min. between doses of nicotine
• Tolerance and withdrawal
• Sudden abstinence from nicotine produces
  predictable withdrawal symptoms severe cravings,
  insomnia, confusion, tremors, difficulty
  concentrating, fatigue, muscle pains, headache,
  nausea, etc., increased heart rate and bp

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Why People Use Tobacco

• Social and Psychological Factors
• Secondary reinforcers are activities the smoker
  associate with tobacco use
• Genetic Factors
• CYP2A6
• DRD2 (reward gene)

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Why Start in the First Place?

• 90 of all new smokers in this country are
  children and teenagers
• 1,300 children and adolescents start smoking
  every day
• Average age to start
• 13 for smoking
• 10 for spit tobacco
• Rationalizing the dangers, invincible
• Emulating smoking in the media??

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Health Hazards

• Contains hundreds of damaging chemical substances
• Unfiltered cigarettes 5 billion particles per
  cubic mm
• 50,000 times more than in an equal volume of
  smoggy urban air
• Condensed particles in the cigarette produce a
  sticky brown mass called cigarette tar

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Carcinogens and Poisons in Tobacco Smoke

• 43 chemicals are linked to development of cancer
• Benzo(a)pyrene is a carcinogen- research has
  found that this causes mutations in lung cancer
  cells identical to those found in many lung
  cancer patients
• Urethane- also a carcinogen (directly causes
  cancer)
• Cocarcinogens (ex. formaldehyde)
• Combine with other chemicals to cause cancer
• Poisonous substances
• Arsenic
• Hydrogen cyanide
• Carbon monoxide
• Contains amounts 400 times greater than is
  considered safe in industrial workplaces
• Displaces oxygen in red blood cells
• Additives
• Humectants, sugars, bronchodilators, ammonia,
  things to make sidestream smoke less obvious

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Light and Low-Tar Cigarettes

• Low-tar, low-nicotine, or filtered cigarettes
• No such thing as a safe cigarette
• Users often smoke more, inhale more deeply,
  blocking ventilation holes
• Less likely to quit than smokers
• of regular cigarettes
• As of June 2010, federal law prohibited the use
  of terms such as light and mild

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Menthol Cigarettes

• About 70 of African American smokers smoke
  menthol cigarettes
• These individuals absorb more nicotine and
  metabolize it slower than other groups
• Anesthetizing effect of menthol, means smokers
  inhale more deeply and hold smoke longer in the
  lungs

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Immediate Effects of Smoking

• Nicotine can either Excite or Tranquilize the
  Nervous System Depending on Dosage
• Constricts blood vessels, elevates HR and BP
• Stimulates adrenal glands to discharge adrenaline
• In adults can increase alertness, concentration,
  information processing, etc.) opposite effect in
  young people
• Can act as a sedative, and relieve symptoms of
  anxiety and irritability
• Depresses hunger

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The Long-Term Effects of Smoking

• Cardiovascular Disease
• Coronary heart disease (CHD) causes just as many
  deaths from smoking as lung cancer
• Atherosclerosis leading to angina pectoris and
  myocardial infarction (heart attack)

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The Long-Term Effects of Smoking

• Lung cancer and other cancers
• The risk of developing lung cancer increases w/
  number of cigarettes smoked each day and number
  of years smoking
• Research has linked smoking to cancers of the
  trachea, mouth, esophagus, larynx, pancreas,
  bladder, kidney, breast, cervix, stomach liver,
  colon and skin
• Chronic obstructive pulmonary disease
• Emphysema and Chronic bronchitis

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Additional Health, Cosmetic, and Economic Concerns

• Ulcers
• Impotence
• Reproductive health problems
• Dental diseases
• Diminished physical senses
• Injuries
• Cosmetic concerns
• Economic costs

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Cumulative Effects

• People who smoke before 15 yrs. old and continue
  to smoke are half as likely to live to 75 versus
  those who did not smoke
• Smokers spend one-third more time away from their
  jobs because of illness than nonsmokers
• Both men and women show a greater rate of acute
  and chronic diseases

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Other Forms of Tobacco

• Spit (smokeless) tobacco
• Contains at least 28 chemicals known to cause
  cancer
• Cigars and pipes
• Users do not need to inhale in order to ingest
  nicotine - its absorbed through gums and mouth
• Cigars contain more tobacco than cigarettes
  more nicotine

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The Effects of Smoking on the Nonsmoker

• Environmental Tobacco smoke (ETS)
• Consists of mainstream smoke (exhaled by smokers)
  and sidestream smoke (smoke from burning end of a
  cigarette, cigar, or pipe)
• Sidestream smoke has twice the tar and nicotine,
  3X the benzo(a)pyrene, CO, and ammonia
• EPA designated ETS as a class A carcinogen and
  Surgeon General has concluded that there is no
  safe level of exposure to ETS.

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ETS Effects

• Develop cough, headaches, nasal discomfort, eye
  irritation, breathlessness, and sinus problems
• Allergies will be exacerbated
• Causes 3,000 deaths due to lung cancer
• Contributes to about 35,000 heart disease deaths
  each year
• Nonsmokers can be affected by effects of ETS
  hours after they leave a smoky environment
• Carbon monoxide lingers in bloodstream 5 hours
  later

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Infants, Children, and ETS

• Children exposed to ETS are more likely to have
• SIDs and low-birth weight
• Bronchitis, pneumonia, and asthma
• Reduced lung function
• Middle-ear infections
• Lung cancer, emphysema, and chronic bronchitis
  later in life

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Smoking and Pregnancy

• Estimated 4600 infant deaths in the U.S.
• Increased risk of miscarriage, premature birth,
  low birth weight, SIDS, and long term impairments
  in growth and intellectual development

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What Can Be Done?

• The best way to avoid all of the added chemicals
  in cigarettes is to stop smoking right now!! This
  very minute!! THE BENEFITS OF QUITTING ARE
  IMMEDIATE!
• Action at many levels
• CDC-Tips From Former Smokers
• Smokefree.gov
• Individual action-Talk with your friends and
  family who have quit smoking and see what helped
  them, 'quit smoking' products

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How A Tobacco User Can Quit

• The benefits of quitting
• Options for quitting
• Cold-turkey
• Changes to routines
• Over-the-counter prescription products
• Support from family and friends
• Smoking cessation programs
• Free telephone quitlines
• 1-800-QUITNOW

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Toward a Tobacco-Free Society

• Chapter 11