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Tobacco or Health (Respiratory)


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What developments lead to tobacco becoming a major health problem in the 20th century? (5)
1. Mass production of cigarettes - the most deadly form of tobacco use
2. Invention of reliable paper and wood matches
3. Shift in the purpose of advertising from information to persuasion
4. Fear of TB that led to curbs on spitting tobacco and favored cigarettes
5. Dramatic increase in life expectancy (47 years in 1900 steadily rising to 77 years in 2000)
Eight organs in which smoking increases the risk of cancer?
1. Lungs (smoking causes > 90%)
2. Upper airway (mouth, pharynx, larynx)
3. Esophagus
4. Bladder
5. Pancreas
6. Kidney
7. Cervix
8. Bone marrow (leukemia)
6 non-neoplastic diseases that are affected by smoking?
1. Coronary heart disease
2. Stroke
4. Peripheral vascular disease
5. Increased infant mortality 6. Increased risk of:
a. Spontaneous pneumothorax b. EG (eosinophilic granuloma)
c. DIP (desquamative interstitial pneumonia)
d. RBILD (respiratory bronchiolitis/interstitial lung disease)
e. UIP (usual interstitial pneumonia)
f. Macular degeneration (can cause blindness)
g. Abdominal aortic aneurysm
At what age do most smokers begin daily smoking?
90% of smokers begin before age 21; 50% by age 14
How great is the risk that the average smoker will die from lung cancer?
Disease risk from smoking is dose related; dose is counted in pack-years

The average lifetime smoker has a one in three chance of dying a death caused by
smoking, including a one in 10 chance of dying of lung cancer

The average smoker (25 cigarettes a day) loses 7 years of life; the average smoker who dies loses 21 years of life
What are the effects of pipes and cigars?
1. smoke has an alkaline pH, so nicotine can be absorbed through the oral mucosa - inhaling is not necessary for pipe and cigar smokers as it is for cigarette smokers (cigarette smoke has a more neutral pH)
2. Increased risk of upper airway cancer (lip, mouth, throat, esophagus)
3. Increased risk of peptic ulcer
4. Increased risk of heart disease, but not nearly as much as with cigarettes
What is the effects of smokeless tobacco on users?
1. Appeals to young boys
2. Is highly addictive
3. Causes oral cancer and periodontal disease
Why do children smoke?
1. Peer Pressure
2. Following older role models
3. Rebelling from authority
4. Feeling bored
Why do adults smoke?
1. Nicotine (depending on how puffed can get different pharmacologic effects)
a. can enhance alertness and concentration
b. induce relaxation and calm
Name the 5 stages of smoking cessation cycle?
Stages of the behavior change cycle
1. Use (precontemplation)
2. Contemplation of change (quitting)
3. Action (attempt to quit)
4. Abstinence
5. Relapse (or not)

Do not skip stages --> doesn't work; moving thru stages may take a day or decade.
Describe 4 steps health care providers can take?
What all health care providers should do --

1. Ask your patients if they smoke
2. Advise smokers to quit and choose a quit date
3. Assist them by counseling, providing materials, prescribing, and referring
4. Arrange follow-up
Describe the information that providers can offer patients to help them stop smoking?
- Nicotine gum and patches
- Nicotine spray and inhalers
- Bupropion (reduce smoking desire)
- Voluntary health agencies offering group programs
- Individual counseling
- Hypnosis
- pamphlets, audios, videos, web sites
- ** more tatics tried, the better the success
What are 4 key points to consider about tobacco?
1. Tobacco is very profitable to grow and to make into cigarettes.
2. Tobacco causes a huge burden of preventable disease, increasing health care cost by many billions of dollars a year (and also providing a lot of health care jobs).
3. Smoking increases disability costs, but saves retirement costs (since smokers die younger).
4. Tobacco use is decreasing in the U.S. American
and foreign tobacco companies are heavily promoting cigarettes in developing countries, and foreign and world-wide consumption is climbing.
Name the 6 public health strategies to decrease tobacco use in the U.S. population?
Six strategies
1. Increase the cigarette tax 2. Enforce laws that prohibit sales to people under 18
3. Ban advertising of tobacco
4. Make all work places and public indoor areas smoke-free
5. Help smokers quit
6. Use tobacco lawsuit settlement funds for programs that decrease tobacco use

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