Smoking Smoking Cessation Presented by The Point of

Smoking & Smoking Cessation Presented by:

The Point of this Presentation • To learn about the effects of smoking so that you can make a more educated decision if an opportunity comes for you to start smoking. • To learn about resources for people trying to quit smoking.

QUIZTIME! 1. Is tobacco smoking responsible for: a. 1/5 deaths? b. 1/10 deaths? c. 1/25 deaths? d. 1/100 deaths? ANSWER: it is estimated that tobacco smoking causes the death of 1 in 5 adults worldwide

QUIZTIME! 2. Smoking increases the risk of developing: a. lung cancer b. heart disease c. stroke d. emphysema e. cancer of the mouth f. all of the above ANSWER: f. all of the above

QUIZTIME! 3. True or false: A single cigarette can contain over 4000 chemicals. ANSWER: true; cigarettes contain over 4000 chemicals, 60 of which are known carcinogens (cancer-causing agents)

QUIZTIME! 4. How does cigarette smoking affect skin? a. makes you look younger b. premature aging c. dry skin d. all of the above ANSWER: b. premature aging; cigarettes cause skin to stain and darken and cause premature wrinkling

QUIZTIME! 5. Smoking is responsible for what percentage of all lung cancer? a. 20% b. 50% c. 90% d. 99% e. It is not proven that smoking causes lung cancer. ANSWER: c. 90%

QUIZTIME! 6. True or false: If a mother smokes during her pregnancy, her child is more likely to smoke as a teenager. ANSWER: true; even if the mother quits smoking after the baby is born, the child has already developed more nicotine receptors in the brain

QUIZTIME! 7. True or false: Smoking is the single largest preventable cause of death and disease in Canada. ANSWER: true; according to the Alberta Lung Association, smoking is the number one preventable cause of death in Canada

QUIZTIME! 8. True or false: The nicotine in smoking cessation products, such as NicoretteÔ or NicodermÔ is less harmful than the nicotine in cigarettes. ANSWER: false; the benefit of these products is that the amount of nicotine can gradually be reduced, until the person can quit altogether. The other benefit is that these products do not contain the other harmful chemicals found in cigarettes.

QUIZTIME! 9. Side effects of nicotine include: a. insomnia b. nausea c. dizziness d. all of the above ANSWER: d. all of the above. Nicotine can cause all of the side effects listed.

QUIZTIME! 10. True or false: Quitting smoking only involves breaking the physical addiction to nicotine. ANSWER: false. Quitting smoking also involves changing social habits as well as mental addiction.

Factoid! CIGARETTES ARE THE ONLY LEGAL PRODUCT THAT KILLS UP TO 50% OF THE USERS WHEN USED AS INTENDED BY THE MANUFACTURER!

What’s in a Cigarette? w Tobacco leaves w Fillers (usually “waste” products of tobacco leaves) to give cigarette “bulk” w Water w “Moisturizers” to enhance shelf life (prevents cigarettes from drying out)

What’s in a Cigarette? -- ADDITIVES • Sugars: make cigarettes easier to inhale • Ammonium: makes cigarettes less acidic • Eugenol/menthol: numb the throat (smoker cannot feel the smoke's aggravating effects) • Cocoa: expands airways; smoke can go deeper into lungs (more nicotine exposure & more tar) • Flavoured cigarettes

What’s in Cigarette Smoke? Chemical: Found in: Acetone Ammonia Arsenic Butane Paint stripper/nail polish remover Floor cleaner/carpet cleaner Rat Poison Lighter Fuel Car Batteries Car Exhaust Cadmium Carbon Monoxide

What’s in Cigarette Smoke? Chemical: Found in: DDT Hydrogen Cyanide Methanol Naphthalene Toluene Vinyl chloride Insecticide Gas Chambers Rocket fuel Moth balls Industrial solvent Plastics

What’s in Cigarette Smoke? w remember, over 4000 chemicals are found in cigarette smoke; only some have been listed w in every cigarette, there are 60 known carcinogens

What’s in Cigarette Smoke? w Types of smoke: 1. “sidestream” smoke from the burning tip of the cigarette (2 nd hand smoke. . . ) 2. “mainstream” smoke from the filter or mouth end. 3. the latest. . . third hand smoke

Second Hand Smoke w major cause of stillbirths and Sudden Infant Death Syndrome (SIDS) w associated with asthma and respiratory problems w increases the risk of coronary heart disease by 25 -35% w increases bronchitis, pneumonia, and ear/respiratory tract infections

What Does Smoking Do to the Body? Hair: smells and stains Eyes: sting & water, blindness, cataracts Skin: premature wrinkles & aging Brain: stroke, addiction/withdrawal, anxiety about harm of smoking w Nose: decreases sense of smell w Teeth: stains, plaque, loosens teeth, gum disease w Hands: staining and decreased circulation (cold hands!) w w

What Does Smoking Do to the Body? • Mouth/throat: lip/throat/mouth cancer, sore throat, reduced sense of taste, smelly breath • Lungs: lung cancer, cough, shortness of breath, colds/flu, pneumonia, emphysema • Heart: blocks/weakens arteries of the heart, heart attack • Chest: esophagus cancer • Abdomen: stomach ulcers, stomach/pancreas/colon • Liver, Kidneys, Bladder: cancer

Brain after stroke due to smoking Chronic smoker’s lung Mouth cancer

What Does Smoking Do to the Body? • Wounds: take longer to heal, longer time to recuperate from surgery • Blood: leukemia • Legs/Feet: leg pain and gangrene • Can also cause: – Diabetes: Non-insulin dependent diabetes mellitus (Type 2, adult-onset) – Weakened immune system

http: //www. who. int/tobacco/en/atlas 9. pdf What Does Smoking Do to the Body?

Costs of Smoking - to individuals w 1 pack in Canada ~ $10. 00/25 cigarettes w 1 pack/day = $10. 00/day x 30 days = $300. 00/month x 12 months = $3600/year - If you were making $9. 00/hour, that is 400 hours before taxes! - One year of smoking a pack a day costs almost as much as a down-payment on a car!

Costs of Smoking - to the economy w 6 -15% of total annual healthcare expenses are due to smoking n n n $4. 4 billion in direct health care costs for tobaccorelated illnesses Sick days from work Lower worker productivity Increased life insurance premiums Costs for smoking areas at work Lost income from dying young w 20% of trash removal due to tobacco products

Costs of Smoking - to the economy • 1 000 fires started due to cigarette lighters • Percentage of deaths by fire due to cigarettes: 10% • Total deaths due to fire from cigarettes: 300 000 (global) • China 1987: World’s worst forest fire caused by cigarettes (300 killed, 5000 homeless, 1. 3 million hectares of land destroyed)

Smoking – Opinions of Youth - (Grades 6 -12; Canadian Statistics, survey 2008 -2009) • 84% of youth believed tobacco was addictive • 85% also believed smoking harmed the health of non-smokers • About 4% of all non-smokers believe that the most common reason youth start smoking is the behavior of peers (“It’s cool”) • 18% of non-smokers believed smoking would help you “stay slim”

Youth Smoking Survey -Results Profile 2010/2011 w Survey was first conducted in 1994 and has been repeated every 2 years since 2002. n n 26% of youth from across Canada in grades 6 -12 have tried smoking and 3% report smoking on a daily basis. 85% of current smokers started smoking by age 19.

Peer and Family Influences w Influences can be direct (peer pressure) but more often indirect (modeling) w Non-smokers are most susceptible to start smoking if their friends smoke. w Youth with family members who smoke are more likely to start smoking. w Younger smokers are more likely to obtain cigarettes from friends and family.

Smoking – Becoming Less Popular - (Canadian Statistics, 2012) • The current smoking rate in Canada (12 and older) was 19. 9% in 2011 (down from 25. 9% in 2001). • The rates for men and women both dropped 6% during this period - men from 28. 1% to 22. 3% and women from 23. 8% to 17. 5%. • The smoking rate fell more rapidly among teens (15 to 19 years) than any other age group. • 18 to 19 year-olds: decline from 33. 2% to 19. 8% • 15 to 17 year-olds: decline from 19. 3% to 10. 1%

http: //www. hc-sc. gc. ca/hc-ps/tobac-tabac/research-recherche/stat/ctums-esutc_2011 -eng. php#tabc

What about Hookah Also Called: • Hookah • Argeela • Nargeela • Shisha • Goza • Bong …etc Originally from India. Popular in the Middle East and becoming more and more popular in North and South America, Europe and Australia

Hookah How it works: Flavored tobacco is put in a bowl (called a “rass” or “head”), and tin foil with holes covers it. A charcoal heats the head and the smoke is cooled through a water chamber at the bottom The smoke is then inhaled through a hose and a mouthpiece

Concerns with Hookah Although cigarette use has decreased significantly, alternative forms of tobacco such as hookah are becoming more popular, especially among youth. In 2010… - 10% of Canadians in grades 9 to 12 reported ever trying Hookah and 4% use it regularly. - 29% of Canadians thought smoking hookah was less harmful than smoking cigarettes. - 34% thought it contained less tar.

HOOKAH TRUE OR FALSE? Smoking hookah is less harmful than smoking cigarettes

Hookah Vs. Cigarettes When compared to smoking cigarettes, hookah smoke produced: 1. 7 times more nicotine 8. 3 times more carbon monoxide 36 times more tar

Cigarette Smokers Vs. Hookah Smokers What is Carbon Monoxide? A colorless and odorless gas which can decrease the amount of oxygen in your blood. Hemoglobin binds oxygen, but when carbon monoxide is present, you get carboxyhemoglobin! “after a single smoking session found that carboxyhaemoglobin levels increased by more than 400% in hookah smokers compared to less than 40% in cigarette smokers. ”

The Health Risks When measuring the 24 -hour urinary cotinine level in hookah smokers, they found out it is equivalent to smoking 10 cigarettes a day!

The Health Risks According to the WHO, a typical one-hour session of hookah smoking produces 100 to 200 times the volume of smoke produced by one cigarette It is still associated with all the diseases we’ve talked about, including: -All types of cancers -Heart Disease -Lung Disease and more…

Also Cost! How much for one box of hookah tobaco? Works out to costing more than cigarettes…

http: //www. offthemark. com/smoke. htm

There is hope!

Tips for Quitting w Decide positively that you WANT to quit; avoid negative thoughts. w List reasons for wanting to quit. w Set a target date for quitting–perhaps a special day such as your birthday. w Know quitting isn't easy, but it's not impossible either; withdrawal is temporary! w Tell your family and friends that you're quitting; they can give support!

Tips for Quitting w Spend as much free time where smoking isn't allowed (e. g. libraries, museums, theatres). w Avoid food/beverages that you normally associate with smoking (mental addiction/habit is almost as hard to break as the physical addiction!). w Avoid activities you associate with smoking (e. g. if you normally smoke while watching TV, lay off TV for a while).

Ways to Quit: w Switching brands: - switch to a brand you find distasteful - switch to a brand with less tar/nicotine and gradually wean off w Gradually quitting: - smoke only half of each cigarette - postpone the lighting of a cigarette by 1 hour - change your eating habits to help you cut down (e. g. reach for a glass of juice instead of a cigarette)

Other Aids: w nicotine replacement: nicotine gum, inhaler, lozenge or patch; can be used to reduce cravings and withdrawal symptoms w prescription medications: e. g. Zyban®, Champix® - nicotine-FREE - can help reduce the urge to smoke and reduce withdrawal symptoms - only recommended for smokers over 18 years of age w other treatments – so many aids!!

http: //www. glasbergen. com/images/fit 49. gif

Resources w Smoker’s Help Line 1 -866 - 33 A-ADAC (1 -866 -332 -2322) w Alberta Lung Association www. ab. lung. ca/smokingandtobacco. html w Canadian Cancer Society "One Step at a Time" Program: - http: //66. 59. 133. 166/tobacco/pubs/osaat/indexe. htm - Phone: 1 -888 -939 -3333 (toll free) w Smoke-Free Alberta www. smokefreealberta. com/ So many resources!!

The Difficulties of Quitting w withdrawal w It can be HARD WORK!! w multiple tries SUPPORT AND ENCOURAGEMENT!!

The Positives of Quitting w money w control in your life; “I have to go for a smoke”; pride w finding a mate – look prettier; healthy = hot w your health – lungs, heart, everything! sports, sticky situations, energy, dancing, fun with friends w friends’, others’ health w example for others, children

Barb Tarbox: A Life Cut Short by Tobacco http: //www. youtube. com/ watch? v=YQQXH 2 gqbtc • In September 2002 , Barb Tarbox was diagnosed with incurable lung (stage IV) and brain cancer at the age of 41. • She smoked for 30 years, totaling a 60 pack-year smoking history. • She died May 18, 2003 after speaking to more than 50, 000 students about the dangers of smoking.

Any Questions?

References w World Health Organization. Tobacco Free Initiative: Retrieved September 18, 2004: http: //www. who. int/tobacco/about/en/, http: //www. who. int/tobacco/en/atlas 9. pdf, http: //www. who. int/tobacco/en/atlas 13. pdf http: //www. ab. lung. ca/ w Tobacco Free Kids. (2003, April 3) Health Harms From Second Hand Smoke. Retrieved September 18, 2004: http: //tobaccofreekids. org/research/factsheets/pdf/0103. pdf w Health Canada. (2004, September 13) Summary of Results of the 2002 Youth Smoking Survey. Retrieved September 18, 2004: http: //www. hc-sc. gc. ca/hecs-sesc/tobacco/research/yss/index. html w Nicorette. (2004) Retrieved September 18, 2004: http: //nicorette. quit. com/ w Nicoderm. (2004) Retreived September 18, 2004: http: //nicodermcq. quit. com/ w Zyban. (2004) Retrieved September 18, 2004: http: //www. zyban. com/zp_1000. html w Canadian Lung Association. (2010) Smoking and Tobacco. Retrieved February 12, 2010: http: //www. lung. ca/protectprotegez/tobacco-tabagisme/quitting-cesser/benefits-bienfaits_e. php w C Health. (2010) Smoking. Retrieved February 12, 2010: http: //chealth. canoe. ca/channel_section_details. asp? text_id=3263&channel_id=2022&relation_id=16495

References w w w w WHO Study Group on Tobacco Product Regulation. Waterpipe Tobacco Smoking: Health Effects, Research Needs and Recommended Actions by Regulators. Geneva, Switzerland: World Health Organization, 2005. Maziak W. The global epidemic of waterpipe smoking. Addictive Behaviors; 2011: Jan-Feb; 36(1 -2): 1 -5. Canadian Tobacco Use Monitoring Survey (CTUMS) 2006. Health Canada http: //www. hc-sc. gc. ca/hc-ps/tobactabac/ research-recherche/stat/_ctums-esutc_2006/ann_summary-sommaire-eng. php. Youth Smoking Study (YSS) 2006. Health Canada. Dugas E, Tremblay M, Low NCP, Cournoyer D, O’Loughlin J. Water-pipe smoking among North American youth. Pediatrics 2010; 125: 1184 -1189. Cobb C, Ward KD, Maziak W, Shihadeh AL, Eissenberg T. Waterpipe tobacco smoking: An emerging health crisis in the United States. American Journal of Health Behavior 2010; 34(3): 275 -285. Theron A, Schultz C, Ker JA, Falzone N. Carboxyhaemoglobin levels in water-pipe and cigarette smokers. South African Medical Journal 2010; 100: 122 -124. Neergaard J, Singh P, Job J, Montgomery S. Waterpipe smoking and nicotine exposure: A review of the current evidence. Nicotine and Tobacco Research 2007; 9(10): 987 -994. Akl EA, Gaddam S, Gunukula SK, Honeine R, et al. The effects of waterpipe tobacco smoking on health outcomes: a systematic review. International Journal of Epidemiology 2010; 39: 834 -857.

References w • • • Daher N, Saleh R, Jaroudi, E, Sheheiti H, et al. Comparison of carcinogen, carbon monoxide, and ultrafine particle emissions from narghile waterpipe and cigarette smoking: Sidestream smoke measurements and assessment of second-hand smoke emission factors. Atmospheric Environment 2010; 44: 8 -14. CDC. Bidi and Hookah Use Among Canadian Youth: Findings from the 2010 Canadian Youth Smoking Survey: Retrieved August 25, 2013: http: //www. cdc. gov/pcd/issues/2013/12_0290. htm Propel. Tobacco Use in Canada: Patterns and Trends 2012 Edition: Retrieved August 25, 2013: http: //www. tobaccoreport. ca/2012/Tobacco. Usein. Canada_2012. pdf Alberta Health Services. Smoking is Expensive: Retrieved August 25, 2013: http: //www. albertahealthservices. ca/2570. asp Statistics Canada. Health at a Glance – Current Smoking Trends: Retrieved August 25, 2013: http: //www. statcan. gc. ca/pub/82 -624 -x/2012001/article/11676 -eng. htm 2008 -2009 Youth Smoking Survey (YSS) Public Use Microdata File: Retrieved August 25, 2013: http: //search 2. odesi. ca/documentation/YSS 2008 -2009/yss 08_microdata_publicuse_091202_ver 3. pdf Youth Smoking Survey. Results Profile for Alberta: Retrieved August 25, 2013: http: //www. yss. uwaterloo. ca/results/yss 10_EN_Provincial%20 Report_Alberta_20120514. pdf