3.4.3. Tobacco and Smoking Cessation Flashcards
military personnel ________ likely as civilians to use smokeless tobacco
military personnel more than twice as likely as civilians to use smokeless tobacco
Relationship between smoking and rank
inverse relationship between smoking prevalence and military rank (lower rank = more smokers)
Smoking by branch
Army 27%
Navy 24%
MC 31%
AF 17%
every day, nearly ____ youth try smoking and ____ become regular smokers (education has reduced this data a lot)
every day, nearly 4,000 youth try smoking and 1,000 become regular smokers (education has reduced this data a lot)
almost 90% adult smokers began when?
almost 90% adult smokers began by 18 years of age
Ethnic background vs smoking
- 8% American Indians/Alaska Natives
- 7% whites
- 1% African Americans
- 9% Hispanic
- 7% Asians (including Hawaiians and other Pacific Islanders)
World Cigarette Consumption
48% western pacific
24% Europe
11% Americas
8% South East Asia
6% Eastern Mediterranean
3% Africa
Non-neoplastic Bronchopulmonary Diseases (e.g. COPD) can cause death in smokers. How often?
Non-neoplastic Bronchopulmonary Diseases (e.g. COPD (third leading contributor to mortality associated with cigarette smoking))
What percent of bronchopulmonary diseases are secondary to smoking?
80-90% of these diseases are due to smoking
5 problems with babies who had smoking moms, and I don’t mean smoking hot.
babies born to women who smoke during pregnancy are on average 200g lighter (and have
- decreased body length
- chest circumference
- head circumference
- abnormal lung development)
This finding is associated with mothers who smoke
nicotine is found in the breast milk of smokers
smoking + oral contraceptives can increase risks of ______by 10 fold
smoking + oral contraceptives can increase risks of cardiovascular disease by 10 fold
What are we worried about with post menopausal women and smoking
post-menopausal women smokers tend to have decreased bone density and increased risk for hip fractures
What condition with men increases due to smoking?
Men: smoking has been associated with erectile dysfunction
What is third hand smoke
third-hand smoke: contamination remains as toxins that lingers on surfaces and materials (carpets and clothes) for hours and days after cigarette is extinguished and build up over time.
Mortality: single most important factor contributing to premature mortality in the US (and it’s a preventable cause!)
Prematurity mortality ratio with smoking?
2.0
increases with amount smoked
increases with duration of smoking
every ____ seconds someone dies from tobacco use
every 6 seconds someone dies from tobacco use
tobacco kills 2x more Americans than what?
tobacco kills 2x more Americans than AIDS, alcohol, auto accidents, homicides, drugs and suicides combined
What was the silver screen in smoking?
the silver screen in 1920s: tobacco a symbol of masculinity and strength
Discuss the image of smoking from the 20s through the 60s
the silver screen in 1920s: tobacco a symbol of masculinity and strength
1950s→ when smoking was first considered dangerous: you have to be a tough guy to smoke (rebellious image)
1960s→ heros of silver screen replaced with rock bands, Rolling Stones and the Beatles, also smokers
What are hooks?
hooks: devices or techniques used to appeal to target audience, i.e. implying you will get something if you buy their product, like happiness or sex appeal
What are messages?
messages: what the ad is really saying in words and in pictures (overt and covert)
Salient vs subliminal
Relate it to the message of the ad
Marlboro: the Marlboro man→ appeals to men and boys
salient (what you see): Marlboro man
subliminal (the background): clear sky and snow
message:→ you are manly and smoking is clean like a clear sky and white snow if you smoke Marlboros
Number one reason given for why people smoke?
to relax or calm down 75.3% (nicotine has bimodal action→ can bring us up when we are down, and down when we are up)
Why is nicotine so addictive?
Most powerful way to get drug to the brain: smoke it (nicotine crosses the blood brain barrier)
Nicotine mechanism
binds to nicotinic acetylcholine receptors
mood modulating chemicals
other stimulating actions
→ cascade of events leads to a strong reward
Why mechanistically is nicotine so powerful on the brain?
nicotine is the only chemical that upregulates number of its own active receptors in brain over course of exposure so you need more over time, and it has a greater hold on the brain and its actions when it arrives in the brain
How is nicotine altered in a cigarette?
pH alters nicotine delivery
chemicals are added to tobacco to alter nicotine’s “kick”
Positive vs. negative reinforcement effects of nicotine
positive reinforcement -
eupphoria induced by nicotine
calming effect of nicotine
negative reinforcement -
off-setting withdrawal effects of nicotine abstinence
the ideal tobacco cessation program considers what three things?
the ideal tobacco cessation program considers the specific patient and both biological and psychological factors
In regards to pharmacotherapy, what is Nicotine Replacement Therapy an example of?
Nicotine agonist
Four steps to maximizing steps of smoking cessation
multicomponents
motivation and stages
custom tailoring
relapse prevention
5 best settings for smoking cessation
home/work
hospitals/clinics
community centers
places of worship
deployment settings
5 key steps for quitting
get ready
get support and encouragement
learn new skills and behaviors
get medication and use correctly
be prepared for relapse and difficult situations
Four A’s of quitting smoking
The Four A’s
Avoid trigger situations until confident in the ability to stay quit
Alter strength of trigger by changing behaviors that one typically engages in during the trigger situation
Alternative oral substitutes (e.g. gum) for trigger situations
engage in other Activities (e.g. walking) to distract from cravings
Philosophy of smoking advice from doctors prior to 1988
Prior to 1988: physicians’ general approach to patients who smoked was not to counsel them on their smoking habit unless they presented with symptoms (i.e. it’s the patient’s choice to smoke and none of the doctors’ business)
Philosophy of smoking advice from doctors after 1988
After 1988, since surgeon general determined that cigarette smoking and nicotine was addictive, physicians felt they should tell patients that the drug was addictive, to counsel them against smoking, and definitely tell them to stop smoking if they have symptoms
What happened after the 1988 surgeon general warning regarding tobacco companies?
Since 1998
Master Settlement Agreement, MSA, tobacco industry under some regulations
What was the truth campaign?
unlike food and drug companies, tobacco companies aren’t required to include list of ingredients on packaging
Control of cigarettes prior to 2009
age and advertising restrictions
packaging and labeling guidelines
WHO tobacco control initiatives
What happened in 2009?
Family Smoking Prevention and Tobacco Control Act (FSPTCA) of 2009
FDA granted regulatory control over tobacco products and established the Center for Tobacco Products as focal point to implement FSPTCA policies and initiatives
FSPTCA guidelines
Tobacco companies must disclose: ingredients
marketing research
delivery method
Requires larger, more prominent warning labels on tobacco products
When did the DOD begin smoking policies? What did it entail?
DoD Policy: “Smoke-free DoD Workplace” 2001
provides limited prohibition of tobacco-usage by DoD employees
