the health risks of smokin Flashcards
smoking kills
1) more than 400,000 people per year in USA
2) leading preventable cause of death in the US
exposures to provider
1) dentists are also exposed to this during biopsy
2) carbon monoxide
benzopyrene
1) when smoking, exposure to it
2) it is a potent carcinogen
3) risk of lung cancer is related to intensity of exposure
- one pack daily for 10 years equals 10 pack years
- 20 cigs / pack
- pack year = packs per day * number of years
smoking and cancer
1) 90% lung cancers occur in smokers
2) colorectal and liver cancers
3) combo of smoking and alcohol has multiplicative effect on oral cancer
pathogenesis
1) there are enzymes that convert benzopyrene to something that can attach to guanine
2) the body’s DNA repair system will catch it and initiate apoptosis
3) if not, a mutation occurs and can be carcinogenic
morphology
1) mutations can disrupt cellular growth and organization
2) epithelial tumors
smoking and the circulatory system
1)1/3 of heart attacks are associated with smoking
2) increased platelet aggregation, etc.
smoking and diabetes
1) increases cell threshold response to insulin
2) increases risk of type II diabetes
3) higher risk for amputation
smoking and pregnancy
1) reduced fertility, miscarriage, sudden infant death, birth defect, babies that breath smoke die
smoking and immune system
1) smoking makes body less successful at fighting wound healing and infection
2) neutrophils and nicotine
- chemotaxis
- phagocytosis
- releases of ROS
3) autoimmune disorders
- rheumatoid arthritis
smoking and eye disease
1) vasoconstriction
- nicotine and other chemicals
2) 4x more likely age-related macular degeneration
3) and cataracts
secondhand smoke
1) triggers heart attacks, strokes
2) lung cancer, etc
nicotine is
1) addictive
2) alkaloid
3) absorbed in lung and passes to brain
- dopamine
4) quitting = withdrawal symptoms
teens
1) more sensitive to nicotine
2) most current smokers became addicted as teens
quitting and reduced risks
1) one year after quitting, risk of heart attach drops sharply
2) risks for cancers drop by half within 5 years
3) 10 years, lung cancer risk drops by half
4) if quit by age 30, their health may become as good as a nonsmoker
cessation pharmacotherapy
1) FDA approved
- nicotine replacement therapy (NRT)
- bupropion
- varenicline
2) all approved cessation medication doubt quit rates when compared with placebo treatment
nicotine replacement therapy
1) no Rx
2) plasma concentrations lower and slower1
bupropion
1) increases brain levels of dopamine and norepinephrine, stimulating effects of nicotine
varenicline
1) partial agonist of the major receptor involved in nicotine addiction
counseling
1) pharmacotherapy is much more effective when combined with counseling and behavioral treatment
2) provider advice doubled the likelihood of patient abstaining from smoking
e-cigs
1) studies have shown they do work as a modality to quit conventional cigarettes
2) not safe for youth, pregnant women, and adults who do not currently use tobacco
3) the most used tobacco product among youth in the US
e-cigs and the oral cavity
1) periodontal and peri-implant clinical and radiographic parameters are worse
2) proinflammatory cytokine levels are higher
3) nicotinic stomatitis, hairy tongue, angular cheilitis being more prevalent
4) component of vapor have a known cytotoxic and carcinogenic properties
5) microbiological studies show that users have a distinct microbiome
cold turkey
1) does not work
2) failure of 95-98%
