Tobacco Flashcards
Where does tobacco come from?
Comes from a plant
Explain the 4 criteria for the public heath problem and how it fits this criteria
- Prevalence is high
One-in-five (20%) adults in the world smoke tobacco
• More than one-third (35%) of men in the world smoke
• Although it is declining worldwide and in many countries, the prevalence of tobacco smoking appears to be increasing in the WHO Eastern Mediterranean Region and the African Region
In the UK, 14.9% of people aged 18 years and above smoked cigarettes in 2018 (7.2 million people)
This represents a decline of more than 5% since 2011
Men were more likely to smoke than women
10.8% of mothers were smokers at the time of delivery
6.3% of people in 2018 said they currently used an e-cigarette (3.2 million adults) - Affects quality of life
In 2017-18, 77,900 deaths a year in England were related to smoking tobacco
Smoking causes lung cancer, respiratory disease and heart disease and cancers in other organs (lip, mouth, throat, bladder, kidney, stomach, liver and cervix)
Smoking reduces both quality of life and life expectancy - Impact on wider society
Around 474,300 NHS hospital admissions were attributable to smoking (4% all hospital admissions)
The cost of smoking to the NHS in England is estimated to be £2.5 billion a year
54% of deaths for cancers were estimated to be attributable to smoking in 2018 - Condition preventable and effective treatments available
Tobacco is the single greatest preventable cause of death in the world today (WHO-Report on the Global Tobacco Epidemic, 2008)
What are the two types of tobacco?
Smoking and non-smoking
What are the diseases that tobacco mainly causes?
Cancer, heart, respiratory and periodontal disease
How many toxic chemicals does tobacco have?
over 7000
Explain how tobacco use is related to periodontal disease?
Tobacco smoking is associated with higher risk of chronic destructive periodontal disease
Smoking increases risk of tooth loss
Smoking can lower the chances of successful treatment
Evidence suggests a ‘dose- response’ relationship
Smokers have reduced levels of salivary and serum immunoglobulins, i.e. decreases immune response to periodontal pathogens
Smokeless tobacco users are more likely to develop periodontal disease
Quitting smoking reduces the risk of periodontal disease
What oral health effects does tobacco have?
Dental Implants • Patients who smoke may be at twice the risk of experiencing dental implant failure and postoperative infections than are patients who do not smoke due to the bone loss
Smokers had more statistically significant marginal bone loss than did non-smokers
Aesthetic and oral health habits • Smoking and chewing tobacco stains and discolours teeth, dentures and restorations
Pipe smokers and smokeless tobacco users are more likely to tooth wear
Tobacco, whether smoked or chewed, can cause halitosis
Heavy smokers were found to have worse oral hygiene habits than non-smokers
Head and neck cancer
- laryngeal
- pharyngeal
- oral cavity
Oral Mucosal conditions .e.g smokers palate, smokers melanosis, oral candidosis
What are the main places in the mouth that cancer can occur?
- tongue
- inside mouth
- tonsils
- oropharynx
How can smoking affect dry mouth?
→ Smoking has been shown to reduce salivary flow rate
→ A drier mouth with poorer oral hygiene will also result in an increased incidence of dental caries
→ Evidence suggests that exposure to second-hand smoke in the home might increase the risk of dental caries in children
How can smoking affect wound healing?
→ Decreased levels of salivary and serum immunoglobulin
→ Decreased blood oxygenation leads to decreased oxygen delivery to the tissues
→ Constriction of blood vessels
→ Increased risk of osteitis after tooth extraction (more likely to get infection of bone tissue)
→ Wound healing is improved following smoking cessation
What is the main public policy and what are the 6 preventative policies it uses?
WHO-MPOWER
Tool to help countries implement WHO FCTC demand reduction measures
Six effective tobacco control policies can counter the epidemic
1 Monitor tobacco use and prevention policies
2 Protect people from tobacco smoke
3 Offer help to quit tobacco use
4 Warn about the dangers of tobacco
5 Enforce bans on tobacco advertising, promotion and sponsorship
6 Raise taxes on tobacco
What are the 4 levels of prevention that can be done with tobacco?
- Production
- Growing (alternatives to producing tobacco)
- Manufacturing (ban additives used for flavour) - Display
- Packaging (plain)
- Marketing (ban advertising, promotion and sponsorship) - Purchase
- Tax
- Point of purchase (out of sight) - Use
- Product use (ban smoking in public places)
- Disposal (industry must take action on environmental issues from tobacco production)
What role does the dentist have for smokers?
- Every member of the dental team should recognise their ethical responsibility as a public health advocate in promoting health and preventing disease
- Prevention and cessation of tobacco use contributes to general and oral health
- It involves working with professionals from other disciplines and agencies in multi-agency systems, e.g. healthcare, education, social care
- The team should use the ‘common risk factor approach’ to focus on diet, hygiene, tobacco, alcohol, thus promoting general health
ASK, ADVISE, ACT
Are e-cigarrettes harmful?
→ E-cigarettes are helping people to stop smoking
→ They usually contain nicotine, which is addictive but doesn’t cause cancer. They do not contain tobacco, which causes the damage from smoking
→ Switching from tobacco to e-cigarettes substantially reduces a major health risk
→ e-cigarettes are very popular with young people
→ Non-smoking youth who use e-cigarettes are more likely to try conventional cigarettes
→ Unknown long-term impact
→ e-cigarette emissions are not merely “harmless water vapor,” as is frequently claimed, and can be a source of indoor air pollution
→ Potentially harmful ingredients:
• ultrafine particles that can be inhaled deep into the lungs
• flavourings such as diacetyl, a chemical linked to serious lung disease
• volatile organic compounds
• heavy metals, such as nickel, tin, and lead
