Tobacco & Diet (2.13)

Question 1

1) What is tobacco use and exposure the leading cause of? 2) Define this term

Answer 1

1) Disability-adjusted life years
2) Measure of overall disease burden; number of years lost from poor health, disability or premature death

Question 1

1) List some of the complex interactions when it comes to tobacco use/ exposure
2) Smokers have a mortality rate ____ times higher than never-smokers and die _____ years younger
3) 1 in 5 deaths a year or ______ deaths every day

Answer 1

1) Psychological, social, cultural, economic
2) 2.8;10
3) 1300

Question 2

List the 5 most common Premature Death Causes by Smoking and Exposure to Secondhand smoke from 1965-2014 in order of number of cases

Answer 2

1) Cardiovasc. and metabolic disease
2) Smoking-related cancers
3) Pulmonary diseases
4) Coronary heart disease caused by exposure to secondhand smoke
5) Lung cancers caused by exposure to secondhand smoke

Question 3

1) Nicotine is highlight addictive and it’s absorbed in the linings of the mouth and respiratory tract and travels to the __________ and ________.
2) What does it do to the body?

Answer 3

1) heart and brain
2) Raises blood pressure, cholesterol, and HR.
-Lowers HDL.
-Carcinogen: tar left from the cigarette, arsenic, benzene…
-Damages cilia

Question 4

A study in 2018 found that 58% of adult tobacco smokers tried to quit and ____% were successful

Answer 4

7.5%

Question 5

Describe the widespread use of cigarettes in the 20th century

Answer 5

1913: Camel began mass marketing
Distribution of free cigarettes to military
1960: approximately 34% of women smoked

Question 6

1) When did disease start to emerge that linked to smoking?
2) Describe the rates

Answer 6

1) Lung cancer increased in 1930s
2) Started to decrease after epidemiologic studies
Climbed again when filters became a “safe” alternative

Question 7

What lead to government actions restricting cigarette marketing? (warning labels, radio/television ads balanced with public service announcements, etc)

Answer 7

1967: Surgeon General’s Report
(Tobacco companies then shifted to magazines, newspapers, billboards)

Question 8

What is the new focus on?

Answer 8

Environmental smoke; subsidies to tobacco growers

Question 9

1) What does secondhand smoke increase?
2) When did Connecticut become the first state to place restrictions on smoking in restaurants?
3) EPA declared environmental smoke to be a carcinogen in what year?

Answer 9

1) Risk of lung cancer/heart disease
2) 1974
3) 1992

Question 10

Tobacco companies spend about $_____/person on advertising in the US and target teens with promotional items such as T-shirts, caps and sporting goods

Answer 10

$29

Question 11

What are the tobacco use rates in high schoolers and middle schoolers?

Answer 11

27.1% in high school
7.2% in middle school
E-cigarettes now a big draw

Question 12

Tobacco companies agreed to stop advertisements targeted at children and had to pay $365.5 Billion over 25 years because of what?

Answer 12

1998 Master Settlement Agreement

While some advertisements were aimed at reducing youth smoking, they sometimes had the opposite effect.

Question 13

Who is affected by tobacco taxes? Explain

Answer 13

Raising taxes affects youth more than adults
Still can be affective for adults too
More likely new smokers will quit than long-time smokers

Question 14

1) In 1989 California Increased taxes from 10c to ___c per pack
2) What % was dedicated to programs to prevent/reduce use?
3) What was the result?

Answer 14

1) 35c per pack
2) 20%
3) Young smokers reduced from 22.7% > 20%> 16.9%> 13.3%> 6.3%

Question 15

What are the current tobacco taxes?

Answer 15

1) Federal tax is $1.01/pack
2) Additional taxes are state dependent:
-NY now highest at $5.35/pack
-MS lowest at 17c

Question 16

California’s Tobacco Control Program started the _______ initiative

Answer 16

truth

Question 17

California’s Tobacco Control Program:
1) Describe “Nicotine Soundbites”
2) Tobacco companies tried to sue the California Department of Health; what happened?

Answer 17

1) Executives swore nicotine wasn’t addictive; viewers were angry because they felt manipulated
2) Later dropped; tried to outspend the state
$10 for every $1 spent

Question 18

The original Master Settlement Agreement wanted a provision to allow the FDA to regulate tobacco; was this approved?

Answer 18

Congress did not approve that agreement

Question 19

Until ________ there were no restrictions concerning tobacco ingredients

Answer 19

2009

Question 20

Family Smoking Prevention and Tobacco Control Act: What did it do?

Answer 20

1) FDA regulates tobacco products
2) More restrictions on advertising/promotion
3) Larger warning labels
4) Ingredient list
5) Bans candy-flavored cigarettes (did not include menthol)

Question 21

Are Ecig rates increasing?

Answer 21

Yes; 2017: 2.8% > 2021: 4.5%

Question 22

1) Who is vaping highest among?
2) Who launched a $10 mil TV campaign
“make the switch”
3) Describe the healthiness of vaping
4) Summer of _____ shoed an epidemic of lung illnesses related to vaping (EVALI; median age of death 45)

Answer 22

1) Highest among 18-24 y/o
2) Juul
3) Health benefits have not been proven; some states have banned flavored e-cigarettes
4) 2019

Question 23

What are the top two factors contributing to causes of death? Why?

Answer 23

Adverse dietary patterns and physical inactivity
-Foods are often high in fat, sugar and salt

Question 24

1) Survey (NHANES) showed what? 2) Define obesity

Answer 24

1) 56% of women and 42% of men are trying to lose weight 2) Complex condition influenced by genes and individual, social and structural factors

Question 25

1) How is obesity usually defined? 2) When do weight associated health risks begin to appear? 3) True or false: Childhood obesity is declining

Answer 25

1) Usually defined as BMI 2) BMI of 25 and rise 3) False; it's rising

Question 26

True or false: College graduates report lower BMIs compared to those with few years of education, esp among females

Answer 26

True (& less than 12 years education 2x likely to be overweight)

Question 27

1) Poorer health outcomes with non-Hispanic ______ women compared to non-Hispanic white women 2) Higher rates of obesity/diabetes are within the ___________________ population

Answer 27

1) Black 2) Indigenous/Native American

Question 28

Explain how shape matters when it comes to health

Answer 28

1) “Apple shape” worse than “pear shape” 2) Waist-to-hip ratio: >1.0 for males and >0.8 for females are obesity

Question 29

___________ and _________ increase in diets high in meat and low in fruits/vegetables

Answer 29

Breast and colon cancers

Question 30

1) Diet is a major factor in Type ____ DM 2) What are the Dietary Guidelines for Americans? 3) US population consumes more than _______ calories each day from sugary drinks

Answer 30

1) Type II 2) Reports every 5 years ; Myplate.gov 3) 200

Question 31

1) What influences a person's healthy eating choices? 2) What can we do to help influence this?

Answer 31

1) Family traditions, ethnicity and media -Attempts have been made to create a social environment that favors healthier eating 2) Nutritious food more available (“heart healthy” menu options); greater success if family adopts a diet together; proposals on posting calories on menus

Question 32

Youth Obesity: Parental perceptions can be inaccurate; only _____% correctly identified their child’s weight category

Answer 32

21%

Question 33

1) How can you combat youth obesity? 2) Federal Trade Commission report notes that over ____% of television advertisements directed at children promote candy, fast food, snacks and soft drinks

Answer 33

1) Limiting sugary beverages, high-calorie snacks and sweets 2) 50%

Question 34

Give techniques and examples to incorporate into Weight Loss Conversations

Answer 34

1) Initiate communication about weight loss gently -Mention a time when weight has been discussed previously -“I know we have talked about weight before…” 2) Tailor communication to what is relevant for the patient -Referencing back -“You mentioned earlier about developing diabetes and high blood pressure. So all of those things will be helped with weight reduction.” 3) Ask questions and tailor responses "How do you feel about that option?” 4) Communicate positively and emphasize the benefits of weight loss -Include optimistic projections for the future -“And if you get your weight down, the outlook is often better for things like blood pressure.” 5) Offer specific treatment, rather than advice only -Clearly state the treatment options available -"We can offer you a referral to one of the weight loss programs in this area.”

Question 35

1) Most effective approach to losing weight involves what? 2) _________ Study showed that exercise protects against cardiovascular disease, DM, lowers cholesterol 3) What can physical activity do to shape?

Answer 35

1) Both dieting and exercise (diet plays a larger role) 2) Framingham 3) Can help change the “apple shape"