1. Smoking

2. Smoking…… Tobacco has been known and used for centuries: • It can be snuffed; • It can be chewed; • It can be placed between gum& lips; or • It can be smoked.

3. Smoking…… The most popular method of tobacco use is smoking→ cigarettes became popular in the early 1900s-before this time tobacco was usually chewed or smoked in pipes.

4. Annual Deaths Attributable to Smoking in the United States

5. Tobacco Products • Cigarettes • Cigars – contains 23 poisons, 43 carcinogens • Bidis – small hand-rolled, flavored cigarettes, contain 3 times more CO and nicotine, and 5 times more tar than cigarettes • Smokeless tobacco • Chewing tobacco • Snuff

6. Effects of tobacco smoking: The primary drug in tobacco isnicotine. • There is 1-2 mg nicotine in one cigarette and 90% of this amount being absorbed when inhaled.

7. Tobacco And Its Effects • Smoke contains 4,700 chemical substances • Nicotine – chemical stimulant • nicotine impairs the cleansing function of cilia • Tar – condensed particulate matter from smoke that accumulates in the lungs • Phenols – chemical irritant in smoke that may combine with other chemicals to contribute to the development of lung cancer • Carbon monoxide – tobacco smoke contains 800 times the level considered safe by the U.S.E.P.A

8. Physiological Effects Of Nicotine • Nicotine is a powerful central nervous system stimulant • Nicotine increases heart and respiratory rates, constricts blood vessels, and raises blood pressure • Nicotine decreases blood sugar levels and increase hunger • Nicotine poisoning symptoms: • Dizziness • Lightheadedness • Rapid pulse • Nausea

9. Health Hazards Of Smoking • Cancer • Cardiovascular disease • Platelet adhesiveness • Hypertension • Stroke • Respiratory disorders • Chronic bronchitis • Emphysema • Sexual dysfunction • Gum disease

10. Smoking increases the risk of the cancer in the following organs: • 1-Larynx cancer: • 2-Oesophageal Cancer: • 3-Oral Cancer: • 4-Stomach Cancer: • 5-Liver Cancer: • 6-Pancreas Cancer: • 7-Colorectal Cancer: • 8-Kidney Cancer: • 9-Blood Cancer:

11. Chronic Horseness&Laryngeal Polyps:Persistant horse voice&Vocal cord polypsGum,Dental and Mouth Disease:periodontal disease&poor mouth hygieneStroke:Atherosclerosis&throbus formation

12. How Cigarette Smoking Damages the Lungs

14. Effects of Smoking on Pregnancy • 1-Miscarriage 2-Pre-mature Delivery • 3-Stillbirth 4-Low Birth Weight 5-SIDS • Thenicotine,carbon monoxide&other harmful chemicalsenters her blood stream, passdirectly into the baby’s body &prevent the baby from getting essential nutrients&Oxygen for growth

15. Effect of Smoking on Lactation • If the mother smokes, the baby is exposed to the nicotine and other smoke poisonsfrom her breast milk. Nicotine could cause numerous unwanted symptoms in the baby (such as restlessness, a rapid heartbeat, vomiting, or diarrhea). • *Smoking affects Oral Contraceptives: • Women who are smoking&using oral contraceptives are ten times more at risk of Heart attack&Stroke compared to those who are smoking but not taking contraceptives

16. Environmental Tobacco Smoke (ETS) • Mainstream – smoke drawn through tobacco while inhaling • Side stream – smoke from the burning end of a cigarette or exhaled by a smoker • Involuntary or passive smokers – breath smoke from someone else’s smoking product • 9 out 10 nonsmoking Americans are exposed to ETS

17. Risks From ETS • Sidestream smoke contains more carcinogenic substances • Sidestream smoke has 2 times more tar and nicotine, 5 times more carbon monoxide, 50 times more ammonia • ETS is responsible for 3,000 lung cancer deaths, 35,000 CVD deaths, 13,000 deaths from other cancers

18. Protecting Yourself and Others from Secondhand Smoke

19. Criteria for Nicotine dependency: • nicotine • Tolerance • Withdrawal symptoms when use discontinued • Used in greater amounts over longer period of time than intended • A persistent desire or unsuccessful efforts to cut down or quit • A great deal of time spent using the substance

20. Criteria for Nicotine dependency: • Giving up important social, occupational, or recreational activities because of use of the substance • Continued use despite knowledge of medical problems related to use and/or social& legal problems resulting from use.

21. Withdrawal of nicotine • nicotine It refers to the cessation of nicotine use by an individual in whom dependence is established. • When the use of products containing nicotine is stopped abruptly, within 24 hours the user will likely experience maximal physical and/or psychological withdrawal symptoms.

22. Criteria for Nicotine withdrawal syndrome • nicotine • Dysphoric or depressed mood • Insomnia • Irritability, frustration, and anger • Anxiety • Difficulty concentrating • Restlessness • Decreased heart rate • Increased appetite or weight gain • Cravings for tobacco

23. Criteria for Nicotine withdrawal syndrome Nicotine A-Duration • Most symptoms diminish over a few weeks. • Relapse is common within 1week when the withdrawal symptoms are at peak. • Cravings for tobacco, increased appetite, and weight gain may persist for months or years.

24. Quitting • Nicotine replacement products • Nicotine gum • Nicotine patch • Nasal spray • Nicotine inhaler

25. Recommended Therapies for Smoking Cessation

27. Benefits Of Quitting • Many tissues damaged by smoking can repair themselves in the absence of smoke • Airways are cleared of mucous • Circulation improves • Senses of taste and smell are restored • At the end of 10 smoke-free years, the ex-smoker can expect to live a normal life span