Hazards of Smoking on General Health

1. SUMMARY OF ACTUAL PRESENTATION FOR PATIENT EDUCATION Hazards of Smoking on General Health

2. SMOKING FACT SHEET • More than 400,000 people die each year in US alone due to smoking • Annually, smoking kills more people than a combined mortality from AIDS, alcohol, drug abuse, car crashes, murders, suicides, and fires

3. SMOKING FACT SHEET • Globally, 1 person dies every 7 seconds from smoking related diseases • A smoker loses an average of 13.8 years of life • One out of every five deaths is caused by tobacco

4. Passive Smoking • Passive or involuntary smoking occurs when the exhaled and ambient smoke from one person's cigarette is inhaled by other people. • Passive smoking involves inhaling carcinogens, as well as other toxic components, that are present in secondhand tobacco smoke.

5. How Many Cigarettes Have You Smoked Without Knowing It? If you have been. . . it’s like you’ve smoked. . • In a smoky bar for 2 hrs = • In a nonsmoking section for 2 hrs = • In a car with someone, windows closed for 1 hr =

6. Passive Smoking (Cont…) • Secondhand smoke is known to harm children, infants and reproductive health • Acute lower respiratory tract illness, • Asthma induction and exacerbation, • Chronic respiratory symptoms, • Middle ear infection, • Lower birth weight babies, • Sudden Infant Death Syndrome, or SIDS. • Low-level exposure to secondhand smoke has a clinically important effect on susceptibility to cardiovascular disease,

7. Facts about shisha (waterpipe) smoking • A shisha is a waterpipe, inside which flavoured tobacco is partially burned. • The smoke passes through water held in the waterpipe before being inhaled by smokers through tubes attached to pipe. • Shisha is seen as a popular social activity, especially among youths who view this as harmless recreational activity. • But Shisha smoking is dangerous. • The water in the shisha pipe does NOT absorbs harmful substances in the smoke, contrary to popular belief., • In fact, even after passing through water, shisha smoke still contains higher levels of carbon monoxide, nicotine and cancer-causing chemicals.

8. Facts about shisha (waterpipe) smoking • This is because the burning of tobacco in a shisha using charcoal produces high levels of carbon monoxide and cancer-causing chemicals than conventional cigarettes. • A smoker will inhale 100–200 times the amount of smoke produced by a single cigarette in 1 hr. As people tend to sit around and socialize with friends when smoking shisha, a session can easily last for 20–80 minutes. • As people smoking shisha take more and deeper puffs from the waterpipe, a shisha smoker absorb a greater concentrations of harmful substances than a cigarette smoker

9. Tobacco Addiction • Motivated by the desire for nicotine. • Smokers regulate their nicotine intake and blood levels by adjusting the frequency and intensity of their smoking both to obtain psychoactive effects and avoid withdrawal. • Smokeless tobacco contains nicotine, carcinogens and other toxins capable of causing gum and oral disease mainly. • When tobacco is burned resultant smoke contains Nicotine, CO + 4000 other toxic compounds that result from volatilization, pyrolysis, pyrosynthesis of tobacco and various chemical additives.

10. Staining and shifting of teeth Oral cancers Mouth sores Root caries (cavities) Sinusitis Hairy tongue Smoker’s lip Leukoplakia Snuff Dipper’s lesions Smoker’ palate Effects of Smoking on Health ORAL • Periodontal diseases which includes bone and tooth loss, if unchecked, it can lead to complete destruction of the tooth’s supporting tissues, abscesses and, ultimately, loss of the tooth. • Dangerous gum diseases • Loss of taste sensation • Halitosis (Bad breath)

11. Gastrointestinal Respiratory Cardiovascular Ocular ED & Infertility Pregnancy related Skin wrinkling Osteoporosis Effects of Smoking on Health NON MALIGNANT

12. Smoking directly causes the following cancers Males Females Lung cancer ……………….……23.3………..12.7 Bladder cancer …………….…….3.3………....2.2 Oral cancer …...............……..…10.9………....5.1 Throat cancer …………….……..14.6……...…13.0 Cancer of the esophagus ….…..6.8…………..7.8 Cervical cancer ………………………….………1.6 Cancer of the kidney ……………2.7………..…1.3 Pancreatic cancer………………. 2.3………..…2.3 Stomach cancer …………………2.0…………..1.4 Effects of Smoking on Health MALIGNANCIES

13. SMOKING HAZARDS – PEPTIC ULCER

14. SMOKING HAZARDS - COPD Increased incidence of Asthma Chronic obstructive pulmonary disease (COPD) is a permanent, incurable reduction of pulmonary capacity characterized by shortness of breath, wheezing, persistent cough with sputum, and damage to the lungs, including emphysema and chronic bronchitis

15. SMOKING HAZARDS - VASCULAR • CVA • CARDIAC - CAD & MI • OCULAR • HYPERTENSION • THROMBOANGITIS OBLITERENS (BURGER’S DISEASE)

16. SMOKING HAZARDS - VASCULAR

17. SMOKING HAZARDS - EYE • Smoking doubles the risk of nuclear cataract. cataracts are more serious in heavy smokers than in light smokers. • Age related macular degeneration (AMD) risk among smokers is 2 to 3 times higher. • Smoking may accelerate the development of, or worsen diabetic retinopathy, • Anterior ischaemic optic neuropathy is an eye disease that results in a sudden, painless loss of vision, often leading to permanent blindness. Smokers are at a 16-fold increased risk of developing this disease

18. SMOKING HAZARDS - SEXUAL • Smoking increases the risk of erectile dysfunction because blood flow into the penis is blocked by atherosclerosis. • Smoking also causes • Abnormal sperm shape, • Impaired sperm motility • Damaged sperms, • Oligospermia • Reduced ejaculate vol

19. Smoking and Periodontitis Roughly half of periodontitis cases are attributed to current or former smoking. Smokers experience widespread periodontal destruction and have significantly greater loss of bone height

20. Smoker’s Palate Relatively common tobacco related white lesion seen in the palate of a pipe, cigar or a cigarette smoker. Unless the habit is particularly intense or the patient is a reverse smoker, risk for malignancy is quite low. The combination of tobacco smoke and heat combustion is believed to be important for this tissue change.

21. Smoking Stains Smoking wrinkles “For smokers, middle-age starts in their early 30’s as the tell-tale wrinkles around the mouth and eyes begin to appear. Young female smokers are likely to be wasting their money on anti-aging face creams if they continue to smoke.”

22. SMOKING HAZARDS - LARYNX Anterior Left Vocal Cord Polyp Larynx – Supraglottic Squamous Cell carcinoma

23. SMOKING & ORAL CANCER A large cancer (Squamous CC) is shown growing out of neck of this patient’s neck. The cancer was due to smoking and started in patient’s mouth. The cancer eventually eroded into Carotid Artery causing massive bleeding & death.

24. Snuff Dipper’s lesions A white or discolored lesion of the oral mucosa occurring at the site at which the powdered tobacco is retained. Malignant transformations are not common but do occur, usually as low-grade VERRUCOUS CARCINOMAS.

25. E – CIGARETTE or PSEUDO CIGARETTE • The latest craze in the UK, the battery-powered cigarette may be the answer to indoor smoking bans. • Smokers still get their nicotine kick through an atomiser, which creates puffs of vapour to resemble cigarette smoke. • e-cigarette is widely available throughout Europe.

26. Electronic addiction: Facts about e-cigarettes • E-cigarettes are devices made to resemble real cigarettes. • An e-cigarette consists of a mouthpiece that has a steel chamber containing nicotine solution. • As the user inhales through the e-cigarette, a heating element powered by a rechargeable battery is activated and vaporises the nicotine solution, generating a fine heated mist. • The fine mist generated contains nicotine that is inhaled and absorbed into the user’s lungs. • Some marketers of e-cigarettes claim that their product is an effective nicotine replacement therapy and a smoking cessation aid endorsed by the World Health Organizations (WHO). • However, WHO has never officially endorsed e-cigarettes!

27. Hazardous e-cigarette Smoked out of Market • ABU DHABI — Electronic cigarette (e-cigarette) can be hazardous to people’s health as it contains carcinogens and toxic materials, according to a senior official at the Ministry of Health (MoH). • The e-cigarette cannot be recognised or marketed as a ‘quit smoking’ therapy in the Gulf Cooperation Council region, Dr Wedad Al Maidoor, head of Tobacco Control Team at the MOH told Khaleej Times. • “There is general agreement in the GCC Tobacco Control Committee that e-cigarette should not be circulated in the (Gulf) market as therapy. It cannot be recognised or marketed as a kind of therapy. • “There was no approval from (United States) the Food and Drug Administration (FDA) that it can be used as a therapy (and) no recommendation from the MoH,” she pointed out.

28. Hazardous e-cigarette Smoked out of Market • Contd.. • “If circulated, then the same rule applies as the (real) cigarette (with) specific requirements for marketing and selling cigarette — with picture and hazard (warning),” she added. • According to Dr Al Maidoor, Dubai Municipality did a test of e-cigarette recently and found them “to be very dangerous and containing a lot of hazards to health.” • She added that based on the findings, the municipality will recommend a ban on the import of e-cigarettes. • To read full story click below (or copy & paste) – published Khaleej Times Aug 18, 2009 • http://www.khaleejtimes.com/displayarticle.asp?xfile=data/theuae/2009/August/theuae_August322.xml&section=theuae&col=

29. Benefits of Quitting • 20 min. – blood pressure and pulse return to normal, circulation improves to make hands & feet warmer • 24 hours – carbon monoxide is eliminated from the body and the lungs start to clear out mucus • 72 hours – breathing becomes easier and energy levels increase • 2-12 weeks – circulation improves through the body, exercise is easier • 5 years – risk of heart attack falls to half that of a smoker (and you save $5,000!) • 10 years – risk of lung cancer falls to about half that of a smoker; risk of heart attack now similar to someone who has never smoked source: US Department of Health & Human Services http://www.hhs.gov/ and www.gasp.org.uk

30. Global Treaty 2004 WHO Framework Convention for Tobacco Control (FCTC) Need now to legislate and fund campaigns in accordance with it The Convention entered into force on 27 February 2005 -- 90 days after it had been acceded to, ratified, accepted, or approved by 40 States. ( now 160 countries have ratified) 24 Countries refused to ratify inc. USA, Switzerland, Cuba Lack of smoking bans Some countries have no legislation against smoking whatsoever. These countries include Cameroon, Central African Republic, Chad, and many other countries in Central and Western Africa, where people can smoke wherever they want. New developments

31. The Fork on Tobacco Road • If we act now • Result of improved funding can cut smoking rates from present 20% to 10% OR even LESS by 2015 If we do nothingon present global trends, it’s estimated ONE BILLION people will die from smoking this century