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Others effect

Health related motivations to quit. Cardiovascular effects. Tobacco’s attack on lungs. Tobacco and pregnancy. Others effect. Cardiovascular effects. Interaction tobacco /contraceptives Increase in cardiac related death.

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Others effect

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  1. Health related motivations to quit Cardiovascular effects Tobacco’s attack on lungs Tobacco and pregnancy Others effect

  2. Cardiovascular effects • Interaction tobacco /contraceptives • Increase in cardiac related death

  3. Cerebrovascular accident risk is increased in young women when smoking is combined with oestrogen intake. Thrombophlebitis risk is also increased when smoking is associating with oestrogen intake. Taking the pill and smoking must not be associated. Interaction tobacco / contraceptives

  4. • The risk of dying from a cardiac related illness diminishes rapidly. • Gradually the risk will reduce to become that of a non smoker. Source Health Ministry USA After smoking cessation:fall in cardiac related deaths Good News !

  5. source : Health Minister USA Decrease in coronary related deaths after smoking cessation smokers 10 8 6 4 2 0 Death for 1000 ex-smokers Non smoker risk 0 5 10 15 20 25 Years after cessation

  6. Chronic Bronchitis Emphysema Attack on the elastic fibres of the lung Reduces lung efficiency to deliver oxygen to blood. Main cause of obstructive respiratory insufficiency. Lung cancer Smoking is responsible for 9 out of 10 cases of lung cancer. A 20 cigarettes-a-day smoker has 20 times higher risk of suffering from lung cancer than a non-smoker. Less than 10% of patients with lung cancer survive more than 5 years. A second-hand smoker living or working with a smoker has himself an increased risk of lung cancer. Tobacco’s attack on lungs

  7. source : Doll R et Peto R. British Medical Journal Lung cancer risk drop after smoking cessation 5 10 15 20 25 0 1.4 1.2 1.0 0.8 0.6 0.4 0.2 smokers deaths for 1 000 ex-smokers Non smoker risk Years after cessation

  8. Obstructive respiratory insufficiency If the death risk of dying from chronic bronchitis is as 1 for a non-smoker, the risk can be multiplied by 66 for a heavy smoker. 66 relative death risk 58 51 44 32 27 21 9,7 1 NF 10 20 30 40 50 60 70 80 Tobacco consumption (packs/years) Source: R Doll B med J 1976, 25, 1526-1536

  9. Smoking cessation leads to : • A progressive drop in the risk of dying from lung cancer. After 10 years, the risk remains higher than that of a non-smoker. • Halts the progression of emphysema. • A relief in coughing, often in breathlessness and even in the results of respiratory function tests. After smoking cessation, the drop in respiratory related deaths

  10. Smoking cessation is a major treatment for cardiac and respiratory diseases After myocardial infarction : Beta blockers and aspirin increase survival chances by at least 50%. Smoking cessation is the only treatment which doubles survival chances and divides in two the risk of coronary thrombosis recurrence. Source :US department of health and human Service N°PHS 84-50204 Dally L BMJ 1983, 287, 324-326 After an operation for lung cancer, smoking cessation has more benefits than radiotherapy or chemotherapy.

  11. Tobacco and pregnancy : facts risk X 1,5 less than 10-20g per cig - 450g for smoking > 20 cig/d 20cig = risk X 3 > 30cig. : risk X 5 Risk X 2 1- Spontaneous abortion 2- Intra uterin growth retardation 3- GEU 4- Premature labour nicotine accumulates in the amniotic fluid 1 = Kline NEJM 1977; 297 : 793-796 2 = Liberman Am J Public Health 1994; 84 : 1127-1131 3 = Coste Am J Epidemiol 1991, 133, 839-849 4 = Williams Am K épidemiol 1992, 135 : 895-903

  12. Health related motivations Others effect • 23 tobacco related illnesses • Other cancers • Tobacco, alcohol and oesophageal cancer • Smoking effects on skin and voice • Risk of contracting an illness due to smoking • Smoking cessation benefits

  13. MOUTH & PHARYNX • cancer 23 tobacco related illnesses BRAIN • Stroke HEART • coronary disease LARYNX & TRACHEA • cancer • inflammation OESOPHAGUS & STOMACH • cancer • ulcer LUNGS • cancer • emphysema • chronic bronchitis WOMB & OVARIES • infertility • abortion • growth delay • early menopause • cervical cancer PANCREAS • cancer URINARY • kidney cancer • bladder cancer • TESTICLES • • infertility • impotence • BONES • osteoporosis SKIN • dry, wrinkled complexion PERIPHERIAL ARTERY • arteritis

  14. (% attributed amongst men) • Mouth cancer (74%) • Oesophageal cancer (53%) • Cancer of the Larynx (87%) • Cancer of the Bladder (50%) • Cancer of the Kidneys (39%) • Cancer of the Pancreas (38%) • Cancer of the Cervix (6% femme) Other cancers attributed & associated with tobacco Source : Hill Conf Consensus, 1998

  15. Tobacco, alcohol and oesophageal cancer Oesophageal cancer risk 45 40 35 30 25 20 15 120g/d 10 80g/d 5 40g/d Alcohol 0 30 cig/d 20 cig/d 10 cig/d Source : CRDP Nice

  16. Smoking damages skin elastic fibres. Elastic fibres are thicker, shorter and less numerous in smokers’ skin. Skin gets wrinkled earlier. When quitting smoking skin tone improves rapidly and skin is less grey. Smoking makes voice become hoarse especially for women. Smoking effects on skin and voice

  17. Quality of life After give up smoking the former smoker rediscovers - pleasure of a normal breath - taste and good smell of food - freedom from nicotine ( the end of nicotine slavery) - disappearance of tobacco smell - pleasure in not generating a smoky atmosphere for friends, family… - pleasure in better health

  18. Risk of contracting an illness due to smoking Risk smoker “Risk” non-smoker % of deaths smoking related illness 1 COPD 6 80 - 90 % Arteritis 1 9 68 - 98 % Lung cancer 1 10 80 - 85% Fatal heart attack before 45 years 1 5 75 - 80% 1 2 30 % Death from carcinoma Coronary heart disease 1 2 25 - 43% Sources :Fielding, 1985 ; US Dept of Health and Human Services, 1989; Wald, 1996; Slama, 1998.

  19. Smoking cessation benefits Risk reduction from cessation Risks of disease Short term Long term Drop by 50% of the risk at 1 year same risk as a non smoker after 5-20 years Coronary thrombosis same risk as a non smoker at 1 year Cerebro -vascular incidents Drop in risk after 5 years 50-90 %risk drop after 15- 20 years Lung cancer Low risk reduction 50 %drop in 20 years COPD Lips, mouth and pharynx cancer Pancreas carcinoma Fast risk reduction same risk as a non smoker after 10 years same risk as a non smoker after 28 years Unknown Sources : Engleland,1996; Fielding, 1985; Samet,1991; Slama, 1998.

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