NCDs Risk Factor No. 3 - Smoking. Commonwealth Nurses Federation

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1 NCDs Risk Factor No. 3 - Smoking Commonwealth Nurses Federation

2 Overview Definition of smoking and passive smoking Complications associated with smoking Disease process of smoking Reasons for smoking The prevalence of smoking Effects on lifestyle choices Treatments available for smoking cessation

3 Definition Smoking is the inhalation of the smoke of burning tobacco encased in cigarettes, pipes, and cigars. Casual smoking is the act of smoking only occasionally, usually in a social setting. Passive smoking is the inhalation by non-smokers of the smoke from other people's cigarettes, pipes, or cigars.

4 Complications associated with Smoking Increase risk of heart disease by 2-4 times Stroke by 2 to 4 times Men are 23 times more likely to develop lung cancer Women developing lung cancer 13 times Dying from chronic obstructive lung disease e.g. emphysema 12 times Abdominal aortic aneurysm (where it runs through the abdomen) Lung cancer

5 Complications associated with Smoking Lung disease e.g. emphysema, bronchitis etc by damaging the alveoli Contribute to causing the following cancers acute myeloid leukemia, bladder ca, ca of the cervix, ca of the esophagus, kidney ca, ca of the larynx, ca of the oral cavity, ca of the pharynx, stomach ca, pancreatic and ca of the uterus. Contribute to the following reproductive infertility, preterm delivery, impotence, stillbirth, low birth weight, miscarriage and SIDS

6 Complications associated with Smoking Other complications lower bone density for postmenopausal women Increase risk of hip fracture in women Cerebro-vascular disease Pneumonia hs.uk/chq/pages/2344.aspx?categoryid=53&subcategoryid=536

7 Disease Process of Smoking The tar in the cigarette smoke coats the mouth, esophagus and lungs and can therefore cause many health issues associated with the respiratory system e.g. cancer. The carbon monoxide in cigarettes robs the muscles, brain and blood of oxygen making the heart and body work harder to get what in needs. Over a period of time it reduces circulation by narrowing the blood vessels (arteries) and puts smokers at risk of developing peripheral vascular disease and other circulatory problems.

Health behaviour in the first 1000 days (the uterine environment and the

8 Disease Process of Smoking It is crucial for long-term health that the risk factors are tackled in childhood. Health behaviour in the first 1000 days (the uterine environment and the early years of life) is increasingly seen as a marker for the lifelong increased risk of several chronic diseases

9 Reasons for Smoking Many people start smoking for very different reasons. Why do you think people smoke?

10 Reasons for Smoking Cont... Despite the prevalence of smoking why someone starts smoking is not easy to understand, however the below may provide insight into some of the contributing factors: Psychological Reasons Reduce stress Habit forming once you have started you build habits around smoking i.e. putting something to your mouth Way to relax (take a break away from stressors in life) Associations with things that you do i.e. morning coffee, work tea break

11 Reasons for Smoking Cont. Teenagers may believe it is cool or start from peer pressure Experimentation with family and/or friends Felt like tying it to see what all the fuss was about Advertising and media e.g famous people smoking and sponsorship of sporting events

12 Reasons for Smoking Cont... Once a person begins to smoke or chew tobacco it is extremely hard to stop. This is due to the addictive behaviors of smoking due to the presence of nicotine and other chemicals generated from smoking. These addictive substances trigger biochemical reactions and pleasant sensations which a person becomes quickly accustomed to. When a child commences smoking you need to be able to have open communication with that child to ascertain their reasons for commencing to smoke. Some of their reasons to commence will have a lot to do with the attitudes of their friends.

13 The Prevalence of Smoking Rank Country Percentage 1 Nauru 54 2 Guinea Tonga Samoa Fiji Australia

14 The Prevalence of Smoking cont. Globally, about 1.3 billion people smoke 84% of smokers live in developing/transition economies 5 million smokers die prematurely from tobacco use each year. By 2020, this could increase to 10 million. Worldwide, about one in five year old teenagers smoke worldwide, and between 80,000 and 100,000 children start smoking every day. 40% of children are exposed to second-hand smoke in their home environment An estimated 165,000 children die of smoke-related respiratory infections each year, mostly in SE Asia and Africa. Sources: The Tobacco Atlas and WHO 2005

15 The Effects of Smoking on Lifestyle Choices Smoking is a lifestyle choice that is not beneficial to the health of the individual or their family. For an individual to quit smoking then they must make a conscious decision to alter their lifestyle. They must learn to break all habits that they have formed or that they associate with smoking. That means in the short term they should avoid social, work or personal situations that may present them with temptation e.g. don't go to bars etc. As a health care professional you need to help to build and change the psychological association that a person has with smoking e.g. cigarette with their morning coffee and help then to form new ones.

16 The Effects of Smoking on Lifestyle Choices cont. Smoking can irreparably damage the health of the smoker and it can also damage the health of loves ones which will consequently alter future lifestyle choices. The cost of smoking can impact on the costs of living e.g. being able to purchase fresh fruit and/or vegetables, purchasing clothing etc

17 Willpower / 'cold turkey' Treatments Psychological Assistance e.g. hypnotherapy, counseling, acupuncture. These therapies assist the psychological aspects of smoking cessation but does not affect the withdrawal symptoms of the body from nicotine. Medical Management Tablets e.g. zyban, champix and bupropion work by interfering with the chemical receptors in your brain so that you no longer crave the taste of nicotine. It does not influence the psychological aspects associated with smoking.

18 Treatments cont. Alternative Management Nicotine therapy Includes transdermal patches, chewing gum, sprays, inhalers, tablets nd lozengers. Usually use for a 12 week period on a gradual reducing dose Able to combine treatment for both short and long term benefits Side effects skin irritation, nasal irritation, disturbed sleep patterns, upset stomach, dizziness and headaches

19 Treatment Cont. Combination Therapy this is where you combine alternative therapies, medical management and psychological management Cut down to quit Community Intervention Education Comprehensive clean indoor laws can increase smoking cessation rates by 12-38% One on One Programs

Smoking vs Smokeless. Tobacco is a plant that contains nicotine. Cigars and pipes contain more tar and other chemicals.

Smoking vs Smokeless. Tobacco is a plant that contains nicotine. Cigars and pipes contain more tar and other chemicals. Tobacco Smoking vs Smokeless Tobacco is a plant that contains nicotine. Cigars and pipes contain more tar and other chemicals. Smoking Tobacco is tobacco that is smoked or inhaled. Smokeless tobacco is