Tobacco 101. Truncated Historical Perspective

Transcription

1 Tobacco 101 Truncated Historical Perspective

2 Who am I? Keith A. Vensey, MBA, MPH Director of CADCA s Geographic Health Equity Alliance Born in raised in Alabama Graduated from the University of Alabama at Birmingham and University of Georgia Enjoy hiking with my partner, dogs Zeke and Coco and reading

3 Overarching Themes of Today s Discussion History of Tobacco Use Health Effects of Tobacco Use Current Trends of Tobacco Use Among Youth Electronic Nicotine Delivery Systems or ENDS Heated Tobacco Products

4 The Presentation s Goal Provide a truncated overview of how tobacco use and control evolved in the United States. Share some ideas and activities youth coalition members can do on the community level to the local conditions responsible for entrenched tobacco use.

5 The History of Tobacco Use

6 The Journey of Tobacco Use Americas first cultivated the tobacco plant Christopher Columbus discovers tobacco smoking in Cuba and takes it to Europe Tobacco is first grown commercially The cigarette machine is created in the United States BC BC Indigenous Americans begin smoking and using tobacco enemas European settlers in Santo Domingo begin growing and harvest tobacco Canada first grows tobacco commercially The creation of the modern cigarette of today by RJ Reynolds

7 Before 1964 Cigarette smoking increase in the 1900s due to mass production and effective advertising False health claims were made about tobacco products Surgeon General warned about smoking yet was as smoker Early condemnations were based on adverse moral and social impact

8 What did doctors and scientists know? In the 1930s scholars and activists became aware of increase cancer deaths Lung cancer in particular began to happen more often Pneumonectomy removal of a lung was performed more frequently by doctors Some doctors were still skeptical about smoking causing lung cancer

9 What was the tobacco industry doing? Starting in the 1950s Denying the harms of its products Discredit scientific evidence showing harms of tobacco use Funded research to divert attention from cigarettes Marketing new products with implied lower risks

10 Surgeon General Luther Terry releases Surgeon General s Report with the biggest finding yet: Cigarette smoking is causally related to lung cancer in men; the magnitude of the effect of cigarette smoking far outweighs all other factors. What happened in 1964? cigarette smoking contributes substantially to mortality from certain specific diseases and to the overall death rate.

11 After 1964 President John F. Kennedy developed an unbiased Advisory Committee Advisory Committee conducted research and emphasized information that was more formal and explicit Advisory Committee used tons of evidence from diverse sources Surgeon General Luther Terry televised the release of the Surgeon General s report for the entire country to see

12 So, how did doctors respond to the Report? Had begun accepting the evidence before Surgeon General Luther Terry s Report 60% of doctors smoked in 1949, 30% of them in 1964 and by the early 1980s only 5 10% of physicians smoked Younger doctors became more likely to report concern over the health effects of smoking to patients and agreed they should not smoke to set the right example.

13 General Public Slow to Change Its Mind No dramatic change in public beliefs about smoking after 1964 Report Big Tobacco marketing efforts and organized campaign spread doubt about the Report Many Americans still had limited knowledge of health risks or how they applied to their behavior Finally in 1970, majority (70%) of Americans said smoking caused lung cancer; 80% in 1980 and 95% in 1990s

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15 How does using tobacco affects your body?

16 Health Consequences Linked to Smoking

17 Health Consequences Linked to Secondhand Smoke

18 Smoking and Asthma People who smoke may develop asthma If you already have asthma and start smoking or find yourself around people who smoke, your condition can worsen Even if you are an adult without asthma, smoking can cause you to develop it

19 Tobacco and Nicotine Major chemical component responsible for addiction in tobacco products Increases your risk for diseases, harm to pregnant women and unborn child, and severe brain damage in teenagers and adults High enough does of nicotine causes nausea, vomiting, diarrhea, increased salivation, increase respiratory secretions, bradycardia, seizures and respiratory depression

20 Tobacco Products Examples

21 Electronic Cigarettes Males: 13.1% Females: 9.5% Cigarettes Males: 9.1% Females: 6.9% Youth Tobacco Use High School* *Tobacco Use Among Middle and High School Students United States Smokeless Tobacco Males: 8.3 Females: 3.3

22 E-Cigarettes or ENDS ENDS = Electronic Nicotine Delivery Devices Rapidly diversified product class typically delivering nicotine, flavorings and other addictive through an inhaled aerosol E-Cigarettes have several names: E-cigs, e-hookah, mods, vape pens, vapes, and tank systems Most commonly used tobacco product among youth, surpassing traditional cigarettes in 2014

23 No, ENDS are far from being completely safe ENDS use strongly associated with use of other tobacco products among youth and young adults, including traditional cigarettes ENDS aerosol is not harmless it contains harmful and potentially harmful chemicals such as volatile organic compounds Other ingredients in the e-liquid such as solvents, flavorants, and toxicants are not completely understood E-liquids containing nicotine can cause nicotine poisoning and possibly death if swallowed

24 Cigarette Smoking Among Youth* Most first use of cigarettes happens by 18 years of age 87% Nearly all first time use of cigarettes occurs by 26 years of age 98% Overall, 22% of youth cigarette smokers were daily smokers No significant differences between male and female youth smokers Caucasians Americans were more likely to smoke than African Americans or Hispanic Americans *The Health Consequences of Smoking 50 Years of Progress

25 What is in a cigarette? 600 ingredients in a cigarette, including nicotine. When burned, it creates 7,000 chemicals 69 are known to cause cancer. Many are poisonous.* Acetone found in nail polish Arsenic used in rat poison Butane used in lighter fluid Lead used in batteries Tar material for paving roads Formaldehyde embalming fluid *The Health Consequences of Smoking 50 Years of Progress

26 Smokeless Tobacco Products Snuff Chewing Tobacco SNUS Dissolvables

27 Snuff Finely ground tobacco packaged in cans or pouches Placed between the lower lip, cheek, and gum or inhaled Popular Brands Burton and Dental Snuff Copenhagen and Skoal

28 Available in loose leaves, plugs or twists of tobacco Usually placed between the cheek and gum or teeth Many versions offered in flavors Popular Brands Red Man and Levi Garrett Chewing Tobacco or Chew

29 Snus Pronounced snooze Originated from Sweden & Norway Comes packaged in small pouches and often is flavored Does not produce excess saliva Popular Brands Camel Snus Marlboro Snus

30 Dissolvables Another spit-less, often flavored tobacco products Shaped into pellets, strips or other forms Dissolve in the mouth Popular Brands Ariva Stonewall

31 Have you heard of any of these products? Do you know them by a different name?

32 Dip Chaw Worm Dirt Spit Tobacco Chew Pinch Lipper Mouth Tobacco Hog

33 Smokeless Tobacco Use Since 1970: Use changed from older men to young men and boys Smokeless tobacco promotions increased dramatically New generation of smokeless tobacco products hit market Use among high school boys exceeds national average in 19 states High school athletes uses smokeless tobacco more than non-athletes Flavored smokeless tobacco very popular, often with other tobacco product

34 Smokeless Tobacco and Nicotine You are more likely to become severely addicted by young adulthood Risk of developing periodontal degeneration with lesions increases Disruption in the proper formation of brain circuits Increased likelihood that you will smoke cigarettes Can cause nicotine poisoning in children

35 Chemicals Galore Exposes users up to 4,000 chemicals formaldehyde, arsenic and lead among others Contains up to 30 cancer causing chemicals Polonium-210, polynuclear aromatic hydrocarbons Most harmful chemicals Nitrosamines Amount varies by products, forms when the tobacco leaves are curated and processed

36 What can smokeless tobacco do to your mouth? Linked to three types of cancers oral (mouth), esophageal and pancreatic May increase the risk for death due to heart disease and stroke You could immediately experience mouth and tooth problems, Leukoplakia, stained teeth, halitosis, and/or gum disease

37 So, what can you do to curb tobacco use?

38 ...as youth coalitions members, you can lead or support interventions that: Eliminate Restrict Prohibit Ban Ensure Support Eliminate all flavors from ENDS and smokeless tobacco Restrict youth-targeted marketing of all ENDS and smokeless tobacco Prohibit sales of ENDS and smokeless tobacco to those under 21 Ban Internet and other non-face-to-face sales Ensure ENDS and smokeless tobacco are subject to tobacco-free laws and polices Support taxation proportional to harms of each type of tobacco product

39 Fit Coalition Activities to Community Context Listen to your neighbors to determine how using tobacco products fit into their lives Determine how cultural characteristics, history, values and beliefs shape opinions about tobacco products Do not assume everyone will want to quit tobacco use or even care about others who use it Consider cross-cultural settings to mobilize people

40 Youth Participation in Tobacco Control Try having fun in your tobacco related coalition work Embrace meeting people outside your social circle Ensure adult leaders involve you in the decision making Ask to have a say in how money is spent or funding for future activities Know that as a young coalition member you can: Say things that adults sometimes cannot You d can make people listen that would not listen to adults

41 Photovoice Use the power of pictures with short and meaningful captions to illustrate how tobacco use and other public health problems look in your community Completed two projects Kentucky and South Dakota Helped with enforcing existing policies and get meetings with local officials to discuss how best to pass policies to decrease tobacco use.

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43 Questions or Feedback?