Effect of smoking on community by benbenzhou

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									  EFFECT OFSMOKING ON COMMUNITY
             HEALTH
                         LEARNING OBJECTIVES
 STUDENTS WILL BE ABBLE TO DISCRIBE
  “                                 History of Tobacco Smoking.
 Chemical constituents of Tobacco.
 Habits of Tobacco Smoking.
 Health effects of Tobacco smoking
 Tobacco production in Pakistan.
 Tobacco control program.
 Tobacco free initiative.


                     HISTORY OF TOBACCO
• Tobacco plant was originally found in central America & was in
  use by American Indians in 1493.
• About 1600 Tobacco reached the Indian subcontinent.
• From then on till today, the British commercial interests control
  the tobacco industry in Pakistan, India & many other countries of
  S ou t h E a s t A s i a
                                 Chemical Box:
                                   What’s in Tobacco?
 Tar: black sticky substance used to pave roads
 Nicotine: Insecticide
 Carbon Monoxide: Car exhaust
 Acetone: Finger nail polish remover
 Ammonia: Toilet Cleaner
 Cadmium: used batteries
 Ethanol: Alcohol
 Arsenic: Rat poison
 Butane: Lighter Fluid
      CHEMICAL CONSTITUENTS OF TOBACCO
                                (CIGRATTE )
• Over 3900 compounds have been identified in tobacco plant in its natural
  form.
• Major hydrocarbons, aldehydes, ketones, alcohols, phenols, ethers,
  carboxylic acids, esters, anhydrides, lactones, carbohydrates, amines,
  amides, imides, nitrites, N - & O – heterocyclic compounds, chlorinated
  organic compounds & at least 35 metal compounds.
• Over a dozen carcinogens have been identified among the above
  compounds.
• The most important ingredient of tobacco & responsible for its addiction is
  NICOTINE.
                   Consequences of Tobacco-Use:
                            Preventable Causes of Death


                        SMOKING HABITS
• The most common & universal tobacco habit is SMOKING – Cigarettes, Cigars,
  Bidri, Hookah, Chellum, Pipe.
• Chewing of tobacco alone or with Pan / Challia / Choona or their combination is a
  common habit in Pakistan, India & many other parts of South East Asia.
• In Northern Pakistan, Afghanistan, Iran, & Central Asia tobacco is used as NISW AR or
  NAS.
• The habits of the KARACHI population were studied from 1967 – 1972. The
  commonest habit was that of Cigarette Smoking followed by different forms of
  chewing tobacco (Patti, Qiwam, Niswar etc).

              CHEWING AND SMOKING HABITS IN KARACHI
         TOBACCO PRODUCTION IN PAKISTAN
• In the 1990 – 91 season tobacco was grown on 439,000
  Hectares & 75,000 Tones of different varieties of tobacco were
  produced.
• During the same year 29,887 million cigarettes were
  manufactured in Pakistan.
                SMOKING HABITS IN KARACHI
  What are the tobacco-related diseases that
    are contributing to all these deaths?
     HEALTH EFFECTS OF TOBACCO SMOKING
• Tobacco has significant effects on the portal of entry (mouth, throat, lung)
  and after absorption on nearly all the systems of the body.
• The major effects of tobacco derived chemicals is to produce
  CARCINOMAS (cancers) when they come into contact with different
  epithelia either at the time of entry or on excretion.
• Smoking leads to CHRONIC BRONCHITIS (commonest disease amongst
  smokers) which ultimately leads to EMPHYSEMA.
• Cancers of lung is a major hazard of smoking & over 90 % of lung cancers
  are seen in smokers.
    HEALTH EFFECTS OF TOBACCO SMOKING
• Along with diet, cigarette smoking is one of the major etiological factors in
  producing ATHEROSCLEROSIS OF CORONARY ARTERIES
  subsequently leading to ACUTE MYOCARDIAL INFARCTION.
• NICOTINE, the major addictive agent in tobacco increases the heart rate
  and blood pressure.
• Carbon monoxide & carbon dioxide of the smoke, affect the oxygen
  carrying capacity of the blood.
• Tobacco also decreases HDL levels.
    HEALTH EFFECTS OF TOBACCO SMOKING
• The use of tobacco particularly smoking is also associated with increased
  risk of CEREBRO – VASCULAR ACCIDENT and TEMPORARY
  ISCHEMIA.
• The use of tobacco leads to adverse effects on the reproductive health of
  both males and females.
• In PAKISTAN it is estimated that nearly half of all male and one third of all
  female cancers are related to the use of tobacco.
 EVIDENCE OF TOBACCO SMOKING AS AN ETIOLOGICAL FACTOR IN
                            HUMAN DISEASE
1. HIGHLY SIGNIFICANT EVIDENCE:
 EVIDENCE OF TOBACCO SMOKING AS AN ETIOLOGICAL FACTOR IN
                            HUMAN DISEASE
2. SIGNIFICANT EVIDENCE:
 EVIDENCE OF TOBACCO SMOKING AS AN ETIOLOGICAL FACTOR IN
                            HUMAN DISEASE
3. SOME EVIDENCE:
  What are the tobacco-related diseases that
    are contributing to all these deaths?
 Tobacco use: The single largest cause of preventable death.
    Arteriosclerosis & Atherosclerosis:
                   Heart Attack:
       Peripheral Vascular Disease
                  Stroke:




                    Emphysema:




                   Lung Cancer:
The uncontrolled growth of abnormal cells in one or both lungs
                Fetal Damage:
               Laryngeal Cancer
                           Dental Problems:
          Consequences of chewing tobacco:
                PASSIVE SMOKING
• Non – smokers who share the living or working environment with
  smokers also run the risk of becoming victims of all the diseases
  related to tobacco.
• Infants of parents who smoke are prone to have repeated
  episodes of Respiratory Infections and Asthma
                          Secondhand smoke:
              MORTALITY & FUTURE TRENDS
• WHO estimates about 3 million people die each year due to tobacco
  related diseases.
• At present 2 million of these deaths are in the developed world & 1
  million in the developing world.
• Cigarette smoking has increased rapidly in the developing world, it
  is estimated that by the year 2020 the number of deaths will
  increase to 10 million per year, most of which will be in the
  developing world.
• If the tobacco habit continues as it is now, then 200 – 300 million of
  those born between 1970 – 1990 will be killed by tobacco.
If smoking is so bad for us, why do we start?


                            Tobacco Myths
• Myth: Clove cigarettes are less harmful than regular cigarettes.

• Myth: Cigars are safe

• Myth: It’s OK to smoke as long as it’s a “natural” cigarette


                           What is a cigar?
                                 Cigar Use:
              Using beauty and fame to promote a dirty, devastating habit
                         What is marijuana?
    A drug obtained from the flowering tops of the female cannabis or hemp
                                    plant
                          What is a blunt?
A blunt is when you take a cigar and
slice it open removing the tobacco and
replacing it with marijuana.
                                  Hookahs:
•   Not safer than regular tobacco smoke.
•   Causes the same diseases
•   Raises the risk of lip cancer, spreading infections like tuberculosis.
•   Users ingest about 100 times more lead from hookah smoke than from a
    cigarette.


                      TOBACCO CONTROL
• In 1600’s a number of countries banned the use of tobacco due
  to its harmful effects.
• But the addictive nature of the product turned it into a lucrative
  trade.
• Gradually the governments found taxes on tobacco a good of
  revenue & now they become addicted to these taxes.

• In the developing world the tobacco industry, controlled mostly by British
  and American companies.
• In PAKISTAN a number of voluntary organizations and individuals have
  been carrying on a campaign, but its impact is mostly on the educated
  class.
• Cancer society of KARACHI has been producing pamphlets, posters and a
  bimonthly tobacco news letter.
• It has also with the assistance of WHO produced a film for School
  Children.
• In 1994 on the appeal of a LAWYER from Rahim Yar Khan, the
  Ombudsman issued orders banning all tobacco advertisements on TV but
  then PTV appealed to the PRESIDENT to reverse it.
• Restriction on advertisements and sponsorship of sporting events is one of
  the major demands of tobacco control.
                     Think About Quitting
• P i c k a q u i t d a te
• Keep a record of why, when, where and with whom you smoke
• Get support and encouragement from your family, friends, and
  health providers.

                          The Quit Plan:
                           • Treat yourself well
                           • Drink lots of water
                         • Change your routines
                              • Reduce stress
                             • Deep breathing
                            • Regular exercise
                   • Do something enjoyable every day
                  • Increase non-smoking social support
                               • Other ideas?


            TOBACCO FREE INITIATIVE (TFI)
 BACKGROUNDS / INTRODUCTION:
• More than 70,000 scientific articles have established tobacco as
  the leading cause of premature death & disabling disease.
• More than 11,000 people die from tobacco related diseases
  every day.
• World wide mortality from tobacco is likely to rise from about 4
  million deaths a year in 1999 to about 10 million a year in 2030

            TOBACCO FREE INITIATIVE (TFI)
• The government of PAKISTAN identified smoking as one of the country’s
  leading causes of morbidity and mortality in its December 1997 health
  policy.
• Tobacco Free Initiative–Pakistan (TFI-Pak) project was introduced in May
  2000. WHO provided initial support through its Global Tobacco Free
  Initiative (TFI) project.
• PAKISTAN is among the fifteen (15) countries identified as “change
  agents” for tobacco control by the TFI project worldwide.
             PRIMARY GOAL OF TFI - PAKISTAN
•   To mount resistance against the tobacco industry’s onslaught.
•   To educate people about hazards of tobacco use.
•   To lobby the government to introduce adequate controls on
    tobacco sale and promotion.
                OBJECTIVES OF TFI - PAK
• Effective advocacy by mustering national support for evidence – based tobacco
  control measure e.g ban on all kinds of tobacco promotion.
• Contribution towards development and advocacy for comprehensive anti -
  tobacco legislation in Pakistan.
• Building a national awareness campaign about the hazards of tobacco.
• Undertaking policy & operational research to fill knowledge gaps for effective
  control on tobacco consumption.
• To lobby for and contribute towards development of the Framework Convention
  for Tobacco Control (FCTC) at national and international levels.
              OPERATIONAL STRATEGIES
• TFI – Pak believes that the tobacco issue should be tackled through a mix
  of price & non – price measure such as progressive taxation and bans on
  promotion.
• TFI – Pak considers a total ban on the direct & indirect promotion of
  tobacco products on print & electronic media the first and foremost step,
  but this should be accompany pricing measures.
• Tobacco free Home Campaign helps to declare your homes tobacco free,
  saving your friends & family from the hazards of Passive Smoking.
              WHO’S “TOBACCO - FREE INITIATIVE”
• The WHO took the “Tobacco – Free Initiative” in 1998.
• WHO has come up with two proposals.
1.The governments should gradually increase the sale prices of
  cigarettes up to 70 %.
2.The international trade of cigarettes should come under strict
  control to curb smuggling.
                           CHALLENGES
• I appeal to the LEADERS of all countries to carry out programs of
    information & education that will create societies free of smoking.
•   To non smokers: Don’t start.
•   To smokers: Stop smoking or cut down.
•   To planners & economists: Find economic alternatives to
    tobacco – growing.

                          CHALLENGES
• To Parliamentarians: Fulfil your social responsibilities by passing
  legislation.
• To trade union leaders: Do not forget the battle to protect workers from
  that toxic substance, tobacco;
• To entertainers, athletes, & public personalities: You are role models for
  young people; please avoid tobacco & so help them to choose health.
• To the mass media: Use your communication skills to spread the news
  that the use of tobacco is “out” and to deliver the simple message –
  “choose health”.
                               THANKS

								
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