Smoking Cessation Training

Smoking Cessation Training “Commit to Quit” The University of Texas Medical Branch Galveston Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 1 Annual Number of Deaths: U.S. Alcohol AIDS Secondhand Smoke Tobacco Smoke Alcohol Cocaine Heroin Homicide Suicide Cars Fires AIDS Tobacco Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 2 Lung Cancer Death Rates (British Physicians, 1951-1961, per 100,000) 3.5 3 Death Rates 2.5 2 1.5 1 0.5 0 0 5 10 15 20 25 30 35 40 Average # of Cigarettes Smoked / Day Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 3 Cigarette Smoking and Lung Cancer Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 4 Risk Factors for Heart Disease Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 5 Most Common Cancers Men Women Incidence Mortality Incidence Mortality 1. Prostate 1. Lung 1. Breast 1. Lung 2. Lung 2. Prostate 2. Lung 2. Breast 3. Colorectal 3. Colorectal Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 6 Smoking Risks and Pregnancy SIDS 1.25 1 1.98 1 1.7 1 1.36 1 0 0.5 1 1.5 2 Smokers Nonsmokers Low Wt Preterm SpnAbort Relative Risk Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 7 Smoking Cessation Reduces Risk CORONARY  HEART DISEASE STROKE COLD / Enphasema LOW BIRTH WT. Preterm Births, SIDS, ENT Infections OSTEOPOROSIS FIRE DEATHS CANCERS Lung Head & Neck Stomach Pancreatic Kidney Bladder Cervical 8 Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 Life Expectancy: Smokers vs. Nonsmokers 100 % Surviving 80 60 40 20 0 0 35 45 55 Age 65 75 85 Smokers NonSmokers Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 9 How Smoking Causes Disease Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 10 Dose Response Mortality Ratios by # Cigarettes Smoked 40+/day 21-39/day 10-20/day <10/day Nonsmoker 0 0.5 1 1 1.5 2 2.5 1.29 1.67 2.03 2.36 Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 11 Carcinogens in Cigarette Smoke Benz(a)anthracene  Benzo(b)fluoranthene  Cadmium/compounds  Dibenz(a,h)acridine  Dibenz(a,h)anthracene  7HDibenzo(c,g)  Dibenzo(a,j)pyrene  Dibenzo(a,I)pyrene  Indeno(1,2,3cd)pyrene  2-Naththylamine  N-Nitrosodiethylamine  – carbazole  Dibenz(a,j)acridine  – sonornicotine, – sopiperidine,etc. 2,3,7,8Tetrachlorodibenzo-p-dioxin 12 Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 Ciliotoxins in Cigarette Smoke Hydrocyanic Acrolein Ammonia Formaldehyde Acetaldehyde acid Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 13 Nicotine Levels in Smokers Blood Nicotine Concentrations (ng/ml) 30 25 20 15 10 5 0 8: 00 A M H N 4: 00 P M 8: 00 P M M N 4: 00 A M 8: 00 A M 14 24 20 20 12 26 23 24 26 27 18 17 12 13 Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 Carbon Monoxide in Smokers Carboxyhemoglobin (%) 10 8 6 4 2 0 8am 10 HN 2 4 6 8 10 MN 2 4 6 8am Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 15 Nonsmoker’s Exposures to ETS Respirable Suspended Particulates 600 500 400 300 200 100 0 589 417 351 202 187 (UG/M3) Party Bar Bingo Bowling Public Area Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 16 Nonsmoker’s Absorption of Nicotine Urinary Cotinine Excretion 1.5 (ug/mg Cr) 1 0.5 0 None Work only Both Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 17 Who Smokes Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 18 Cigarette Smoking in the U.S. 50 Prevalence % 40 30 20 10 0 1970 1975 1980 1985 1990 1995 2000 19 Men Women Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 Educational Status and Smoking 40 35 30 25 20 15 10 5 0 1975 1980 1985 1990 1995 2000 High School Dropout High School Graduate Some College College Graduate Prevalence % Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 20 Smoking Among Young People Compared to teens that don’t smoke, teens who smoke are:  3 times more likely to use alcohol;  8 times more likely to use pot; and  22 times more likely to use cocaine! Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 21 Cigarette Smoking in the U.S. Surgeon General’s Report 1964 60 Prevalence % 50 40 30 20 10 0 1965 1970 1975 Broadcast Ads Ban 1973 Cigarette Tax Doubles 1983 Tobacco Companies Law Suits 1995 Tax Doubles Again 1989 Men Women Tobacco Free Schools 1997 1980 1985 1990 1995 2000 22 Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 Why People Smoke Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 23 Model Nonsmoking Behavior Out of 1,000 kids who smoke, 750 come from families where one or both parents smoke! Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 24 Factors in Smoking Psychosocial Factors  Social Acceptability  Feelings of Well-being Physiological Factors  Nicotine Addiction  Secondary Gains Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 25 Kicking the Habit Smoking Triggers  Stressful life situations  Other habits - coffee, alcohol, eating, sex  Cues - others smoking, weight gain, etc... Cessation Triggers  Encouragement from significant others  New Coping Skills Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 26 Readiness to Change  Precontemplation  Contemplation  Preparation  Action  Maintenance Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 27 Persistence Pays 1,000 smokers trying to quit 400 300 200 100 0 1st try 2nd try 3rd try 4-6th try 7th try # Successful Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 28 Commit to Quit Billy U. Philips, Jr., Ph.D., M.P.H. (409) 772-9132 29