NCDs Risk Factor No. 3 - Smoking

Commonwealth Nurses Federation

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

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.

http://medical-dictionary.thefreedictionary.com/smoking

http://medical-dictionary.thefreedictionary.com/passive+smoking

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

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

Complications associated with Smoking

Other complications – lower bone density for

postmenopausal women

Increase risk of hip fracture in women

Cerebro-vascular disease

Pneumonia

www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smokingwww.n

hs.uk/chq/Pages/2344.aspx?CategoryID=53&SubCategoryID=536

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.

www.mydr.com.au/addictions/smoking-what-are-the-effects

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

Reasons for Smoking

Many people start smoking for very different

reasons. Why do you think people smoke?

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

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

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.

The Prevalence of Smoking

Rank Country Percentage

1 Nauru 54

2 Guinea 51.7

18 Tonga 38.3

79 Samoa 23.3

89 Fiji 20.5

91 Australia 19.5

www.nationmaster.com/graph/hea_tob_tot_adu_smo-health-tobacco-total-adult-smokers

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 13–15-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

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.

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

www.tipsandadvice.com.au/index.php/2011/06/change-your-lifestyle-to-quit-smoking/

Treatments

Willpower / 'cold turkey'

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.

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

Treatment Cont ….

Combination Therapy – this is where you combine alternative

therapies, medical management and psychological management

Cut down to quit

Community Intervention

Comprehensive clean indoor laws can increase

smoking cessation rates by 12 - 38%

Education

One on One

Programs

www.nhs.uk/Conditions/Smoking-(quitting)/Pages/Treatment.aspx

www.wikipedia.org/wiki/Smoking_cessation