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![Tobacco CarcinogensTobacco Carcinogens
Polycyclic aromatic hydrocarbons (PAH)Polycyclic aromatic hydrocarbons (PAH)
Benzo[a]pyrene first to be recognizedBenzo[a]pyrene first to be recognized
Causes mutaion in TP53 tumor suppressor geneCauses mutaion in TP53 tumor suppressor gene
Nitrosamines (TSNA)Nitrosamines (TSNA)
Most prevalent strong carcinogens inMost prevalent strong carcinogens in
unburned and smokeless tobaccounburned and smokeless tobacco
Aromatic aminesAromatic amines
Weaker carcinogens like acetaldehydeWeaker carcinogens like acetaldehyde
JS Levitz et al: Med Clin N Am 2004; 88:1655](https://image.slidesharecdn.com/illeffectsofsmokingamirakadal-161216132242/85/Why-Should-You-Not-Smoke-24-320.jpg)
![Tobacco CarcinogensTobacco Carcinogens
Polycyclic aromatic hydrocarbons (PAH)Polycyclic aromatic hydrocarbons (PAH)
Benzo[a]pyrene first to be recognizedBenzo[a]pyrene first to be recognized
Causes mutaion in TP53 tumor suppressor geneCauses mutaion in TP53 tumor suppressor gene
Nitrosamines (TSNA)Nitrosamines (TSNA)
Most prevalent strong carcinogens inMost prevalent strong carcinogens in
unburned and smokeless tobaccounburned and smokeless tobacco
Aromatic aminesAromatic amines
Weaker carcinogens like acetaldehydeWeaker carcinogens like acetaldehyde
JS Levitz et al: Med Clin N Am 2004; 88:1655](https://image.slidesharecdn.com/illeffectsofsmokingamirakadal-161216132242/75/Why-Should-You-Not-Smoke-24-2048.jpg)
Uploaded byProf. Shad Salim Akhtar
Why Should You Not Smoke
This document discusses the harms of tobacco use and provides a history of tobacco cultivation and smoking. It notes that tobacco was first cultivated as early as 6000 BC in some regions. In 1492, Christopher Columbus and his men encountered indigenous people in the Americas smoking dried tobacco leaves wrapped in palm or maize leaves. By the late 15th century, smoking had spread to Spain and became popular. The document outlines the various types of tobacco products and notes there are over 4000 chemicals in tobacco, more than 60 of which cause cancer. It discusses the health, economic, and social impacts of tobacco use, highlighting that it causes over 5 million deaths worldwide each year and costs economies billions in health care costs. The summary provides an overview of the
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Why Should You Not Smoke
- 1. Tobacco- Why It ShouldNot Be Used Prof. Shad Salim Akhtar MBBS, MD, MRCP(UK), FRCP(Edin), FACP(USA), FICA (USA) Fellow Association of Members UICC Member Global Cancer Control Committee UICC Overseas Advisor Royal College of Physicians of UK Consultant Medical Oncologist & Director Hakim Sanaullah Specialist Hospital & Cancer Center, Sopore, Kashmir, J &K
- 2.
- 3.
- 4. When Was TobaccoCultivated?When Was Tobacco Cultivated? 14921492 6000 BC6000 BC 1 BC1 BC 15311531
- 6. 1492-10-12: On thisbright morning Columbus and his men set foot on the New World for the first time, landing on the beach of San Salvador Island or Samana Cay in the Bahamas, or Gran Turk Island. The indigenous Arawaks, possibly thinking the strange visitors divine, offer gifts. Columbus wrote in his journal, “the natives brought fruit, wooden spears, and certain dried leaves which gave off a distinct fragrance.” As each item seemed much-prized by the natives; Columbus accepted the gifts and ordered them brought back to the ship. The fruit was eaten; the pungent "dried leaves" were thrown away.”
- 7. 8 1492-11: Rodrigo deJerez and Luis de Torres, in Cuba searching for the Khan of Cathay (China), are credited with first observing smoking. They reported that the natives wrapped dried tobacco leaves in palm or maize "in the manner of a musket formed of paper." After lighting one end, they commenced "drinking" the smoke through the other.
- 8. 9 Jerez Becomes First EuropeanSmoker Jerez became a confirmed smoker, and is thought to be the first outside of the Americas. He brought the habit back to his hometown, but the smoke billowing from his mouth and nose so frightened his neighbors he was imprisoned by the holy inquisitors for 7 years. By the time he was released, smoking was a Spanish craze.
- 10. Types of TobaccoTypesof Tobacco Manufactured CigarettesManufactured Cigarettes BidisBidis CigarsCigars KreteksKreteks PipesPipes ClayClay WaterWater SticksSticks Chewing TobaccoChewing Tobacco SnuffSnuff
- 12.
- 16. is still acigarette, and still as dangerous! 3 times CO and 5 times Tar compared to a cigarette a cigarette by any other name …
- 17. “Short, snappy, easily attempted,easily completed or just as easily discarded before completion – the cigarette is the symbol of the machine age." New York Times, 1925
- 21. Quantum of theProblemQuantum of the Problem Number of regular smokersNumber of regular smokers 1.3 billion1.3 billion Third of the word population aged >=15yrsThird of the word population aged >=15yrs 47.5% men and 10.3% women smoke47.5% men and 10.3% women smoke 82-90,000 young people start82-90,000 young people start smoking dailysmoking daily 15 billion cigarettes are smoked daily15 billion cigarettes are smoked daily 5.5 trillion consumed in 20005.5 trillion consumed in 2000 Other tobacco (smokeless tobacco) useOther tobacco (smokeless tobacco) use data???data???
- 22.
- 23. Tobacco CarcinogenesisTobacco Carcinogenesis >4000chemicals>4000 chemicals >60 carcinogenic>60 carcinogenic Hecht SS: Nat Rev Cancer 2003;3:733
- 24. Tobacco CarcinogensTobacco Carcinogens Polycyclicaromatic hydrocarbons (PAH)Polycyclic aromatic hydrocarbons (PAH) Benzo[a]pyrene first to be recognizedBenzo[a]pyrene first to be recognized Causes mutaion in TP53 tumor suppressor geneCauses mutaion in TP53 tumor suppressor gene Nitrosamines (TSNA)Nitrosamines (TSNA) Most prevalent strong carcinogens inMost prevalent strong carcinogens in unburned and smokeless tobaccounburned and smokeless tobacco Aromatic aminesAromatic amines Weaker carcinogens like acetaldehydeWeaker carcinogens like acetaldehyde JS Levitz et al: Med Clin N Am 2004; 88:1655
- 25. Tobacco SmokeTobacco SmokeAlso found inAlso found in AcetoneAcetone Paint StripperPaint Stripper AmmoniaAmmonia Floor CleanerFloor Cleaner ArsenicArsenic Ant poisonAnt poison ButaneButane Lighter fuelLighter fuel CadmiumCadmium Car BatteriesCar Batteries Carbon MonoxideCarbon Monoxide Car exhaust fumesCar exhaust fumes DDTDDT InsecticideInsecticide Hydrogen CyanideHydrogen Cyanide Gas ChambersGas Chambers MethanolMethanol Rocket FuelRocket Fuel NaphtaleneNaphtalene Moth BallsMoth Balls TouleneToulene Industrial SolventIndustrial Solvent Vinyl ChlorideVinyl Chloride PlasticsPlastics LeadLead Lead based paintsLead based paints AcrolienAcrolien A chemical weaponA chemical weapon FormaldehydeFormaldehyde Embalming fluidEmbalming fluid
- 27. Tobacco CarcinogenesisTobacco Carcinogenesis >4000chemicals>4000 chemicals >60 carcinogenic>60 carcinogenic Nicotine content important to causeNicotine content important to cause addictionaddiction Not carcinogenicNot carcinogenic ToxicToxic Hecht SS: Nat Rev Cancer 2003;3:733 Combination needed
- 28. Nicotine Delivery Device AddictingNicotine 4000 Chemicals 60 Carcinogens Perfect Killing Machine Hecht SS: Nat Rev Cancer 2003;3:733
- 33.
- 44. Preterm delivery Reduced fertility Reducedoxygen to placenta Sudden infant death syndrome Early menopause Irregular menstrual bleeding Premature wrinkling and aging
- 45.
- 47. 90% of newsmokers begin as teenagers; more than 5 million of whom will eventually die as a result Source: CDC Office of Smoking and Health; National Center for Tobacco-Free Kids
- 48. Of young adultswho started smoking in their teens and continue to smoke cigarettes regularly: • about 25% will die prematurely in middle age • about 25% will die prematurely in old age Smoking and the Risk of Premature Death
- 49. Tobacco Related DeathTobaccoRelated Death 8.8% deaths globally8.8% deaths globally 5 million per year5 million per year 13,500 per day13,500 per day Every 6.5 seconds someoneEvery 6.5 seconds someone dies from tobacco usedies from tobacco use Death toll to rise to 10 million per yearDeath toll to rise to 10 million per year 7 million in non industrialized countries7 million in non industrialized countries Half the people smoking today will beHalf the people smoking today will be eventually killed by tobaccoeventually killed by tobacco
- 50. Every 6.5 secondsEvery6.5 seconds someone diessomeone dies from tobacco usefrom tobacco use
- 51. The World HealthOrganisationThe World Health Organisation describes smoking as an:describes smoking as an: epidemicepidemic that will causethat will cause 1/3 of all adult deaths1/3 of all adult deaths world-wide by 2020world-wide by 2020
- 52. Bryan Curtis startedsmoking at 13, never thinking that 20 years later it would kill him and leave a wife and children alone. In his last weeks, he set out with a message for young people.32 yrs 33 yrs
- 55.
- 56. What is theeconomic impact ofWhat is the economic impact of smoking?smoking? Cost of smoking--- directCost of smoking--- direct Loss of income due to prematureLoss of income due to premature deathdeath Cost of medical careCost of medical care Loss of propertyLoss of property Loss of time of family for care takingLoss of time of family for care taking
- 57. Direct Medical Costs:DirectMedical Costs: Consequences of SmokingConsequences of Smoking Physicians $20.2 Billion Hospitals $39.9 Billion Nursing Homes $9.8 Billion Home Health Care $1.9 Billion Prescription Drugs $8 Billion Estimated $80+ Billion Total Direct Medical Care Costs in 1993
- 58. Economic Impact ofSmokingEconomic Impact of Smoking
- 60. Every year 1,000,000 firesstarted by children using cigarette lighters
- 62.
- 63. Teens who smokeare — • 3 times more likely to use alcohol • 8 times more likely to use marijuana • 22 times more likely to use cocaine — than teens who don’t
- 65. More than 3,000kids under 18 try smoking every day; that’s more than 1,000,000 every year. CDC, 1997
- 66. We react toone but to the other!!!!!
- 67. Tobacco CarcinogenesisTobacco Carcinogenesis MainstreamsmokeMainstream smoke Inhaled through the column ofInhaled through the column of cigarettecigarette Sidestream (passive, secondSidestream (passive, second hand smoke)hand smoke) Emitted from the burning coneEmitted from the burning cone of the cigaretteof the cigarette Has similar chemicals butHas similar chemicals but higher level of carcinogenshigher level of carcinogens “Particulate phase” only 5% of all output is visible
- 68. Passive or secondhandPassive or second hand smokesmoke One of the most dangerousOne of the most dangerous cancer-causing agents incancer-causing agents in humanshumans Group A carcinogenGroup A carcinogen
- 69. 74 Parents warned aboutnew 'tobacco sticks' A new tobacco product being sold in Kansas has prompted warnings from state health officials, who say the tiny "smokeless tobacco sticks" could pose a danger to children. Altria Group Inc., the parent company of Philip Morris USA and U.S. Smokeless Tobacco Co., recently began test- marketing the tobacco-coated sticks at select retailers in Kansas, including Wichita, said company spokesman Ken Garcia. The sticks, sold in matchbook-like packs under the brand names Marlboro and Skoal, are aimed at adult smokers and snuff users who want a smokeless, spit-free alternative, ….. BY SUZANNE PEREZ TOBIAS Thu, Jun. 02, 2011
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- 71.
Editor's Notes
- #8 Associated with Columbus in the voyage were at least five Jews: Luis de Torres, interpreter; Marco, the surgeon; Bernal, the physician; Alonzo de la Calle, and Gabriel Sanchez. Luis de Torres was the first man ashore, the first to discover the use of tobacco; he settled in Cuba and may be said to be the father of Jewish control of the tobacco business as it exists today.
- #11 Kretek ( /ˈkrɛtɛk/) are cigarettes made with a blend of tobacco, cloves and other flavors. The word "kretek" itself is an onomatopoetic term for the crackling sound of burning cloves. Haji Jamahri, a resident of Kudus, Java, created kreteks in the early 1880s as a means to deliver the eugenol of cloves to the lungs, as it was thought to help asthma[1] Jamahri believed the eugenol cured his chest pains and he started to market his invention to the village, but he died of lung cancer before he could mass market it. M. Nitisemito took his place and began to commercialize the new cigarettes. Today, kretek manufacturers directly employ over 180,000 people in Indonesia and an additional 10 million indirectly.[2] Dissolvable tobacco is a tobacco product. Unlike ordinary chewing tobacco, it dissolves in the mouth. Major tobacco manufacturers that sell dissolvable tobacco products include R. J. Reynolds Tobacco Company (Camel-branded "Orbs," "Strips," and "Sticks," 2009) and Star Scientific ("Ariva," 2001 and "Stonewall," 2003). The move of the major players into the smokeless tobacco market is attributed to smoke-free laws in the United States.[1] Research into health effects of this and other new tobacco products was among the reasons of the establishment of the Tobacco Products Scientific Advisory Committee of the Food and Drug Administration in 2009.[2]
- #13 Several species of Areca nuts, known for their bitter and tangy taste, are routinely used for chewing, especially in combination with the leaves of Betel, tobacco and calcium oxide (lime). This practice is popular among elderly people in southeastern Asia, often the main cause of oral cancer in the region.
- #17 •A bidi is a small brown cigarette, often flavored, that consists of hand-rolled tobacco in tendu or temburni leaf tied with string at one end. India is the primary producer of bidis. The Federal Trade Commission requires that they carry the Surgeon General’s health risk warning •Bidis are not safe alternatives to traditional cigarettes. Research has found that a bidi produces three times the amount of carbon monoxide and nicotine and more than five times the amount of tar contained in one traditional cigarette. •Bidi smokers are at increased risk of coronary heart disease and cancers of the lung, larynx, mouth, esophagus, pharynx, and liver. Smoking bidis while pregnant can cause perinatal death. •There are no national statistics on the use of bidis in the U.S., but anecdotal reports show that they are gaining in popularity, particularly among the young. •According to a Massachusetts study, bidis are preferred over cigarettes because they taste better, they are cheaper, and easier to buy. They are also perceived to be safer than cigarettes.
- #25 TSNA Tobacco specific nitrosamines
- #46 •This list of health risks is compiled from data from the American Cancer Society, the American Lung Association, the National Cancer Institute, The Heart Association, and the Centers for Disease Control. •The message from these slides is the mind-boggling number of preventable illnesses and conditions that are attributable to smoking. In fact, there are too many to fit on one slide.
- #48 •The overall decline in adult smoking has moved the tobacco industry to recruit almost one million new smokers a year, most of whom are children and adolescents.1 •Tobacco advertising is targeted to children and adolescents to encourage them to begin a lifelong addiction to smoking before they are old enough to fully understand the long-term consequences.1 •The average teenage smoker begins smoking by age 14 and becomes a daily smoker by age 18.1 •Studies show that a person who does not begin smoking as a child or adolescent is not likely to begin as an adult.1 •Adolescents with lower levels of school achievement are more likely than their peers to use tobacco. •Many girls as young as third and fourth graders are already concerned about their weight and body image, and many have already been on diets by the time they enter junior high school. •Health professionals, educators, mothers and other female role models must strike a balance between validating a young girl’s concern about weight, while trying to shift focus to health, self-esteem, and well being. •More than five million smokers under age 18 alive today will eventually die as a result of smoking.2 •According to the CDC, in 1999, 34.8% of all high school students reported using some type of tobacco product.3
- #49 •Hazards for the individual cigarette user: 1990s US/UK evidence.1 •About half of the teenagers who continue to smoke steadily will die as a result: about one-quarter in old age, plus one-quarter in middle age. •Those killed by tobacco in middle age (35-60) lose an average of 20 to 25 years of nonsmoker life expectancy •Most of those killed by tobacco were not particularly “heavy” smokers, but most did start smoking in their teenage years •Smoking cessation works. Even in middle age, stopping smoking before getting cancer or some other serious disease avoids most of the later excess risk of death from tobacco (and the benefits of stopping at earlier ages are even greater). •Because the body is still developing during the teen years, smoking during these years may cause even more damage.
- #53 Bryan Curtis started smoking at 13, never thinking that 20 years later it would kill him and leave a wife and children alone. In his last weeks, he set out with a message for young people.
- #58 Besides the enormous health consequences of smoking, there are also enormous economic consequences as well. •It is conservatively estimated that, in 1993, $50 billion were spent in direct medical care costs•$39.9 billion for hospitals•$20.2 billion for physicians•$9.7 billion for nursing homes•$8.9 billion for prescription drugs•$1.9 billion for home health care1 These estimates underestimate the overall costs as they do not include such things as:•burn care resulting from smoking-related fires•perinatal care for low-birth-weight infants of mothers who smoke•diseases caused by exposure to environmental tobacco smoke•premature smoking-related morbidity and premature mortality1
- #64 •According to the CDC, smoking is associated with a variety of risky behaviors, including higher use of alcohol, marijuana, and cocaine; as well as fighting and engaging in unprotected sex. •Cigarettes are a “gateway drug.” Their use tends to precede use of alcohol and other drugs. If teens don’t smoke, their chance of using illegal drugs are very low. This is an important message, for teens and for their parents, many of whom view smoking cigarettes as the “lesser of two evils.”1 •Researchers with the Monitoring the Future project of the University of Michigan have tracked large samples of young people from high school through the adult years, studying their use of cigarettes, alcohol, marijuana, and cocaine. Their work demonstrates that teens are far more likely to continue their use of cigarettes into adulthood than the other substances studied. Parents and teens need to understand that the use of cigarettes during teen years often leads to a lifetime of addiction, and the strong likelihood of a premature death.2
- #66 •According to the 1995 Surgeon General’s Report on the use of tobacco among young people:•tobacco use primarily begins in early adolescence, typically by age 16; almost all first use occurs before the time of high school graduation•69% of respondents to the National Household Surveys on Drug Abuse aged 30 through 39 reported trying a cigarette by age 18•of all persons who had ever tried a cigarette, 88% had done so by age 18•the mean age of first trying a cigarette was 14.5 years of age1 •Tobacco companies provide very substantial subsidies to store owners to display cigarettes, both packs and “loosies” in prominent positions at check-out counters. The result is that many children shoplift cigarettes and become addicted, creating a life-time consumer of tobacco.