HSS 1101 - Determinants of Health
uOttawa.ca
Chapter 15
Toward a
Tobacco-Free
Self and
Society
Slides prepared by:
Dave Kato
MacEwan University
Figure 15.1 Percentage Who Smoke
Daily or Occasionally, by Group and Sex,
2019
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Young People, Tobacco and Other
Drugs
• Although banned by provinces and territories, 800 million
cigarettes are consumed by minors each year
• Obtained from social sources, supermarkets, purchased on
reserves, bought from family/friends, given free from family/friends
• The use of smokeless tobacco is not as prevalent as cigarette use
• Those with drug abuse problems frequently use tobacco
• 4x as prevalent with those with a mental health diagnosis
•Major depression, social phobias and generalized anxiety disorder
•70% of people with alcohol use disorder and 97% of heroin users are
smokers
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Nicotine Addiction
• Scientific evidence shows that nicotine is highly addictive despite
the comments from the tobacco industry
• Works in the same way as cocaine and heroin
•Release of chemical mediators in the brain – epinephrine, norepinephrine
and dopamine
• Loss of control
• Tolerance and withdrawal
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Why Start in the First Place
• By grade 6, students are likely to start experimenting with smoking
•80% started before they were 18 years old
• Health Canada Youth Smoking Survey (associations, correlates)
•A parent or sibling uses tobacco
•Peers use tobacco
•Child comes from a blue-collar family
•Child comes from a low-income family
•Child is headed by single parent
•Child performs poorly in school
•Child drops out of school
•Child has positive attitudes about tobacco use
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Figure 15.2 Smoking Prevalence by
Grade/Age 2016-2017, and Age 15-19,
2017
• Rationalizing the dangers
•Persuade themselves they are too
intelligent to get hooked
•Can quit anytime they want
• Evaluating Smoking in the
media
•Films typically depict the smoker
as white, male, successful, well
educated and attractive
•Smokers tend to have lower
incomes and have less education
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The Immediate Effects of Smoking
• Beginner has mild nicotine poisoning: nausea, vomiting and
diarrhea
• Effects of nicotine vary greatly
• Stimulates the cerebral cortex and the adrenal medulla to release adrenaline
(epinephrine)
Tobacco Smoke: A Toxic Mix
• Carcinogens and poisons
•Nicotine // Carbon monoxide (CO) – 400 times higher than is considered
safe // Tar
• Results of inhaling tobacco smoke
•Most of what is inhaled stays in the lungs
•As the cigarette burns down there is less and less filter
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Figure 15.3 The Short-Term Effects
of Smoking a Cigarette
Long-Term Effects of
Smoking
• Cardiovascular disease
•Coronary heart disease (CHD) is
most prevalent - results from
atherosclerosis
• Lung cancer (other cancers),
Stroke, and Pulmonary heart
disease
• Chronic obstructive pulmonary
disease (COPD)
•Emphysema // Chronic bronchitis
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Figure 15.4 Lung Cancer Mortality
Over Time
Long-Term Effects of Smoking
• Additional health, cosmetic and
economic concerns
• Ulcers, Erectile
dysfunction, Reproductive
health problems, Dental
disease, Diminished
physical senses, Injuries,
Cosmetic concerns,
Economic costs
• Cumulative effects
• Reduced life expectancy
and quality of life
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Table 15.6 Taxes on Cigarettes in
Canadian Jurisdictions
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Figure 15.7 Prevalence of Flavoured Tobacco
Use in the Past 30 Days for Various Tobacco
Products, 2009 - 2017
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Environment Tobacco Smoke
• ETS effects
•Secondhand smoke: mainstream + sidestream smoke
•Sidestream smoke is not filtered
• Infants, children and ETS
•Cases of bronchitis, pneumonia, respiratory infections
•Increased risk for lung cancer and COPD later in life
Smoking and Pregnancy
• Maternal smoking causes an estimated 100 deaths of
infants each year
• Premature delivery and issues with the placenta
• Risk of lower birthweight
• Children born to mothers smoking 2+ packs/day,
developmental challenges
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Table 15.1 Bans on Smoking in
Public Places in Canada
• Prince Edward Island banned smoking in public places and workplaces in 2003.
• Manitoba banned smoking in any indoor location where children or youth where present in 2002,
and subsequently banned smoking in public areas in 2004.
• New Brunswick banned smoking in public places in 2004.
• Nunavut and the Northwest Territories banned smoking in business and work sites in 2004.
• Saskatchewan banned smoking in bars, casinos, and restaurants in 2002, and in all public places
in 2005.
• Newfoundland and Labrador amended its Smoke-Free Environment Act in 2005 to ban smoking in
all public places.
• Alberta banned smoking in public places in 2006.
• Quebec made restaurants, bars, clubs, casinos, and shelters smoke-free in May 2006, and
subsequently banned smoking in all public places in June 2006.
• In Halifax, Nova Scotia, smoking was restricted in 2009 in outdoor venues where children are
present (i.e., parks, rinks, and sports fields).
• Ontario banned smoking in public places in various cities between 2001 and 2006, banned
tobacco displays in 2008, and banned smoking in vehicles carrying children in 2009.
• British Columbia banned smoking in public places in 2008 and smoking in vehicles with minors in
2009.
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Table 15.3 Benefits of Quitting
Within 20 minutes of your last cigarette
•You stop polluting the air.
•Blood pressure drops to normal.
•Pulse rate drops to normal.
•Temperature of hands and feet increases to normal.
8 hours
•Carbon monoxide level in blood drops to normal.
•Oxygen level in blood increases to normal.
24 hours
•The chance of heart attack decreases.
48 hours
•Nerve endings start regrowing.
•Ability to smell and taste is enhanced.
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Table 15.3 Benefits of Quitting
Within 2 weeks to 3 months of your last cigarette
•Circulation improves.
•Walking becomes easier.
•Lung function increases up to 30 percent.
•Coughing, sinus congestion, fatigue, and shortness of breath all decrease.
1 year
•Heart disease death risk is half that of a smoker.
5 years
•Stroke risk drops nearly to the risk for non-smokers.
10 years
•Lung cancer death risk drops to 50 percent of that of a continuing smoker.
•Incidence of other cancers (mouth, throat, larynx, esophagus, bladder, kidney, and
pancreas) decreases.
•Risk of ulcer decreases.
15 years
•Risk of lung cancer is about 25 percent of that of continuing smokers.
•Risks of heart disease and death are close to those for non-smokers.
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Options for Quitting Smoking
• No single method works for everyone
• Health Canada offers resources to help smokers quit: Smokers’
help-line
• Develop a strategy for success
• Support groups - Family and friends
• Nicotine replacement therapy
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Strategies for Dealing With High-
Risk Smoking Situations
Cues and High-Risk Suggested Strategies
Situations
Waking up in morning Brush your teeth as soon as you wake up. Take a shower or bath.
Drinking coffee or tea Do something else with your hands. Drink another beverage
instead.
Eating meals Get up from the table right after eating and start another activity.
Brush your teeth right after eating.
Driving a car Have the car cleaned when you quit smoking. Chew sugarless gum
or eat a low-calorie snack. Take public transportation or ride your
bike. Turn on the radio and sing along.
Socializing with friends Suggest non-smoking events (movies, theatre, shopping). Tell
who smoke friends you have quit and ask them not to smoke around you, offer
you cigarettes, or give you cigarettes if you ask for them.
Drinking alcohol Try to take a non-smoker with you or associate with non-smokers.
Let friends know you have just quit. Moderate your intake of
alcohol (it can weaken your resolve).
Encountering stressful Practise relaxation techniques. Take some deep breaths. Get out of
situations your room or house. Go somewhere that doesn’t allow smoking.
© 2023 McGraw Hill Ltd. Take a shower, chew gum, call a friend, or exercise. 18
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