Tag Archives: tar in cigarettes

Cigarettes in a Pile

How Much Tar in That Cigarette?

The yellow stains on a smoker’s fingers and teeth is caused by the tar that results from smoking tobacco.

Tar causes great damage to a person’s lungs as it kills the cilia, affecting breathing ability.

The accumulation of this substance can be difficult to imagine, but a graphic video demonstrates for people the levels of tar that is extracted from approximately 20 packs of cigarettes.

Smoking Video Shows Tar Extraction

The video Still Smoking? Watch This! shows an experiment where almost 400 cigarettes are “smoked” through water using a vacuum. The water turns brown and then eventually black as the tar is extracted from the cigarettes. The more “tarry” the water, the more smoke is trapped as well.

Cigarettes in a PileThe experimenters then boil the tar water. After the water as evaporated, only the thick black tar remains. After letting the substance dry, the result is a sticky, crusty tar crust.

This experiment was done to stimulate what substance settles in a smoker’s lungs.

More Reason to Quit Smoking

The cigarettes used in this experiment contained 18 mg of tar. Cigarette companies manufacture cigarettes in three categories:

  • low tar cigarettes with 7 mg of tar or less
  • medium tar cigarettes with 15 to 21 mg of tar
  • high tar cigarettes with 22 mg of tar or more

Cigarettes contain over 4,00 chemicals, including more than 40 known carcinogens. Tar in cigarettes is the byproduct of smoking tobacco. Tar build up in the lungs causes damage as it prevents proper functioning. The accumulation of tar in a smoker’s body contributes to several health problems, including the following few:

  • emphysema
  • bronchitis
  • lung cancer
  • chronic respiratory disease
  • mouth cancer
  • throat cancer.

Watch the video Still Smoking?

See for yourself the amount of tar that’s produced

Video Demonstrates How Smoking Destroys Your Lungs

Lung cancer accounts for approximately one third of cancer deaths in the American population.

Over $10 billion is spent annually on the diagnosis and treatment of lung cancer.

The majority of people with this disease are smokers, but former smokers and people exposed to secondhand smoke are still at risk.

What Smoking Does to Your Lungs

Smoking and exposure to secondhand smoke causes the invasion of over 4,000 chemicals into the lungs through the mouth and nose. These chemicals are deposited as tar in the lungs, sticking to the cilia. The function of the “hair-like” cilia is to keep the airways and lungs clean. When covered with tar, the cilia dies off. Germs and dirt do not get cleaned out and there is an accumulation of mucous. “Smoker’s Cough” is attributed to dead cilia. When dirty mucous clogs the airways and blocks the inhalation and exhalation of breath, a person’s reaction is to cough.

Long Term Effects of Smoking on the Lungs

Smoking destroys the body in many ways. A few of the long term consequences to the lungs caused by smoking and continued exposure to secondhand smoke includes:

  • emphysema
  • cancer
  • bronchitis
  • asthma
  • chronic obstructive pulmonary disease (COPD)

To see the difference in functioning between healthy lungs and tumor-covered lungs, watch the following video:

May 31 Celebrate World No Tobacco Day

In 1987 World No Tobacco Day was created by WHO, the World Health Organization.

With a focus on the negative health effects of tobacco smoking, the aim of May 31st is to reduce tobacco deaths each year.

Right now that number stands at about five million yearly. That number is expected to double within the next ten years which is pretty scary.

On this date WHO provides awards to individuals and organizations who have supported the cause of reducing tobacco use in exceptional ways.

We are looking forward to see to whom this year’s awards are given for their outstanding work to bring greater awareness to the world.

Ban on Tobacco Advertising

Just last year, WHO moved to lobby for a ban on tobacco advertising because of the obvious link between ads aimed to get young people to start smoking and ads that attempt to make smoking look attractive, appealing, or whatever motivator they can conjure up to market the poisons they package.

The Great American Smokeout is another world event, which is recognized the Third Thursday in November. Just in time for the holiday season. This is a gift that can keep on giving for it can save a life if a smoker stops in time.

This Years World No Tobacco Day Theme – Tobacco Health Warnings

pic-crushing-ciggysThis year the celebration is centered around warning people around the globe about the dangers of tobacco and cigarette use.

Attention is drawn to the practices that big tobacco companies partake to keep the smoking epidemic growing each year even though every year thousands of lives are lost due to the dangerous effects of smoking.

Some deaths are also due to second hand smoke, and links have been made to smoking during pregnancy and the negative effects it has on the fetus and baby.

Pass the Word – No Smoking!

On May 31st, take the lead and tell everyone you know to pass the word. One voice at a time may make the difference in someone’s life.

Watch this short video to see what the effects in just one year from the accumulation of tar in cigarettes.

 

FTC Rescinds Guidance On Cigarette Testing

For over four decades the tobacco industry has used machine testing approved by the Federal Trade Commission (FTC) to measure tar and nicotine levels in cigarettes.

But in a 4-0 vote, the FTC has now shunned the tests, known as the Cambridge Filter Method, rescinding guidance it established 42 years ago.

The National Cancer Institute (NCI) found that cigarette design changes had reduced the amount of tar and nicotine measured by smoking machines using the Cambridge Filter Method. However, there was no evidence the changes reduced disease in smokers. Furthermore, the machine does not account for ways in which smokers adjust their behavior, such as inhaling deeper or more often to maintain nicotine levels.

The FTC said the test method is flawed, and results in erroneous marketing of tar and nicotine levels that could deceive consumers into believing that lighter cigarettes were more safe.  The move means that future advertising that includes the tar levels for cigarettes will not be permitted to include terms such as “by FTC method.”  “Our action today ensures that tobacco companies may not wrap their misleading tar and nicotine ratings in a cloak of government sponsorship,” said FTC Commissioner Jon Leibowitz.  “Simply put, the FTC will not be a smokescreen for tobacco companies’ shameful marketing practices.”

Using current methods, cigarettes with a tar levels in excess of 15 milligrams per cigarette are typically called “full flavored”, while those with less than 15 milligrams are considered “low” or “light”. Cigarettes with tar levels below 6 milligrams are regarded as “ultra low” or “ultra light.”  “The most important aspect of this decision is that it says to consumers that tobacco industry claims relating to tar and nicotine are at best flawed and most likely misleading,” Matthew Myers, president of the Campaign for Tobacco-Free Kids, told Reuters.

The commission said that during the 1960s it believed that providing consumers with uniform, standardized information about tar and nicotine levels in cigarettes would help them make better decisions. At that time, most public health officials believed that reducing the amount of tar in a cigarette would also reduce a smoker’s risk of lung cancer. However, that belief no longer exists.Sen. Frank Lautenberg (D-N.J.) introduced legislation earlier this year that would prohibit companies from making claims based on data derived from the Cambridge testing method.  But the bill did not progress to the Senate for a full vote.  “Tobacco companies can no longer rely on the government to back up a flawed testing method that tricks smokers into thinking these cigarettes deliver less tar and nicotine,” said Lautenberg.

Pamela Jones Harbor, an FTC commissioner, called on Congress to approve the regulation of the tobacco industry by the U.S. Food and Drug Administration, a move that would authorize government scientists to monitor, analyze and regulate cigarette components.  Tobacco companies have been clear over the years in saying that there is no such thing as a safe cigarette.

In a statement by Philip Morris USA, the United States’ largest tobacco company, the company said it is committed to working with the federal government to identify and adopt testing strategies that improve on the Cambridge method.

FTC BuildingThe FTC said that all four major domestic cigarette makers told commissioners the 1966 recommendations should be retained until a suitable replacement test was approved.  Philip Morris told commissioners that eliminating the current guidance could lead to a “tar derby”, in which cigarette makers would employ different methods to measure yields in their cigarettes, leading to greater consumer confusion.

Source:  Red Orbit

Smoking Bad for You Inside and Out

The cosmetics sector undoubtedly cashes in on our desire to look good.

We spend large amounts of money on creams and different products to enhance or maintain our appearance.

However we often fail to remember how much what we consume affects us.

Cigarettes, which are universally acknowledged to take a toll on our lungs, are an item that can hinder our appearance as well. Whether we are simply social smokers or chain smokers, we may be doing damage to more than our lungs.

Recent research carried out by dermatologists has shown that people addicted to smoking cigarettes have around five times as many wrinkles as those who do not indulge in the habit.

Experts, noting that some studies have even proven that cigarettes yield a stronger effect than sunrays, say: “If you don’t want to experience early aging, quit smoking!”

Photo of Girl SmokingDull, wrinkled, dirty-gray skin, recognized by many as being “smokers skin,” is a phenomenon experienced by 79 percent of smokers, says Dr. Bayram Börekçi, a skin and venereal diseases expert.

Börekçi explains; “Some of the symptoms we see on smokers’ faces include permanent lines and wrinkles, as well as a collapsed facial expression resulting from the protruding bones underneath the skin.

We also see thinning skin, a light-gray appearance, as well as a light orange/purple/red coloring. The “cigarette addict’s face” is the same face seen on women over the age of 70. It is worth noting that people addicted to cigarettes start getting wrinkles very early. The amount of wrinkling is parallel to the number of cigarettes smoked over the course of a year.

Some of the factors which lead to the formation of wrinkles on the skin as a result of cigarette smoking are the widening veins due to the stimulation of the nervous system by nicotine, the reduction of oxygen in soft tissues, the increase in clotting and the reduction of collagen.”

Börekçi, mentioning the toxic, mechanical and genetic effects of smoking, notes that the reduction of moisture in smokers’ skin is connected with the toxic effect of cigarettes. The doctor also notes that the wrinkling seen around the lips of some smokers is a result of the “mechanic” effects of cigarette smoking, the muscles used when actually inhaling smoke.

He notes: “Many people believe that there are also genetic factors at play here, as not all cigarette smokers have a cigarette addict’s face. The elasticity layer in the parts of bodies which are not regularly exposed to the sun in cigarette smokers are, when compared to the same areas of the body in non-smokers, much thicker and more fragmented. The chronic reduction of oxygen to the skin also reduces the synthesis of collagen, making visible wrinkles emerge.”

He went on: “Cigarettes can cause a variety of anti-estrogen effects, such as infertility, early menopause and menstrual irregularities. The physiological effects and importance of estrogen to the skin can be seen clearly in the post-menopausal period. In women who are addicted to cigarettes, the hypo-estrogen situation that is brought about shows itself in dry skin and wrinkles.

Cigarettes reduce the levels of vitamin A in the body, which means that the cells have a greatly reduced level of protection against their number-one enemy, free radicals. This too makes it easier for wrinkles to appear. In people who already have white or grey hair, there is a yellowish color that appears in the hair because of the tar in cigarettes.

The same sort of yellowish-brown color appears on the fingers and fingernails of people who smoke. This is called a “nicotine stain.” The insides of smokers’ mouths are darker than other people’s mouths. In fact, sometimes the insides of the cheeks develop a tough, irregular whitish film. The fact that veins become narrower as a result of smoking means that it is harder for wounds to heal.

It has been shown that even smoking just one cigarette can have the effect of narrowing veins for up to 90 minutes. There are more than 4,000 chemical elements found in cigarette smoke, although it is mostly nicotine, which is responsible for the decrease in the flow of blood.”

So bearing all this mind, you might want to ask yourself: Is enjoying a cigarette really worth all this potential physiological damage you could be dealing yourself?

Seven Reasons to Stop Smoking

Do you smoke?

Thinking of quitting?

Discovery Health lists seven reasons why you should quit smoking right now.

Don’t wait another minute, read this list now, and really think about these seven reasons.

If not just for yourself, think of how you are effecting your loved ones.

They might just persuade you ditch the smokes before it’s too late…

seven.jpg1. You smell pretty bad
Bad breath and body odor, sallow skin, smelly clothes, yellow teeth – what’s not to love? Maybe it is time stub it out.

2. Food doesn’t taste as good
Smoking can permanently harm your sense of smell, which in turns affects your tasting experience. This can be reversible, but you do run the risk of permanent damage to this sensory experience.

3. More time in hospital
The carcinogens released when you light up gives you a better chance to develop cancer of the mouth, lung and throat, and your basic flu easily turns into bronchitis or pneumonia. You are more likely to spend some quality time with healthcare professionals than a non-smoker.

4. Your body ages faster
Want to look nine years older than you actually are? Then have a cigarette, don’t exercise too much and just for good measure add a bit of weight to your frame. The good news is that it is reversible. If you stop smoking, do some mild exercise and lose the weight, you can look and also feel younger than your actual age.

5. Smoking harms your children
Smoking during pregnancy can lower your child’s IQ and lead to low birth weight, still births, miscarriages, birth defects such as cleft lip and sudden infant death syndrome (cot death). Cigarette smoke contains an estimated 4000 chemicals, with nicotine, tar, and carbon monoxide thought to be the most dangerous to the fetus.

6. You have to exercise harder
Your lungs aren’t operating at full volume due to the tar and increased levels of carbon monoxide in your lungs. This poisonous gas is quickly absorbed into the blood, reducing its capacity to carry oxygen. As a result, the smoker has to exert more physical effort to attain a given task than does a non-smoker. The heart in particular must work harder, particularly during rigorous exercise. Increased levels of carbon monoxide in the blood can impair vision, perception of time, and co-ordination.

7. You can pass risks onto your kids
Like father like son… Most children of smokers will take up the habit as well or suffer the consequences of second-hand smoke.

Big Tobacco Before Congress: Ex-Tobacco Scientist Tells Story at Pinon Hills, Nevada

Minden – Students of Pinon Hills Elementary School expressed both wonder and disgust when Victor DeNoble walked around showing them a piece of a human brain.

“It looks pretty cool but kind of disgusting,” said fourth-grader Timothy Cadaret at the presentation.

DeNoble, a former tobacco scientist for Philip Morris, said he approached a 63-year-old hospital patient dying of lung cancer and asked him if he could have his brain after he died. He explained to the patient that he was conducting experiments on the effects of nicotine on the human brain.

“You’re weird,” DeNoble said the patient told him.

The patient said he also hadn’t smoked for two years. But DeNoble, who had been experimenting on rats and monkeys, was convinced that the effects of nicotine on the human brain lasted even after an individual quit smoking.

“The man told me that although he hadn’t smoked in years, he still woke up every morning wanting a cigarette,” DeNoble said.

After the man died, his wife gave DeNoble permission to use his brain for experimentation. DeNoble said his initial hypothesis was right: The man’s brain cells showed nicotine-related alteration even though he hadn’t smoked for years.

Brain Image“Young people don’t really recognize that nicotine is a drug that changes their brain,” DeNoble said.

In 1983, DeNoble took the results of his experiment to his bosses at Philip Morris. According to DeNoble, they were outraged that he had been performing experiments on the brain and not working on a safer cigarette like they had hired him to do. But DeNoble told them he had also invented a safer cigarette, one with special filters and a substitute for nicotine that could reduce tar by 80 percent.

DeNoble said at first the tobacco company seemed optimistic about the new cigarette but later changed its mind.

In April 1984, DeNoble was called to the executive offices of Philip Morris.

“Our decision is final: We’re not going to lose money, and if people have to die, that’s the way it is,” DeNoble said executives told him.

Philip Morris subsequently fired DeNoble, but only after showing him a confidentiality contract he had signed that prohibited him by law from volunteering any information about the company or the experiments he had conducted.

“I went to the lab and told my partner that we had been fired,” said DeNoble. “I told him to pull our van around back, and when he asked why, I said, ‘Because we’re going to steal top secret documents.'”

DeNoble said that he gathered everything he could in his office. He said he worked so quickly and nervously that he broke one of his desk drawers. He said he threw the drawer in a box, loaded the van and left.

DeNoble said he talked to his lab partner, and they both decided to take what they knew to Congress. They found a lawyer interested in the case, and DeNoble gave him all the boxes of evidence he had been keeping in his garage.

However, DeNoble said his lawyer called a few weeks later and said someone had broken into his office and stolen all the evidence.

“Years later, I actually found out that our lawyer sold all the boxes back to Phillip Morris,” said DeNoble.

DeNoble said nothing happened for 10 years. But then, in 1994, DeNoble found out that CEOs of the seven major tobacco companies were going to testify before Congress about whether nicotine was addictive.

“My wife, who was also a scientist, came to me and said, ‘Remember when you had all that evidence in the garage, before giving it to the lawyer? Well, I looked through it, and I kept something,'” DeNoble said his wife told him.

He said his wife had found the desk drawer he had broken and hid it away without telling him. DeNoble said after his wife informed him of its whereabouts, he retrieved the drawer and in it found evidence of the experiments he had performed at Phillip Morris.

Knowing he was prohibited by law to volunteer the information, DeNoble said he drove to New Jersey and from a discreet location mailed to the FBI a photo of the secret lab he had worked in, a photo that he had found in the drawer his wife saved. Unwilling to give his name, DeNoble said he left his fingerprints all over the picture in hopes the FBI would track him down.

DeNoble said a few days later, agents showed up to his house. DeNoble said he denied everything until they took him in for questioning.

In front of a judge, DeNoble was sworn under oath to divulge what he knew.

“What does the oath mean?” DeNoble said he asked the judge.

“It means you have to tell the truth,” DeNoble said the judge said.

Because the judge’s statement was on the record, DeNoble said he felt comfortable revealing what he knew because he wasn’t volunteering the information as prohibited in his contract but rather being ordered by the court to tell the truth.

After testifying under oath, DeNoble said he raced home and told his wife to pack up because they were going to move.

“They’re going to kill us,” he said he told his wife.

Before they could leave, DeNoble said the phone rang. The person on the phone: President Bill Clinton, DeNoble said.

He said he told the president what he knew, and told him that he was scared for his life and his family. DeNoble said President Clinton told him an executive order was being issued that would nullify his contract with Philip Morris and that the Secret Service would provide protection for his family. In fact, DeNoble said, two agents were already outside his house.

According to DeNoble, the tobacco executives testifying before Congress had no idea that President Clinton knew everything he did. DeNoble said the companies were subsequently sued for $700 billion for lying to Congress and the American people.

“I’m not here today to tell you what to do,” DeNoble told students as he concluded his lecture. “I’m just giving you information. You need to make your own decisions.”

Source: Scott Neuffer at sneuffer@recordcourier.com

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National Association of Psychiatric Health Systems Teleconference Notes

The following information is a the Position Statement on Smoking Policy and Treatment at State Operated Psychiatric Hospitals.

Silently and insidiously tobacco sales and tobacco smoking became an accepted way of life not only in our society, but also in our public mental health treatment facilities.

Revenue from sales of tobacco provides discretionary income for facilities. Smoke breaks became an “entitlement,” deserved and protected, and are one of the only times consumers can practice relating to each other and staff in a “normalized” way.

When, what, and how much to smoke are often the only choices consumers make as inpatients, reinforcing cigarette use by virtue of the autonomy it appears to allow. More troubling, cigarettes used as positive/negative reinforcement by staff to control consumer behavior.

Logo ImageWhile taking seriously and treating illicit drug use by those with mental illness for some time, a substance far more deadly and pervasive, and used disproportionately by this population, has largely been ignored. And now, a few words about tobacco. It Kills. And, it kills those with mental illness disproportionately and earlier, as the leading contributor of disease and early death in this population.

A preponderance of evidence has clearly established the deleterious health effects of tobacco smoking and second hand or environmental tobacco smoke. Science as well as experiences in mental health facilities have also shown that tobacco smoking leads to negative outcomes for mental health treatment, the treatment milieu, overall wellness and, ultimately, recovery.

Smoking promotes coercion and violence in facilities among patients and between patients and staff. It occupies a surprising amount of staff and patient’s time that could be better used for more productive activities.

It is a poor substitute for practice in decision-making and relationship building and is inappropriate as a means to manage behavior within the treatment milieu. And, while smoking can be framed as the one – choice consumers get to make while inpatients, and a personal – choice for staff, it is critical to realize that addiction is not a choice. But, quitting smoking is.

While smoking has become more socially unacceptable and prevalence has decreased in the general population, much needs to be done to assist those with mental illness to quit. Currently, 59% of public mental health facilities allow smoking. If we agree that the goal shared by consumer and physician for mental health is recovery and that health and wellness is an integral part of that recovery, the issue of tobacco use in our facilities cannot be ignored.

As individuals committed to supporting health, wellness and recovery, and entrusted with the care and management of consumers and staff in our facilities and of limited public funds, we must act on what we know. Therefore, NASMHPD stands against tobacco and will take assertive steps to stop its use in the public mental health system.

As physicians, we commit to educating individuals about the effects of tobacco and facilitating and supporting their ability to manage their own physical wellness.

We will practice the 5 A’s; ASKING individuals about tobacco use, ADVISING users to quit, ASSESSING their readiness to make a quit attempt, ASSISTING with that attempt and ARRANGING follow-up care.

As administrators, we will commit the leadership and resources necessary to create smoke free systems of care, provide adequate planning, time and training for staff to implement new policies and procedures, and ensure access to adequate and appropriate medical and psychosocial cessation treatment for consumers and staff alike.

As partners in the recovery process, we will work with national organizations and decision makers, public and private service providers, and other support systems to ensure that those who want to be tobacco free have access to continued cessation treatment and support in the community.

Health and wellness is a shared responsibility. NASMHPD is committed to doing their part to assist individuals in going tobacco free and will continue to advocate for those with mental illness in their right and hope to be well in recovery.

Approved by the NASMHPD Membership on July 10, 2006

In a health care system:

  • Figure out who smokes
  • Educate staff
  • Integrate smoking cessation into mental health tx
  • Be attentive to co morbidity, make facility smoke-free to protect pts, families, staff

Smoke Free Facilities

50% of psychiatric facilities in the U.S. are now smoke-free, with approx 1 added each month.

SSM Health Care (21 Hospitals in 4 states) became totally smoke free (indoors and outdoors) in 2004.

Outcomes:

  • Number of behavioral health outpts identified as non-smokers increased by 20% after 5 months
  • Number of behavioral health inpts identified as non-smokers increased by 7%
  • Additional inpatient benefits:
  • Former smoking areas freed up space for alternate use
  • Daily chore of managing pt smoking, arguments about smoke break times and
    access to cigarettes, all disappeared
  • Census and pt satisfaction remained stable
  • Staff satisfaction increased because all the limit-setting regarding cigarettes was
    no longer an issue
  • Pt violence decreased on inpatient units without tobacco available.

From The National Association of Psychiatric Hospital Systems, July, 2007

  • The data is simply too compelling re: loss of life and function to continue to ignore the issues of smoking and mental illness any longer. This is a leadership issue as much as a policy and practice issue.
  • We must address staff-related smoking prevalence and quitting. Otherwise, culture change will not occur.

Banning smoking in psychiatric hospitals actually reduces mayhem. Facilities that do not allow smoking report fewer incidents of seclusion and restraint and a reduction in coercion and threats among patients and staff.

EMPLOYER BENEFITS of investing in a smoke-free workforce:

  • Health care costs are 40% higher for smokers than nonsmokers.
  • Smokers are absent from work 26% more often than non-smokers.
  • Smokers cost a company drug plan about twice as much as employees who do not smoke.

Additional teleconference notes:

There are approximately 438,000 tobacco-related deaths in the US each year. 44% of all cigarettes smoked are smoked by people who also suffer from mental illness and/or substance abuse. In contrast, only 102,000 will die from drugs and alcohol.

Psychiatric patients who smoke have 7X the heart disease rate and 7X the suicide rate of psychiatric patients who don’t smoke.

One third to one half of mentally ill smokers will die from smoking.

Tobacco companies have targeted poor, mentally ill, minorities with fewer resources. Sub Culture Urban Marketing (SCUM)

The number of cigarettes a person smokes a day directly correlates with an increased lifetime risk of developing Major Depression.

9% (approx. 40,000) of tobacco-related deaths are from second-hand smoke alone. This is nearly as many who die in the U.S. from motor vehicle accidents, and twice as many from drugs (other than alcohol). The Surgeon General’s most recent report states that there is no safe level of exposure to second-hand smoke.

8.6 million people become disabled each year in the US from tobacco.

The smoke, tar, and additives are what kill people. The nicotine just hooks them.

JCAHO is requiring that hospitals and both inpatient and outpt settings be conducive to quitting.

There are 11 PROVEN human carcinogens in tobacco smoke.

Fifty more are not yet proven, but suspected.

None of these are the nicotine itself, but the nicotine is what is addictive.

20.9% of adults smoke in the general population.

75% of those with addictions or mental illness smoke. 70% of people who smoke want to quit, including
the mental health population.

30-35% of the staff in mental health settings smoke.

35% people with panic disorder smoke

49% with depression smoke

80% with EOTH dependence smoke

88% with schizophrenia/bipolar disorder smoke

Depressed smokers have higher suicide rates than depressed non-smokers. People with any psychiatric disorder who smoke have 7X the rate of heart disease AND 7X the suicide rate than similar patients who don’t smoke.

Smokers have greater anxiety and panic than non-smokers. Heavy smoking in adolescence increases risk of later developing agoraphobia, GAD, panic disorder, increased risk of relapse during quit attempt.

Alcoholics have an increased urge to drink when they smell cigarettes.

People with serious mental illness die 25 years earlier than the general population, mostly from smoking, obesity, substance abuse, and inadequate access to medical care.

Smokers with schizophrenia spend more than one-quarter of their total income on cigarettes.

Smoking affects blood levels of psychotropic drugs. It can increase medication metabolism, so higher doses are needed when smoking, with greater potential for adverse effects. Doses may need to be lowered when pts quit, increased if pts start again.

There is increasing evidence that nicotine dependence treatment does not hurt recovery from mental illness or substance abuse and may improve outcomes. A short hospital stay is an opportunity to educate, give tools.

To TX Smoking Cessation and Depression

  • NRT (nic replacement therapy) alone is insufficient
  • SSRI’s alone have no benefit for smoking cessation but can reduce chance of depression during quit
    attempt, can be combined with Bupropion, NRT, and Varenicline
  • Bupropion can be used as monotherapy for both dx’s, can be combined with varenicline, tx may need
    to extend beyond usual 3-6 months.
  • Adding CBT has had mixed results.

*Anxiety and Smoking Cessation

  • SSRI’s alone have no benefit for smoking cessation but can reduce chance of anxiety or panic during
    quit attempt.
  • Bupropion not appropriate as monotherapy, but can be combined with NRT and Varenicline.

PTSD

  • Bupropion tolerated and effective

*Alcohol Dependence

  • Standard cessation treatments are effective.
  • No evidence of increased use of other substances during cessation treatment.
  • Alcohol abstinence days are greatest for those who quit smoking.
  • Alcoholics who smoke are 10X more likely to develop pancreatitis, have a 3X greater risk of
    cirrhosis,and are at greater risk of severe brain damage associated with alcohol dependence.
    Continued smoking diminishes recuperation from alcohol-related cognitive defecits during alcohol
    abstinence.

*Cessation for Shizophrenia and Bipolar Disorder

  • Traditional cessation treatments may be inadequate.
  • Harm reduction and NRT
  • Hospitalization may be unique opportunities to initiate tx.
  • Bupropion can lead to quit rates comparable with general population.
  • Quit rates enhanced with CBT
  • Overall symptoms not worsened.

Resistance to Smoking Cessation for People with Mental Illness

  • Loved ones resist helping them quit
  • They feel protective and want to focus on quality, not quantity of life
  • But diseases caused by smoking can severely hamper quality as well as quantity of life
  • And second-hand smoke imperils loved ones and workers

Barriers to Successful Smoking Cessation

  • Provider inattention/pessimism
  • Belief that smoking cessation will adversely affect SA/MH tx
  • Co-dependency and mental illness
  • Mental health staff smoke
  • Historic attitudes about smoking in mental health community
  • No coverage for cessation drugs
  • Improper use of the drugs
  • Ignorance of quitlines 1-800-QUIT NOW
  • Lack of knowledge or risks/current research
  • Centuries-old split between treating the mind “vs.” the body
  • Social isolation of the mentally ill
  • Recovery from mental illness a relatively new concept
  • Historical use of cigarettes as behavior modification/control/reward/distraction/coping in psychiatric
    settings
  • Clash of emerging sense of inappropriateness of health care settings encouraging/permitting smoking
  • Mental health typically lagging behind other innovations and technologies in health care
  • Different agencies, funding, reimbursement (state Medicaid plans reimburse for smoking cessation; most
    private insurers don’t.)
  • Historical lack of research data (though current research demonstrates that quitting smoking does NOT
    jeopardize recovery and in fact leads to 25% greater chance of success in recovery)

Benefits From Treating Tobacco Dependence

  • Reduced morbity
  • 25% greater chance of abstinence from other substances (continued smoking identified as a factor in
    relapse to active substance abuse)
  • Reduce financial burden
  • Increase self-confidence
  • Increase focus on mental health and wellness
  • Remember that about half of smokers who want to quit will die from smoking.
  • If the cessation rate could increase to even just 10%, 1.2 million additional lives would be saved. No
    other health intervention could make such a huge difference!
  • Tobacco use negatively impacts other psychosocial issues that challenge clients in recovery: finances,
    health, HIV status, pregnancy, children’s health, treatment compliance, medications, dealing with
    feelings, social stigma

NEW DEVELOPMENTS
The National Partnership on Wellness and Smoking Cessation
Members:
NAPHS (National Association of Psychiatric Health Systems)
NASMHPD (National Association of State Mental Health Program Directors) See their tool kit “Tobacco
Free Living in Psychiatric Settings
http://www.nasmhpd.org/general_files/publications/NASMHPD.toolkit.FINAL.pdf

NAMI (National Alliance on Mental Illness). Read Position Statement section 7.3
http://www.nami.org/Content/ContentGroups/Policy/Public_Policy_Platform_April_07_marked.pdf
Depression and Bipolar Support Alliance
NASW (National Association of Social Workers)
+ approx. 20 other organizations and growing
Smoking Cessation Leadership Center Mental Health section web site:
http://smokingcessationleadership.ucsf.edu/Presentation07/NASMHPBHealth.pdf


Notes from Sally Caltrider [Retreath Healthcare, Brattleboro, VT]
Conference: July 26, 2007]

Smoking Cigarettes Effects on Lung Health

Every time you inhale smoke from a cigarette, you kill some of the alveoli, or the air sacks in your lungs.

These air sacks are where the oxygen that you breathe in is transferred into your blood.

The alveoli will not grow back.

So if you destroy them, you permanently have destroyed part of your lungs.

Alveoli Lung Air Sacks ImageSmoking paralyzes the cilia that line your lungs.

Cilia are little hair like structures that move back and forth to sweep particles out of your lungs. When you smoke, the cilia can not move and can not do their job.

So dust, pollen, and other things that you inhale they sit in your lungs and build up.

Also, there are a lot of particles in smoke that get into your lungs. Since your cilia are paralyzed because of the smoke and can not clean them out, the particles sit in your lungs and form tar.

How Smoking Damages The Lungs

The video “How Smoking Damages The Lungs,” explains in easy terms why the 4000 chemicals released by smoking a cigarette will damage your lungs.

A simple demonstration helps to give a visual perspective of the tar and chemicals that reach the lungs with each cigarette that is smoked.

The message really drives home the point that on average a smoker’s life is decreased by sixteen years.

Photos of tar in cigarettes covering lungs are shown and pictures of what is happening to a smoker over time. The different types of permanent damage that will occur are also covered.

This health video gives plenty of reasons why smoking is something that should be given up for good: