Unit 4 Chapters 12 13 14 15 Chapter 12 1 Smoking tobacco 2 Objectives 3 History of tobacco 4 Who smokes a Early explorers learned to smoke from Native Americans b Grows well in VA and NC i Took practice back to Europe c Spread to other places quickly d Some emphasis on trying to curtail it but it took off e Highest rates of smoking in early 20th century In 1963 more than 50 of men in the US were cigarette smokers i ii Especially cigarettes but before that pipes and things iii Declined by 50 since 1965 smoked a 21 of Americans are smokers 21 are former smokers and 58 have never b Predictors i Men lower income lower education HS more than college grads lower intelligence higher impulsivity less health conscious c In order i 23 Native Americans highest rates of tobacco use ii 15 European Americans more likely to smoke to control weight iii 9 Hispanic Americans iv 6 5 African Americans v 4 Asian Americans lowest rates of tobacco use d Those that are depressed are more likely to smoke impulsive men depression less health conscious lower income American Indians lower education lower intelligence e Strongest biggest predictors 5 Why smoke a Genetics i Education and Ethnicity i Twin studies since 1950 Identical twins have more similar rates of smoking than fraternal twins 1 2 There is a genetic component ii Genes that regulate dopamine functioning 1 May be responsible for relationship between inheritability and 2 A neurotransmitter than affects pleasure and reward center of iii Gene environment interaction Initiation and genetic predisposition X environmental factors 1 2 When control for genes the environment matters 3 Environment can cause genes to be expressed or turned on or smoking the brain not 1 b Social pressure iv Genetic predisposition in who 1 Starts smoking 2 Quits smoking 3 We see a genetic relationship among those that relapse a Common to relapse 85 of people v Should we tell people there s a genetic component 1 Causes distress when we tell them they have a predisposition to 2 People are not more likely to quit smoking if you tell them they smoke have a genetic predisposition to smoke i Starting to smoke results from a social contagion process ii Social contagion smoking doesn t occur in isolation 1 Being in the presence of smokers can reduce perception that iii Nonsmokers are more likely to smoke when contacted by friends who smoking is harmful are smoking 1 Behaviors contagious like the flu 2 Over 70 of all cigarettes smoked by an adolescent are smoked in the presence of a peer smokers iv Once they are smokers they often desire or prefer the company of v Smoking can spread in groups and quitting smoking can spread in vi Can feel pressure to smoke from seeing people smoke on TV and groups movies 1 Even if they don t know people that smoke 2 See less smoking on TV now than before 3 More in period pieces like Mad Men c Advertising and marketing is related to smoking behavior In particular adolescents and teen smoking i ii Advertising and smoking boosts smoking among older adolescents iii For years ads targeted youth iv Said cigs influence youth tobacco company said no v Study 1 6 year olds showed Jo Camel and Mickey Mouse 2 They identified both 3 60 of all cigs smoked by teens were Camels 4 Settled out of court 5 Removed Jo Camel from ads i Young girls ii Adolescents may begin smoking to control weight 1 They re likely to engage in other unhealthy behaviors to try to control weight diet pills laxatives iii Some smokers don t quit because they re scared to gain weight 1 More common for women 2 Of women who smoke for this reason pregnant women d Weight control 2 e Addiction to smoke for weight control iv Younger more likely v Euro American more likely i When blood levels of nicotine begin to reduce to smoke for weight control Irritability 1 Withdrawal symptoms 2 3 Depressed mood 4 Sleep disturbances 5 Increased appetite 6 Cognitive problems not thinking clearly 7 Craving cigarettes ii Nicotine affects dopamine 1 Dopamine is related to pleasure and reward sensations 2 Cocaine also affects dopamine levels iii Smoking can improve performance and affect mood iv Nicotine affects 1 Acetylcholine 2 Norepinephrine 3 Dopamine 4 Endogenous 5 Vasopressin 6 People may smoke to affect these v Acetylcholine norepinephrine can increase memory vi Acetylcholine can reduce anxiety and tension vii Dopamine norepinephrine and opioids can improve mood viii Performance on basic tasks can be improved by ix Habitual smokers who quit experience memory impairments and poor x Other factors associated with smoking that people find pleasurable 1 Acetylcholine and norepinephrine concentration 1 Ritual 2 Feel of cigarette 3 Smell of cigarette xi Nicotine addiction is complex f Positive and Negative reinforcement i Positive a motivating stimulus is present after the behavior is 1 Smell 2 Way it feels in hand 3 Pleasure in smoking 4 Enjoy some stimulus that comes with smoking ii Negative an aversive stimulus is removed after the behavior is exhibited exhibited 1 Feel less anxious anxiety reduced after smoking 2 Feel less stressed 3 Experience less other negative emotions 4 Avoid withdrawal symptoms 5 Reduced boredom 3 iii Optimistic bias happening to them 1 Many people who smoke have an optimistic bias 2 Underestimate the number of negative health consequences 3 Study chances you ll live to 75 a Smokers overestimate b Nonsmokers more accurately estimated their life 6 Consequences of Smoking a Biggest cause of preventable death b Cancer expectancy i Smoking associated with lung lip oral cavity esophagus pancreas ii For many years rates of lung cancer rose but are now decreasing larynx trachea bladder and kidney c Smoking by itself d Smoking with other risk factors e Biggest cause of death in developed countries i Synergistic effect i 443 000 deaths per year in US f Most smoking deaths due to cancer 1 in 5 of smoking related deaths g Smoking is associated with more cancers than those on slide h 1950 1989 a large number of deaths due to lung cancer i CVD and smoking i Decreasing since then especially in men i Smoking doubles risk for CVD ii Smoking accounts for 30 of CVD related deaths iii Of smoking related deaths 1 Most attributed to cancer 2 2nd reason is CVD j Chronic lower respiratory disease i 3 rd leading cause of death in the US ii Chronic bronchitis causes limited air flow k Emphysema walls in lungs destroyed not as much oxygen flow l Cig smoking accounts for the majority of these deaths m Other