Tobacco Statistics

TOBACCO CESSATIONAngela F. Testa, CHES, TTSHealth Services ConsultantAetna, Inc.Tobacco StatisticsCigarette smoke contains over 4,800 chemicals, 69 of which are known to cause cancer. Smoking is directly responsible for approximately 90 percent of lung cancer deaths and approximately 80-90 percent of COPD (emphysema and chronic bronchitis)deaths.

In 2009, an estimated 46.6 million, or 20.6% of adults (aged 18+) were current smokers. The annual prevalence of smoking declined more than 50 percent between 1965 and2009.

http://www.lung.org/stop-smoking/about-smoking/facts-figures/general-smoking-facts.htmlMarian2Tobacco StatisticsPercentage of U.S. adults who were current smokers in 2011:1019.0% of all adults: 21.6% of males, 16.5% of females (43.8 million people)

Cigarette smoking costs more than $193 billion (i.e., $97 billion in lost productivity plus $96 billion in health care expenditures).http://www.lung.org/stop-smoking/about-smoking/facts-figures/general-smoking-facts.html & http://www.cdc.gov/tobacco/data_statistics/fact_sheets/fast_facts/Marian3Types of TobaccoCigarettes, Cigars, Cigarillos, Smokeless, Snuff, Snus, Pipe, Dip, Spit, Chew, Bidis, Dissolvable, Hookah, Kreteks

There is no safe level of tobacco use. There is no safe form of tobacco use. All forms contain nicotine and can cause addiction and health problems.

Cigars, Cigarettes, CigarillosRegular cigars are larger than cigarettes and do not have a filter.Little cigars or cigarillos are very similar in size and shape of cigarettes, have filters and are filled with pipe tobacco. They often have a flavor. They are sold in packs of 20 just like cigarettes.

SMOKELESS TOBACCOTwo main types of smokeless tobaccoChewing Tobacco Comes in the form of Loose Leaf, Plug or TwistSnuffFinely ground tobacco that can be dry, moist, or in sachets

Smokeless TobaccoHolding an average-size dip in your mouth for 30 minutes gives you as much nicotine as smoking three cigarettes. A 2-can-a-week snuff dipper gets as much nicotine as a 1-1/2 pack-a-day smoker does.

A can of dip costs an average of nearly $3. A two-can-a-week habit costs about $300 per year. A can-a-day habit costs nearly $1,100 per year. Likewise, chewing tobacco costs about $2. A pouch-a-day habit costs over $700 a year.

Marian7 About NicotineNicotine is harmful to the developing brain.

Less than one tablespoon is enough to kill an adult and as little as 1 teaspoon could kill a child.

Liquid nicotine can be lethal when inhaled. Also harmful when ingested or absorbed through skin.

Side Effects of Nicotine

How Long Does Nicotine Stay in the BodyNicotine patches and gums contain a specific dose of nicotine that is designed to clear from the body after a short period of time. Nicotine absorbed by the body through smoking, chewing and other tobacco use can linger for a longer period of time. Each person's unique metabolism also plays a role in how quickly the body gets rid of nicotine.

Nicotine withdrawal symptoms usually peak between 12 and 24 hours after the last cigarette. As the nicotine slowly leaves your system, these symptoms will decrease.

http://answers.webmd.com/answers/1200374/how-long-does-nicotine-stay-in-the-bodyMarian10

Marian11Types of NRT GUM

White Ice Mint, Fresh Mint, Cinnamon Surge, Fruit Chill

How to Use:Chew the gum slowly until you feel a tingle in your mouth (peppery taste)Park the gum between your cheek and gumWhen the tingle is gone, chew a few more times to get it back, then park againRepeat this procedure for about 30 mins to release most of the nicotineFood or drink can affect how well the nicotine is absorbed. Do not eat or drink 15 before and during gum useMarian12Types of NRTGum

Dosage:More than 25 cigarettes a day or smoke within 30 mins. of waking 4 mg, up to 24 pieces per day

Less that 25 cigarettes a day 2 mg, up to 24 pTypes of NRTGUM

Possible Side EffectsHiccupsNauseaJaw DiscomfortRacing HeartbeatThroat irritationThe gum can also stick to and damage dentures and dental work.

Types of NRTGUM

Advantage for Use:Fast ActingAllows you to control nicotine dosesCan be used as needed or on a fixed schedule (1-2 pieces per hour)Good choice if you have sensitive skin and cannot use the patch

Types of NRTLOZENGES: (mini or regular)

2 or 4 mgRegular Mint or Regular Cherry Mini Lozenges only come in mint Size of a Tic TacFaster acting

Types of NRTLOZENGES:

DOSAGE:

Smoke first cigarette more than 30 mins after waking 2 mgSmoke first cigarette within 30 mins of waking - 4 mgHow to Use:Place lozenge in mouth and allow to dissolve slowly (20-30 mins)Do not bite or chew and do not swallow.Do not use more than 5 lozenges in 6 hours or 20 lozenges/day.Do not use while drinking hot or cold beverages

Types of NRT LOZENGES

Possible Side Effects:NauseaHiccupsCoughing Trouble Sleeping Heart BurnHeadache

Types of NRT PATCHES

Give a measured dose of nicotine through the skinDosage:16 or 24 hour patchMore than 10 cigs/day: 21 mg x 6 weeks; 14 mg x2 weeks ;7 mg 2 weeksFewer than 10 cigs/day:14 mg. x6 weeks; 7 mg x2 weeks

Types of NRT Patches:

Possible Side Effects:Skin Irritation Racing HeartbeatSleep problems or unusual dreamsHead AcheNauseaTypes of NRTPATCHES:

What to do about side effects:

Sleep problems may go away after 3-4 days. If not try switching to 16 mg patch or remove patch before bedtime.Try using a lower dose patchStop using and try a different form of NRT.Use a hydrocortisone cream for minor skin reactions

Contraindications for NRT1. Under 18 years of age 2. Pregnant or breast feeding 3. Plan on continuing to smoke, chew tobacco, use snuff, or other nicotine containing product 4. Heart disease, recent heart attack, or irregular heartbeat 5. High blood pressure, not controlled with medication 6. Using a non-nicotine stop smoking drug 7. Taking a Rx medicine for depression or asthma. Dose may need to be adjusted 8. Stomach ulcer or diabetes (Gum & Lozenge onlyrecommend Patch) 9. Sodium restricted diet (Gum & Lozenge onlyrecommend Patch) 10. Allergy to adhesive tape (Patch onlyrecommend Gum or Lozenge)

https://aetsps.aetna.com/sites/WellnessResourceTool/HealthyLifestyleCoaching/Nicotine%20Replacement%20Therapy/NRT%20Decision%20Tree_Rev%203-1-12_Aetna%20(2).pdfMarian22ZYBAN (Wellbutrin, Bupropion)

Dosage:MD prescription150 mg in the am for first 3 days. On the 4th day begin taking one 150 mg. tablet in am and on 150 mg. tablet in the evening. Take at least 8 hours apart.Begin taking 8-15 days before quit date.Continue use for at least 7-12 weeks.Pharmacologic Products Pharmacologic Products ZYBAN

Contraindications:Seizure DisorderCurrent or prior diagnosis of bulimia or anorexiaAre abruptly discontinuing use of alcohol or sedatives< 18 years oldPregnancy and Breast FeedingPharmacologic Products CHANTIX

Dosage:Days 1-3: take white .5 mg. tablet once per dayDays 4-7: take white. 5 mg. tablet twice per dayDay 8: Take 1 blue tablet once per dayStart taking one week before quit date

Pharmacologic Products CHANTIX:

Most Common Sid Effects:NauseaVivid DreamsConstipationGasWhen to Use or Not to Use NRTWhen Not to Recommend the PatchesSmokes 5 or less a day (offer 2 mg lozenges or gum as an alternative)When Not to Recommend any NRTSmokes a few cigs every other day or smokes sporadically (examples include: situational smoker, social smoker, etc.)

Marian27Electronic CigarettesDeveloped in China and introduced to the US market in 2007.E-cigs, Vapors, Personal VaporizersMany brands, flavors, and nicotine strengthsConsists of a cartridge filled with liquid, vaporization chamber and an indicator light. Runs on lithium battery.E-cigs heat up liquid. The liquid turns into a vapor which is then inhaled of vaped.

Electronic CigarettesCurrently not regulated by the FDAProposed FDA Regulations:Banning sales to minorsMakers to register with the FDAFDA approval to market productsApproval to make direct and implied claims of of reduced riskInclude Health Warnings31Electronic CigarettesWhat the new rules dont cover:

Do not ban online sales, TV ads, or flavored e-cigs

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