Pills, Potions, Drugs and Alcohol

Smoking cigarettes and tobacco

Acknowledgement:
Adapted from CEIDA (NSW Health) information in the 'Tobacco Brochure'.

What is tobacco?

Tobacco is dried leaves of the tobacco plant. They have been used by many cultures for hundreds of years. Most tobacco is smoked in cigarettes or pipes or cigars. There is also chewing tobacco.

Q: What's in tobacco smoke?
A: Nicotine, tar, carbon monoxide and over 4000 other chemicals.

Nicotine

Nicotine is a poison and if used in a concentrated insect spray it would be 10 times more deadly than DDT but in small doses as delivered in tobacco it is one of the most addictive substances known to man. Most smokers attempt to quit on average 7-10 times before they succeed. The tobacco industry in Australia ensures that Australian made cigarettes have only 1.4mg.

How does nicotine affect the body?

Nicotine acts on the brain within 7.5 seconds of inhaling cigarette smoke.

It is rapidly absorbed and distributed to the brain and other body organs.

It causes blood vessels to narrow, affects circulation and causes blood pressure to rise. Even one or two cigarettes will cause your blood pressure to rise, increase your heart rate and decrease circulation to your fingers and toes.

Did you know? - A one packet a day smoker will inhale more than half a cup of tar per year.

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Tar

How does tar affect the body?

Tar, along with other substances of cigarette smoke, reduces the flexibility of the small air sacs in the lungs, causing smokers cough, shortness of breadth and wheezing. Tar is the main cause of throat cancer in smokers and also causes bronchial and other respiratory diseases.

Carbon monoxide

Although carbon monoxide is odourless and colourless it is a very toxic gas. It's the same stuff produced in car exhaust fumes and smoke from fires but smoking cigarettes causes a greater concentration of carbon monoxide in the lungs than breathing polluted air.

How does carbon monoxide affect the body?

When you breathe in cigarette smoke an exchange of gases takes place in the lungs and as blood takes up carbon monoxide more readily than oxygen the result is that the blood leaving a smokers heart will contain less oxygen to supply the cells of the body. Smokers have higher levels of carbon monoxide in the blood than non-smokers and therefore have a greater risk of circulation problems, hardening of the arteries and coronary heart disease.

Immediate effects of smoking:

• Increased pulse rate
• Temporary rise in blood pressure
• Acid in the stomach
• Kidneys produce less urine
• Brain and nervous system activity stimulated then reduced
• Weaker appetite, taste and smell
• Paralysed cilia (small hair like filaments that line the airways and lungs)
• Decreased blood flow to body extremities like fingers and toes
• Dizziness, nausea, watery eyes.

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Long term effects of smoking on the body:

• Shortness of breath, coughing
• Stains on fingers and teeth
• Narrowing and/or hardening of blood vessels, particularly in the heart and legs
• Speeds up some of the physical signs of ageing, such as dry skin and wrinkles.

Increased risk of:

• Respiratory infections eg. colds, pneumonia, chronic bronchitis
• Emphysema (a chronic and progressive lung disease)
• Heart attack and coronary heart disease
• Cancer of lungs, mouth, larynx, pharynx, oesophagus (gullet), bladder, kidney, pancreas and cervix
• Stomach ulcers
• Peripheral vascular disease due to decreased blood flow in blood vessels in the legs.

Passive smoking

There are two types of smoke that passive smokers are exposed to:

1. Exhaled smoke:
The smoke that a smoker exhales - this is filtered.

2. Side-stream smoke:
The side stream smoke that drifts from the end of a cigarette into the air. This smoke is completely unfiltered therefore passive smokers are being exposed to some poisons that the smoker who smokes filtered cigarettes is not exposed to.

The effects on passive smokers depends on how long they are exposed to passive smoking and how well the room is ventilated etc. There is evidence that passive smoking is a significant cause of lung cancer in non-smokers and acute asthma attacks in asthma suffers. There is also an increased risk of sudden infant death syndrome with babies whose parents smoke.

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Why people smoke

Smokers use tobacco to fill many different needs. Studies show that most people smoke for one or more of the following reasons:

1. Smoking gives me more energy.
2. I like to touch and handle cigarettes.
3. Smoking is a pleasure.
4. Smoking helps me relax when I'm tense or upset.
5. I crave cigarettes: smoking is an addiction.
6. Smoking is a habit.
7. Smoking gives me more energy.

Understanding which need smoking fills for a person is important if they want to quit.
Finding other ways to meet these needs can make it easier to give up tobacco.

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'I reach for a cigarette when I need a lift.'

Many people use tobacco like they use coffee: to help them wake up, get moving, keep going when they feel worn out. The nicotine in tobacco, like caffeine in coffee, is a stimulant. Morning time is when (smokers) (you) have the lowest level of nicotine in (their) (your) blood as (they) (you) have been sleeping for 7-8 hours. Nicotine and Caffeine are both stimulants, and they complement each other. (Recent research has shown that smokers can handle larger doses of caffeine than non-smokers.)

'I like to touch and handle cigarettes.'

'I feel more comfortable with a cigarette in my hand.'

This type of smoker gets physical pleasure from handling cigarettes and the rituals of smoking. It just 'feels right' to have a cigarette in his hand or mouth. In fact, many smokers say they've gone back to smoking because 'I had nothing to do with my hands'.

Being prepared to Quit is a very important part of the process of quitting, planning in advance ways to deal with the physical cravings of holding and feeling cigarettes is very important.

'Smoking is a pleasure.'

'Smoking makes good times better.'

Almost two out of three smokers say they just plain enjoy smoking. When you associate smoking with the 'good times' it can strengthen your smoking habit. But it can be easier to quit when you focus on enjoying yourself without tobacco.

'Smoking helps me relax when I'm tense or upset.'

'Smoking relaxes me in a stressful situation.'

Lots of smokers use cigarettes to help them through bad times. If you've used cigarettes as a crutch, finding another way to cope with stress can help you stay quit. Otherwise, you may want to smoke again whenever problems arise.

'I crave cigarettes: I am addicted to smoking.'

'When I run out of cigarettes, its almost unbearable until I get more.'

Many smokers are addicted or 'hooked' on the nicotine in tobacco. When addicted smokers quit, many go through a withdrawal period. They may have both physical symptoms (feeling tired and irritable; headaches; nervousness) and an emotional need for a cigarette.

'Smoking is a habit'

'I smoke cigarettes automatically without even being aware of it'

This type of smoker is no longer getting much satisfaction from their cigarettes. Unlike people who smoke for pleasure, they might not miss it very much if it is stopped. The key is for them to break their smoking habits.

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Quitting smoking - the 10 stages

Smokers tend to think of quitting as a huge, insurmountable obstacle. It is more realistic - and more useful - to think of it as a gradual, step-by-step process. The following is an indication of how someone should plan to quit, what to expect along the way, and also some suggested activities to help them cope.

Stage 1: Think about cutting down / quitting

Talk to others about smoking. Observe how non-smokers react to smokers. Observe negative aspects of smoking. Smoke in front of a mirror to see exactly what you look like when you are smoking.

Stage 2: Seek more information about quitting

Ask ex-smokers how they did it. Tell a friend you're exploring healthier alternatives to smoking. When you feel an urge to smoke, wait a minute before lighting up; experience the urge fully and think of other ways to respond to it. Reward yourself for becoming more aware of your smoking patterns.

Stage 3: Modify your smoking risk (switch brands, cut down etc.)

Start a smoking journal and record when you smoke more or less than usual. Try stress-reduction techniques. Adopt a healthy new activity that's incompatible with smoking (swimming, dancing etc.). Switch to a lower tar brand. Reward yourself for each risk modification.

Stage 4: Decide to quit (no date set)

Keep track of the number of cigarettes you smoke each day. Stop buying cartons; buy one pack at a time. Identify your top cigarette triggers. Brush your teeth several times a day. List the reasons you want to quit. Switch brands every week, each brand being lower in tar than the last. Postpone every third cigarette. Ask family and friends for ways they can help you quit.

Stage 5: Set a quitting date

Sign a stop-smoking contract. Sit in the non-smoking sections of restaurants. Prepare at least three responses to your top 10 cigarette triggers. Switch brands after every pack. Postpone every other cigarette. Cut back on alcoholic beverages. Set up a health bank (deposit a certain amount of money each week that you'll get back after you stay smokeless for a specified period of time. Or quit with a group; whoever remains smokeless after a specified period divides the kitty).

Stage 6: Refrain from smoking for 24 hours

Schedule healthy activities (walks, bike rides, fishing etc.). Have your teeth cleaned. Send your favourite clothes to the cleaners. Discard all your ashtrays. Pamper yourself as much as possible.

Stage 7: Complete your first week as a non-smoker

Treat yourself to daily rewards (massages, hot baths etc.). Avoid smoking and drinking areas. Notice how much better your food tastes. Continue to work on your cigarette triggers.

Stage 8: Complete your first month

Begin a regular exercise program. Add one new stress-reduction technique to your activities each week.

Stage 9: Complete your first trimester

Gently increase your exercise level. Treat yourself to a weekend getaway. Volunteer to help a smoker quit. If you've been using a nicotine replacement, begin to cut back.

Stage 10: Complete your first year

Throw a party to celebrate!

During stages 1 through 5, you may find yourself in a state of profound and confusing guilt. Studies show that during this period a smoker's positive feelings about smoking do not disappear, although the negative feelings increase considerably. It is only after you actually quit that this conflict begins to ease.

One smoking researcher suggests you make a list of pros and cons of smoking. Chances are they will be fairly evenly balanced in stages 1 through 5. But after you have actually quit, the list of cons will get longer while the list of pros will get shorter and shorter - and gradually disappear altogether.

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What happens when you quit smoking?

• Within 30 minutes of quitting smoking, your pulse rate slows down and blood pressure drops toward normal
• Within hours of stopping, the level of carbon monoxide in your blood drops, enabling the blood to carry more oxygen
• Two days after quitting, nerve endings begin to recover and your sense of smell and taste begin to return
• Within 72 hours of quitting, your lungs' bronchial tubes expand and lung volume increases
• Months after quitting, shortness of breath diminishes
• In the first year, the risk of heart attack attributed to smoking declines for both men and women
• Two to three years after quitting, the risk of heart attack attributed to smoking is virtually gone
• After 10 years, the risk of developing cancer is about the same as for non-smokers.

Where can I go for help?

• Your GP
• National Heart Foundation
• DVA
• Victorian Smoking Health Program - QUIT
• NSW Cancer Council
• The National Tobacco Campaign

For information about quitting, contact:

Quitline on 131 848

On the web

• Oxygen website
  www.quitnow.info.au
• Tobacco Control Supersite
  http://www.ceida.net.au/tools_for_workers/drugs/tobacco.html
• ASH - Action on Smoking & Health Australia
  www.ashaust.org.au
• Life Education
  www.life-educationaustralia.com.au

Further reading

Tobacco in Australia: Facts and Issues 1995

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