Making Wise Decisions about Tobacco, Caffeine and Drugs

Tobacco

Looking Back

• More than 4,000 people under the age of 18 begin smoking in the U.S. everyday, which is almost 1.5 million each year

• FDA can restrict and regulate access to tobacco products and control the labeling on tobacco packaging. However, the advertising cannot be regulated by the FDA.

Prevalence of Tobacco Use In Women

• There are 46 million smokers in the U.S.
• 21 million of them are female; at least 1.5 million are adolescent girls
• One half of all long-term smokers will die based upon this habit
• Ethnicity, education, and socio-economics are factors in the probability that a woman will die prematurely from the use of tobacco

Why Women Smoke

• Media influence is pervasive, compelling, and influential
• In 2008, the tobacco industry spent $9.94 billion on cigarette advertising
• The idea of smoking gave women the portrayal of having freedom and choice, a show of strength and purpose
• Other factors included parental modeling, peer pressure, maintaining weight, and their environment

Substances in Tobacco

• Over 4,000 chemical compounds are found in tobacco smoke
• Particulate phase (small particle compounds)

- Nicotine

• Physiologically and psychologically addictive stimulant
• Constricts blood vessels and bronchial tubes
• Causes serious effects upon the cardiovascular system

- Carbon Monoxide

• One of the 270 poisonous gases in tobacco smoke

- Tar (phenol, cresol, benzopyrene, DDT)

• Accumulates in the alveoli (sacs in the lung tissue) and inhibits lung function
• Disables the function of cilia
• Precursor to oncogenes

Adverse Health Effects

Respiratory Concerns

• Bronchiectasis is a condition that develops within the bronchial tree and results in irreversible dilatation and destruction of the bronchial walls
• Chronic Bronchitis (inflammation/infection of air passageways) is characterized by long-term and persistent coughing
• Emphysema (destruction of the alveoli) is a lung disease that reduces air exchange
Adverse Health Effects: Cardiovascular Diseases
• Women who smoke have a greater chance of developing heart disease and stroke than non-smokers
• Smoking is the leading risk factor for the following

- Myocardial infarction risk
- Sudden cardiac death risk
- Development of Angina
- Increase of Platelet Adhesiveness

• Tobacco is a vasoconstrictor, which becomes potentially dangerous to the blood supply to the heart
• Smoking is also linked to change in blood chemistry
• The use of oral contraceptives and smoking cigarettes increases the risk for a woman to have a heart attack vs. only smoking

Smoking and Cancer

• There is a strong relationship between smoking and the development of cancer sites at:
• Larynx
• Pharynx
• Lungs
• Stomach
• Uterus
• Kidney
• Smoking accounts for 80% of all lung cancer deaths in women
• Lung cancer deaths are the leading cause of cancer deaths for women annually

Other Physical Consequences

• There are other health conditions related to tobacco smoking that affect women

- Cataract formation
- Adult onset Leukemia
- Reduction of bone density/bone loss
- “Smoker’s face” (deep facial wrinkles)

• As the result of using tobacco, 40% will die prematurely of diseases that would not have developed, if smoking did not occur

Addiction

• Tobacco users develop a physiological and psychological dependence on nicotine
• Studies show that between a third to half of all smokers become addicted
• Over 90% of women who smoke develop a dependence on nicotine
• A woman’s body cells adapt to a certain level of nicotine, compelling this user to maintain that level of nicotine
• Withdrawal symptoms are unfavorable, creating a difficult bond to break
Environmental Tobacco Smoke
• Referred to as passive or involuntary smoke

- Mainstream (smoke inhaled by smoker)
- Side-stream (smoke from the burning product)

• Effects include:
• Increase in indoor pollution
• Watery, itchy eyes
• Coughing, wheezing
• Increased levels of stress
• Unpleasant odors on clothes, skin, hair
• Respiratory problems for children and pets

Smoking and Pregnancy

Reduction of fetal blood flow
Ability of fetus to metabolize vitamins is reduced
Ectopic pregnancies and miscarriages risks are greater
Premature labor and low birth weight
Learning disabilities
Sudden Infant Death Syndrome (SIDS)
Increased chance of hemorrhaging during delivery
Increased chance of having a stillborn during delivery
Hospital stays are longer
Mothers heal slower
Must spend more time caring for newborns due to difficulties of feeding, digestion, sleeping, and restlessness

Smoking Cessation

• Behavioral Changes
• Counseling and support groups
• Smoking Cessation Products

- Over-the-Counter - gum, patches, lozenges
- Prescription – nasal spray, inhaler
- Medication – Bupropion, Varenicline

How to Stop Smoking!

• Make a decision to quit
• Set a quit date
• Make a plan
• Change smoking-related habits
• Deal with withdrawal
• Stay tobacco-free

Benefits of Smoking Cessation

• Food begins to taste and smell better
• The smoker smells better
• The cough disappears
• Your energy begins to return
• Sick days are reduced
• Fewer complaints about overall general health
• Miss fewer days of work and play, in lieu of sickness

What is Caffeine?

• Chemical compounds known as methylxanthines (CNS stimulant)
• Caffeine, taken into the body in a water-soluble form, is absorbed in to the bloodstream via the small intestine
• It may be passed into the placenta and to the fetus of any pregnant woman
• Products with caffeine: coffee, tea, soda, chocolate, medications

Effects of Caffeine

• Caffeine produces a wide variety of stimulating effects upon the body
• Many food products contain caffeine these days
• It has been demonstrated to do the following:
• Increase alertness
• Decrease reaction time
• Reduce drowsiness
• Can enhance athletic performance by assisting with fat metabolism and possibly delaying exhaustion following exertion
Effects of Caffeine on Health
• Osteoporosis and Caffeine
• Relationship of substituting caffeine beverages instead of calcium-containing products, causing possible bone loss
• Pregnancy and Caffeine
• Pregnant women increase the risk of miscarriage if they drink over 2 cups of coffee/day
• Decreased birth weight could be associated with intake
• Breast Health and Caffeine
• No relationship has been found to substantiate the relationship between caffeine use and fibrocystic breast disease

Illegal Drugs

Drug Use and Pregnancy

• Consequences to the fetus due to a woman’s abuse of illegal drugs during pregnancy is a grave concern
• Most drugs pass easily from the mother’s blood through the placenta
• Overall, drug use results in lower levels of oxygen and nutrients reaching the growing cells of the fetus
• If screening tests reveal a positive drug result, immediate medical and anti-drug treatment need to begin

Cocaine and Crack

• Cocaine comes from a plant, Erythroxylon coca which produces an exhilarating effect
• Crack is a rock-like substance, resulting from mixing cocaine with baking soda or ammonia.
• Psychological and physical dependency develop with short and long-term use
• Research has found the following the following consequences of this drug during pregnancy:
• Intrauterine growth retardation
• Premature labor and spontaneous abortion
• Other complications such as premature separation of the placenta
• Severe consequences upon the fetus and newborn can be profound

Marijuana

• Marijuana can produce sedating, hallucinating, intoxicating and/or analgesic effects
• Chronic long-term use can effect the following body systems:
• Central Nervous System
• Respiratory System
• Cardiovascular System
• Reproductive System
• THC easily can cross the placenta of the mother to the fetus, however, research is still lacking in this area

Heroin and Methadone

• Heroin is a very addictive, semisynthetic narcotic produced from chemically changed morphine
• Produces a dream-like state and creates a strong physical and psychological dependency
• Can cause women to resort to life-threatening activities in order to fulfill their addiction
• Methadone is a synthetic narcotic, intended to be a legal replacement for heroin or morphine
• High risk births are associated with the use this drug as well as newborns.

Amphetamines and Methamphetamines

• Stimulants, produced synthetically, increases the activity of the CNS
• Abuse of these drugs can produce strong psychological dependence
• Women who abuse these drugs reduce their quality of life and the lives of their children and family
• Damage upon major organs of the fetus is profound during pregnancy
Women, Drugs, and HIV Infection
• The number of women who contract HIV is increasing at a rate almost 4 times faster than men
• HIV can be passed on to their unborn children
• The association between women drug users and contracting HIV or other STI’s is a serious concern
• Awareness, prevention, and support services are needed to help diminish the connection between women, drugs, and HIV
Women, Drugs, and Homelessness
• Use of drugs, including alcohol, is a major risk for women and children as it relates to homelessness
• Being involved with drugs will interfere with a woman’s ability to locate employment, purchase essential resources, and medical services for her and the family
• Even though less women are homeless compared to men, women usually have the responsibility for children, placing them as risk
• Treatment programs are needed for homeless women that would address the issues of childcare, healthcare, and drug addiction