Institute for Oncology and Radiology of Serbia Ana Jovićević Institute for Oncology and Radiology...
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Transcript of Institute for Oncology and Radiology of Serbia Ana Jovićević Institute for Oncology and Radiology...
Institute for Oncology and Radiology of SerbiaAna JovićevićInstitute for Oncology and Radiology of SerbiaAna Jovićević
HEALTH EFFECTSHEALTH EFFECTSHEALTH EFFECTSHEALTH EFFECTS
OFOFOFOFSMOKINGSMOKING
Belive it or not
• Tobacco causes 5 million deaths per year
•In the 20th century, 100 milion people were killed by tobacco • In the 21st century, 1 billion peole will be killed
Smoking kills ½ of smokers! Smoking kills ½ of smokers! HHalf alf of them will die of them will die in middle agein middle age
The only legal produt that kills when used as prescibed
6000 BC: first cultivation of the tobacco plant in the Americas
Around 1 BC: use of tobacco by natives of Americas
For ceremonial and religious purposes, as hallucinogen
Chewing, smoking, drinking syrup, licking paste, snuff, rubbing into skin/eyes, tobacco enemas… trance-like state (nicotine intoxication)
How did we end up here?How did we end up here?
History of tobacco useHistory of tobacco use
Columbus is to blame for everything
1492: Columbus brings tobacco back to Europe
1614: tobacco shops opened in England
1788: tobacco reaches Australia with the convicts
Rodrigo de Jerez, crew member of Columbus’s ship, became addicted to smoking; on return to England, he was imprisoned and killed by the Inquisition which believed he was possessed by the devil
The Tobacco Epidemic, Gary HuberNational Archives and Records Administration
Epidemic of cigarette smoking
At the end of 18th century, tobacco chewing became unpopular – fear of TB transmission through spitting
Tobacco industry reacted quickly – they increased the production of “practical and safe” cigarettes
Cigarettes included in
rations during: WW I and II
up to 80% smokers among men serving in military (Great Britain, US)
Practicing marketing on women…
Smoking was considered unacceptable for women
1920s: women first became the targets of the tobacco companies
“To keep an slender figure, reach for a Lucky instead for a sweet”
1968, Philip Morris links cigarettes with women's liberation: ”You’ve come a long way, baby !”
…and on youth
1913 R.J. Reynolds Tobacco Company: Camel
1964: Marlboro Man
Early Efforts to Control Tobacco Use
1604 King James I of England: “Counterblast to tobacco”
1633 Sultan Murad IV , Turkey: tobacco and coffee users to be executed as infidelsDuring the night, he would disguise himself and wander around looking for people smoking or drinking coffee and executing them
1638 Quing dynasty: decapitation for use/distribution
1771 France: hanging for tobacco users
1624 Pope Urban VIII: threatened to excommunicate snuff users
Since 1950: over 60,000 studies confirming impact of tobacco use on morbidity and mortality
British doctors study
Sir Richard Doll, Austin Bradford Hill, Richard Peto
34.439 british doctors followed-up from 1951 to 2001Evaluating and publishing results ≈ every 10 years Irrefutable scientific evidence for harmful effects of
smoking and benefits of quitting smoking
Tremendous effects on smoking prevalence in GB
“It became serious when doctors realized that not only patients die from tobacco but doctors as well...”
Richard Doll (1912-2005) presented his 50-year results at a press conference in 2004
Decrease in number of smokers in GB
Prevalence of smokers:
• 1950: 80% men
• 1970: 50% women
• 2002:
27% men
25% women
1950 1960 1970 1980 1990 2002
0
20
40
60
80
%
80%
50% 27%
25%
% smokers
“Mortality in relation to smoking:50 years’ observations on male British doctors”Doll R, Peto R et al. BMJ 2004; 328: 1519-28
1964 US Surgeon General’s Report on Smoking and Health
Based on the analysis of 7,000 studies
Conclusion: smoking is the main cause of lung cancer
Impact on tobacco consumption in the US
14
12
10
8
6
4
2
Cigarette consumption
per adultper day (m+f)
1880 1890 1900 1910 1920 1930 1940 1950 1960 1970 1980 1990 2003
100
80
60
40
20
0
US: cigarette consummation and LC mortality
LC mortality rates
www.deathsfromsmoking.net
1964 US Surgeon General's Report
LC – rare disease until the 30’s
Latent period
Tobacco smoke: 7.537 componds -tobacco constituents (1/2)-- combustion products
-- aditives Numerous toxic compound and 70 carcinogens!
h.cyanide – death penaltymetanol -rocket fuelleadpolonijum 210propilen glicol –antifreeze radoncarbon monoxide
amonic aceton e arsenbenzen - napalmbutan (lighter)cadmium - bateriesDDT – pesticide phenol – toilet dezinfectionformaldehyde- balming
THERE IS NO TRESHOLD !
NICOTINE
Smoking and cancer
Lung cancer – 90% of cases Lung cancer – 90% of cases
cancers of...cancers of...•ooralral cavity cavity•nasal cavitynasal cavity•larynx, pharynxlarynx, pharynx•oesophagusoesophagus•sstomachtomach•large bowelbladderlarge bowelbladder•KidneyKidney•pancreas pancreas •lliveriver•ccerviervix uteryx utery
Ishaemic heart diseaseHeart attack StrokeVascular dementia
PPeripheripheraleral vascular disease vascular diseaseProlonged would healingProlonged would healing......
Cardiovascular diseases
• Chronic obstructive lung disease
• EmphisemaEmphisema• Chronic bronchitisChronic bronchitis• Ear infectionsEar infections• PneumoniaPneumonia• AsthmaAsthma
Respiratory diseases
Reproductive health
MEN: reduced fertility , impotenceWOMEN: reduced fertility, earlier menopause
PREGNANCYPregnancy complicationsSpontaneus abortionPreterm delivery
BABYLower birth weightSudden infant death syndrome Reduced pulmonary functions
Passive smoking
Immediate effects• Irritation of airways • Difficult breathig• Cough, sneezing• Eye iritation• Headache• Nausea• Vertigo • Lower concentration• Odour
LongtermCancerCardiovascular diseasesRespiratory diseasePregnancy complicationsFetal growth, chilhood health
Benefits of quitting
At 20 minutes after quitting:Blood pressure decreases, pulse rate dropsBody temperature of hands and feet increases
At 8 hours: Carbon monoxide level in blood drops to normalOxygen level in blood increases to normal
At 48 hours: Ability to smell and taste improves
Between 2 to 9 weeks: circulation improves, walking and exercise easier , lung function increases.
By 3 months: fertility improves
By 9 months: no shortness of breath, or coughingfatigue improved
By 1 year : risk of coronary heart disease is already at half
By 10 years: risk for lung cancer similar to the risk in nonsmokers
Prevalence of smoking in men (2009)2008 ili poslednji raspoloživi podaci
Kiribati 71%
Greece 63%, Albania 60%, Russia 59%
Niger 7%, Gana 8%The Tobacco Atlas 2012, ACS / WLF
Sweeden 13%
The Tobacco Atlas 2012, ACS / WLF
Učestalost pušenja kod žena
Nauru 50%, Kiribati 43%
x
Nigeria... 0,2% Azerbaijan 0,6%
Austria 45%, Greece 41%,B&H 36%
Belarus 9%
Prevalence of smoking in women
What about Serbia ?
Institute for Public Health of Serbia survey
Smoking prevalence in adults 2000.g. 2006.g.
48 % 38 % in men (↓ 10%)
34 % 30 % in women (↓ 4%)
Exposure to secondhand smoke
66% 62% at home (↓ 4%)
56% 45% at work (↓ 11%) 31% AFTER THE NEW LAW!
In Serbia, tobacco kills 4 times more people than all the accidents and injuries togeather!
Smoking:
16 016death
per year
3 809
Deaths due to:InjuriesPoisoningMurderSuicideTrafic accidentsAccidents at workplaceAccidents at homePlaincrashDrowningFireFlood....
Do you mind if I...
... burn a hole in your shirt, spill ashes in your coffee, cough on your food, smell up your hair and clothes, and double your chance of getting cancer?