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Section 3

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ObjectivesBefore class begins, write the objectiveson the board. Have students copy theobjectives into their notebooks at thestart of class.

Use the clickers to survey student responses.

Statement three is the false state-ment. Explain that treatments existfor emphysema and chronic bronchitis,but no cures. Ask students if theywere surprised that any of the otherstatements were actually true.

Teaching Transparency W55

1. Focus

Warm-Up Quick Quiz

Risks of Tobacco Use

Sample answer: I would usethe label “Warning: Smoking

these cigarettes can kill you!” I woulduse this label because tobacco use is theleading cause of preventable death inthe United States.

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Focus On ISSUESFocus On ISSUES

Point out that tobacco is the only legalproduct that can cause death and disabilitywhen used as intended. For this reason,many people think tobacco productsshould be illegal. Other people thinktobacco products should remain legal. They

argue that adults should have the right to do what they want as long as they donot harm others. Assign groups of studentsto debate this issue. Give groups a chanceto present their debate to the rest of theclass.

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410 Chapter 16

Objectives� Describe the long-term

health risks of tobaccouse.

� Identify the long-termrisks of exposure tosecondhand smoke.

� Examine how smokingby a pregnant woman canaffect her baby.

Vocabulary• chronic obstructive

pulmonary disease(COPD)

• chronic bronchitis• emphysema• leukoplakia• mainstream smoke• sidestream smoke• secondhand smoke

Risks of Tobacco UseSection 3

Long-Term RisksIn Section 2, you read about the immediate effects that tobacco has on aperson’s health. You may have noticed some of these effects, such asstained teeth and bad breath, in tobacco users you know. What you cannotnotice, however, is the development of much more serious problems.With every dose of tobacco, users increase their risk of developing respiratory diseases, cardiovascular disease, and several different forms of cancer.

Did you know that tobacco use is the leading cause of preventabledeath in the United States? Cigarette smoking alone is directly responsi-ble for the deaths of over 400,000 Americans each year. Many more peopledie each year from cigar, pipe, and smokeless tobacco use. More than 6 million children living today may die early because of a decision theywill make during their teen years—the decision to use tobacco.

What warning label would you put on cigarettepackages? Why?

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Quick Quiz All of the following statements are true except for one. Which statement do you think is false?

In the United States, over 400,000 people die from smoking each year.

Children of people who smoke have a greater risk of developing asthma.

Scientists have developed cures for chronic bronchitis and emphysema.

Smokers die about 13 years earlier than nonsmokers.

Smokeless tobacco increases one’s risk of cardiovascular disease.

Explain why you gave the answer that you did.

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Sensitive Issues If students have family members withtobacco-related illnesses, the issue oflong-term risks of tobacco use may besensitive to them. Be careful not toimply that the sick individuals areresponsible for their own illnessesbecause they chose to use tobacco.Point out that most older smokerswere already addicted to tobaccowhen they learned of its health risks.Add that most tobacco users wishthey had never started using tobaccobecause it is so hard to stop.

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English Language LearnersSome of the section vocabulary terms,including emphysema and leukoplakia,may be difficult for students to pronounceand learn. Read the vocabulary termsaloud, and ask students to repeat the

terms after you. Students can also makevocabulary flashcards that include phoneticspellings of difficult terms. Pairs of studentscan practice pronouncing the terms andquiz each other on the definitions.

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Reading/Note Taking 16-3

Adapted Reading/Note Taking 16-3

Long-Term Risks

Building Health SkillsAccessing Information Challenge studentsto find several recent, reliable statisticsabout deaths related to tobacco use.(Examples might include: Tobacco killshalf of the smokers who do not quit;and almost one in three cancer deaths isdue to tobacco use.) Have students usethe facts to create a brochure about thedangers of tobacco use. Display thebrochures in the classroom.

Respiratory Diseases

Teacher DemoObtain a three-dimensional model ofthe respiratory system from the sciencedepartment or a physician’s office, hos-pital, or anti-smoking clinic. Trace thepath of smoke into the lungs and pointout the respiratory structures thatsmoke affects. Call on students todescribe how the structures are dam-aged by tobacco smoke.

Building VocabularyStudents who have had bronchitis maybe confused by the use of the term inthis context. Explain that it means“inflammation of the bronchi” and canbe caused by infection or smoking.When bronchitis is caused by infection,it is called acute bronchitis and can becured with antibiotics. When bronchitisis caused by smoking, it is called chronicbronchitis and cannot be cured.

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Tobacco 411

Respiratory DiseasesYou may know smokers who suffer from a hacking cough that does notgo away.“Smoker’s cough” is the result of damage caused by tar. Cells thatline the respiratory tract have hairlike extensions called cilia. The ciliamove in a sweeping motion and push mucus and particles away from thelungs and toward the throat to be swallowed.

Tar sticks to the cilia, prevents them from moving, and damages them over time. Dust, tobacco smoke toxins, and mucus then accumulatein the airways. Coughing is the body’s attempt to clear the airways.

Tobacco smoke and other accumulating toxins also irritate the liningof the bronchi. Bronchi are the tubes that carry air between the tracheaand the lungs. The bronchi become inflamed, which restricts the amountof air that can enter and leave the lungs.

Chronic Obstructive Pulmonary Disease If a person con-tinues to smoke over a long period of time, the damage that occurs tothe respiratory system becomes permanent. He or she may develop

a disease that resultsin a gradual loss of lung function.

COPD develops slowly, but its effects are severe. People with COPDfind it difficult to fill their lungs with air. Simple activities, such as climb-ing stairs, may leave them gasping for breath. Chronic bronchitis andemphysema are two types of COPD. Many people with COPD have bothchronic bronchitis and emphysema.

� Chronic Bronchitis In people with the airwaysare constantly inflamed. Over time, mucus-producing cells increase insize and number, producing more and more mucus. The constrictedairways and overproduction of mucus make breathing difficult.

chronic bronchitis,

chronic obstructive pulmonary disease (COPD),

FIGURE 7 Over time, smoking canaffect the function of many bodysystems and processes. Althoughsome of these effects may bemerely unpleasant, serious damageto the respiratory system can be life threatening.

Smoking also leads to . . .• Increased risk of stomach

ulcers

• Slower healing of injuries

• Increased colds and flus

• Increased allergies and asthma

• A constant runny nose

• Frequent headaches

• Dulled sense of taste and smell

• Premature wrinkling


412 Chapter 16

Active LearningChallenge students to create a model of lungs affected by emphysema. Forexample, students might use a new balloon to represent a healthy alveolusand a stretched out balloon to representan alveolus that has lost its shape andelasticity. Torn balloons could representalveoli that have started to break down.Set aside class time for students todemonstrate their models.

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Chapter 16, Section 3

Make a Model of a Smoker’s LungsYou may want to do this activity as aclass demonstration. Use a 1-liter bottle.Rinse and dry both the bottle and cap.The tubing should be 5–10 cm long andabout the same diameter as a cigarette.You can use a nail to make the holes inthe cap and side of the bottle. Keep theroom well ventilated to reduce students’exposure to sidestream smoke.

Make sure you get permission fromschool administrators before lighting acigarette on school grounds.

Think and Discuss Answers1. The cotton ball is brown because it is

covered with sticky tar.

2. The inside of the bottle is coated witha brownish gray film of tar.

3. Smoking coats the teeth, throat, andlungs with tar, causing irritation andpossibly cancer.

and HealthPublic Service Announcement

Have groups of students write a publicservice announcement segment that warnsabout the long-term risks of smoking onthe cardiovascular system. The PSA shouldmention increased risks of high blood

L3pressure, high blood cholesterol, athero-sclerosis, heart attack, and stroke. Arrangeto have students present their PSAs at ameeting of the school board or parent-teacher organization.

Make a Model of a Smoker’s LungsIn this activity, you will construct a simple smoking machine to demonstrate how smoking affects the lungs.

Materials• plastic bottle with cap • plastic tubing • clay• cotton ball • twist tie • cigarette • safety matches

Try ThisYour teacher will make a hole in the bottle capabout the size of the tubing. Your teacher willalso poke a hole in the side of the bottle.Thread the tubing into the hole in the bottlecap, and seal the edges with clay.Place the cotton ball over the tubing on theunderside of the cap. Use the twist tie tosecure it.Insert the cigarette into the other end of thetubing so that the side you light points up.Screw the cap onto the bottle.Squeeze the bottle to force some air out of it.Then cover the hole with your thumb.Have your teacher light the cigarette. Withyour thumb over the hole, pump the bottleslowly and steadily. This will draw air inthrough the cigarette.

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� Emphysema Recall that your lungs contain millions of tiny alveoli, orair sacs. Normally, the alveoli expand as you breathe in oxygen andcontract as you breathe out carbon dioxide. Tobacco smoke damagesalveoli tissue. The damage can lead to a disorder inwhich alveoli in the lungs can no longer function properly.

With emphysema, the alveoli lose shape and elasticity. Less oxygencan get into the alveoli and less carbon dioxide can get out. Eventually,the alveoli walls start to break down, which reduces the area in whichgas exchange can occur. As a result, people with emphysema arealways short of breath.

COPD Treatments Cigarette smoking is responsible for about 90 percent of all COPD deaths. Although there is no cure for COPD, quit-ting smoking will prevent symptoms from getting worse. Treatmentsfocus on relieving symptoms and slowing the progress of the disease.Possible treatments include medications that open airways, breathingexercises, oxygen treatments, and in severe cases, lung transplants.

emphysema,

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When the bottle is full of air, uncover the holeto let some air out. Cover the hole beforedrawing air in through the cigarette again.Your teacher will extinguish the cigarette anddispose of it.

Think and DiscussDescribe the appearance of the cotton ballafter the smoking test.What does the inside of the bottle look like?Use the model to describe what smoking doesto a smoker’s teeth, throat, and lungs.

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Twist tie

Puncturehole here

Cotton ball

Tubingand clayHands-On ActivityActivityHands-On


Tobacco 413

Cardiovascular Disease

Building Health SkillsCommunicating Have students make anintricate, illustrated concept map thatdemonstrates how the various risk factors for cardiovascular disease arerelated to or compounded by smoking.For example, three risk factors for cardiovascular disease are high bloodpressure, high blood cholesterol levels,and physical inactivity. Concept mapsshould indicate smoking increases bloodpressure and blood cholesterol. Smokersare also less able to be physically active.

Cultural ConnectionSome groups have high rates of certainconditions that can be worsened bysmoking. For example, African Americanshave high rates of high blood pressurecompared to many other groups. Ask:How might smoking affect someonewith high blood pressure? (It mightmake the person’s blood pressurehigher and increase the risk of heartattack and stroke.)

Sample answer: It wouldmake it harder to stay active,

because I would be out of breath andmy heart would be unhealthy.

Cancer

Class DiscussionAsk students to recall from Chapter 1the kinds of factors that influencehealth. (heredity, physical and socialenvironments, culture, media, technol-ogy, healthcare, behavior) Ask: Whichfactors that influence a person’s cancerrisk are discussed on this page? (socialand physical environments, behavior)What other factors might influence atobacco user’s risk of cancer? (heredity,other physical environment factors suchas air pollution)

Visual Learning: Figure 8Ask a student to answer the captionquestion. Ask other students to explainwhy the lungs of people with cancer oremphysema look so different from thehealthy lung.Caption Answer Sample answer: Thelungs of people with emphysema orcancer look misshapen and discolored.

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Tobacco 413

Cardiovascular DiseaseCardiovascular disease—diseases of the heart and bloodvessels—kill about 138,000 smokers in the United Statesevery year.

� A smoker is two to three times more likely to have aheart attack than a nonsmoker.

� Cigarette smoking doubles a person’s chances of suf-fering a stroke.

� Smokers are 10 times more likely to develop circu-lation problems in blood vessels that bring blood tothe stomach, kidneys, legs, and feet.

These statistics are not surprising when you con-sider the damage that substances in tobacco products do to the heart and blood vessels. The combined effectsof nicotine, tar, and carbon monoxide force the cardiovascular system to work harder to deliveroxygen throughout the body. Tobacco use also raisesblood pressure, which, over time, weakens blood vesselsand places strain on many organs.

Studies also show that the chemicals in tobaccosmoke increase blood cholesterol levels and promoteatherosclerosis—the thickening and hardening of arterywalls. In addition, nicotine increases the blood’s ten-dency to clot. Clots may block blood flow throughnarrowed arteries, leading to a heart attack or stroke.

How do you think smoking wouldaffect your ability to stay active asyou age?

CancerBoth tobacco smoke and smokeless tobacco containmany ingredients that are known carcinogens. Tobaccouse is a major factor in the development of lung cancer,oral cancers, and several other cancers.

Many factors influence a tobacco user’s risk of devel-oping cancer. Some of these factors include when theperson started using tobacco, how much tobacco theperson has used, and how often the person is exposed toother people’s smoke.

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YOUR LIFE

� Healthy lung

FIGURE 8 Most smokers are not fullyaware of the damage occurring to theirlungs until it is too late.Comparing and Contrasting Comparethe lungs of a person with emphysemaand a person with lung cancer to thehealthy lung.

� Lung with emphysema

� Lung with cancer

Less Proficient Readers Have students make graphic organizers ofthe effects of smoking on the cardiovascu-lar system. Tell students to include as manyas possible of the following terms andphrases: smoking, cardiovascular system,heart, blood vessels, heart attack, stroke,

circulation problems, high blood pressure,high blood cholesterol, atherosclerosis,increased clotting. Check that students’completed graphic organizers accuratelyrepresent the relationships among theterms and phrases.

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Teacher DemoPrint images of leukoplakia from theInternet. Pass the pictures around theclass for students to examine. Whetheror not students remember the termleukoplakia, they should rememberwhat the condition looks like and that it may lead to cancer. Tobacco useleads to most cases of leukoplakia, butbadly-fitted dentures and long-termalcohol use are other causes. Peoplewith an impaired immune system mayhave a similar condition called hairyleukoplakia. Point out that leukoplakiarequires medical attention.

Class DiscussionDiscuss how smoking causes cancer inorgans other than the lungs and mouth.Ask: How can smoking cause cancer inorgans that smoke does not contact,such as the pancreas and blood?(Carcinogens in smoke enter the bloodthrough the lungs and travel through-out the body.)

Secondhand Smoke

Building VocabularyHave students make a concept mapshowing their understanding of theterms mainstream smoke, sidestreamsmoke, and secondhand smoke.Concept maps should show that second-hand smoke consists of mainstreamsmoke and sidestream smoke. Conceptmaps should also show how mainstreamand sidestream smoke differ. Suggestthat students save their concept mapsfor section and chapter reviews.

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Q: I live with a parent who smokes. Howcan I reduce my risk of health problems dueto secondhand smoke?

A: Start by trying to convince your parentto quit smoking. Encouragement generallyworks better than nagging. However, if thatdoesn’t work, try to persuade your parentto stop smoking inside the house and car. Itmay help if you explain the health problems

associated with secondhand smoke. If yourparent continues to smoke inside, try toreduce your exposure to the smoke bygoing to your room, taking a walk outside,or opening a window when your parentlights up. Also, make sure you eat fruit.Studies suggest that the fiber in fruit mighthelp protect lungs from damage due tochildhood secondhand smoke exposure.

TEENS Are Asking . . .

Lung Cancer Lung cancer is the leading cause of cancer death forboth women and men. Scientists estimate that more than 85 percent of alldeaths caused by lung cancer are related to smoking. Unfortunately, by thetime most lung cancers are diagnosed successful treatment is unlikely.Only 15 percent of lung cancer patients survive for more than five years.

Oral Cancer Smoking and smokeless tobacco are also associated withoral cancers—cancers of the mouth, tongue, and throat. About 90 percentof oral cancers occur in people who use or have used tobacco. The sur-vival rate for oral cancer is higher than for lung cancer. However, surgeryto remove the cancer may be disfiguring.

Tobacco users may develop white patches on their tongues or the liningof their mouths called (loo koh PLAY kee uh). Because thesores sometimes become cancerous, they should be monitored by a doctor.

Other Cancers Tobacco carcinogens affect many organs in the body.As a result, tobacco users also have an increased risk of cancers of theesophagus, larynx, stomach, pancreas, kidney, bladder, and blood, amongother sites.

Secondhand SmokeWhen a person smokes, smoke enters the air from two sources.

is exhaled from a smoker’s lungs. Both the cigarettefilter and the smoker’s lungs trap a lot of substances before they can enterthe air in mainstream smoke. The other source, issmoke that goes into the air directly from the cigarette. Sidestream smokecontains twice as much tar and nicotine as mainstream smoke.

The combination of mainstream and sidestream smoke is calledor environmental tobacco smoke. Secondhand

smoke is inhaled by everyone near the smoker.secondhand smoke,

sidestream smoke,

Mainstream smoke

leukoplakia

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Gifted and TalentedAsk students who need an extra challenge towork together to create a Web site aboutsecondhand smoke that uses a question-and-answer format. Suggest that they first learnmore about the problem by visiting Websites of the American Lung Association,Environmental Protection Agency, or similarorganizations. Tell students that their Web

sites should inform people of the dangers ofsecondhand smoke and suggest ways toreduce the dangers. Supervise their efforts to make sure the information they post isreliable and accurately represented.Encourage other class members to visit students’ Web sites.

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Online ActivityUse the Web Code toaccess an online activity about second-hand smoke. Have students completethe Web activity.

Building Health SkillsAdvocacy Have students write a letterto the editor of a local newspaperencouraging smokers in their communityto protect the people around themfrom secondhand smoke. Letters shouldidentify the dangers of secondhandsmoke, especially to infants and children.Ask pairs of students to exchange andcritique each other’s letters. Then,encourage students to send their letters to the editor.

Journal WritingAsk students to write a journal entrydescribing situations in which they areexposed to secondhand smoke. For each situation, have them describe away they could reduce their exposure.(e.g., If a friend or relative smokes, they could ask the person to smoke outside.)

Students might say they feelirritated by the smoke and

annoyed by the smokers.

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Ear infections from secondhand smoke lead to over 1 million doctor visits each year.

Chemicals from second-hand smoke soak into hair, clothing, furniture, and other surfaces.

Millions of school days are missed each year due to illnesses caused by secondhand smoke.

Dangers of Secondhand Smoke Long-term exposure to secondhand smoke can cause cardiovascular disease, many respiratoryproblems, and cancer. In fact, secondhand smoke exposure increases therisk of a sudden heart attack by about 30 percent. Each year, secondhandsmoke causes about 50,000 deaths from heart attacks and lung cancer.

Children are especially vulnerable to secondhand smoke. Each year,secondhand smoke contributes to about 300,000 respiratory infections inchildren younger than 18 months. Children who are exposed to second-hand smoke are more likely to develop allergies and asthma. Their asthmasymptoms are more likely to be worse than those of children who are notexposed. Inhaled secondhand smoke can cause recurring, long-lasting ear infections—a leading cause of hearing loss.

Avoiding Secondhand Smoke Although secondhand smoke isstill a serious problem, great progress has been made to eliminate it.Federal, state, and local laws now prohibit or restrict smoking in manypublic places and workplaces. As smoking becomes less socially accept-able, smoking in public will become even less common.

Breathing clean air is a serious issue for everyone. The governmentand several health organizations have made great strides to protect youfrom secondhand smoke. But it is important that you also protect yourself.

� Ask smokers not to smoke around you.

� Be firm when telling guests that they can't smoke in your home or car.

� Pick restaurants that do not allow smoking or at least sit in no-smoking areas.

Describe how you feel when you are exposed tosecondhand smoke.

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FIGURE 9 About 35 percent ofchildren in the United States areexposed to secondhand smoke athome on a regular basis.

For: More on secondhandsmoke

Visit: PHSchool.comWeb Code: ctd-5163


3. Assess

416 Chapter 16

EvaluateThese assignments can help you assessstudents’ mastery of the section content.

Section 3 ReviewAnswers appear below.

Teaching Resources• Practice 16-3• Section 16-3 Quiz

ReteachHave students use the major headingsin this section to make an outline theycan use to study for a test. Their out-lines should include all of the vocabu-lary terms.

Enrich

Teaching Resources• Enrich 16-3

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Health at School

Anti-Smoking Quotes Suggest that students interview at least tenstudents. Remind students that thequotes should be suitable for youngerchildren. Help students arrange toshare their brochures with students inlower grades.


Tobacco Use and PregnancyVisual Learning: Figure 10

Have students read the warning label forpregnant women. Then have them skimthe text to find additional problems thatmay result when pregnant women smokecigarettes. Ask students to rewrite thewarning label so that it also includesthese other problems.

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3. cardiovascular disease, respiratory problems,and cancer

4. Any four: low birthweight, cerebral palsy,sight impairment, hearing problems, learningdifficulties, sudden infant death syndrome

5. Sample answer: yes, because they alsobreathe their own sidestream smoke

6. Sample answer: I think this argument isflawed, because it does not address therights of nonsmokers, who deserve to beprotected from secondhand smoke.

1. respiratory diseases, cardiovasculardisease, and several forms of cancer

2. white patches on the tongue or lining of the mouth; the patchescan become cancerous

Section 3 Review

416 Chapter 16

Section 3 Review

Key Ideas and Vocabulary1. What are three long-term health risks associated

with smoking?

2. Describe leukoplakia. Why should leukoplakia bemonitored by a healthcare professional?

3. Identify three health risks associated with exposureto secondhand smoke.

4. List four problems for which babies of smokingmothers are at risk.

Critical Thinking5. Relating Cause and Effect Do you think that

smokers are also vulnerable to the dangers ofsecondhand smoke? Explain.

6. Evaluating People who fight for the rights ofsmokers claim that smoking is a personal choiceand that they should be allowed to smokeanywhere they want to. Do you agree with thisargument? Why or why not?

SchoolHealth at

Anti-Smoking Quotes Interview your peers whodo not use tobacco. Ask them to describe howand why they made their decision. Create abrochure containing the most notable quotesalong with related facts about tobacco. Do notuse students’ names. Work with your teacher tofind out how you can share your brochure withyounger students.

SURGEON GENERAL’S WARNING: SmokingCauses Lung Cancer, Heart Disease, Emphysema,

and May Complicate Pregnancy.

SURGEON GENERAL’S WARNING: Smoking By Pregnant Women May Result in Fetal Injury,Premature Birth, and Low Birth Weight.

FIGURE 10 Despite warning labels, somepregnant women continue to smoke.However, the numbers are falling.

Tobacco Use and PregnancyMany of the harmful chemicals in tobacco smoke pass directlyfrom a pregnant woman to her developing baby. Pregnantwomen who smoke put their babies at risk for many healthproblems. Tobacco smoke increases the baby’s heart rate, reducesthe baby’s oxygen supply, and slows cell growth.

The babies born to mothers who smoke weigh, on average,six ounces less than the babies of nonsmokers. Low birthweight isa risk factor for many problems that could affect a baby through-out his or her entire life.

� Cerebral palsy

� Sight impairment

� Hearing problems

� Learning difficulties

Pregnant women who smoke also have higher rates of miscar-riages, premature births, and stillbirths than women who do notsmoke. Babies whose mothers smoked during pregnancy are alsoat much higher risk for sudden infant death syndrome (SIDS).SIDS is an unexplained disorder in which a seemingly healthybaby dies suddenly, usually while sleeping.

In addition, nursing mothers who smoke produce less milk than nonsmoking mothers. The nicotine in their milk cancause vomiting and diarrhea in nursing babies.


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