Womens Health 13

© 2008 McGraw-Hill Higher Education. All rights reserved.

Chapter Thirteen

Making Wise Decisions about Tobacco, Caffeine, and Drugs


Women and Tobacco Use

• There are 46 million smokers in the U.S.• 22 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• Since 1980, more than 3 million U.S. women have died

prematurely based on smoking tobacco• 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

• The idea of women using smoking tobacco was introduced in 1919 by the media, however, was considered illegal years prior

• 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


Smoking and Body Weight

• Nicotine decreases the strength of hunger contractions of the stomach, increases blood sugar levels, and deadens taste buds

• When a smoker tries to quit, food becomes more appealing due to the increased sense of taste and smell

• Studies show that smokers are weigh less than non-smokers


The Source of Physiologically Active Compounds

• Over 4,800 chemical compounds are found in tobacco smoke• Particulate phase (small particle compounds)

– Nicotine• Physiologically and psychologically addictive stimulant• Acts upon the dopamine neurotransmitter in the brain to

cause excitement• Causes serious effects upon the cardiovascular system

– water– 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

Sixty of these chemicals are considered carcinogens


Sources of Physiologically Active Compounds, cont’d

• Over 270 poisonous gases are present in tobacco smoke• Gaseous phase (gas compounds)

– carbon monoxide (CO)• Robs the body of oxygen by combining to form carboxyhemoglobin

– carbon dioxide, ammonia, hydrogen cyanide, isopyrene, acetone, etc.

Many of these chemicals are considered carcinogens


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

• Pulmonary Emphysema (destruction of the alveoli) is a lung disease that reduces air exchange

(Chronic Obstructive Pulmonary Disorders)


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 Smoke

• Referred to as passive or involuntary smoke– Mainstream (smoke inhaled by smoker)– Side-stream (smoke from the burning product)

• Effects on Adults include:• Triple chance of non-smoking women married to smokers to

have a heart attack• Increases lung cancer by 34% on non-smokers• Increases 20% of death due to lung cancer on non-smokers• Increases risk of cervical cancer• Increases the chances of having a premature baby• Depletion of certain vitamins

Side-stream smoke accounts for 85% of smoke in a room


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

Women who smoke while pregnant harm their babies in numerous ways


Smoking Cessation

• Behavioral Changes• Counseling and support groups

• Nicotine Replacement Products (patch, gum, lozenge, nasal spray)

• Medications (anti-depressants)

• Inhalation Systems


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

Remember all the very important reasons not to smoke


Effective Smoking Cessation Programs

• Offer group or individual counseling

• Have intense program counseling and goals

• Have sessions that are at least 20-30 minutes in length

• Have at least 4-7 sessions

• Last for at least 2 weeks

• Have a leader who is trained in smoking cessation

Guide to quitting smoking; http://www.cancer.org


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

See Table 13.1-Short and Long Term Benefits of Smoking Cessation


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

• Peak effects are felt within 2 hours following ingestion• It may be passed into the placenta and to the fetus of

any pregnant woman


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

Caffeinism is the result of excessive use of caffeine products, leading into poor health consequences


Drug Use and Pregnancy

• Consequences to the fetus due to a woman’s abuse of illegal drugs during pregnancy is a grave concern

• Research reveals that 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

• The Cannibis plant’s active ingredient, tetrahydrocannabinol (THC) is responsible for a variety of psychoactive 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


Chapter Thirteen

Making Wise Decisions about Tobacco, Caffeine, and Drugs

Womens Health 13

Health & Medicine

tobacco smoking

nonsmokers smoking

heart smoking

smoking tobacco ethnicity

idea of smoking

smoking cigarettes

women lung cancer deaths

use of tobacco