Tobacco and Cannabis - Study Notes

Tobacco Overview

  • Tobacco is considered the most dangerous substance globally.
      - Accounts for more deaths than:
        - DDT
        - PCBs
        - Industrial chemicals
        - Pesticides
        - Cocaine
        - Alcohol
        - Homicide
        - Suicide
      - Cumulative Impact: Tobacco kills more than all of the above listed combined.

Causes of Death in the U.S. (2016)

  • Heart Diseases: 633,842 deaths (24.1% of total)

  • Cancer: 595,930 deaths (22.7% of total)

  • Chronic Lower Respiratory Diseases: 155,041 deaths (5.9% of total)

  • Accidents: 146,571 deaths (5.6% of total)

  • Stroke: 140,323 deaths (5.3% of total)

  • Alzheimer's Disease: 110,561 deaths (4.2% of total)

  • Diabetes: 79,535 deaths (3.0% of total)

  • Influenza and Pneumonia: 57,062 deaths (2.2% of total)
     

Tobacco Kill Statistics

  • Annual Deaths in North America: 480,000 due to tobacco.

Impact on Life Expectancy (Ontario, 2007)

  • Non-Smokers: Average life expectancy of 84 years.

  • Smokers: Average life expectancy of 73 years.

  • Quitting before age 30: Can add up to 10 years to lifespan.

  • Healthcare Costs: Smoking accounts for 6% - 15% of healthcare costs.

Historical Context of Tobacco

  • Discovery: Tobacco was "discovered" by Columbus in 1492.

  • Native Traditions: Indigenous peoples used tobacco for various medicinal purposes, including to revive drowning victims.

Modern Tobacco Use

  • Social Settings: Early tobacco use in smoking clubs was infrequent and could be harsh in taste; also, cigars were expensive.

  • Innovation in Use:
      - Water pipes became popular in eastern countries as they reduced the harshness of smoke by filtering it.
      - Machine Manufacturing: Cigarettes became mass-produced; first by the Bonsack machine which greatly reduced production costs.

Changes in Consumption

  • Consumption Shift:
      - Late 1800s: Average smoker used about 80 cigarettes per year.
      - Today: Average smoker consumes about 10,000 cigarettes per year, deeply inhaling smoke.

Tobacco Addiction and Health Risks

  • Nicotine: The primary addictive substance in tobacco, approximately 2 mg per cigarette required to induce addiction.

  • Mechanisms:
      - Nicotine acts as an agonist at low doses (amplifying normal signals) and as an antagonist at high doses (blocking normal signals).

  • Health Risks: Nicotine stimulates dopamine release, which plays a significant role in addiction.
      - Leads to increased heart rate and potential heart attack issues due to stimulation of heart tissue.

Toxicity and Cancer Risks

  • Toxic Substances in Tobacco Smoke: Includes carbon monoxide which impairs oxygen transport, adversely affecting the heart.

  • Carcinogens Found:
      - Benzopyrenes (PAHs)
      - Nitrosamines
      - Aldehydes
      - Epoxides
      - Aza-arenes
      - Trace metals

  • Lung Health: Long-term tobacco use leads to severe lung damage and cancer; linked to a drastic increase in lung cancer cases from 1919 (only 400 cases) to 2004 (190,000 cases).

Tobacco Marketing and Social Influence

  • Marketing Campaigns: Tobacco advertising heavily targeted men initially, shifting later to women in the 1950s (Virginia Slims).

  • Cultural Integration: Tobacco products were often marketed in connection with soldiers and celebrities, normalizing usage.

Smoking Cessation and Alternatives

  • Nicotine Replacement Therapies (NRT): Options include nicotine gum, patches, and inhalers.

  • E-Cigarettes: Marketed as a potentially safer alternative, e-cigarettes have drawn increasing controversy; studies show modest effectiveness compared to traditional cessation methods.

Cannabis Overview

  • Legalization in Canada: Cannabis use has been legalized for recreational and medical purposes; active ingredients include Tetrahydrocannabinol (THC) and Cannabidiol (CBD).

  • Medical Uses: THC is documented for treating severe conditions like cancer and anorexia by stimulating appetite.

Cognitive and Driving Impairment

  • THC Effects: Heavy cannabis use is associated with cognitive impairments, including memory issues, and can slow reaction times, especially in occasional users.

  • Driving Risks: THC levels must be monitored as even low levels can impair driving capabilities.

Vaping and Its Challenges

  • Vaping Risks: Products were associated with severe lung illnesses; organizations call for rigorous regulations. Concerns include vaping of unauthorized substances and flavors targeting youth.

  • Health Studies: Continuous data collection reflects on the lack of substantial long-term studies defining vaping's complete safety compared to traditional smoking methods.

Cannabinoid Hyperemesis Syndrome (CHS)

  • Individuals often learn to manage CHS symptoms with heat (hot baths or showers) despite severe nausea and vomiting associated with heavy cannabis use.