TOBACCO USE

Created by
FRIADINATA REGI ISKA FEBRIANA LILIANA ( 08310175 ) MIRZA HELTOMI ( 08310196 ) ( 08310127 )

LANGUAGE CENTRE OF MALAHAYATI UNIVERSITY BANDAR LAMPUNG 2010

Table of content 1. Abstract 2. Chapter II a. Inroduction 3. Chapter III a. Frame of theory 4. Chapter IV a. Analycis 5. Chapter V a. Conclusion 6. References ....................................................... i ....................................................... ....................................................... ....................................................... ....................................................... ....................................................... ....................................................... ....................................................... ....................................................... .......................................................

I.I Abstrak
Tobacco use is the leading preventable cause of premature death in the United States. It is estimated that directly or indirectly, tobacco causes more than 400,000 deaths in the U.S. annually, a figure that represents nearly 20 percent of all U.S. deaths. These deaths have been attributed to a number of conditions defined as tobacco-related, including heart disease (115,000 deaths), cancer (136,000), chronic pulmonary disease (60,000), and stroke (27,000). According to a study published by the British medical journal Lancet, the rate of tobacco-related mortality throughout the entire developed world also averages about 20 percent of all deaths. There are approximately 47 million smokers in the U.S. About 23 percent of adults smoke, and about 30 percent of adolescents. It is widely acknowledged that people who havent used tobacco by age 21 are likely to remain non-smokers. So it would seem reasonable for much tobacco advertising to target potential adolescent users, although tobacco companies deny this. What is undeniable, however, are statistics showing that the average age of first tobacco use in the United States is 13. Tobacco is a plant that comes in two varieties, nicotiana tabacum and nicotiana rustica. The latter is the most cultivated of the two and the source of all the tobacco produced in the U.S. The raw leaves are dried and shredded and then rolled into cigarettes or cigars, or packaged as pipe or chewing tobacco or as snuff. Tobacco is the only organic source of nicotine, which is its addicting agent. In addition to nicotine, tobacco smoke contains some 4,000 different gases and particles, including "tar," a conglomeration of many chemicals, which is especially harmful to the lungs. Among the harmful gases in tobacco smoke are nitrogen oxide, carbon monoxide, and cyanide. More than 40 carcinogenschemicals capable of causing cancer have been identified in tobacco smoke, and one of these, benzo(a)pyrene, is being studied as a possible direct link to cancer.

Chapter I Introduction A 55-year-old male comes to your office for follow-up of a chronic cough. He also complains of shortness of breath with activity. He reports that this has been getting worse over time. As you are interviewing the patient, you note that he smells of cigarette smoke. Upon further questioning, he reports smoking 1 pack of cigarette perday for the last 35 years and denies ever being advised to quit. On examination, he has no respiratory distress at rest. His vital vital signs are normal, and he has no abvious sign of cyanosis. His pulmonary examination is notable for reduced air movement and faint expiratory wheezing auscultation.

Chapter II Frame of Theory What is Tobacco? The first European settlers in North America were introduced to tobacco smoking by Native Americans. By the early 16th century, the settlers were exporting tobacco to Europe, where it was believed to have curative powers. By the end of the 19th century, tobacco use was common in North America, but the quantity of tobacco that each individual used was still relatively small. A number of factors contributed to a 20th-century surge in tobacco use. Invention of the safety match made it safe and easy to light up, and invention of the cigarettemanufacturing machine made it possible to produce pre-rolled cigarettes in great quantities. The advent of mass-circulation newspapers and magazines made widespread advertising of cigarettes possible. Initially, men were the sole targets of the ads smoking by women was considered impoliteand cigarettes were portrayed as a product for the rugged and powerful. With the rise of the Womens Suffrage movement, however, the tobacco companies began to fashion campaigns that encouraged women to smoke. Cigarette use continued to grow at a rapid pace and peaked at over 40 percent of the nations adolescent-and-older population by the mid-1960s. About this time, several epidemiological studies were released, including the U.S. Surgeon Generals influential 1964 report, pointing to a connection between smoking and such diseases as cancer and respiratory illness. As these and subsequent studies were publicized, fear of long-term illnesses caused many smokers to quit and many potential users never to begin. At present, about 25 percent of Americans smoke, but the decline in use has now leveled off, and there are some indications that cigarette use may be increasing. Since the number of Americans who die each year from tobacco-related illnesses is still appallingly high and adolescent use is on the rise, there are now renewed efforts to prevent smoking.

What is Passive Smoking? Passive smoking is the process that causes non-smokers to inhale smoke involuntarily. Some of the smoke they inhale is known as "sidestream smoke"the smoke that smolders off the end of a cigarette, cigar, or pipe. This smoke has neither passed through a filter nor through the lungs of a smoker and is therefore extremely potent, containing more tar, nicotine, particles, and gases than inhaled smoke. Sidestream smoke can cause respiratory distress and allergic reactions, as well as lung cancer.

How Does Tobacco Affect You? Smoking or chewing tobacco stimulates the habitual user, creating a pleasurable sensation not unlike a high. The effect is generally described as relaxing, although smoking releases the hormone epinephrine, which may create stress in the user. Nicotine, perhaps the most commonly recognized ingredient of tobacco, is an addictive central nervous system stimulant. When nicotine is taken into the lungs, it is transmitted to the brain in seconds. It causes the heart to beat more rapidly, drawing in and pushing out more blood. It also makes the veins and arteries constrict, thus requiring the heart to labor harder. This results in increased blood pressure and heart rate. Carbon monoxide is among the many toxic chemicals present in tobacco smoke. It impedes the ability of red blood cells to carry oxygen to bodily tissues, including heart and brain tissue. The lack of oxygen causes the heart to work harder and can lead to a thickening of the walls and possible heart failure. Despite the fact that tobacco is a stimulant, addicted smokers usually feel that smoking relaxes them. This feeling of relaxation is in reality the result of their having satisfied a physical craving. Smokers are constantly experiencing the symptoms of nicotine withdrawal, and drawing smoke into their lungs relieves these symptoms by

satisfying their craving for the chemical. Almost all tobacco users, including those who use smokeless varieties, thus become physiologically and psychologically dependent on nicotine. When they stop using, the withdrawal symptoms they experience can include changes in heart rate, blood pressure, appetite, temperature, and digestion. Withdrawal can also be accompanied by anxiety, insomnia, nausea, irritability, and fatigue. Most smokers begin during adolescence or early adulthood. Smoking has elements of risk-taking and rebellion, which often appeal to young people. The presence of high-status models and peers may also encourage smoking. Because teenagers are influenced more by their peers than by adults, attempts by parents, schools, and health professionals at preventing people from trying cigarettes are unsuccessful. Children of smoking parents are more likely to smoke than children with nonsmoking parents. One study found that parental smoking cessation was associated with less adolescent smoking, except when the other parent currently smoked. A current study tested the relation of adolescent smoking to rules regulating where adults are allowed to smoke in the home. Results showed that restrictive home smoking policies were associated with lower likelihood of trying smoking for both middle and high school students. Many anti-smoking organizations claim that teenagers begin their smoking habits due to peer pressure, and cultural influence portrayed by friends. However, one study found that direct pressure to smoke cigarettes did not play a significant part in adolescent smoking. In that study, also reported low levels of both [[Norm (sociology) and direct pressure to smoke cigarettes. A similar study showed that individuals play a more active role in starting to smoke than has previously been acknowledged and that social processes other than peer pressure need to be taken into account. Another study's results revealed that was significantly associated with smoking behavior across all age and gender cohorts, but that intrapersonal factors were significantly more important to the smoking behavior of 1213 year-old girls than same-age boys. Within the 1415 year-old age group, one peer pressure variable emerged as a significantly more important predictor of girls' than boys' smoking. It is debated whether peer pressure or is a greater cause of adolescent

Psychologists such as have developed a personality profile for the typical smoker. is the trait that is most associated with smoking, and smokers tend to be sociable, impulsive, risk taking, and excitement seeking individuals. Although, personality and social factors may make people likely to smoke, the actual habit is a function of . During the early stages, smoking provides pleasurable sensations (because of its action on the system) and thus serves as a source of positive reinforcement. Persistence Because they are engaging in an activity that has negative effects on health, people who smoke tend to rationalize their behavior. In other words, they develop convincing, if not necessarily logical reasons why smoking is acceptable for them to do. For example, a smoker could justify his or her behavior by concluding that everyone dies and so cigarettes do not actually change anything. Or a person could believe that smoking relieves stress or has other benefits that justify its risks. The reasons given by smokers for this activity are broadly categorized as addictive smoking, pleasure from smoking, tension reduction/relaxation, social smoking, stimulation, habit/automatism, and handling. There are gender differences in how much each of these reasons contribute, with females more likely than males to cite tension reduction/relaxation, stimulation and social smoking. Some smokers argue that the depressant effect of smoking allows them to calm their nerves, often allowing for increased concentration. However, according to the Imperial College London, "Nicotine seems to provide both a stimulant and a depressant effect, and it is likely that the effect it has at any time is determined by the mood of the user, the environment and the circumstances of use. Studies have suggested that low doses have a depressant effect, while higher doses have stimulant effect."[69] The lack of deterrence by the deleterious health effects is a prototypical example of optimism bias. Patterns

A number of studies have established that cigarette sales and smoking follow distinct time-related patterns. For example, cigarette sales in the United States of America have been shown to follow a strongly seasonal pattern, with the high months being the months of summer, and the low months being the winter months. Similarly, smoking has been shown to follow distinct circadian patterns during the waking daywith the high point usually occurring shortly after waking in the morning, and shortly before going to sleep at night. On February 27, 2005 the WHO Framework Convention on Tobacco Control, took effect. The FCTC is the world's first public health treaty. Countries that sign on as parties agree to a set of common goals, minimum standards for tobacco control policy, and to cooperate in dealing with cross-border challenges such as cigarette smuggling. Currently the WHO declares that 4 billion people will be covered by the treaty, which includes 168 signatories.Among other steps, signatories are to put together legislation that will eliminate secondhand smoke in indoor workplaces, public transport, indoor public places and, as appropriate, other public places. Taxation See also: Cigarette taxes in the United States Many governments have introduced excise taxes on cigarettes in order to reduce the consumption of cigarettes. In 2002, the Centers for Disease Control and Prevention said that each pack of cigarettes sold in the United States costs the nation more than $7 in medical care and lost productivity,over $2000 per year per smoker. Another study by a team of health economists finds the combined price paid by their families and society is about $41 per pack of cigarettes. Substantial scientific evidence shows that higher cigarette prices result in lower overall cigarette consumption. Most studies indicate that a 10% increase in price will

reduce overall cigarette consumption by 3% to 5%. Youth, minorities, and lowincome smokers are two to three times more likely to quit or smoke less than other smokers in response to price increases, Smoking is often cited as an example of

aninelastic good, however, i.e. a large rise in price will only result in a small decrease in consumption. Many nations have implemented some form of tobacco taxation. As of 1997, Denmark had the highest cigarette tax burden of $4.02 per pack. Taiwan only had a tax burden of $0.62 per pack. The federal government of the United States charges $1.01 per pack. Cigarette taxes vary widely from state to state in the United States. For example, Missouri has a cigarette tax of only 17 cents per pack, the nation's lowest, while New York has the highest cigarette tax in the U.S.: $4.35 per pack. In Alabama, Illinois, Missouri, New York City, Tennessee, and Virginia, counties and cities may impose an additional limited tax on the price of cigarettes. [ Sales taxes are also levied on tobacco products in most jurisdictions. In the United Kingdom, a packet of 20 cigarettes typically costs between 4.25 and 5.50 depending on the brand purchased and where the purchase was made. The UK has a strong black market for cigarettes which has formed as a result of the high taxation, and it is estimated 27% of cigarette and 68% of handrolling tobacco consumption was non-UK duty paid (NUKDP). In Australia total taxes account for 62.5% of the final price of a packet of cigarettes (2007 figures). These taxes include federal excise or customs duty, and the more recently introduced Goods and Services Tax (GST).

Chapter III Analycis

Biology
Nicotiana

Nicotine is the compound responsible for the addictive nature of Tobacco use.

Tobacco flower, leaves, and buds Main article: Nicotiana See also: List of tobacco diseases

There are many species of tobacco in the genus of herbs Nicotina. It is part of the nightshade family (solanacae ) indigenous to North and South America, Australia, South West Africa and the South Pacific. Many plants contain nicotine, a powerful neurotoxin to insects. However, tobaccos contain a higher concentration of nicotine than most other plants. Unlike many other Solanacae, they do not contain tropane alkaloids, which are often poisonous to humans and other animals. Despite containing enough nicotine and other compounds such as germacrene and anabismae and other piperlidine alkaloids (varying between species) to deter most herbivores, a number of such animals have evolved the ability to feed on Nicotina species without being harmed. Nonetheless, tobacco is unpalatable to many species, and therefore some tobacco plants (chiefly tree tobacco, N. Glauca) have become established as invasive weeds in some places.

Types
There are a number of types of tobacco including, but are not limited to:

Aromatic fire-cured, it is cured by smoke from open fires. In the United States, it is grown in northern middle Tennessee, central Kentucky and in Virginia. Fire-cured tobacco grown in Kentucky and Tennessee are used in some chewing tobaccos, moist snuff, some cigarettes, and as a condiment in pipe tobacco blends. Another fire-cured tobacco is Latakia, which is produced from oriental varieties of N. tabacum. The leaves are cured and smoked over smoldering fires of local hardwoods and aromatic shrubs in Cyprus and Syria.

Brightleaf tobacco, Brightleaf is commonly known as "Virginia tobacco", often regardless of the state where they are planted. Prior to the American Civil War, most tobacco grown in the US was fire-cured dark-leaf. This type of tobacco was planted in fertile lowlands, used a robust variety of leaf, and was either fire cured or air cured. Most Canadian cigarettes are made from 100% pure Virginia tobacco

Burley tobacco, is an air-cured tobacco used primarily for cigarette production. In the U.S., burley tobacco plants are started from palletized seeds placed in polystyrene trays floated on a bed of fertilized water in March or April.

Cavendish is more a process of curing and a method of cutting tobacco than a type. The processing and the cut are used to bring out the natural sweet taste in the tobacco. Cavendish can be produced from any tobacco type, but is usually one of, or a blend of Kentucky, Virginia, and burley, and is most commonly used for pipe tobacco and cigars.

Criollo tobacco is a type of tobacco, primarily used in the making of cigars. It was, by most accounts, one of the original Cuban tobaccos that emerged around the time of Columbus.

Dokham, is a tobacco originally grown in Iran, mixed with leaves, bark, and herbs for smoking in a midwakh. Turkish tobacco, is a sun-cured, highly aromatic, small-leafed variety (Nicotiana tabacum) that is grown in Turkey, Greece, Bulgaria, and Macedonia. Originally grown in regions historically part of the Ottoman Empire, it is also known as "oriental". Many of the early brands of cigarettes were made mostly or entirely of Turkish tobacco; today, its main use is in blends of pipe and especially cigarette tobacco (a typical American cigarette is a blend of bright Virginia, burley and Turkish).

Perique, a farmer called Pierre Chenett is credited with first turning this local tobacco into the Perique in 1824 through the technique of pressure-fermentation. Considered the truffle of pipe tobaccos, it is used as a component in many blended pipe tobaccos, but is too strong to be smoked pure. At one time, the freshly moist Perique was also chewed, but none is now sold for this purpose. It is typically blended with pure Virginia to lend spice, strength, and coolness to the blend.

Shade tobacco, is cultivated in Connecticut and Massachusetts. Early Connecticut colonists acquired from the Native Americans the habit of smoking tobacco in pipes, and began cultivating the plant commercially, even though the Puritans referred to it as the "evil weed". The industry has weathered some major catastrophes, including a devastating hailstorm in 1929, and an epidemic of brown spot fungus in 2000, but is

now in danger of disappearing altogether, given the value of the land to real estate speculators.

White burley, in 1865, George Webb of Brown County, Ohio planted red burley seeds he had purchased, and found that a few of the seedlings had a whitish, sickly look.

Wild tobacco, is native to the southwestern United States, Mexico, and parts of South America. Its botanical name is Nicotiana rustica. In the 1990s, the United States Food and Drug Administration (FDA) used it as evidence that tobacco companies were intentionally manipulating the nicotine content of cigarettes.

Chapter IV Discussion 1. would you recommend for smoker ? 2. What interventions are available to aid with smoking cessation ? 3. Therapy with medicine for smoker ? 4. How can goverment for control smoker ?

1. We can critical to smoker o Smoke dangerous for health people like smoke o With consumen cigarette can short of live in the world. o Smoker have to stoping because dangerous for people of love him. o Stoping smoke faster that good.

2. Give education

o Give explanation about composition from cigarette ( nicotine, tar, etc ) and also the influence to our healty. o Believe your main to stop the smoking. o Ask the people to give a support

o Beginning to healty life style ( exercise, consumption many fruit and vegetables and also take a rest ) o Dont forget thinking again to doing like before

3. Therapy for smoker o Support from people of love him can help in medicine. o Give milk because can press from nicotine and tea. o Exercise everyday.

4. Recommendations to reduce smoking in health professionals: Need for strict tobacco control regulations or policies in all the hospitals. Improve and promote health professionals as role models non smokers to their patients and the public. Recommendations to reduce smoking in medical students: More attention should be given to early smoking prevention, when medical students start studying at the university. National tobacco control policies should include official and strong regulations on non smoking areas and penalties for violations. These should

be strictly enforced in the medical universities. Promotion of medical students as role models for monks: Involve monks in developing tobacco control programs. Continue education to raise awareness of smoking laws in religious places including prohibiting worshippers offering cigarettes to monks. Encourage monks to take an increasing role in tobacco control advocacy. Incorporate tobacco control into Buddhist educational programs. nonsmoking and the health Recommendations to reduce smoking among

Chapter V Conclusion From discussion, smoke can dangerous health for people actif and pasif because in cigarette can substansion dangerous is nicotin and tar, etc. Consumen cigarette in long time can generated many disease Example : brain ( cancer ), respiratory ( shortness ), etc. If you want health far long cigarette for this today.