Choosing a - Free Lifestyle

• I will avoid tobacco use and secondhand smoke. obacco products contain a called . You are more likely to become addicted to nicotine after using a tobacco product once than Tyou are to become addicted to after using it once. This lesson 38 explains why you must avoid tobacco use and secondhand smoke. You What You’ll Learn will learn about techniques used to convince people to use tobacco 1. Discuss the harmful physical products, skills to resist pressure and mental effects of nicotine. to use them, and suggestions (p. 425) for teens who use tobacco 2. Understand the negative effects products and want to quit. has on a fetus. (p. 427) 3. Explain the harmful effects of secondhand smoke. (p. 428) 4. Discuss laws regarding the sale and use of tobacco. (p. 430) 5. Discuss how tobacco companies try to convince minors to use tobacco products. (p. 430) 6. Outline steps to stop using tobacco products. (p. 432) 7. Outline eight ways to resist pressure to use tobacco products. (p. 434) Why It’s Important Smoking is a major public health problem. Each year, smoking contributes to more deaths than AIDS, , homicide, , car accidents, and suicide combined. k Key Terms • nicotine • tobacco • carcinogen •tar • carbon monoxide Writing About Resisting Pressure to Smoke Suppose that you • emphysema have been really stressed out lately. You are feeling overwhelmed by the • secondhand smoke demands of school, practice for the school swim team, and your job. A • snuff friend tells you that smoking is a good way to relax, and urges • leukoplakia you to try it. What should you do? After you read the information on the • nicotine patch dangers of smoking on page 426, write a response to this situation in your health journal. 424 UNIT 7 • Alcohol, Tobacco, and Other Drugs Stockbyte/SuperStock drug found in tobacco products—including cigarettes, clove cigarettes, cigars, , pipe tobacco, and snuff—is called nicotine. Nicotine Astimulates the nervous system and is highly addictive. It dulls the taste buds, constricts the blood vessels, and increases heart rate and blood pressure. When tobacco smoke is inhaled into the lungs, nicotine is absorbed into the bloodstream and quickly reaches the brain. Nicotine also can be absorbed into the bloodstream from that is placed in the mouth. When the “pick-me-up” effect of nicotine wears off, a user is motivated to use more tobacco. What to Know About Nicotine

Nicotine dependence Many health headache, and have difficulty concen- experts and health organizations trating; can become frustrated and have declared that nicotine is as addic- angry; and have heart palpitations Smoking Every day, tive as heroin, , and alcohol. and an increased appetite. almost 3000 teens in Nicotine dependence causes more pre- Why experimenting with tobacco is the United States— mature and disease than all risky Experimenting with tobacco 1 million a year— other forms of drug dependence com- puts you at risk for nicotine depend- become smokers. bined. People who regularly use ence. According to the Surgeon One-third of these tobacco develop a tolerance to nicotine. General, the probability of becoming teens will eventually They need more and more to produce addicted to nicotine after one expo- die from smoking. the desired effect. At first, the desired sure is higher than for other addic- effect is to feel the stimulation that tive substances, such as heroin, nicotine causes. Later, it is to lessen cocaine, and alcohol. Teens have a the craving for nicotine. People develop more difficult time quitting smoking a physical dependence on nicotine than people who start smoking when when the body becomes used to its they are older. A majority of adult effects. Psychological dependence smokers started before the age of 18. develops when people feel the need to They also are more likely to become smoke or chew tobacco at certain times heavy smokers and to die of a disease or for specific reasons. caused by smoking. Nicotine withdrawal syndrome What is tobacco? An herbal plant People who try to quit using tobacco that is grown for its leaves and that often have nicotine withdrawal syn- contains nicotine is tobacco. It can drome. Nicotine withdrawal syn- be smoked in different forms, such as drome is the body’s reaction to cigarettes, cigars and pipes. quitting the use of tobacco products. Smokeless tobacco is tobacco that People with nicotine withdrawal syn- is chewed or snorted, but not smoked. drome feel a craving for tobacco; may Chewing tobacco and snuff are forms be anxious, irritable, restless, have a of smokeless tobacco.

healthmh.com/smoking LESSON 38 • Choosing a Tobacco-Free Lifestyle 425 obacco smoke contains many harmful chemicals in addition to nicotine. Scientists estimate there are more than 4,000 different chemicals in tobacco Tsmoke, at least 43 of which are carcinogens. A carcinogen is a chemical that is known to cause cancer. Most carcinogens in tobacco smoke are found in tar. Tar is a sticky, thick fluid that is formed when tobacco is burned. Tar irritates respiratory tissues and is a major cause of lung cancer. Another dangerous substance that forms when tobacco is burned is carbon monoxide. Carbon monoxide is an odorless, tasteless gas. It interferes with the ability of blood to carry oxygen. How Smoking Harms Health Smoking causes cancer. Smoking reaching the lungs. This increases Make the causes lung cancer and increases the the risk of respiratory infection. Connection risk of many other types of cancer. Smoking also aggravates asthma. Health Concerns Lung cancer kills more people than Smoking is a risk factor for For more information any other cancer. It is rare for some- chronic obstructive pulmonary about the nation’s one who has never smoked to develop disease (COPD), a disease that major health concerns, lung cancer. Lung cancer almost interferes with breathing. Examples see page 58 in always causes death. Most people of COPDs are chronic bronchitis and Lesson 6. with lung cancer die within five years emphysema. Chronic bronchitis is a of learning that they have cancer. recurring inflammation of the Smoking also is a major risk factor bronchial tubes that causes mucus for cancer of the throat, mouth, esoph- to line the bronchial tubes. This agus, pancreas, and bladder. The increases risk of lung infection and American Cancer Society reports that interferes with the ability to breathe. one-third of all cancer deaths are due A condition in which the alveoli lose to tobacco use. They also report that most of their ability to function is nine out of every ten lung cancer cases are caused by smoking cigarettes. The blackened lung tissue on the left is diseased with pulmonary emphysema, while the lung tissue on the right is healthy. Smoking harms the respiratory sys- tem. Smoking prevents the lungs from working effectively. When a per- Mini-Review son smokes, tar lines the lungs and 1. What is nicotine air passages. Tobacco also harms the withdrawal cilia in the nose, throat, and syndrome? bronchial tubes. Cilia are hair-like 2. Name three cancers structures that remove dust and that are associated other particles from the air and with smoking. prevent harmful substances from

426 UNIT 7 • Alcohol, Tobacco, and Other Drugs (tt)Photodisc/Getty Images, (b)Dr. E. Walker/Photo Researchers emphysema. The lungs lose their resting heart rate ability to properly inflate and hold air. approximately 20 As a result, it is difficult for oxygen to beats per minute. be absorbed into the bloodstream. This change in Some people with emphysema must heart rate and remain in bed and use special equip- inhaled carbon mo- ment to receive an adequate amount of noxide places extra Many people with oxygen. Emphysema cannot be cured. strain on the heart. emphysema need breathing assistance. Smoking causes cardiovascular dis- Smoking causes accidents. eases. Smoking is a major cause of smoking is a leading cause of fires. death from heart and blood vessel dis- Cigarette smoking also is a factor eases and stroke. Smoking speeds up in many motor vehicle accidents. the development of fat deposits in the Accidents have happened when a arteries and damages the inner lining driver was distracted trying to light a of arteries. Fat deposits reduce the cigarette or by dropping a lit cigarette. space in the artery through which blood can flow. The risk of developing Smoking causes other health problems. blood clots increases. Smokers are more likely to develop A clot in an artery in the heart can gum disease and to lose teeth and sup- cause a heart attack. A clot in the porting gum tissues. Smoking may brain can result in a stroke. Smoking cause or worsen ulcers in the stomach also is a risk factor for aortic and small intestine. Smoking during aneurysm. An aortic aneurysm is pregnancy harms the developing baby. a bulging in the aorta. The aorta is Studies show that if a female quits the main artery in the body. An smoking during pregnancy, the risk of aneurysm is the result of a weaken- infant death, having a low birth- ing in an artery wall. The nicotine weight baby, and delivering prema- in tobacco smoke raises a person’s turely could be lowered.

TABLE 38.1 Myths and Facts About Smoking Teens Who Smoke May The Truth Convince Themselves…

“I look cool when I smoke.” People who smoke have yellow teeth and dirty and stained fingernails. Their clothes stink of smoke.

“It is ‘in’ to smoke.” In 2002, only 22.9 percent of high school students were current smokers. Many people will not hang out with people who smoke. They will not date a person who smokes.

“My smoking doesn’t bother Many people do not want to be around people who smoke. Many people do not want people to anyone.” smoke around their children.

“My favorite TV and movie Many celebrities and athletes do not use tobacco products. The celebrities and athletes who do use stars use tobacco products.” tobacco products face the same risks from tobacco use as others do. Many have died of cancer.

healthmh.com/smoking LESSON 38 • Choosing a Tobacco-Free Lifestyle 427 Aaron Haupt f you are in a room in which other people are smoking, you will be exposed to over 4000 chemicals. Of these chemicals, 200 are poisonous and many are carcinogens. The Ismoke from other people’s cigarettes is responsible for 3000 lung cancer deaths and 35,000 deaths from heart disease per year in the United States. In addition, the smoke from other people’s cigarettes is responsible for causing between 150,000 to 300,000 lower respiratory tract infections in infants and children under 18 months of age. What to Know About Secondhand Smoke

A lit cigarette burns for Mainstream smoke is smoke that is about 10 minutes. During directly inhaled into the smoker’s those 10 minutes, people who mouth and lungs. are near the smoker will breathe Major health risk Secondhand smoke in secondhand smoke. Exhaled main- is more than just an annoyance. The stream smoke and Environmental Protection Agency are types of secondhand smoke, or (EPA) has classified secondhand environmental tobacco smoke. smoke as a Group A carcinogen, and involuntary which is a substance that causes can- smoking are other terms used to cer in humans. Secondhand smoke is describe breathing in secondhand the most hazardous form of indoor air smoke. Smoke that enters the air pollution. It can cause lung cancer in from a burning cigarette, cigar, or nonsmokers and increase their risk of pipe is sidestream smoke. Side- developing heart disease and respira- stream smoke has more tar, nicotine, tory problems. People who already carbon monoxide, ammonia, and ben- have heart disease or respiratory zene than mainstream smoke. problems are especially affected. Secondhand smoke is a major health risk for children with parents who How You Can Avoid Secondhand Smoke smoke. The children are at increased risk for ear infection, bronchitis, and The following are suggestions on how to avoid secondhand smoke: pneumonia. The lungs of children exposed to secondhand smoke may • Speak up to the person who • Encourage family members not develop properly. is smoking, but be polite. Let who smoke to quit smoking people know that you are and to go outside if they Protecting nonsmokers Laws are being concerned about your health. must smoke. passed to prevent smoking inside pub- • Ask smokers not to smoke in • Request seating in nonsmok- lic buildings and schools and in the indoor areas that you share. ing sections of restaurants or workplace. Airlines have restricted • Encourage your family to in public areas. smoking during flights. Many busi- have a nonsmoking policy for nesses no longer allow smoking in your home. their office buildings or factories.

428 UNIT 7 • Alcohol, Tobacco, and Other Drugs (tt)Photodisc/Getty Images, courtesy of American Lung Association mokeless tobacco is manufactured and sold in two forms. Chewing tobacco is a tobacco product made from chopped tobacco leaves that Sis placed between the gums and cheek. Snuff is a tobacco product made from powdered tobacco leaves and stems that is snorted or placed between the gums and cheek. Smokeless tobacco has most of the same harmful ingredients as other tobacco products. What to Know About Smokeless Tobacco Smokeless tobacco causes nicotine Smokeless tobacco causes problems dependence. Every time people use with the gums and teeth. Smokeless smokeless tobacco they feel the stim- tobacco permanently stains teeth and ulating “pick-me-up” effects of nico- causes bad breath. Chewing tobacco tine. The body becomes used to these includes particles that scratch and effects, and tolerance is the result. wear away teeth, and the sugar in Cravings and tolerance are both smokeless tobacco mixes with dental signs of nicotine dependence. plaque to form acids that cause tooth Nicotine dependence makes it diffi- decay. Smokeless tobacco also can cult for people to quit. cause the gums to pull away from the teeth, exposing the roots and making Smokeless tobacco contains many them more likely to fall out. chemicals that harm health. Smoke- less tobacco contains formaldehyde, What to do If you use smokeless lead, nitrosamines, cadmium, and tobacco, quit now. (See page 432 for quitting strategies.) Check your polonium. All forms of smokeless Leukoplakia, abnormal tobacco contain carcinogens. gums and teeth for signs of oral cells, is often a result of cancer: a persistent sore, lump, or using smokeless Smokeless tobacco increases the risk white patch in the tobacco. of developing cancer. When people mouth; a persistent use smokeless tobacco, the tobacco sore throat; and/or and its irritating juices are in contact difficulty chewing with the gums, cheeks, and lips for and moving the long periods of time. tongue or jaw. This causes a change in the cells of Contact a physician the mouth. Abnormal cells in the or dentist immedi- mouth that appear as white patches ately and have an of tissue are leukoplakia. The oral examination. abnormal cells can develop into can- Have your mouth cer. Using smokeless tobacco also checked by a den- increases the risk of cancer of the lar- tist every three ynx, the pharynx, and the esophagus. months.

healthmh.com/smoking LESSON 38 • Choosing a Tobacco-Free Lifestyle 429 (tt)Aaron Haupt, Amanita Pictures, (b)Corbis paid announcement about a product or service is an advertisement. Tobacco manufacturers are not allowed by law to put tobacco ads on TV or radio. A Advertising in stores and on billboards and signs on the inside and outside of buses no longer can have photos or artwork and cannot be in color. The same rule applies to advertising in publications read by a significant number of people under the age of 18. What to Know About Tobacco Advertising Influencing young people Tobacco sponsorship of these events can be manufacturers have promoted done in the corporate name only. their products in many ways. Only the automobile industry spends One way was by distributing more money than tobacco companies clothing and other items that on advertising. Make the displayed their logos and sym- Connection Required warnings on tobacco prod- bols. People wearing or using these Evaluating Ads For ucts Tobacco manufacturers include items were a “walking ad” for the warnings on their packages and in more information tobacco company. In 1997 the FDA about evaluating their ads to educate people about the prohibited the sale or giveaway of advertisements, see dangers of using tobacco products. products such as caps or gym bags page 37 in Lesson 4. Tobacco companies have different that carry tobacco product brand warnings on their cigarette packages. names or logos. In 2000, the FDA lost (See page 431 for a photo of one of the its power to control tobacco products. warnings.) Much of this power is now local and Smokeless tobacco Smokeless tobacco state controlled. The Federal Trade manufacturers place different warn- Commission (FTC) also has control ings on their packages and in their over tobacco products. ads, such as: “This product is not a Tobacco companies also promote safe alternative to cigarettes,” “this their products by offering merchan- product may cause gum disease and dise in exchange for coupons found tooth loss,” and “this product may on cigarette packs or smokeless cause mouth cancer.” tobacco containers. They may have promoted their products by sponsor- FTC The FTC regulates tobacco ing sporting events and rock con- advertising, including health warning certs, wanting people to associate labels. The FTC provides data on the their product and their logo with tar, nicotine, and carbon monoxide excitement and glamour. This was a levels of domestic tobacco products. way to advertise their products on What tobacco ads do not tell you TV, as advertising tobacco products Tobacco companies spend billions of on TV was banned. Now brand-name dollars each year to influence people

430 UNIT 7 • Alcohol, Tobacco, and Other Drugs CORBIS Advocating for Health: Advocating quitting smoking If someone you know smokes, you can try to convince them to stop. It will take a lot of work, but the results will be worth your efforts. Remember, though, that even if you try hard, you cannot force someone to stop smoking. It’s ultimately up to the smoker to quit. To advocate for health, follow these four steps: 1) select a health-related concern; 2) gather reliable information; 3) identify your purpose and target audience; and Suggest boundaries. Agree 4) develop a convincing and appropriate message. to make certain places off- 4limits for smoking, such as the car, the kitchen, or maybe the whole house. Explain how the person Get involved. Encourage smoking makes you feel.’s your loved one to be active Add up how much money 1It could be as instead of smoking, then 3 could be saved every month if simple as saying that join him or her in a walk, a bike 5your loved one didn you don ride, or seeing a movie. Offer him ’t like the way Be patient and Encourage him or her to set’t smoke.aside the smoke smells on his or her gum or hard candy to supportive. Nagging that money for something special as or her clothes, or you replace cigarettes. will just annoy the a reward for quitting. could say you 2 ’re afraid this habit could shorten smoker or make him or your loved one her defensive. Show that ’s life. you understand that giving up cigarettes is difficult. Try not to be judgmental. Smoking ’hass life. become a part of this person

to use tobacco. They want you to think How tobacco companies hook young Tobacco companies are tobacco use is “in” and to take your children Tobacco companies claim required to display warnings on their attention away from the warnings. they do not design ads that target products. Many tobacco ads are designed to children. On the Internet, tobacco appeal to teens. People in the ads are companies appeal to children by models who are attractive, healthy using interactive games, giveaways, looking, and well-dressed. They are and chats to promote their products. having fun and are very appealing to They promote the idea that using members of the opposite sex. tobacco products makes a person Don’t be fooled by these ads. What seem more grown-up and “cool.” they fail to tell you is that smoking In the past cigarette companies cigarettes does not help you to look hooked children by placing “kiddy attractive, healthy, or well-dressed. packs” and “loosies” in stores. A kiddy People are likely to be turned off by pack is a package of cigarettes con- your behavior, your breath, and your taining fewer than the standard 20 stained teeth. Tobacco ads also do not cigarettes in a pack. A loosie is a sin- Mini-Review tell you that more than 400,000 peo- gle cigarette that is available for pur- 1. Who has ple die each year from smoking. They chase. However, many cities and regulatory control do not show people dying of lung dis- states have laws banning the sale of over tobacco ease or restricted to bed because of kiddy packs and loosies. There are products? emphysema. They do not show family also laws that ban free samples of 2. Give examples of members grieving the death of loved tobacco products. warning labels on ones who used tobacco. tobacco products.

healthmh.com/health_influences LESSON 38 • Choosing a Tobacco-Free Lifestyle 431 (tk) here are many reasons to quit using tobacco. People who quit using tobacco live longer than those who continue to use tobacco. They reduce their risk of heart Tdisease, stroke, emphysema, chronic bronchitis, and some forms of cancer. There are even more immediate rewards to quitting smoking. Within a day after people stop smoking, the body begins to heal itself from the damages caused by tobacco. Breathing is easier, and a smoker’s cough is not as frequent. The senses of taste and smell improve. How to Quit Using Tobacco List the reasons why you want to previously used tobacco. Stay busy quit. Focus on all the things that and active. you do not like about using tobacco. Join a tobacco cessation program. A For example, you might think about tobacco cessation program is a pro- the mess, the inconvenience, wasting gram to help a person stop smoking money, and the way it makes you or using smokeless tobacco. Tobacco smell. Ask family members and cessation programs are offered by friends to contribute to reasons. Smoking Expenses local chapters of the American Smoking costs the Decide when you want to quit. Set a Cancer Society, the American Lung nation over $150 target date to quit. Know what to Society, the American Heart billion per year in expect. Understand that nicotine Association, health departments, health-related withdrawal symptoms are tempo- schools, and hospitals. economic costs. rary. Understand that quitting is not Get help from others. Tell family easy, but it is possible. Expect to members and friends that you are experience pressures to use tobacco quitting. Ask for encouragement and when you feel stress. support. Make a health behavior contract. Throw away all tobacco products. Get Make a health behavior contract with rid of items associated with tobacco the life skill “I will stop using smoke- use, such as ashtrays, , and less tobacco” or “I will stop smoking.” matches. Design a plan to quit using tobacco. Be prepared for temptation. For the Consider situations in which you usu- first few weeks or longer after quitting, ally have a cigarette or use smokeless you may have the urge to use tobacco. tobacco. Change your daily routines Try to stay away from people and to avoid situations in which you places that might trigger a craving.

432 UNIT 7 • Alcohol, Tobacco, and Other Drugs (tt)Photodisc/Getty Images TABLE 38.2 Methods to Help Quit Smoking Type Description Side Effects

Nicotine patch A nicotine patch is worn on the skin Can cause redness, itching, swelling, of the upper body or arms. It releases nervousness, dry mouth, and inability nicotine into the bloodstream at a slow to sleep rate; it does not contain cancer-causing chemicals

Nicotine Chewing gum that releases nicotine Can result in sore jaws, upset stomach, chewing gum when chewed; does not contain cancer- nausea, heartburn, loosened dental causing chemicals fillings, and problems with dentures

Nicotine nasal Spray nicotine in each nostril. Nasal and sinus irritation spray Recommended dosage is 1–2 sprays/hour, 5 sprays/hour, or 40 sprays in a day

Nicotine inhaler Mouthpiece the size and shape of a Mild throat and mouth irritation; cigarette, which puts out vaporized coughing; or upset stomach; should not nicotine when you puff on it; simulates be used for more than 6 months the hand-to-mouth ritual; good for beginners trying to quit

Non-nicotine Antidepressant that helps reduce Most common side effects are shakiness pill cravings and withdrawals; take two and skin rash. More severe side effects pills/day 1–2 weeks before quitting and include: increased blood pressure, maintain up to six months seizures, kidney and liver failure

Participate in activities that keep your Avoid weight gain. Eat a healthful mind off of using tobacco. Try vigor- diet with the proper amount of pro- ous exercise to release beta-endor- tein, carbohydrates, and fat. Eat phins. Beta-endorphins may help plenty of fruits and vegetables. Have relieve tension caused by quitting. low-fat and low-calorie snacks. Participating in other activities, such as working on a hobby or going to a Keep your guard up. The urge to use movie, also may help. tobacco often comes at predictable times. Continue to plan ahead for Get help from a health-care profes- these situations. sional. Make an appointment with a school nurse or a physician to help If you slip up and use tobacco, keep you with your plan. A physician may trying to quit. Slipping up does not prescribe a nicotine patch, nicotine have to mean failure. Figure out why chewing gum, nicotine nasal sprays, you slipped up and how to avoid it a nicotine inhaler, or a pill that cuts the next time. Remember that quit- cravings to use nicotine. ting smoking takes perseverance.

healthmh.com/getting_help LESSON 38 • Choosing a Tobacco-Free Lifestyle 433 (t)Laurent/Bouras/Photo Researchers (tc)Micheal Newman/PhotoEdit (bc)Felicia Martinez/PhotoEdit (b)Josh Sher/Photo Researchers ven though an increasing number of teens use tobacco, the majority of teens do not. Think of ways you might be pressured to Euse tobacco, and be ready to use resistance skills if someone pressures you to use tobacco products.

1. Use assertive behavior. 6. Resist pressure to engage in illegal behavior. • Stand tall and look directly at the person • Learn the laws that apply to tobacco use in with whom you are speaking. Say “no” in your community and state. a firm and confident voice. • Do not lie about your age to buy tobacco 2. Give reasons for saying “no” to tobacco. products. • Explain that tobacco use is harmful and • Do not purchase tobacco products from illegal for minors. Using tobacco does not vending machines. show respect for yourself and others. 7. Influence others to choose responsible • Using tobacco is against the guidelines of behavior. your family and school. • Encourage people who pressure you to use 3. Use nonverbal behavior to match verbal tobacco to change their behavior. behavior. • Suggest tobacco cessation programs to peo- • Do not hold a cigarette or pretend to ple who smoke or use smokeless tobacco. smoke. • Be a role model for a tobacco-free lifestyle. • Do not use or carry candy cigarettes or • Tell others who smoke not to light up shredded gum that is designed to look like around you. smokeless tobacco. 8. Avoid being influenced by tobacco ads. • Do not agree to get tobacco for a minor. • Recognize that ads are designed to con- • Do not keep tobacco products in your pos- vince people to use a product and make session for someone else. profit for the company. • Do not behave in ways that indicate that • Recognize that tobacco use is not sexy, you approve of tobacco use. sophisticated, adventurous, healthful, fun, or 4. Avoid being in situations in which there will be the “in” thing to do. pressure to use tobacco. • Do not attend or view sporting events or • Think ahead about what to say or do if concerts sponsored by tobacco companies. your peers are using tobacco. • Pay attention to the warnings on tobacco 5. Avoid being with people who use tobacco. ads. • Choose friends who do not use tobacco. • Make complaints to city officials if bill- boards for tobacco are placed in your • Stay away from secondhand smoke. neighborhood or near your school.

434 UNIT 7 • Alcohol, Tobacco, and Other Drugs (tt)Photodisc/Getty Images, (cl)Photodisc/Getty Images k Key Terms Review Complete these fill-in-the-blank statements with the lesson Key Terms on the left. Do not write in this book.

1. The stimulant drug found in tobacco 6. A(n) herbal plant that contains nicotine 38 products is _____ . and is grown for its leaves is called _____ . STUDY 2. The inability of alveoli to function is called 7. Any chemical known to cause cancer is _____. a(n) _____. GUIDE 3. A product that is placed on the skin of the 8. A gas that interferes with the ability of the carbon monoxide arm to release nicotine in the body is blood to carry oxygen is _____ . carcinogen called a(n) _____ . 9. The sticky, thick liquid formed when emphysema 4. Powdered tobacco leaves and stems form a tobacco burns is called _____ . leukoplakia product called _____ . 10. Exhaled and sidestream smoke also is mainstream smoke 5. White patches of abnormal cells in the called _____. nicotine mouth are called _____ . nicotine patch secondhand smoke Recalling the Facts sidestream smoke 11. What are the effects of nicotine on the 15. Why is nicotine considered a stimulant? snuff body? 16. How does smoking harm the respiratory tar 12. Name three types of tobacco products. system? tobacco 13. What are the three types of tobacco smoke? 17. How is smoking related to heart disease? 14. Name two methods people use to quit 18. What is the relationship between smoking smoking. and automobile accidents? Critical Thinking 19. Analyze the physical, mental, social, and Real-Life Applications legal consequences of tobacco use. 23. Why do you think teenagers start 20. Discuss the laws and policies regarding the smoking? sale and use of cigarettes. 24. What tip to resist peer pressure do you 21. Why do you think people who began think is the most useful and why? smoking as teens have a more difficult 25. If you saw a friend or sibling smoking, time quitting than people who began what would you say to him or her? smoking as adults? 26. Why do you think teenagers are influenced 22. Why do you think advertisers target minors? by television or magazine ads? Activities Responsible Decision Making Sharpen Your Life Skills 27. Resist Peer Pressure Suppose your 28. Make Responsible Decisions Find friend offers you a cigarette. You have two different ads for tobacco products. never smoked before. Your friend tells you Identify how each ad is designed to make that trying one cigarette will not harm you. tobacco more appealing to teens. Write a Write a paragraph about what you should story about the scene in each ad that tells do. Refer to the Responsible Decision- the truth about using tobacco products. Making Model on page 61 to see the steps Attach each story to the appropriate ad. involved in making responsible decisions. Share the stories with your classmates.

Visit healthmh.com/study_guide for more review questions. LESSON 38 • Study Guide 435 (cl)courtesy of American Lung Association, (bl)Photodisc/Getty Images