26 Ağustos 2010 Perşembe
Carpal Tunnel Syndrome
Carpal Tunnel Syndrome is the compression of the median nerve travelling through the carpal tunnel. Carpal.The carpal tunnel is an anatomical compartment located at the base of the wrist. Nine flexor tendons and the median nerve pass through the carpal tunnel that is surrounded on three sides by the carpal bones that form an arch.Compression of the median nerve as it runs deep to the transverse carpal ligament causes atrophy of the thenar eminence, weakness of the flexor pollicis brevis, opponens pollicis, abductor pollicis brevis, as well as sensory loss in the distribution of the median nerve distal to the transverse carpal ligament.
Clinical assessment by history taking and physical examination can support a diagnosis of CTS.But diagnosis of carpal tunnel syndrome is confirmed by electrophysiological testing.
* Phalen's maneuver is performed by flexing the wrist gently as far as possible, then holding this position and awaiting symptoms.A positive test is one that results in numbness in the median nerve distribution when holding the wrist in acute flexion position within 60 seconds. • Phalen’s sign is defined as pain and/or paresthesias in the median-innervated fingers with one minute of wrist flexion.
*Tinel's is performed by lightly tapping the skin over the flexor retinaculum to elicit a sensation of tingling or "pins and needles" in the nerve distribution.• Tinel’s sign (pain and/or paresthesias of the median-innervated fingers with percussion over the median nerve) is less sensitive, but slightly more specific than Phalen’s sign.
To aid in the prevention of Carpal Tunnel Syndrome, stretching exercises of the wrist, hand, and fingers have been used to combat against the pain and numbness caused by repetitive actions. Other than using recommended stretches and exercises, useful treatments for CTS include use of night splints, corticosteroid injections and ultimately surgery.
Antiarrhythmic Therapy
Antiarrhythmic drugs are a group of pharmaceuticals that are used to suppress fast rhythms of the heart such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation.Antiarrhythmic agents may be considered the first-line therapy in the prevention of sudden death in certain forms of structural heart disease, and failure of these agents to suppress arrhythmias may lead to implantation of an implantable cardioverter-defibrillator (ICD).
There are five main classes in the Vaughan Williams classification of antiarrhythmic agents:
* Class I agents interfere with the sodium (Na+) channel.
* Class II agents are anti-sympathetic nervous system agents. Most agents in this class are beta blockers.
* Class III agents affect potassium (K+) efflux.
* Class IV agents affect calcium channels and the AV node.
* Class V agents work by other or unknown mechanisms.
The class I antiarrhythmic agents interfere with the sodium channel and they are also called Membrane Stabilizing agents.Class II agents are conventional beta blockers. They act by blocking the effects of catecholamines at the β1-adrenergic receptors, thereby decreasing sympathetic activity on the heart.Class III agents predominantly block the potassium channels, thereby prolonging repolarization.Class IV agents are slow calcium channel blockers. They decrease conduction through the AV node, and shorten the plateau phase of the cardiac action potential.
Asthma
Asthma is a condition that affects a person's airways, which are also called breathing tubes or bronchial tubes. These tubes lead from the windpipe, or trachea, into the lungs.
For most kids, breathing is simple: They breathe in through their noses or mouths and the air goes into the windpipe. From there, it travels through the airways and into the lungs. But for kids with asthma, breathing can be a lot more difficult because their airways are very sensitive.
An asthma flare-up, which some people call an asthma attack or episode, happens when a person's airways get swollen and narrower and it becomes a lot harder for air to get in and out of the lungs. Sometimes the swollen airways produce extra mucus, which makes things pretty sticky, so it's easy to see why it's hard to breathe.
In between flare-ups, a kid's breathing can be totally normal or seem that way. But during a flare-up, it can feel like the person is breathing through a straw. A kid with asthma may wheeze (a whistling sound when he or she breathes), cough, and feel tightness in the chest. An asthma flare-up can get worse and worse if a kid doesn't use asthma medicine. After an asthma flare-up, the airways almost always return to the way they were before, although it can take several days.
Who Gets Asthma?
Asthma is more common than you might think. As many as 6 million kids in the United States have it. Asthma affects about 1 or 2 kids out of 10. That means if you have 20 kids in your class, 2-4 of them might have asthma. Asthma can start at any age — even in a little baby or an adult — but it's most common in school-age kids.
No one really knows why one person's airways are more sensitive than another person's, but we do know that asthma runs in families. That means if a kid has asthma, he or she may also have a parent, sibling, uncle, or other relative who has asthma or had it as a child.
Asthma flare-ups may sound a little like a cold, with coughing and wheezing, but asthma isn't contagious. You can't catch it from someone like you can catch a cold.
What Causes an Asthma Flare-Up?
Different kids have different triggers — things that set off asthma flare-ups. There are a lot of triggers. Some kids are sensitive to allergens, substances that cause allergic reactions in the airways. Common allergens for kids with asthma include dust mites (tiny bugs that live in dust), mold (if you've ever been in a damp basement and smelled something funny, it was probably mold), and pollen (from trees, grass, and weeds).
A lot of kids have asthma flare-ups when they are near furry animals. Cats and dogs both have what's called animal dander in their fur. This is sort of like dandruff, and it's a trigger that can cause a powerful reaction in the airways.Some substances can trigger flare-ups because they really irritate the airways. These include perfume, chalk dust, and cigarette smoke. Smoking is always a bad idea, especially around someone who has asthma.
Sometimes an infection can be a trigger and set off an asthma flare-up. If a kid comes down with a cold or the flu, his or her airways may become more sensitive than usual. In some kids, cold air itself can cause an asthma flare-up, and so can exercise. In fact, some kids have what's called exercise-induced asthma. This means they have breathing problems mainly when they exercise.
How Is Asthma Treated?
Kids who have asthma should try to avoid things that can cause their airways to tighten. But some triggers — like cats, colds, and chalk dust — can't always be avoided. That's why kids who are sensitive to those things must manage their asthma by taking medication.
Not every kid's asthma is the same, so there are different medicines for treating it. It's not like curing a sore throat or an earache, when everybody gets the same medicine. Instead, the doctor will think about what causes the asthma flare-ups, how fast the flare-ups happen, and how serious they are. Then he or she will decide on the best kind of treatment.
Some kids need to take asthma medication only once in a while, when they have a flare-up. This is called rescue medicine because it works fast to open the airways, so the person can breathe. Other kids may need to take controller medicine every day. Controller medicine works to keep flare-ups from happening.
A kid who knows in advance that he or she will be around allergens or other triggers may need to take medication ahead of time that will keep the airways open. And kids who have exercise-induced asthma can take medication before exercising so they'll be able to finish a race or game.
Whatever their triggers are, kids with asthma can use a peak flow meter to get an idea of how well they are breathing that day and whether they need to take any medicine.
Asthma medicine often is taken through an inhaler, a plastic tube that holds a container of medicine. You may have seen a friend or someone in school using an inhaler, which is held up to the mouth. A kid holds the inhaler up to his or her mouth and breathes in. The medicine comes out in a mist that goes into the lungs. The medicine in the mist relaxes the airways, so the person can breathe easier.
Space Out With a Spacer
Sometimes a kid uses an inhaler and something called a spacer. A spacer is a piece that attaches to the inhaler and holds the mist in one place, between the inhaler and the kid's mouth. It lets the kid breathe in when he or she is ready, so it's easier to inhale all the medication.
Using a spacer is important because it makes sure the medicine travels to where it needs to be — the lungs. Without a spacer the medication can be wasted by traveling too short to the mouth or too far to the stomach.
Sometimes kids take other asthma medicines by swallowing them. Whatever medications a kid takes, the goal is always the same: to get the asthma flare-ups under total control, so the triggers don't create problems.
A lot of kids find their asthma goes away or becomes less serious as they get older. Some doctors think this happens because the airways grow wider as a kid grows up and gets bigger. With more room in the airways, the air has an easier time getting in and out.
Some people do have asthma as adults, but it doesn't have to slow them down. Plenty of Olympic athletes and other sports stars manage their asthma and keep on playing!
Reviewed by: Nicole Green, MD
For most kids, breathing is simple: They breathe in through their noses or mouths and the air goes into the windpipe. From there, it travels through the airways and into the lungs. But for kids with asthma, breathing can be a lot more difficult because their airways are very sensitive.
An asthma flare-up, which some people call an asthma attack or episode, happens when a person's airways get swollen and narrower and it becomes a lot harder for air to get in and out of the lungs. Sometimes the swollen airways produce extra mucus, which makes things pretty sticky, so it's easy to see why it's hard to breathe.
In between flare-ups, a kid's breathing can be totally normal or seem that way. But during a flare-up, it can feel like the person is breathing through a straw. A kid with asthma may wheeze (a whistling sound when he or she breathes), cough, and feel tightness in the chest. An asthma flare-up can get worse and worse if a kid doesn't use asthma medicine. After an asthma flare-up, the airways almost always return to the way they were before, although it can take several days.
Who Gets Asthma?
Asthma is more common than you might think. As many as 6 million kids in the United States have it. Asthma affects about 1 or 2 kids out of 10. That means if you have 20 kids in your class, 2-4 of them might have asthma. Asthma can start at any age — even in a little baby or an adult — but it's most common in school-age kids.
No one really knows why one person's airways are more sensitive than another person's, but we do know that asthma runs in families. That means if a kid has asthma, he or she may also have a parent, sibling, uncle, or other relative who has asthma or had it as a child.
Asthma flare-ups may sound a little like a cold, with coughing and wheezing, but asthma isn't contagious. You can't catch it from someone like you can catch a cold.
What Causes an Asthma Flare-Up?
Different kids have different triggers — things that set off asthma flare-ups. There are a lot of triggers. Some kids are sensitive to allergens, substances that cause allergic reactions in the airways. Common allergens for kids with asthma include dust mites (tiny bugs that live in dust), mold (if you've ever been in a damp basement and smelled something funny, it was probably mold), and pollen (from trees, grass, and weeds).
A lot of kids have asthma flare-ups when they are near furry animals. Cats and dogs both have what's called animal dander in their fur. This is sort of like dandruff, and it's a trigger that can cause a powerful reaction in the airways.Some substances can trigger flare-ups because they really irritate the airways. These include perfume, chalk dust, and cigarette smoke. Smoking is always a bad idea, especially around someone who has asthma.
Sometimes an infection can be a trigger and set off an asthma flare-up. If a kid comes down with a cold or the flu, his or her airways may become more sensitive than usual. In some kids, cold air itself can cause an asthma flare-up, and so can exercise. In fact, some kids have what's called exercise-induced asthma. This means they have breathing problems mainly when they exercise.
How Is Asthma Treated?
Kids who have asthma should try to avoid things that can cause their airways to tighten. But some triggers — like cats, colds, and chalk dust — can't always be avoided. That's why kids who are sensitive to those things must manage their asthma by taking medication.
Not every kid's asthma is the same, so there are different medicines for treating it. It's not like curing a sore throat or an earache, when everybody gets the same medicine. Instead, the doctor will think about what causes the asthma flare-ups, how fast the flare-ups happen, and how serious they are. Then he or she will decide on the best kind of treatment.
Some kids need to take asthma medication only once in a while, when they have a flare-up. This is called rescue medicine because it works fast to open the airways, so the person can breathe. Other kids may need to take controller medicine every day. Controller medicine works to keep flare-ups from happening.
A kid who knows in advance that he or she will be around allergens or other triggers may need to take medication ahead of time that will keep the airways open. And kids who have exercise-induced asthma can take medication before exercising so they'll be able to finish a race or game.
Whatever their triggers are, kids with asthma can use a peak flow meter to get an idea of how well they are breathing that day and whether they need to take any medicine.
Asthma medicine often is taken through an inhaler, a plastic tube that holds a container of medicine. You may have seen a friend or someone in school using an inhaler, which is held up to the mouth. A kid holds the inhaler up to his or her mouth and breathes in. The medicine comes out in a mist that goes into the lungs. The medicine in the mist relaxes the airways, so the person can breathe easier.
Space Out With a Spacer
Sometimes a kid uses an inhaler and something called a spacer. A spacer is a piece that attaches to the inhaler and holds the mist in one place, between the inhaler and the kid's mouth. It lets the kid breathe in when he or she is ready, so it's easier to inhale all the medication.
Using a spacer is important because it makes sure the medicine travels to where it needs to be — the lungs. Without a spacer the medication can be wasted by traveling too short to the mouth or too far to the stomach.
Sometimes kids take other asthma medicines by swallowing them. Whatever medications a kid takes, the goal is always the same: to get the asthma flare-ups under total control, so the triggers don't create problems.
A lot of kids find their asthma goes away or becomes less serious as they get older. Some doctors think this happens because the airways grow wider as a kid grows up and gets bigger. With more room in the airways, the air has an easier time getting in and out.
Some people do have asthma as adults, but it doesn't have to slow them down. Plenty of Olympic athletes and other sports stars manage their asthma and keep on playing!
Reviewed by: Nicole Green, MD
23 Ağustos 2010 Pazartesi
What is Smokeless Tobacco?
What is "Smokeless Tobacco"?
Smokeless tobacco, also referred to as spit tobacco, is tobacco that is not smoked or lighted.
Spit tobacco is a mixture of tobacco, nicotine, sweeteners, abrasives, salts and chemical.
Smokeless Tobacco comes in two forms: snuff and chew.
• Most popular variety of smokeless tobacco and may be dry or moist.
• Dry snuff is usually sniffed through the nose and is more common in other countries.
• Snuff is a finely ground tobacco similar to a powder.
• The form most commonly used by youth today is moist snuff often called "dipping".
• Snuff is sold in small round tins or "pucks".
• A pinch of snuff is placed between the cheek and gum.
• A less messy variety of snuff is available in small individual packets that resemble small tea bags.
Chew
• Available in 3 forms - loose leaf, twist or plug.
• Loose leaf chew (shredded tobacco leaves) is the most common and is sold in pouches.
• Twist tobacco consists of dried leaves twisted into ropes.
Smokeless tobacco, also referred to as spit tobacco, is tobacco that is not smoked or lighted.
Spit tobacco is a mixture of tobacco, nicotine, sweeteners, abrasives, salts and chemical.
Smokeless Tobacco comes in two forms: snuff and chew.
Snuff
• Most popular variety of smokeless tobacco and may be dry or moist.
• Dry snuff is usually sniffed through the nose and is more common in other countries.
• Snuff is a finely ground tobacco similar to a powder.
• The form most commonly used by youth today is moist snuff often called "dipping".
• Snuff is sold in small round tins or "pucks".
• A pinch of snuff is placed between the cheek and gum.
• A less messy variety of snuff is available in small individual packets that resemble small tea bags.
Chew
• Available in 3 forms - loose leaf, twist or plug.
• Loose leaf chew (shredded tobacco leaves) is the most common and is sold in pouches.
• Twist tobacco consists of dried leaves twisted into ropes.
• Plug tobacco is compressed into a small brick and a piece must be cut off.
• Loose leaf, twist or plug can be either chewed or sucked.
• Excess tobacco juice and extra saliva builds up in the mouth which must be spit out (into empty water or ice tea bottles for example).
• Loose leaf, twist or plug can be either chewed or sucked.
• Excess tobacco juice and extra saliva builds up in the mouth which must be spit out (into empty water or ice tea bottles for example).
Spit tobacco has over 3,000 chemicals, including 28 cancer causing agents.
Spit tobacco is not a safe substitute for cigarettes. Some side effects include but may not be limited to:
• Cancer of the mouth (lip, tongue, and cheek, floor and roof of the mouth) and throat.
• Leukoplakia (white, leathery sores) may develop where tobacco is held in the mouth, such as the cheeks, gums or tongue. These sores can turn into cancer of the mouth.
• Increased heart rate, high blood pressure and irregular heartbeats.
• Nicotine addiction. Spit tobacco contains more nicotine than cigarettes.
• Constricted blood vessels (caused by the nicotine) can slow your reaction time and cause dizziness.
• Tooth and gum disease including cavities, lost teeth, bad breath and painful sores.
• Spit tobacco contains more nicotine than cigarettes.
• Spit tobacco causes oral cancer.
• About half of all oral cancer victims die within five years.
• Long-term moist snuff users increase their risk of cancer of the cheek and gum by up to 50 times.
• Spit tobacco increases the risk of cancers of the throat, voice box and esophagus.
• Spit tobacco affects the cardiovascular system and may cause heart disease, stroke and high blood pressure.
• Many people start using spit tobacco at a very young age (approximately nine or 10 years old).
• The use of spit tobacco is a health and sanitation issue.
Spit tobacco contains 28 carcinogens (cancer-causing agents).2
All tobacco, including spit tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from spit tobacco is 3 to 4 times the amount delivered by a cigarette. Nicotine is absorbed more slowly from spit tobacco than from cigarettes, but more nicotine per dose is absorbed from spit tobacco than from cigarettes. Also, the nicotine stays in the bloodstream for a longer time.
Smokeless tobacco users increase their risk for cancer of the oral cavity. Oral cancer can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.
People who use snuff for a long time have a much greater risk for cancer of the cheek and gum than people who do not use smokeless tobacco.
The possible increased risk for other types of cancer from smokeless tobacco is being studied.
Some of the other effects of smokeless tobacco use include:
• Addiction to nicotine.
• Oral leukoplakia (white mouth lesions that can become cancerous).
• Gum disease and gum recession (when the gum pulls away from the teeth).
• İncreased risks for heart disease, diabetes and reproductive problems.
All About Smokeless Cigarette
All About Smokeless Cigarette
Smokeless Cigarette: Things You Need to Know About
According to world health statistics, cancer is the second primary cause of death and cigarette smoking causes most of these cases. But because of the advent of advanced research and technology, a smokeless cigarette is now being manufactured and promoted to provide a safer alternative to cigarette smoking.
What Is a Smokeless Cigarette?
A smokeless cigarette, also known as "electronic cigarettes", "e-cigarettes", or "personal vaporizer" is a gadget powered by a battery in which doses of nicotine is inhaled through a vaporized solution. Cigarettes manufacturers endorse this method as a safer substitute to smoking cigarettes; their claim is that most of the hazardous material produced by the combustion of traditional cigarettes like tobacco is non-existent in the atomized liquid of asmokeless cigarette.
What Are the Advantages of a Smokeless Cigarette?
Safe alternative
With the exclusion of nicotine for this matter, the ingredients or composition of a smokeless cigarette have undergone a thorough laboratory test and thus, certified to be food-safe. However, most of the ingredients are not tested as to its safety considering long-term inhalation and use.
With the exclusion of nicotine for this matter, the ingredients or composition of a smokeless cigarette have undergone a thorough laboratory test and thus, certified to be food-safe. However, most of the ingredients are not tested as to its safety considering long-term inhalation and use.
Fresh smell
Smokeless cigarette gets rid of the unwanted, unpleasant, and strong odor which is hard to cover up; so your outfit stays fresh and won't stink with tobacco.
Sanitary and Hygienic
Smokeless cigarette does not contain harmful carcinogenic chemicals; the chemicals that cause and aggravate cancer. The traditional tobacco cigarettes contain more than 4,000 different hazardous chemicals, at least 50 are known to be carcinogens and many other are poisonous. With a smokeless cigarette, worry no more since these harmful chemicals are already eliminated.
Legalities
Cigarette smoking is an absolute No, No in public places but because of this unique innovation, legality issues of smokeless cigarette smoking is now subjected to public health investigations to amend laws and medical drug policies.
Genuine and Authentic
Many of those who tried smokeless cigarette smoking find the sensational feeling of e-smoking nearly identical to that of tobacco smoking. The biggest advantage is smokeless cigarette smoking does not harm the body than smoking does.
Many of those who tried smokeless cigarette smoking find the sensational feeling of e-smoking nearly identical to that of tobacco smoking. The biggest advantage is smokeless cigarette smoking does not harm the body than smoking does.
Economical and Affordable
With a smokeless cigarette, you can have big savings due to its economical marketing scheme - initial one time investment. Buy the Starter Kit and the smokeless cigarette cartridges are replaced as consumed while the battery could last up to a year. A single smokeless cigarette cartridge is already equal to a pack of cigarettes.
With a smokeless cigarette, you can have big savings due to its economical marketing scheme - initial one time investment. Buy the Starter Kit and the smokeless cigarette cartridges are replaced as consumed while the battery could last up to a year. A single smokeless cigarette cartridge is already equal to a pack of cigarettes.
People-friendly and Environment-friendly
It is perfectly safe to smoke near people using smokeless cigarette since no smoke that are harmful both to humans and the environment is being emitted; harmless vapor that dissolves quickly are emitted instead.
It is perfectly safe to smoke near people using smokeless cigarette since no smoke that are harmful both to humans and the environment is being emitted; harmless vapor that dissolves quickly are emitted instead.
How Does a Smokeless Cigarette Work?
Main components of a Smokeless Cigarette:
1. Atomizing chamber
The atomizer is situated at the core of the chamber; this is a small segment made up of wire-wool kind of material that turns nicotine solution to vapor once drawn during the suction. This is connected to the battery through a brass screw fitting also conducting the electricity transversely.
1. Atomizing chamber
The atomizer is situated at the core of the chamber; this is a small segment made up of wire-wool kind of material that turns nicotine solution to vapor once drawn during the suction. This is connected to the battery through a brass screw fitting also conducting the electricity transversely.
2. Mouthpiece / Cartridge
The nicotine solution is enclosed in a cartridge that is attached to the mouthpiece. The cartridge is designed to be disposable. The solution includes flavorings, water, nicotine, and propylene glycol (the active material which makes the solution turn into a smoke-like mist.
3. Battery
The power needed to produce the mist is a substantial function. This will supply the power to the atomizer when the pressure sensor is activated by absorbing the air through. It is only recently that batteries have become powerful enough to fit-in a sensible-sized part of the electronic cigarette.
The entire function of the smokeless cigarette gadget is controlled by a silicon chip created by Motorola. They guaranteed to include the functionality of the smokeless cigarette to be able to regularly clean itself every 1500 puffs, controlling the smoker's response through the LED located at the end of the cigarette.
Smokeless cigarette is one of man's fantastic innovation and hi-tech engineering. Advanced research studies is being undertaken to safeguard the effect of smokeless cigarette smoking to human health, particularly its effect in long-term use. The best way to protect ourselves is to find ways and means to boost the immune system and live life to the fullest - that is having a sound mind, healthy body and cheerful spirit.
Smokeless Tobacco and Cancer: Questions and Answers
What are the facts of smokeless tobacco?
| Key Points
|
- There are two types of smokeless tobacco—snuff and chewing tobacco. Snuff, a finely ground or shredded tobacco, is packaged as dry, moist, or in sachets (tea bag-like pouches). Typically, the user places a pinch or dip between the cheek and gum. Chewing tobacco is available in loose leaf, plug (plug-firm and plug-moist), or twist forms, with the user putting a wad of tobacco inside the cheek. Smokeless tobacco is sometimes called “spit” or “spitting” tobacco because people spit out the tobacco juices and saliva that build up in the mouth.
· Chewing tobacco and snuff contain 28 carcinogens (cancer-causing agents). The most harmful carcinogens in smokeless tobacco are the tobacco-specific nitrosamines (TSNAs). They are formed during the growing, curing, fermenting, and aging of tobacco. TSNAs have been detected in some smokeless tobacco products at levels many times higher than levels of other types of nitrosamines that are allowed in foods, such as bacon and beer.
· Other cancer-causing substances in smokeless tobacco include N-nitrosamino acids, volatile N-nitrosamines, benzo(a)pyrene, volatile aldehydes, formaldehyde, acetaldehyde, crotonaldehyde, hydrazine, arsenic, nickel, cadmium, benzopyrene, and polonium–210.
· All tobacco, including smokeless tobacco, contains nicotine, which is addictive. The amount of nicotine absorbed from smokeless tobacco is 3 to 4 times the amount delivered by a cigarette. Nicotine is absorbed more slowly from smokeless tobacco than from cigarettes, but more nicotine per dose is absorbed from smokeless tobacco than from cigarettes. Also, the nicotine stays in the bloodstream for a longer time.
· Smokeless tobacco users increase their risk for cancer of the oral cavity. Oral cancer can include cancer of the lip, tongue, cheeks, gums, and the floor and roof of the mouth.
· People who use oral snuff for a long time have a much greater risk for cancer of the cheek and gum than people who do not use smokeless tobacco.
· The possible increased risk for other types of cancer from smokeless tobacco is being studied.
- What are some of the other ways smokeless tobacco can harm users’ health?
- Some of the other effects of smokeless tobacco use include addiction to nicotine, oral leukoplakia (white mouth lesions that can become cancerous), gum disease, and gum recession (when the gum pulls away from the teeth). Possible increased risks for heart disease, diabetes, and reproductive problems are being studied.
- Is smokeless tobacco a good substitute for cigarettes?
- In 1986, the Surgeon General concluded that the use of smokeless tobacco “is not a safe substitute for smoking cigarettes. It can cause cancer and a number of noncancerous conditions and can lead to nicotine addiction and dependence.” Since 1991, NCI has officially recommended that the public avoid and discontinue the use of all tobacco products, including smokeless tobacco. NCI also recognizes that nitrosamines, found in tobacco products, are not safe at any level. The accumulated scientific evidence does not support changing this position.
- What about using smokeless tobacco to quit cigarettes?
- Because all tobacco use causes disease and addiction, NCI recommends that tobacco use be avoided and discontinued. Several non-tobacco methods have been shown to be effective for quitting cigarettes. These methods include pharmacotherapies such as nicotine replacement therapy and bupropion SR, individual and group counseling, and telephone quitlines.
- Who uses smokeless tobacco?
· In the United States
· An estimated 7.6 million Americans age 12 and older (3.4 percent) had used smokeless tobacco in the past month.
· Smokeless tobacco use was most common among young adults ages 18 to 25.
· Men were 10 times more likely than women to report using smokeless tobacco (6.5 percent of men age 12 and older compared with 0.5 percent of women).
· People in many other countries and regions, including India , parts of Africa , and some Central Asian countries, have a long history of using smokeless tobacco products.
- Health Promotions in the
Date reviewed: 07/2006
Smokeless Tobacco and Cancer: Questions and Answers
Robert E Bush
Naval Hospital
Twentynine Palms
Health Promotions
760.830.2814
www.nhtp.med.navy.mil
Smokeless Tobacco
Smokeless Tobacco
You don't smoke it. You don't swallow it. All you do is slosh it around your mouth and spit out the brown juices every few seconds. OK, so it actually is pretty disgusting. But so what? After all, it's called smokeless or chewing tobacco. That means you chew and spit it, not smoke it, so it can't be as bad as inhaling tobacco smoke into your lungs, right?
Wrong . . . unfortunately, smokeless doesn't mean harmless. The fact is, chewing tobacco is every bit as dangerous as smoking it.
What Is Smokeless Tobacco?
Smokeless tobacco, also called spit tobacco, chewing tobacco, chew, chaw, dip, plug, and probably a few other things, comes in two forms: snuff and chewing tobacco.
Snuff is a fine-grain tobacco that often comes in teabag-like pouches that users "pinch" or "dip" between their lower lip and gum. Chewing tobacco comes in shredded, twisted, or "bricked" tobacco leaves that users put between their cheek and gum. Whether it's snuff or chewing tobacco, you're supposed to let it sit in your mouth and suck on the tobacco juices, spitting often to get rid of the saliva that builds up. This sucking and chewing allows nicotine, which is a drug you can become addicted to, to be absorbed into the bloodstream through the tissues in your mouth. You don't even need to swallow.
Where Does It Come From?
Smokeless tobacco has been around for a long time. Native people of North and South America chewed tobacco, and snorting and chewing snuff was popular in Europe and Scandinavia (the word "snuff" comes from the Scandinavian word "snus").
In the United States, chewing tobacco has long been associated with baseball. Players chewed it to keep their mouths moist, spit it into their gloves to soften them up, and used it to make a "spitball," a special pitch that involved the pitcher dabbing the ball with saliva to cause it to spin off the fingers easily and break sharply. (Spitballs were banned from the sport in 1920.) By the 1950s, chewing tobacco had fallen out of favor in most of America, so by that time not too many baseball players were spitting big brown gobs all over the infield. Instead of chewing their tobacco, most people were smoking it.
But, in the 1970s, people became more aware of the dangers of smoking. Thinking it was a safe alternative to lighting up, baseball players started chewing on their tobacco again. Some players even developed the habit of mixing their chewing tobacco with bubble gum and chewing the whole thing. Gross, huh?
These days, you don't find the majority of professional ballplayers with wads of chaw in their cheeks. But lots of guys and girls, athletes or not, still find time for chewing and spitting.
Who Chews?
As many as 20% of high school boys and 2% of high school girls use smokeless tobacco, according to the Centers for Disease Control and Prevention (CDC). Of the 12 to 14 million American users, one third are under age 21, and more than half of those developed the habit before they were 13. Peer pressure is just one of the reasons for starting the habit. Serious users often graduate from brands that deliver less nicotine to stronger ones. With each use, you need a little more of the drug to get the same feeling.
So What's the Danger?
Just like smoking cigarettes, chewing smokeless tobacco can eventually rip apart your body and kill you. It's that simple, really. There's no such thing as a "safe" tobacco product.
Take Bill Tuttle, for example. An outfielder for the Detroit Tigers, the Kansas City Athletics (before they moved to Oakland), and the Minnesota Twins, Tuttle chewed tobacco for most of his career. In fact, a lot of Tuttle's baseball cards over the years pictured him with a cheek bulging with chewing tobacco. Thirty-eight years after the end of his baseball career, Tuttle had a more ominous bulge in his cheek — a huge tumor that was so big that it came through his cheek and extended through his skin. Doctors removed the tumor, along with much of Tuttle's face. Chewing tobacco as a young man had cost him his jawbone, his right cheekbone, a lot of his teeth and gum line, and his taste buds. Cancer caused by his chewing habit finally claimed him in 1998, but Tuttle spent the rest of his life trying to steer young people, as well as grown athletes, away from smokeless tobacco.
Other baseball players have met a similar fate. Even one of the greatest of all time, Babe Ruth, was fond of dipping and chewing tobacco. He died at age 52 of an oropharyngeal tumor, which is a cancerous tumor in the back part of the throat.
But, of course, it isn't just baseball players who learn to regret their choice to start chewing tobacco. According to the CDC, each year about 30,000 Americans learn they have mouth and throat cancers, and nearly 8,000 die of these diseases. Sadly, only about half of people with diagnosed mouth or throat cancer survive more than 5 years.
What Can Chewing Tobacco Do to Me?
The more immediate effects can disrupt your social life: bad breath and yellowish-brown stains on your teeth. You'll also get mouth sores (about 70% of spit tobacco users have them). But, it gets a lot more serious than that. Consequences of chewing and spitting tobacco include:
-cracking and bleeding lips and gums
-receding gums, which can eventually make your teeth fall out
-increased heart rate, high blood pressure, and irregular heartbeats, all leading to a -greater risk of heart attacks and brain damage (from a stroke)
-cancer
Oral cancer means cancer of the mouth and can happen in the lips, the tongue, the floor of the mouth, the roof of the mouth, the cheeks, or gums. It's been medically proven that long-time use of chewing tobacco can lead to cancer. But cancer from chewing tobacco doesn't just occur in the mouth. Some of the cancer-causing agents in the tobacco can get into the lining of your stomach, your esophagus, and into your bladder.
Quitting the Dipping
If you're a dipper, put some long thought into breaking the habit and quitting now. When you decide to quit, don't do it alone. Tell friends or family and enlist their support. Strategies for breaking the habit include:
using a nicotine gum or a patch (ask your doctor about these options first)
planning ahead and using substitutes such as tobacco-free, mint-leaf snuff; sugarless gum; hard candy; beef jerky; sunflower seeds; shredded coconut; raisins; or dried fruit
getting involved in healthier activities: lifting weights, shooting baskets, going for a swim, etc.
It's tough to quit, but realize that backsliding is common, so don't give up. Your chances of success increase with each try!
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