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Tobacco cessation fall 2011 Instructor (1)_ For use in lecture (3)

Total nicotine content per cigarette average 135 mg

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Total nicotine content, per cigarette: Average 13.5 mg (range, 11.9 to 14.5 mg)   Machine-measured nicotine yield: Smoker’s nicotine yield, per cigarette: Approximately 1 to 2 mg   Marlboro and Marlboro Light are registered trademarks of Philip Morris, Inc. Type of cigarette Yield per cigarette Full-flavor (regular) 1.1 mg Light 0.8 mg Ultra-light 0.4 mg Average  (all brands) 0.9 mg
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SMOKELESS TOBACCO Chewing tobacco Looseleaf Plug Twist Snuff Moist Dry The Copenhagen and Skoal logos are registered trademarks of U.S. Smokeless Tobacco Company, and Red Man is a registered trademark of Swedish Match.
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SMOKELESS FORMS of  TOBACCO Estimated 8.1 million users in the U.S. in 2007 Males (6.3%) more likely than females (0.4%) to be current users Prevalence highest among Young adults aged 18-25 years American Indians and Alaskan Natives Residents of the southern U.S. and rural areas Significant health risks Numerous carcinogens Nicotine exposure comparable to that of smokers, leading to Physical dependence Withdrawal symptoms after abstinence
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NICOTINE CONTENT in  SMOKELESS TOBACCO  PRODUCTS Dose Product pH Total free  nicotine (mg/g) Low Hawken Wintergreen 5.2 – 5.7 0.01 – 0.02 Skoal Bandits Wintergreen 6.9 – 7.1 0.5 – 1.0 Medium Skoal Long Cut Straight 7.5 – 7.6 2.4 – 3.7 High Kodiak Wintergreen 8.2 – 8.4 5.8 – 6.5 Copenhagen 7.6 – 8.6 3.1 – 9.4 Data from Hatsukami et al. (2007). Am J Prev Med 33(6S) :S368–78.
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HEALTH CONSEQUENCES of  SMOKELESS TOBACCO USE Periodontal effects Gingival recession Bone attachment loss Dental caries Oral leukoplakia Cancer Oral cancer Pharyngeal cancer Oral Leukoplakia Image courtesy of Dr. Sol Silverman - University of California San Francisco
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ASSISTING PATIENTS  with QUITTING A Transtheoretical Model Approach
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Update released May 2008 Sponsored by the U.S. Department of  Health and Human Services, Public  Heath Service with: Agency for Healthcare Research and Quality National Heart, Lung, & Blood Institute National Institute on Drug Abuse Centers for Disease Control and Prevention National Cancer Institute www.surgeongeneral.gov/tobacco/ CLINICAL PRACTICE GUIDELINE for  TREATING TOBACCO USE and  DEPENDENCE HANDOUT
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EFFECTS of CLINICIAN  INTERVENTIONS 0 10 20 30 No clinician Self-help material Nonphysician clinician Physician clinician Type of Clinician Estimated abstinence at  5+  months 1.0 1.1 1.7 2.2 = 29 studies Fiore et al. (2008). Treating Tobacco Use and Dependence: 2008 Update. Clinical Practice Guideline. Rockville, MD: USDHHS, PHS, May 2008.
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