Tobacco

Tobacco use and exposure to tobacco smoke can lead to many health concerns. The Saskatchewan Prevention Institute offers information on the effects of exposure to tobacco smoke for unborn babies, infants, children, youth and women. Preventing exposure to tobacco smoke is one of the ways that parents, future parents, families and communities can promote and support long term health.

What is tobacco smoke?

Here are some definitions related to tobacco:

Tobacco:

a plant

Tobacco products:

any commercially produced product containing tobacco and combinations of other chemicals. To make these products the plant is dried and additives (chemicals) are mixed with the dried plant.

Examples of tobacco products are:
  • Cigarettes
  • Pipe tobacco
  • Cigars
  • Cigarillos
  • Roll-your own cigarettes
  • Bidis (little cigarettes that are hand rolled in leaves, tied with string)
  • Smokeless tobacco – chewing tobacco, pinch, snuff, snus, disolveable tablets
  • Water-pipe (hookah)
  • Sheesha
  • Blunt wraps (a sheet or tube of tobacco used to roll cigarette tobacco)
Tobacco products contain multiple chemicals and a drug called nicotine. Nicotine makes tobacco products extremely addictive.

Tobacco Smoke:

the smoke from a burning end of a tobacco product like cigarettes, cigar, cigarillo, and pipes.
Tobacco smoke contains over 4,000 harmful chemicals. All of these chemicals mix together to form a sticky tar. It is the tar that gives the cigarette smoke its smell and colour. Of the 4,000 chemicals in tobacco smoke, 50 are associated with causing cancer and promoting tumour growth. Some of the other substances in tobacco smoke include carbon monoxide, nicotine, tar, ammonia, arsenic, cyanide, and lead.

Second-hand smoke (SHS):

also referred to as environmental tobacco smoke (ETS).
SHS is made up of the smoke from the burning end of a tobacco product and the smoke that is blown into the air by the person smoking these products.

Third-hand smoke (THS):

the toxic chemicals in smoke that stay in the environment even after the person has put out a burning tobacco product.

These chemicals get trapped in clothes, carpets, fabric, furniture, hair, skin, and toys and can build up over time.

Adapted from: KNOW Tobacco: Think. Learn. Live [Teacher Resource Guide].
Accessed April 2014 from www.gotlungs.ca

E-cigarette

Electronic cigarette (e-cig or e-cigarette):

a cylindrical device made of stainless steel or plastic that mimics a cigarette in terms of its appearance and use and sometimes taste, but does not contain tobacco. The cartridge contains water and flavouring in a base of propylene glycol (PG), vegetable glycerine (VG), or polyethylene glycol 400. An atomizer containing a heating element turns the liquid nicotine into a vapour. The rechargeable battery that powers the atomizer and the indicator light that glows (usually red) like a lit cigarette when the user inhales.

In Canada there are regulations that e-cigarettes cannot be sold with nicotine in them however in the United States there are e-cigarettes that contain nicotine.

There is not a solid scientific evidence base for using e-cigarettes as a method to quit smoking cigarettes. The behaviour of using an e-cigarette does not de-normalize the act of smoking.

For more information on e-cigarettes visit Non-Smoker’s Rights Association May 2014

E-Cigarettes as an Aid to Quitting Smoking

Why aren’t more people quitting if many smokers want to quit and the health benefits of doing so are great?

  1. Tobacco products contain nicotine, a highly addictive substance.
  2. Quitting smoking can be difficult. Many smokers who try to quit experience repeated relapses.2

Why have people tried e-cigarettes to quit smoking?

  • Belief that E-Cigarettes are an Effective Way to Quit Smoking.
    Many advertisements have claimed that e-cigarettes are an effective way to quit smoking conventional cigarettes.3
    However, there is conflicting evidence as to whether e-cigarettes are an effective way to quit smoking; further research is needed.
  • Belief that E-Cigarettes are a Safer Alternative to Commercial Cigarettes.
    Some have claimed that e-cigarettes are a safer alternative to commercial tobacco products.4 Because of these claims, some parents may use e-cigarettes with the belief that it is safer for them and their children (e.g., to be exposed to e-liquid vapour, compared to conventional cigarette smoke.5
    However, further research is needed to answer key questions about the safety of e-cigarettes.6
  • Belief that E-Cigarettes are a More Appealing Alternative to Quit Smoking.
110547887
1 Fiore, 2008; National Health Service, 2008; as cited in Cahill, Stevens, Perera, & Lancaster, 2015.
2 Rahman, Hann, Wilson, Mnatzaganian and Worrall-Carter, 2015.
3 Kalkoran & Glantz, 2016.
4 Cobb, Brookover, & Cobb, 2016.
5 Garbutt et al., 2015.
6 Rahman, Hann, Wilson & Worrall-carter, 2014.

For some who smoke they do not find cessation aids such as Nicotine Replacement Therapy (NRT) and medication (i.e. Champix) appealing.7 E-cigarettes may be viewed as a more appealing way to quit smoking because they provide a similar experience to smoking regular cigarettes, while providing a dose of nicotine.8
However, e-cigarettes may prolong nicotine addiction in smokers who may otherwise have quit with approved products like Nicotine Replacement Therapy (NRT) or medication.9

Key messages about e-cigarettes

  • The health effects of e-cigarettes are not known, especially for children.
    For example, the vapour exhaled by a parent using e-cigarettes may contain nicotine, particles, heavy metals, and other components, which the child may then inhale.10
  • The e-liquid may contain varying amounts of nicotine and can be poisonous if absorbed through the skin or ingested by children.11
  • The use of e-cigarettes may teach children and youth that smoking is socially acceptable and lead them to start smoking commercial cigarettes. 12
  • The health effects of e-cigarette use during pregnancy and breast-feeding are not known.
    There is concern that exposures of the fetus and neonate to nicotine may contribute to pediatric lung disease and behavioural abnormalities.13
  • E-cigarettes with nicotine may cause a parent to remain addicted to nicotine, thereby continuing to expose their children to tobacco smoke and/or e-liquid vapour. 14

Health-Canada-DOES-NOT-recommend

7 Balfour, Benowitz, Fagerstrom, Kunze, & Keil, 2000.
8 Rahman et al., 2015.
9 Garbutt et al., 2015.
10 Garbutt et al., 2015.
11 Garbutt et al., 2015.
12 McRobbie et al., 2014; Stanwick, 2015.
13 Garbutt et al., 2015.
14 Garbutt et al., 2015.
15 Health Canada, 2009.

Need Help?

  • Did you know? A nicotine addiction can be overcome!
  • Need an aid to quit smoking? Consider an approved product like nicotine gum, lozenges, patches, or the inhaler. Talk to your healthcare professional for advice on the product that’s best for you.
  • Call the Smokers’ Helpline at 1-866-517-5333 or visit their website at www.smokershelpline.ca or find a trained cessation professional by visiting your pharmacist or www.makeapact.ca
  • Balfour, D., Benowitz, N., Fagerstrom, K., Kunze, M., & Keil, U. (2000). Diagnosis and treatment of nicotine dependence with emphasis on nicotine replacement therapy. European Heart Journal, 21, 438-445.
  • Cahill, K., Stevens, S., Perera, R., & Lancaster, T. (2013). Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Systematic Review, 5, Cd009329. doi: 10.1002/14651858.CD009329.pub2
  • Cobb, N.K., Brookover, J., & Cobb, C.O. (2015). Forensic analysis of online marketing for electronic nicotine delivery systems. Tobacco Control, 24, 128-131.
  • Garbutt, J.M., Miller, W., Dodd, S., Bobenhouse, N., Sterkel, R., & Strunk, R.C. (2015). Parental use of electronic cigarettes. Academic Pediatric Association, 15, 599-604.
  • Government of Canada. (2013). Nicotine Addiction. Retrieved from: http://www.healthycanadians.gc.ca/healthy-living-vie-saine/tobacco-tabac/effects-effets/body-corps/addiction-dependance-eng.php
  • Health Canada (archived). Health Canada advises Canadians not to use electronic cigarettes. March 27, 2009. Retrieved from: http://www.healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2009/13373a-eng.php
  • Kalkhoran, S., & Glantz, S.A. (2016). E-cigarettes and smoking cessation in real-world and clinical settings: a systematic review and meta-analysis. The Lancet Respiratory Medicine, 4, 116-28.
  • McRobbie, H., Bullen, C., Hartmann-Boyce, J., Hajek, P. (2014). Electronic cigarettes for smoking cessation and reduction (Review). Cochrane Database, 12, Cd010216.
  • Rahman, M.A., Hann, Z., Wilson, A., Mnatzaganian, G., & Worrall-Carter, L. (2015). E-cigarettes and smoking cessation: Evidence from a systematic review and meta-analysis. PLoS ONE, 10, 1-16. Doi: 10.1371/journal.pone.0122544.
  • Stanwick, R. (2015). E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada. Journal of Paediatrics and Child Health, 20, 101-105.
Electronic Cigarettes (e-cigarettes) and the Health and Safety Risks for Children

4-301: E-Cigarettes Fact Sheet

  • American Academy of Pedaitrics: Julius B. Richmond Centre of Excellence. E-Cigarettes: A Threat to Health. Retrieved from www2.aap.org
  • Canadian Paediatric Society. (2015, March 6). E-cigarettes: Are we renormalizing public smoking? Reversing five decades of tobacco control and revitalizing nicotine dependency in children and youth in Canada. Retrieved from www.cps.ca
  • Children’s Safety Network. (2015, July). E-Cigarette Poisoning. Retrieved from www.childrenssafetynetwork.org
  • Czogala, J., Goniewicz, M.L., Fidelus, B., Zielinska-Danch, W., Travers, M.J., & Sobczak, A. (2014). Exposure to Vapors From Electronic Cigarettes. Nicotine & Tobacco Research, 16, 655-662. Retrieved from www.ntr.oxfordjournals.org
  • Durmowicz, E.L. (2015). The impact of electronic cigarettes on the paediatric population. Tobacco Control, 23, ii41-ii46. Retrieved from www.tobaccocontrol.bmj.com
  • Interior Health Authority: Community Integrated Health Services Tobacco Reduction. (2013, September 10). Electronic Cigarettes: Do they Belong in Schools? Retrieved from www.rms.sd23.bc.ca
  • Non-Smokers’ Rights Association / Smoking and Health Action Foundation. (2015, December). E-cigarettes: Where we are in 2015. Retrieved from www.nsra-adnf.ca
  • Propel Centre for Population Health Impact. (2015 Edition). Tobacco Use in Canada: Patterns and Trends. Special Supplement: E-cigarettes in Canada. Retrieved from www.tobaccoreport.ca
  • Reed, J.L., Gervais, A.A., & Reid, R.D. (2013). Five Things to Know About…Electronic Cigarettes. Canadian Medical Association Journal, 185, 1427. Retrieved from www.cmaj.ca
  • Saskatoon Health Region. (2014). E-Cigarettes (Electronic Cigarettes). Retrieved from www.saskatoonhealthregion.ca
  • The Canadian Dental Hygienists Association. E-Cigarette Fact Sheet. Retrieved from www.dentalhygienecanada.ca
  • The Ontario Lung Association. (2015, April). Position Statement: Electronic Cigarettes. Retrieved from www.on.lung.ca
  • Toronto Public Health. (2014, August 1). Position Statement: Electronic Cigarettes. Retrieved from www.toronto.ca

Effects of Tobacco Smoke Exposure

Women

Smoking, use of tobacco products and being exposed to tobacco smoking during the childbearing years can affect a woman’s health and her ability to become pregnant. Women can take actions to influence the outcome of their health and the health of their future children.
Actions?

  • Know the facts. Get informed by continuing to read below on how tobacco affects women’s health or visit Smoking During Pregnancy
  • Talk with your health care provider about the role tobacco plays in your life.
  • Think about ways to reduce or quit smoking prior to becoming pregnant and stay quit.
  • Protect yourself from second-hand and third-hand smoke by asking others not to smoke around you. There is no level of smoking that has been proven to be safe. All tobacco use carries some health risks.
Find additional information on the phone by calling the Smokers’ HelpLine at 1-877-513-5333 or go online to www.pregnets.com or www.expectingtoquit.ca

Tobacco and Pregnancy

Smoking during pregnancy will increase the risks of complications that include:
  • Miscarriage
  • Ectopic (tubal) pregnancy: a fertilized egg implants outside of the uterus (usually in one of the uterine tubes). This is a critical situation as the life of the unborn baby cannot be supported and can be fatal to the pregnant woman. The only treatment is ending the pregnancy.
  • Placenta Previa: the placenta attaches and develops in the lower part of the uterus, near or covering the opening to the birth canal. It can cause bleeding complications during pregnancy and labour that can be life-threatening to the mother and her unborn baby.
  • Premature rupture of the membranes: the membranes “break” before 37 weeks gestation. This increases the risk of infection and premature birth.
  • Abruptio Placenta: the placenta separates too early from the wall of the uterus. This causes bleeding and can lead to some of the same problems that occur with placenta previa.
  • Pre-eclampsia or Gestational Hypertension often known as toxemia of late pregnancy: high blood pressure during pregnancy.
  • Infection: delayed wound healing following surgery and/or caesarian delivery. This due to less oxygen getting to tissues, increased heart rate, decreased circulation and ability to clear airways.
Adapted from: Tobacco Smoke: The Risk to Unborn Babies, Pregnant Women and Children [Booklet].
Accessed April 2014 from www.skprevention.ca

Unborn Babies

During pregnancy the placenta connects the baby to the uterine wall and this allows for the exchange of nutrients, waste, oxygen, and carbon dioxide between the mother and the baby. The placenta does not filter out the chemicals from tobacco smoke and affects the development of the central nervous system, genital, gastrointestinal, and urinary systems of the unborn baby. Other effects on the unborn baby include:

  • Limited ability of the blood to carry adequate oxygen to the unborn baby’s tissues
  • Narrowed placental blood vessels that diminish the unborn baby’s food supply
  • Damaged lungs
  • Premature birth
  • Low birth weight

Infants and Children

Infants and children are particularly vulnerable to the effects of exposure to tobacco smoke because they are still maturing physically and mentally. Children absorb more smoke because they breathe faster than adults, inhale more air relative to their body weight, and have a higher metabolism than adults. The harmful products of tobacco smoke can be passed to the infant through breast milk. Young children are also exposed to third-hand smoke (THS) because of they often put objects in their mouth and are crawling on the floor.

Infants and children who are exposed to tobacco smoke are at higher risk for:
  • Death within one month after birth and/or within the first year of life (Sudden Infant Death Syndrome (SIDS)
  • Ear infections
  • Asthma
  • Respiratory infections (e.g., bronchitis and pneumonia)
  • Allergies
  • Enlarged adenoids
  • Development problems (e.g., learning and memory)
  • Behavioral problems (e.g., Attention Deficit Hyperactivity Disorder)
  • Type II diabetes
  • Cancer, heart disease and stroke in adulthood

Reducing or Quitting Smoking

The Saskatchewan Prevention Institute does not provide direct service to people wanting to quit tobacco, nor does the Institute endorse any specific program. Any person wanting to quit, should consult their health care provider.

Most women know the general health effects of smoking on their health. Health care providers, friends, family members and those that support pregnant women are encouraged to explore what pregnant women know and understand about how tobacco smoke affects their pregnancy, unborn baby and children. Every woman has her own reasons for smoking and quitting smoking. More information can be found in the links below.

Provincial Tobacco Reduction

The Provincial Tobacco Reduction Coordinator is responsible for coordination of activities to reduce the harmful use of tobacco in Saskatchewan. Focusing on the pillars of the Tobacco Strategy: cessation, prevention and protection, the coordinator works to reduce the negative health impacts caused by the misuse of tobacco. Tobacco Reduction is embedded into the provincial healthy living strategy. The Tobacco Reduction Coordinator will work from a health promotion and population health perspective.

Prevention:

to encourage communities to create environments where it is easier to make healthy choices around tobacco use.

Protection:

to eliminate exposure to environmental tobacco smoke (second-hand smoke) and prevent young people from accessing tobacco products.

Cessation:

to encourage and assist tobacco users to stop or reduce their tobacco use.

For more information contact Cara at 306-651-4323 or czukewich@skprevention.ca

Videos

SK Cancer Society
The Smokers Helpline is now offering services in Cree and Dene. Choose from the links below to watch the videos.

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Watch Smokers’ Helpline in Dene playbtn
Watch Smokers’ Helpline in English playbtn
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Links

Children and Families

Health Care Providers

Women

Aboriginal Peoples

Youth

Teachers and Community Educators

Quitting Smoking

Online Learning

Videos

  • What is the Single Best Thing You Can Do to Quit Smoking?
  • Women and Tobacco: Seven Deadly Myths
  • Prevention Speaks – Keeping Tobacco Sacred
  • Setting the Example
  • Smoking and Pregnancy – What are the facts?
  • Smoking Prevention for Canadian Youth
  • Keeping Teens Tobacco Free
  • Sacred Tobacco, Sacred Children
  • Changing Social Norms to Reduce the Acceptability of Smoking
  • Robbing the Future

Resources