Scrollable Chapter Reader
Chapter 20: Tobacco
Lesson 1 — What's in Tobacco?
Tobacco contains over 7,000 chemicals when burned, including hundreds that are toxic and at least 70 known carcinogens. Understanding what you're inhaling is the foundation of informed refusal.
NicotineThe addictive chemical in tobacco; stimulates the brain's reward centers
Carbon MonoxideBonds to hemoglobin better than oxygen; reduces oxygen delivery to tissues
TarSticky residue that coats lungs; contains most carcinogens
FormaldehydeUsed in embalming; damages lung tissue with every cigarette
Quick Check: How does carbon monoxide harm the body?
Lesson 2 — Health Consequences of Tobacco
Tobacco is the leading cause of preventable death in the United States — responsible for 480,000 deaths per year. It damages virtually every organ system.
Diseases Caused by Smoking
Lung cancer, COPD, emphysema, chronic bronchitis, oral cancer, esophageal cancer, heart disease, stroke, peripheral artery disease, and reduced fertility — all linked to tobacco use.
Lung cancer, COPD, emphysema, chronic bronchitis, oral cancer, esophageal cancer, heart disease, stroke, peripheral artery disease, and reduced fertility — all linked to tobacco use.
- Smokers die on average 10 years younger than non-smokers
- Secondhand smoke causes 41,000 deaths/year among non-smokers (CDC)
- Teen smokers lose lung function faster than non-smoking peers
- Nicotine is especially harmful to the developing adolescent brain
Quick Check: Name three diseases caused by tobacco use.
Lesson 3 — Vaping & E-Cigarettes
E-cigarettes (vapes) heat liquid containing nicotine, propylene glycol, vegetable glycerin, and flavorings to create an aerosol. They were marketed as "safer" — but evidence tells a different story.
EVALI
In 2019, thousands of people were hospitalized with EVALI (e-cigarette or vaping product use-associated lung injury), many of them teens. The outbreak was linked to Vitamin E acetate in some products.
In 2019, thousands of people were hospitalized with EVALI (e-cigarette or vaping product use-associated lung injury), many of them teens. The outbreak was linked to Vitamin E acetate in some products.
- Vaping delivers highly concentrated nicotine — one JUUL pod = ~20 cigarettes of nicotine
- Adolescent vapers are 3x more likely to start smoking cigarettes
- Flavors (mango, mint, candy) are specifically designed to attract teens
- Long-term effects of vaping are still being studied — the risk is real
Quick Check: Why are flavored e-cigarette products especially concerning for teens?
Lesson 4 — Quitting & Prevention
Nicotine addiction is powerful — but quitting is possible. Most smokers try multiple times before successfully quitting, and that's normal. Each attempt teaches something valuable.
- FDA-approved cessation aids: nicotine replacement (patch, gum, lozenge), varenicline (Chantix), bupropion
- Behavioral counseling doubles quit success rates
- Set a quit date, tell someone, remove tobacco from your environment
- Identify triggers (stress, social situations) and plan alternatives
- smokefree.gov offers free tools and apps for quitting
Quick Check: What are two strategies that increase the success of quitting tobacco?
Chapter Vocabulary
NicotineThe highly addictive chemical found in tobacco that stimulates the brain's reward pathway.
TarThe sticky brown residue from tobacco smoke that coats the lungs and contains carcinogens.
Carbon monoxideA colorless, odorless gas in tobacco smoke that reduces oxygen delivery in the blood.
CarcinogenAny substance capable of causing cancer in living tissue.
COPDChronic Obstructive Pulmonary Disease — a group of lung diseases including emphysema and chronic bronchitis.
EmphysemaA lung disease where alveoli are destroyed, causing severe breathing difficulty.
Secondhand smokeTobacco smoke inhaled by a non-smoker in the vicinity of someone smoking.
E-cigaretteAn electronic device that heats a liquid to create an aerosol containing nicotine and other chemicals.
EVALIE-cigarette or Vaping Product Use-Associated Lung Injury — a serious lung condition linked to vaping.
CessationThe act of stopping a behavior, such as quitting tobacco use.