Dr. Brian Primack's presentation at the 3rd Annual Media Literacy Conference in Harrisburg, sponsored by Drug Free Pennsylvania.

1. Tobacco Primer: Four Questions about Smoking Brian A. Primack, MD, EdM, MS March 2010 Drug Free Pennsylvania

2. 1. What’s the big deal?

4. Worldwide deaths, 2010

11. 2. How can it be that bad?

20. Atherosclerosis

21. Myocardial Infarction

22. Stroke = CVA (cerebro-vascular accident)

23. Peripheral Vascular Disease

24. 59 year old female smoker

25. C is for Cancer

27. D is for Destruction of Lungs (COPD)

29. E is for Environmental Smoke (Second-Hand Smoke)

35. 3. Who smokes, and why?

36. Gender

37. Race

39. Wilkinsburg

41. “Menthol X”

42. Ever Smokers Who Have Quit

44. Poverty Level

45. Age

47. “ As this 14-24 age group matures, they will account for a key share of the total cigarette volume for at least the next 25 years.” --RJ Reynolds

48. “ Our studies report on youngsters' motivation for starting, their brand preferences, as well as the starting behavior of children as young as 5 years old.” -- Brown and Williamson Tobacco Company

54. Smoke Top Advertised Brands CDC, 2004

63. $20 Sampler

67. Smoke Contents 1 Shihadeh and Saleh, 2005 2 Djordjevic, 2000 Compound (mg) Hookah 1 Cigarette 2 Ratio Tar 802 22.3 36 Nicotine 2.96 1.74 1.7 CO 145 17.3 8

69. 1 Sepetdjian, 2008; 2 Gmeiner, 1977 Carcinogen (ng) Hookah 1 Cigarette 2 Ratio Benz[a]anthracene 677 35 19 Benzo[a]pyrene 370 10.1 37 Benzo[g,h,i]perlyene 307 7.9 56 Di-benzo[a,h]anthracene 140 2.5 245 Indeno[1,2,3-cd]pyrene 183 3.5 52

73. Tobacco Types * Includes little cigars, cigarillos

74. Hookah Smoking by Grade Level Primack et al., Pediatrics 2009

75. 4. What do we do about it?

86. Is Media Literacy Different?

88. Thank You [email_address]