UNIT 11: Gateway Drugs: Cigarette Smoking

Table of Contents

Introduction 3

Lesson 1: Cigarette Smoking as a Gateway Drug 4

Learning Targets 4
Health Check 4
Learn about It! 5
Check Your Understanding 11
Health Care 12

Lesson 2: Effects of Cigarette Smoking 14

Learning Targets 14
Health Check 14
Learn about It! 15
Check Your Understanding 23
Health Care 24

Lesson 3: Impact of Cigarette Smoking on the Family, Environment and Community 26

Learning Targets 26
Health Check 26
Learn about It! 27
Check Your Understanding 31
Health Care 33

Pro-health Challenge 34

Self-Check 36

Bibliography 38

Glossary 40

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GRADE 8

UNIT 11
Gateway Drugs: Cigarette Smoking

Fig. 1. X-ray of a patient with lung cancer.

James Heilman, MD
(https://en.wikipedia.org/wiki/Lung_cancer#/media/File:LungCACXR.PNG), LungCACXR.PNG,
https://creativecommons.org/licenses/by-sa/3.0

Introduction
Certain substances are accessible, and when used, can increase the chances of a person

2
going on to using other substances that are more dangerous and addictive. These are
known as gateway drugs, and cigarettes are one such example.

This unit will tackle cigarette smoking as a gateway for other drugs, and how cigarette smoke
affects health, family, community, and the environment.

3
Lesson 1: Cigarette Smoking as a Gateway Drug

Learning Targets
In this lesson, you should be able to:
● discuss gateway drugs; and
● identify reasons why people smoke cigarettes.

Health Check
Brainstorming Activity

Materials:
● chalk
● illustration board

Procedures:
1. Divide your class into groups with a minimum of at least three members each, and
make sure there is an even number of groups in the class. Each group should have a
piece of chalk and illustration board.
2. Your group will be given 2 minutes to write a minimum of five words that come to
mind when you hear the phrase “drug use and addiction.”
3. After the statements have been written down, you will be given another 2 minutes to
identify and write phrases that are related to the words you wrote down.
4. Each member of the group explains the answers to the rest of the group.

Guide Questions:
1. How is drug use harmful?
2. What is an addiction? Is it preventable?

4
 Learn about It!
Gateway Drugs
Not all drug users immediately begin with using illegal
drugs and becoming addicted to them. In most cases,
drug users start by using some of the “safer” and more
legal substances that are readily available to them.

These are known as gateway drugs, and these have many different effects on the body,
including increasing the chances of drug use later on.

What are the Gateway Drugs?

A gateway drug is a substance that, while in a way “safer” in terms of health use compared
to other drugs, may lead to the user trying out other substances which may eventually lead
to addiction.

While the gateway drug itself may or may not be addictive, the use of this drug can increase
the chances of the user attempting to use other drugs that are more potent and more
dangerous than the gateway drug itself. The new drug may also be addictive, which can
further lead to many negative health consequences.

Fig. 2. A pack of cigarettes.

Rute MArtins
(https://en.wikipedia.org/wiki/Kent_(cigarette)#/media/File:Kentultra-1.jpg), Kentultra-1.jpg,
https://creativecommons.org/licenses/by-sa/3.0

5
There is, of course, no guarantee that a gateway drug user will move on to use other more
serious substances. However, gateway drugs are risk factors in themselves, that they
increase the chances of substance abuse in the future.

Effects of Gateway Drugs

Many gateway drugs are often very easy to obtain and access, which allows them to become
widely used and misused by the public. This accessibility, as well as the other effects that
they have on emotions and mood, make them even more likely to lead to substance
dependence.

There have been many studies regarding how gateway drugs increase the chances of
substance abuse among users. According to the US Department of Health and Human
Services, teenagers who smoke in the US are more likely to take marijuana and other illegal
drugs compared to non-smokers eventually. The chances are increased 100 times for
smokers. In addition to this, according to the National Institute on Drug Abuse of the US,
drug dependence is six times more likely for youths under the age of 17 if they smoke
marijuana.

Examples of Gateway Drugs

Some examples of gateway drugs are the following:
● Cigarettes and other tobacco products, which contain nicotine. Nicotine is an
addictive substance.
● Alcoholic drinks, which contain ethanol, which causes intoxication.
● Marijuana, or Cannabis, with many different chemicals. One of the most notable is
tetrahydrocannabinol or THC which is known for producing the “high” associated
with marijuana.

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 Fig. 3. The Cannabis plant.
Cannabis Training University (https://en.wikipedia.org/wiki/File:Cannabis_Plant.jpg), Cannabis_Plant.jpg,
https://creativecommons.org/licenses/by-sa/3.0/deed.en

Reasons for Smoking Cigarettes

Millions of people around the world are smokers. Not all of them have the same reason for
beginning and continuing to smoke, but there are some common factors between why
people smoke. Some of these include coping with emotions, stress, and many more. Some
of the reasons include the following:

Peer Pressure
Some people begin smoking as a result of peer pressure. Peer pressure is the social
influence that a group can have on a person, and this influence can lead that person to do
certain actions. The notion that smoking is “cool” and that everyone needs to try it is
something that has led many people, especially teenagers, to start smoking.

It should be noted that peer pressure is not always bad. It only becomes harmful if it leads a

7
person to start doing actions that can potentially be harmful to oneself and others. Smoking
is one of these behaviors, as this can lead to many detrimental effects on health.

Eventually, people that begin smoking due to this reason may develop a continued behavior
of smoking due to the supposed emotional and mental “benefits” derived from cigarettes.
Some even go on to develop a dependence on nicotine, which makes it even more difficult
to stop smoking.

Coping With Stress, Feelings of Relaxation

Cigarettes contain many chemicals, and some of these chemicals have a direct effect on the
brain. These chemicals, if received by the brain, can cause certain feelings, sensations, and
emotions that may feel pleasurable for the smoker.

One of the important chemicals in cigarettes is nicotine when smoked, can cause dopamine
released in higher amounts in the brain. Dopamine is a neurotransmitter, which is a
signaling chemical released by the nervous system, that can produce feelings of happiness
and relaxation.

Fig. 4. Dopamine molecule.

Jynto
(https://en.wikipedia.org/wiki/Dopamine#/media/File:Dopamine_3D_ball.png), Dopamine_3D_ball.png,
http://creativecommons.org/publicdomain/zero/1.0/deed.en

8
Studies show, however, that the feelings of stress relief associated with smoking are only
temporary. In fact, smoking is related to increased levels of stress. The relief becomes
apparent during the act of smoking itself because of the release of dopamine. The stress,
however, usually returns in between smoking sessions. This means that cigarette smoking is
only a temporary relief from stress, and actually increases the overall amount of stress that
a person experiences.

Relief From Symptoms

Some people have developed the behavior of smoking to relieve some symptoms of
psychological disorders that they have. As was mentioned earlier, smoking releases
chemicals in the brain that can help a person feel relaxed or happy.

Psychological disorders are conditions that cause emotional or psychological symptoms to

be felt by the patient. Some psychological disorders cause strong emotions like sadness or
depression. Some patients of these disorders may gain temporary relief from these
symptoms while smoking. Studies have shown, however, that smoking is capable of
damaging some pathways in the brain that can lead to increased chances of mood and
psychological disorders.

Smoking Out of Habit

Eventually, some people continue to smoke because of habit. This can be due to smoking
being associated with an everyday part of life or a strong and positive emotion. For example,
some people have gotten so used to having a cigarette stick with their morning coffee and
smoking has become a habit that is hard to discontinue because of this. An example of
smoking associated with positive emotion is when a person smokes a cigarette after a long
day of hard work, which leads to feelings of contentment and smoking the cigarette is
associated with the reward of a hard day’s work.

The best way to prevent this from happening is to not smoke cigarettes in the first place for
it to not become associated with any habits and behaviors.

Addiction
An addiction is an uncontrollable use of a substance or a drug even though it can cause

9
negative effects on the user. Addictions also usually lead the person to prioritize the use of
the substance or drug above all other activities.

Cigarette smoking is an addictive behavior, primarily because of nicotine. Many cigarette

smokers continue to smoke even though some of them realize the adverse health effects
and wish to quit smoking, but have become addicted to cigarettes.

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Check Your Understanding

A. Identify what is being described by the statements below.

1. This is the active chemical found in cigarettes.

2. These are chemicals in the brain used for signaling.
3. This is the #2 associated with relaxation and pleasure.
4. This is the chemical in alcohol that causes intoxication.
5. This is the chemical that causes the “high” in marijuana.
6. These are disorders that cause mood or psychological symptoms in the
patient.
7. These are factors that increase the chances of drug use and abuse.

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 8. These are drugs that can lead to the use of other drugs.
9. This is the influence that a group may have on a person.
10. This refers to the uncontrollable use of a drug, usually with the person
prioritizing its use over other activities.

B. Write true if the statement is correct, and false if it is not.

1. Nicotine is addictive.
2. Gateway drugs are safe to use.
3. Cigarettes can cause both physical and psychological effects.
4. Addiction can lead to difficulty in quitting smoking.
5. Nicotine is a neurotransmitter.

Answer the following questions.

1. Why is cigarette smoking addictive?

2. How can addiction lead to negative effects on health?
3. How can cigarette smoking lead to psychological disorders?
4. How can cigarette smoking become a habit?
5. How can gateway drugs lead to the use of other drugs?

Health Care
Think-Pair-Share: Gateway Drugs
Find a partner for this activity. Follow the steps below.

Question:
How do gateway drugs lead to the use of other drugs?

Think:
Answer the question above.

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Pair:
Share your answer with your partner.

Share:
You and your partner will group with another pair, and you will take turns sharing your
partners’ answers to the other group.

Guide Questions:
1. How can this smoking be prevented?
2. What are the other drugs that are harmful?

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Lesson 2: Effects of Cigarette Smoking

Learning Targets
In this lesson, you should be able to:
● analyze the negative health impact of cigarette smoking
● describe the harmful short- and long-term effects of cigarette smoking on the
different parts of the body
● discuss the dangers of mainstream, secondhand and thirdhand smoke.

Health Check
Effects of Smoking

Materials:
● chalk
● illustration board

Procedure:
1. Divide your class into groups with a minimum of at least three members each. Each
group should have a piece of chalk and illustration board.
2. Within one minute, your group should list down as many negative health effects of
smoking that your members can think of.
3. After one minute, one member should explain at least one of the items written down
and what consequences it has.

Guide Questions:
1. How is smoking harmful?
2. What are the most notable negative effects on health?

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 Learn about It!
Cigarette Smoke Exposure
Not only smokers are exposed to cigarette smoke. People
become exposed to cigarette smoke in various ways.
Through the different levels of cigarette smoke exposure,
people are also subjected to different risks associated
with these levels.

Mainstream Smoke
Mainstream smoke refers to the cigarette smoke that a
smoker exhales. This smoke has already been inside the
smoker’s body and contains various harmful chemicals that affect both the smoker and the
people in the vicinity.

Mainstream smoke is distinct from sidestream smoke, which is the smoke that comes from
the burning cigarette itself. The smoker is then exposed to both mainstream and sidestream
smoke.

Fig. 5. Sidestream smoke.

Tomasz Sienicki
(https://en.wikipedia.org/wiki/Smoking#/media/File:Papierosa_1_ubt_0069.jpeg), Papierosa_1_ubt_0069.jpeg,
http://creativecommons.org/licenses/by-sa/3.0/

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Secondhand Smoke
Also known as environmental smoke, secondhand smoke is a mixture of mainstream
smoke and sidestream smoke that other people that did not smoke the cigarette are
exposed to.

Exposure to secondhand smoke is associated with many health problems which will be
discussed later on.

Thirdhand Smoke
The smoke coming from the cigarette can cling to different objects and body parts, including
clothes, hair, furniture, and many more. These objects can also expose people to the
chemicals of the cigarette smoke as a result. This is known as thirdhand smoke. Thirdhand
smoke also has many different effects on health.

Effects of Cigarette Smoking on the Body

Smoking cigarettes have many different negative health effects on the body. Some of the
short-term and long-term effects of cigarette smoking will be discussed below.

Take note that all types of cigarette smoke exposure can cause many of these effects, be it
mainstream, secondhand, or thirdhand smoke. Some of the most severe conditions,
however, are caused by mainstream and secondhand smoke. This is not to say that
thirdhand smoke is safe. All levels of smoke exposure carry risks.

Short-Term Effects
Some of the short-term effects include the following:

Effects on the Mouth

Since smoke is directly taken in by the body through the nose and the mouth, there are
several negative effects that cigarette smoking has on the lips, mouth, teeth, and tongue.

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 Fig. 6. Smoking leads to a darkening of the mouth.
Skinstudy
(https://en.wikipedia.org/wiki/Smoker%27s_melanosis#/media/File:Smoker%27s_melanosis.jpg),
Smoker%27s_melanosis.jpg, https://creativecommons.org/licenses/by-sa/3.0

Smoking is associated with the staining of the teeth because of the many chemicals in
smoke. The gums and lips of smokers also become darker over time. Mouth sores become
more common because of the chemicals found in cigarette smoke. Smoking is associated
with weakened teeth and can lead to sensitivity and tooth decay.

The burning of tobacco and the release of chemicals from this burning leads to a foul odor
in the mouth of the smoker. Chronic bad breath is known as halitosis, and may also be
caused by cigarette smoking.

Smoking is also associated with decreased sensations of taste and smell. Smokers report
less intense smells and taste as a result.

Effects on the Respiratory System

Nicotine, tar, and other chemicals can lead to a weakened respiratory system and increase
the likelihood of the smoker developing diseases associated with this system.

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Many respiratory problems are associated with smoking. Asthma is the narrowing of the
lung’s airways which leads to difficulty in breathing and associated with smoking. Another is
bronchitis, which is an inflammation of the tubes that bring air to and from the lungs,
known as the bronchi.

Fig. 7.Bronchitis.
BruceBlaus
(https://en.wikipedia.org/wiki/Bronchitis#/media/File:Bronchitis.png), Bronchitis.png,
https://creativecommons.org/licenses/by-sa/4.0

Several factors that affect the breathing of a person are also impacted by smoking. It leads
to a decline in lung capacity. Lung capacity is the quantity of air the lungs can take in.
Reduced lung capacity can lead to less-than-ideal breathing and oxygenation of the body.

Addiction and Dependence

Smokers also develop an increased risk of addiction to nicotine because of smoking. In
addition, since cigarettes are a gateway drug, smokers have a higher risk of trying out other
substances and developing an addiction.

Long-Term Effects
Some of the long-term effects associated with cigarette smoking are the following health
conditions:

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Cancer
Cancer is a disease mostly caused by abnormal cells forming masses known as tumors.
Cigarette smoke, whether it be mainstream, secondhand, or thirdhand, contains many
carcinogens, the cancer-causing agents. There have been many studies that associate
long-term cigarette smoking and different types of cancer.

Some of the most common cancers associated with smoking are lung cancer, laryngeal
cancer (cancer of the voice box), esophageal cancer, mouth cancer, cervical cancer,
pancreatic cancer, kidney cancer, and many, many more.

Psychological and Mood Disorders

Long-term smoking is associated with mood and mental disorders. Studies show that
cigarette smokers have increased the risk of conditions like depression, anxiety, and others.
This could be due to the chemicals in cigarette smoke that damage the pathways in the
brain which affect many aspects of thinking.

Cardiovascular Problems
The cardiovascular system is in charge of pumping blood around the body, as well as
making sure that the blood gets to where they are supposed to go correctly. This system
includes the heart, the blood, and the blood vessels.

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 Fig. 8. The cardiovascular system.
LadyOfHats
(https://en.wikipedia.org/wiki/Circulatory_system#/media/File:Circulatory_System_en.svg),
Circulatory_System_en.svg, Public Domain

The many chemicals found in cigarette smoke heavily impact the heart and the blood. For
example, weakened blood vessels can be a result of long-term smoking, and this increases
the chance of these blood vessels rupturing. This leads to an aneurysm, a life-threatening
condition caused by a blood vessel bursting. Nicotine also increases a person’s blood
pressure and affects the heart rate. This can result in hypertension, which is characterized
by abnormalities in blood pressure.

There are other serious cardiovascular problems associated with smoking. The chemicals in
smoke damage blood cells, heart tissue, and others. This increases the chances of plaques
of fat, cholesterol, and other substances forming within the blood vessels and causing a
blockage. This is a condition known as atherosclerosis. If these plaques rupture, it may lead
to a myocardial infarction, also known as a heart attack. It is a condition that can be very
deadly if not treated immediately.

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Other cardiovascular problems caused by smoking include the following:
● angina, which is caused by low blood flow to the heart;
● stroke, caused by a blockage of blood to the brain; and
● many others.

Respiratory Diseases
Long-term smoking leads to serious damage in the respiratory system. Smoking deposits tar
in the lungs, which is a dark and sticky substance that can get in the way of the lung
functioning properly.

Fig. 9. Tar deposits in a lung.

Dr. Edwin P. Ewing, Jr.
(https://en.wikipedia.org/wiki/Chronic_obstructive_pulmonary_disease#/media/File:Centrilobular_emphysema_865_l
ores.jpg), Centrilobular_emphysema_865_lores.jpg, Public Domain

The many chemicals found in cigarette smoke can cause the following diseases in long-term
smokers:
● Emphysema: Emphysema is characterized by the destruction of the alveoli or the air
sacs in the lungs where gas exchange happens. This leads to difficulty in breathing
and low oxygenation.
● Chronic bronchitis: Chronic bronchitis leads to an inflammation of the bronchi,
which narrows the passageway of air. Further aggravating the difficulty of breathing is

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 the production of excessive amounts of mucus in these tubes.
● Lung cancer
● Many respiratory infections: Many respiratory infections are also common in
smokers. Some of these include pneumonia, tuberculosis, acute bronchitis, and many
more.

Other Diseases
Long-term smoking is also associated with many other diseases and conditions, including
the following:
● some forms of arthritis, which is a disease of the joints;
● problems with the reproductive system;
● weakened respiratory system;
● cataracts;
● pregnancy problems;
● damage to organs; and
● many more.

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Check Your Understanding
A. Identify what is being described by the statements below.

1. This is cigarette smoke that a smoker exhales.

2. This is cigarette smoke that comes from the burning of the cigarette.
3. This is cigarette smoke that non-smokers are exposed to through inhalation.
4. This is also known as chronic bad breath.
5. This is a condition which is caused by a narrowing of the airways of the lungs
and leads to difficulty in breathing.
6. This is the amount of air that the lungs can take in.
7. These are substances that cause cancer.

23
 8. These are masses of abnormal cells.
9. This is the body system in charge of pumping blood.
10. This is a disease characterized by the destruction of the alveoli.

B. Write true if the statement is correct, and false if it is not.

1. Smokers have increased the risk of cancer.

2. Chronic bronchitis is the destruction of the alveoli.
3. Arthritis is a respiratory disease.
4. Plaques are formed from cholesterol and fat.
5. Plaques cause atherosclerosis.

Answer the following questions.

1. Why is the respiratory system heavily affected by smoking?

2. Why is the cardiovascular system also heavily affected?
3. How does cancer occur?
4. How do strokes occur?
5. What are ways of reducing the amount of secondhand smoke that we inhale?

Health Care

Smoking Effects: Charades

For this activity, reuse the groups that you were with for the warm-up. You will be playing a
game of charades.

Designate one member as the “actor.” The actor will choose from one of the following
allergens and must use actions to describe it without using any words. The other members
must guess which word is being acted out. The choices are the following:
● emphysema; infarction; ● halitosis;
● bronchitis; ● plaques; ● asthma.
● myocardial ● hypertension;

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Each groupmate is only given two guesses. After the action is correctly guessed, the
groupmates that did not guess correctly must identify how these conditions affect a person.

Repeat this activity until all groupmates have acted.

1. How does smoking cause these problems?
2. Are they preventable? How?

25
Lesson 3: Impact of Cigarette Smoking on the
Family, Environment and Community

Learning Targets
In this lesson, you should be able to:
● explain the impact of cigarette smoking on the family, environment, and
community.

Health Check

Act It Out: The Effects of Smoking on Other People

Procedure:
1. Divide your class into groups. Each group should have at least five members.
2. You are to act out how secondhand smoke impacts the dynamics between people in a
household or a community.
3. Make sure that specific roles are assigned to your groupmates.
4. The skit should last no more than 5 minutes.

Guide Questions
1. What is secondhand smoke?
2. How does it affect other people?

26
 Learn about It!
Cigarette smoking not only impacts the smokers
themselves, but also the people around them, the
environment, and many other factors.

This harmful behavior leads to many negative effects

seen in those affected, and this lesson will discuss some
of these effects.

Impact of Cigarette Smoking on the Family and the

Community
Cigarette smoking has many effects on the people that surround the smokers. Some of
these include the following:

The Effects of Secondhand Smoke

Secondhand smoke has numerous negative health effects. Some of these include the
following:
● increased risk of cancer;
● increased risk of heart problems;
● respiratory problems;
● in infants and children, increases the chances of:
○ death;
○ infectious diseases;
○ many other issues.

Influencing Others to Smoke

Having a parent or older sibling that smokes increases the chances that a child will start
smoking later on in life. This can then potentially lead to more problems regarding physical
and mental health.

Peer pressure is also a problem in terms of starting smoking, as it can heavily affect the
chances that other people will smoke as well. Note that peer pressure is most heavily seen

27
in adolescents, but people of any age can be subjected to peer pressure as well.

Smoking Can Decrease Productivity in the Workplace

Smoking in a professional setting when other smokers are not around may have an impact
on productivity, especially if there are no restrictions as to where smoking can be done. This
is even more noticeable if distractions are caused because of smoking.

Damage to Property
The smoke emitted by cigarettes and inhaled by smokers can cause damage to furniture and
upholstery. Stains are produced as a result, and the smells tend to stick to them. The
coloration of these items can also change as a result.

Fires are also a risk that comes with smoking, as some surveys show that many fire incidents
are caused by cigarettes and other smoking paraphernalia like pipes.

Fig. 10. Smoking paraphernalia are fire risks.

Kimmo Palosaari
(https://en.wikipedia.org/wiki/Lighter#/media/File:White_lighter_with_flame.JPG), White_lighter_with_flame.JPG,
Public Domain

Smoking and Income Level

Statistics show that smoking is more prevalent in low-income households and that smokers
at lower income levels tend to smoke more compared to those at higher income levels. This
can possibly mean that expenditure on smoking may leave a household and the family a
lower amount of money to work with, especially if the user is an unusually heavy smoker.

28
Statistics also show that people that live in low-income communities are more exposed to
secondhand cigarette smoke compared to high-income communities. This means that the
negative effects of secondhand smoke may be more pronounced in these communities
since exposure is higher.

Impact of Cigarette Smoking on the Environment

Smoking also has an environmental impact. Some of these include the following:

Air Pollution
Smoking is a significant cause of air pollution, considering the number of people that smoke
worldwide and the identity and amount of smoke and chemicals that are released into the
environment by the cigarettes.

A study was conducted to compare the amount of air pollution that is caused by smoking
and a car engine. The results showed that the released particulate matter which are the
particles suspended in the air, and a good indicator of air pollution, is much higher from
cigarettes compared to a car engine. The amount released by cigarettes was ten times more
numerous compared to the engine. This suggests that smoking can potentially pollute the
air far more than a car can.

Effects of Smoking on Plants and Animals

Photosynthesis is the process by which plants produce their food. Regular smoke from
burning fuels or wood has a negative impact on the photosynthetic ability of plants. Studies
show that excessive exposure to smoke decreases a plant’s photosynthetic capacity.
Cigarette smoke also affects plants negatively. The chemicals found in cigarette smoke can
stunt the growth of some plants and have adverse effects on their survival.

Animals are also negatively affected by cigarette smoke. Secondhand smoke can affect
mammalian housepets similarly as to how it can affect humans, and cigarette smoke can
also negatively affect the health of many other animals. One notable example is how
cigarette smoke is deadly to insects, as nicotine that is produced by the tobacco plant is a
natural insecticide.

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Garbage
While a large part of the cigarette burns while a person is smoking, the end part which
contains the filter does not. A cigarette filter functions to trap some of the tar and chemicals
from a burning cigarette for it to not be inhaled by the smoker. Cigarette filters are made of
plastic and some fibers.

Unfortunately, cigarette filters are also a very significant pollutant in the world’s oceans.
Some surveys show that cigarette filters are the leading source of trash in the sea. These
filters do not decompose quickly and make their way to bodies of water which results in a
significant amount of water pollution.

Fig. 11. Cigarette filters.

Akroti
(https://en.wikipedia.org/wiki/Cigarette_filter#/media/File:Cigarettefiltar.jpg), Cigarettefiltar.jpg,
https://creativecommons.org/licenses/by-sa/2.5

30
Check Your Understanding
A. Identify what is being described by the statements below.

1. This is a measure of the suspended matter in the air.

2. This is the process by which plants produce their food.
3. This is the part of the cigarette that is a significant garbage source.
4. Households with this level of income are more affected by secondhand smoke,
according to studies.
5. This is a natural insecticide produced by tobacco plants.

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 B. Write true if the statement is correct, and false if it is not.

1. Peer pressure always leads to smoking.

2. Low-income households are more likely to have a heavy smoker.
3. Smoking results in the emission of more particulate matter compared to a car
engine.
4. There is a higher risk of fire associated with smoking.
5. Cigarette filters are a significant source of ocean pollution.

C. Write “environmental” if the effect stated has an effect on the environment, or

“community” if it is an effect on people.

1. Diseases caused by secondhand smoke.

2. Damages caused to property.
3. Influence of peers on smoking.
4. Lowering of photosynthetic ability.
5. Causing air pollution.

Answer the following questions.

1. How is secondhand smoking harmful?

2. How does particulate matter in the air affect humans?
3. Why are filters a significant trash source?
4. What are ways of reducing the impact of smoking on the community?
5. How does cigarette smoke affect animals?

32
 Health Care
Quick Write
Find a partner, but answer the following questions on your own:
1. Smoking causes problems like ______________________.
2. It affects other people through ____________________.
3. Some problems it can cause include ____________________.
4. The environment is affected through ____________________.
5. Smoking causes pollution through ___________________.

Share your answers with your partner afterwards.

33
 Pro-health Challenge

Infographic: Health Effects of Smoking

Goal
Your goal is to create a brochure that contains information on the negative health effects of
smoking.

Role
You are students who wish to inform the public about the many negative effects of smoking
on health.

Audience
Your audience will include the members of the school community.

Situation
Smoking introduces many harmful substances into the body, and these can cause many
negative effects on health.

Performance
You are to create a brochure that focuses on one of the following:
● respiratory effects of smoking;
● cardiovascular effects of smoking;
● psychological effects of smoking.

In addition to the information above, you are also to include the following:
● how to avoid smoking; and
● how to lessen the negative impact of cigarette smoke.

Make your brochure clear, concise, informative, and creative. Using photos and figures is

34
encouraged, and citing sources is required.

Standard
Your work will be judged on the following criteria:

Criteria Beginning Developing Accomplished Score

(0-12 points) (13-16 (17-20 points)
points)

Content
(Focus on details/events are
clearly evident; it is clearly
related to the topic.)

Organization
(Logical progression of
details/events; clear
transitions between ideas.)

Language
(spelling, mechanics,
grammar and usage)

Creativity

Clarity

Accuracy

Key Guide Question

What are the negative effects of smoking on health?

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 Reflective Questions

Guide Questions
1. What is in cigarette smoke?
2. Why do people smoke?
3. What are the long and short-term effects of smoking?
4. How is it harmful?

Self-Check
Check I can…

Identify the risks of gateway drugs.

Explain the negative effects of cigarette smoking.

Engage in activities that can lower the chances of smoking.

Identify the negative effects of smoking on the family, community, and

environment,

Reflect

I find __________________________ the most interesting because ______________________.

I got ____ checks because _______________________________________________________.
I need to improve on _______________________because _____________________________.
I need to practice _________________________ because _____________________________.
I plan to _____________________________________________________________________ .

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 Wrap Up
Negative Effects of Smoking
Body Part/System Effects
Oral Area Stained teeth
Dark lips, inner cheeks, and gums
Weak and sensitive teeth
Respiratory System Emphysema
Chronic bronchitis
Chronic cough
Lung cancer
Infections
Cardiovascular System Atherosclerosis
Myocardial infarction
Stroke
Angina
Hypertension
Aneurysm
Others Many types of cancer
Joint and bone problems
Many others

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 Bibliography
n.d. Addiction Education Society: Gateway Drugs.
https://addictioneducationsociety.org/gateway-drugs-fact-sheet/.
n.d. CDC: Cigarette Smoking and Tobacco Use Among People of Low Socioeconomic Status.
https://www.cdc.gov/tobacco/disparities/low-ses/index.htm.
n.d. CDC: Effects of Cigarette Smoking.
https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_sm
oking/index.htm.
n.d. Center for Substance Abuse Research: Tobacco.
http://www.cesar.umd.edu/cesar/drugs/tobacco.asp.
n.d. How does smoking affect those around you?
https://www.quitterscircle.com/how-to-quit/how-does-smoking-affect-those-around-y
ou.
Invernizzi, G, A Ruprecht, E MAzza, E Rossetti, A Sasco, S Nardini, and R Boffi. 2004.
"Particulate matter from tobacco versus diesel car exhaust: an educational
perspective." Tobacco Control 219-221.
n.d. Is MArijuana a Gateway Drug?
https://www.drugabuse.gov/publications/research-reports/marijuana/marijuana-gate
way-drug.
Kirkham, MB. 2006. "Cadmium in plants on polluted soils: Effects of soil factors,
hyperaccumulation, and amendments." Geoderma 137 19-32.
n.d. Mayo Clinic: Secondhand Smoke.
https://www.mayoclinic.org/healthy-lifestyle/adult-health/in-depth/secondhand-smok
e/art-20043914.
n.d. National Fire Protection Association: Smoking.
https://www.nfpa.org/Public-Education/By-topic/Top-causes-of-fire/Smoking.
n.d. NIH: Smoking and Your Heart.
https://www.nhlbi.nih.gov/health-topics/smoking-and-your-heart.
Parrott, AC. 1999. "Does cigarette smoking cause stress?" Am Psychol 817-820.
Rainey, James. 2018.
https://www.nbcnews.com/news/us-news/plastic-straw-ban-cigarette-butts-are-single-great

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 est-source-ocean-n903661. NBC News.
n.d. Reasons People Smoke.
https://smokefree.gov/veterans/nicotine-addiction/reasons-people-smoke.
Rezaeetalab, F, F Rezaeetalab, A Soltaneefa, M Ghaznavi, T Bakhshandeh, and S Saberi. 2012.
"The effect of smoking by family members and friends on the incidence of smoking
among high school students." Pneumologia 234-236.
Virdis, A, C Giannarelli, MF Neves, S Taddei, and L Ghiadoni. 2010. "Cigarette smoking and
hypertension." Curr Pharm Des 2518-2525.

39
 Glossary
An addiction is an uncontrollable use of a substance or a drug even though it can cause
negative effects on the user.

Asthma is a narrowing of the airways of the lungs which leads to difficulty breathing

Cancer is a disease that is mostly caused by abnormal cells forming masses known as
tumors.

A gateway drug is a substance that, while in a way “safer” in terms of health use compared
to other drugs, may lead to the user trying out other substances which may eventually lead
to addiction.

Lung capacity is the amount of air that the lungs can take in.

Mainstream smoke refers to the cigarette smoke that a smoker exhales.

A neurotransmitter is a signalling chemical that is released by the nervous system.

Particulate matter are the particles that are suspended in the air

Photosynthesis is the process by which plants produce their food.

Secondhand smoke is a mixture of mainstream smoke and sidestream smoke that other
people that did not smoke the cigarette are exposed to.

Sidestream smoke is the smoke that comes from the burning cigarette itself.

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