Tobacco Use and Body Weight

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Hello, everyone my name is Jennifer Youngblood, and I'm the educator with the health and preventive services team at Optima Health. Every November we participate in the Great American Smokeout event held by the American Cancer Society. This year, although very different from any other, we wanted to create a great presentation just for this event. Since most, if not, all of you participate in a yearly wellness event, I'm sure you have all heard the term biometric screening because a lot of you inquire about how to improve your biometric value numbers each year, we decided to incorporate one big influencer of these biometric values: tobacco use. Did you know that tobacco use affects your weight and your body mass index, your cholesterol, blood pressure as well as blood glucose and your A1c? Yes, it sure does. Who knew right? So I have created one big presentation and decided to divide into 3 smaller ones for your viewing convenience. In this specific presentation, I will discuss the effects of tobacco use on weight and body mass index. Let's dive in.

So our agenda for the day looks like this. We're going to talk about workplace programs, workplace wellness programs, Rather, and then we're going to dive in a little bit with the biometric screenings and then we'll talk about how tobacco use affects weight and body mass index.

Workplace wellness programs. I'm sure you've probably all heard of these. Might not be in the exact title format, but in some form or fashion, I'm sure you've all heard of them. Workplace wellness programs have become increasingly popular as employers have aimed to lower healthcare costs and improve employee health and productivity. In 2018, 82% of large firms and 53% of small employers in the United States offered some sort of wellness program. This growth Has been aided by public investments, such as the affordable care act, which included funds to promote the development of workplace wellness programs. These programs tend to focus on modifiable risk factors of disease, such as nutrition, Physical activity and smoking cessation. Workplace wellness programs include a coordinated set of activities that support employees in making changes to health behaviors that may reduce their risk for certain chronic conditions and enable employees with existing diagnosis to manage them more effectively. Comprehensive multi-component programs typically include health assessments and biometric screenings to quantify risk factors, education and coaching for lifestyle behavior modifications, such as tobacco cessation, physical activity promotion, stress, reduction and weight management and, in some cases, employers offer chronic disease management. So, let's take a closer look at biometric screenings.

I mentioned that all of these components here are part of workplace wellness programs, but we're focused on tobacco use and how tobacco use affects the numbers or the values that we get from a biometric screening. So, here we go with biometric screenings. A biometric screening is basically a clinical screening that's done to measure certain physical characteristics. It can be used to measure of your height, your weight, your body mass index, or Blood pressure, cholesterol and blood sugar or blood glucose. The goal of a biometric screening is to give a snapshot of your health and alert you to any changes in your health status. The screening may be offered by your employer, your union, a public health organization, or nonprofit group. It may also include wellness counseling and education, a risk assessment or exercise programs. Biometric screenings are not a substitute for a regular physical exam by your health care provider as it doesn't diagnose any type of disease, but it may indicate possible risk factors.

Let's take a closer look. Lots of people ask what is a biometric screening, or what's in a biometric screening? A biometric screening aims to alert you to any possible health risks. It also provides an easy way to keep track of changes in your vital statistics from year to year. The screening process is quick and it usually takes place at your workplace. Your test results are often available right away and can alert you to potential health conditions, such as diabetes, high blood pressure and other heart disease complications. Employers use biometric screenings to get a sense of employee health risks. Sometimes employers offer incentives to encourage employees to participate in the screening and improve their health. During a biometric screening, your vital statistics are measured and sometimes blood work is done as a usual part of the screening. A biometric screening is typically used to measure and assess your height and weight, as We talked about before, your waist measurement, your body mass index, which is an estimate of your body fat, based on your height and weight ratio, your blood pressure, pulse measurement, fasting blood glucose and A1c levels, your blood cholesterol level and triglycerides and some screening programs may include a measure of aerobic fitness. It might ask about your tobacco use or your exercise habits.

So, let's talk about the nuts and bolts of our conversation here; how tobacco use affects our weight and our body mass index. Many people who use tobacco, especially women, report that weight control is a motive for tobacco use and that concerns about gaining weight is a significant barrier to quitting tobacco use. Nicotine suppresses your appetite and increases metabolism and also serves as a behavioral alternative to eating or a distraction from hunger or food craving. Indeed, quitting tobacco use reverses these effects and is accompanied by weight gain for almost 80% of all quitters. Against this backdrop is the rapidly increasing popularity of electronic cigarettes or e-cigarettes. E-cigarettes are battery powered devices that contain a liquid solution and nicotine. Inhalation triggers the liquid to be heated by the battery and vaporize. This vapor is then exhaled as an opaque aerosol that resembles a cigarette smoke. E-cigarettes are distinguished by their potential ability to replicate both the pharmalogical and sensory motor aspects of smoking the old time combustible cigarettes. Indeed, one of the most commonly reported reasons for using e-cigarettes is to aid in cessation of those combustible cigarettes. However, although some individuals do succeed in switching from smoking combustible cigarettes to exclusive e-cigarette use. Otherwise known as vaping, the majority of e-cigarette users continue to smoke The combustible cigarettes, and we call those individuals, the dual users. As electronic cigarettes increase in popularity among current and former tobacco users, emerging data indicate that e-cigarettes are being used for managing weight concerns. Consistent with research Findings in a current study. It indicated that, compared to daily tobacco users who are not using e-cigarettes, Daily tobacco users who were also currently using e-cigarettes Had higher scores on two subscales for appetite control: (1) tobacco used to suppress appetite and (2) tobacco used to prevent over-eating. These findings suggest it is possible That individuals who utilize tobacco to suppress their appetite and/or prevent overeating may find e-cigarettes especially appealing and believe that e-cigarettes will serve these functions as effectively as combustible cigarettes.

According to a study published in health psychology, weight trajectories over time Vary as a function of tobacco use status with tobacco users gaining less weight than non-tobacco users. However, approximately 9 million U. S. tobacco users are obese. Tobacco users with overweight or obesity report more weight control, motivated tobacco use than tobacco users of normal weight. The current National Institute of Health guidelines on obesity treatment recommend that when treating tobacco users. The primary emphasis is on tobacco cessation and advise against initiating in tobacco cessation and weight loss simultaneously or at the same time thus encouragement of weight loss in this population is typically postponed de-emphasized in an effort to promote the tobacco cessation. Yet, tobacco users with obesity report more concerns about gaining weight after quitting tobacco use and have less confidence in their ability to maintain their weight without using tobacco. However, they may be less motivated to quit tobacco use until they have lost weight and/or developed weight management skills.

So in conclusion, we talked about another study that explored the influence of tobacco use and food consumption patterns on BMI after adjusting for various socio-demographic characteristics. Since weight based stereotypes may have an impact on tobacco use behavior and both obesity and tobacco use have been associated with detrimental health effects an interdependency between them is quite possible. Our findings showed that ignoring potential indigeneity may affect both the statistical significance of the tobacco use estimate and the direction of the influence of tobacco use on our body mass index. Tobacco use was positively associated with BMI in both male and female participants. Tobacco users presented a 23.1% higher risk of obesity and a 24.3% lower likelihood of being within a healthy weight range. Male tobacco users also appear to have a considerably augmented probability of being obese compared to their female counterparts. The relationship between tobacco use and body mass index may be attributed to dietary practices since tobacco use was correlated with poor dietary habits characterized by the frequent intake. Of more energy dense foods, like meat products and white toasted breads and less frequent consumption of healthy food items, such as whole grain bread, vegetables and fruit.

So, after looking at these research studies, it can be assumed that tobacco use is positively associated with body mass index or BMI with Tobacco users being at an increased risk of obesity and presenting a lower likelihood to be within a healthy weight range. Furthermore, the impact of tobacco use on the risk of obesity is stronger in male participants compared to female tobacco users, our findings challenge the general belief about the role of tobacco use as an effective weight control strategy. Therefore, health instructors may proceed with anti-tobacco use policies Without suspicions of potential weight gain in overweight and obese tobacco users. Food consumption frequency is also found to influence body weight. Although potential under reporting, especially among overweight individuals, should be considered in future research, Tobacco use behavior is linked with less healthy food choices and poor quality Which may lead to weight gain and a subsequent increase in overweightness and obesity rates in tobacco users. Our results highlight the necessity of properly designed and implemented health strategies to decrease that prevalence of both tobacco use and obesity since both outcomes seem to be interdependent health interventions. And nutrition programs should also be tailored according to the specific characteristics of different consumer groups in order to promote a healthy lifestyle and introduce successful weight loss tactics.

And that's the conclusion for how tobacco use affects our weight and our BMI or a body mass index. I just wanted to remind you that November 19th 2020 is the Great American Smokeout and this great graphic here provided by the American Cancer Society sums it up. You don't have to stop in 1 day but start with day 1. How fitting? So join us on November 19th As the first day of your tobacco cessation efforts. And again, on November 19th, you want to start your journey toward a tobacco free life during the Great American Smokeout and improve your health immediately at any age. We realize that quitting is hard, but you can increase your chances of success with help. We have resources to Sentara employees by calling WebMD telephonic coaching. It's a 12-week program with certified health coaching trained in the tobacco cessation methods. They also offer free nicotine replacement and advice on proper usage. Optima Health members can also seek help or resources on to view self-paced programs. They're called, Get Off Your Butt: Stay Smokeless for Life. Thank you very much for listening to today's presentation.