Pam Spencer is a 39-year-old female who is married to Sam and they have two daughters who are 17 and 14. Pam works full-time at a department store. After getting home from work she still has to take care of everything around the house – cooking, cleaning, grocery shopping, etc. In her spare time, she loves to garden. Her beautiful yard is full of flowers, bushes and trees. She is often tired, but knows it is because of her busy schedule and responsibilities as a wife, mother and employee – and she will be turning forty soon.


Pam tries to stay healthy by gardening, taking nightly walks and watching her diet closely – even though she loves French Fries and sweets – she tries to make smart choices by choosing a salad or fruit. Below you will find a one-day snapshot of her food choices.


Even though Pam enjoys gardening and nightly walks with Sam, lately both activities have become too challenging because she lacks energy and tires quickly. Now when she does any kind of activity, she gets out of breath and starts coughing so much she can’t stop.


Pam started smoking in high school because back then it was the cool thing to do. She knows smoking is harmful to her health but when she tried to quit, she gained weight. She assumes being overweight is worse for her than smoking. Pam is trying to cut back from smoking almost 30 cigarettes a day but cutting back is hard because Sam smokes as well. Pam has read the warning labels on the packages but other than sometimes being short of breath, and now a cough she’s developed, she’s healthy. Besides, smoking gives her time to think and serves as an outlet for her stress.


Pam is feeling stressed out lately and her phlegmy cough isn’t helping. The coughing keeps her up at night, causing her mind to be consumed with worry. She worries her position at the store will be cut. Pam worries about her mother, who was just released from the hospital. Her mother was admitted with chest pains that ended up being a symptom of her emphysema and not a heart attack. Pam also worries about Callie, who has a couple of friends Pam believes are already smoking – at 14. Pam is afraid she will begin to smoke, something she does not want for either of her daughters.


  1. Internet Research: From the list below, select all the health issues caused by cigarette smoking.
    A. Lung Cancer       C. Viral Infection
    B. Mouth Cancer       D. COPD

  2. Internet Research: Which of the following are hazardous substances found in cigarettes? Select all that apply.
    A. Ammonia       D. Tar
    B. Iron       E. Nicotine
    C. Propane       F. Carbon monoxide

  3. Internet Research: Match each of the hazardous ingredients with the negative effect it has on the body.
    ____ Acetone       A. Contains several cancer-causing chemicals that stay in the lungs when inhaled.
    ____ Nicotine       B. Decreases muscle and heart function.
    ____ Tar       C. Highly addictive and a fast-acting drug.
    ____ Carbon monoxide       D. Damages the liver and kidneys.

  4. View the Video: Smoking has many negative effects on the lungs. From the statements below, identify which statements are TRUE (T) and which statements are FALSE (F).
    ____ 1. Smoking damages only one part of the lungs, the alveoli.
    ____ 2. Smoking irritates the bronchial tubes, causing them to swell and make mucus.
    ____ 3. During sleep, the cilia recover and push more pollutants and mucus out of the lungs. When awakened, the body attempts to expel these materials (smoker’s cough).
    ____ 4. Over time, a smoker may develop lung disease because the cilia stop working and the airways become clogged with scars and mucus, making breathing more difficult.
    ____ 5. Over time, so little oxygen reaches the blood that a smoker may develop emphysema – a condition that causes them to gasp for breath and use oxygen to breathe.



  5. Internet Research: TRUE or FALSE: People who are very stressed tend to smoke more than those who are not as stressed.


  6. View Pam’s Personal Health Record: In which of the statements below is Pam “At Risk” as identified on her Personal Health Record. Select all that apply.
    A. Her systolic and diastolic blood pressure is 130/85
    B. Her hemoglobin A1c of 5.7 is above normal
    C. Her screening says she normally feels well
    D. She experiences high levels of stress
    E. She is exposed to secondhand smoke

  7. Review Pam’s Story: What family health history is provided in Pam’s story?
    A. Sam is a smoker
    B. Callie is a smoker
    C. Pam’s mom had a heart attack
    D. Pam’s mom has emphysema

  8. Team Discussion: Each member shares an example of your family’s health history and then list the examples provided in the discussion.
View Pam’s Personal Health Record