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What Are Tobacco-Related Diseases?
Where there is smoke, there is disease. Hundreds of studies have found that cigarette smoking can cause lung disease, heart disease, stroke, cancer and many other diseases. Smoking as few as one to four cigarettes per day is enough to cause serious health problems. About 6 percent of all the money spent on health care each year in the United States is spent to treat tobacco-related diseases and health problems.
Tobacco use eventually leads to death or disability for half of all regular users. In fact, it is the leading cause of preventable death in the United States. Tobacco use is responsible for more than 430,000 deaths each year, or one in every five deaths. It kills more people than AIDS* (acquired immune deficiency syndrome), alcohol, drug abuse, car crashes, murders, suicides, and fires combined. The following are some of the disease and health conditions that are linked to tobacco use.
Chronic bronchitis Bronchitis (brong-KY-tis) refers to inflammation* of the bronchial (BRONG-kee-al) tubes, the airways that connect the windpipe to the lungs. This condition leads to a cough that brings up lots of thick, sticky mucus* . About 9 million Americans have chronic* bronchitis, and smoking is by far the most common cause.
Emphysema Emphysema (em-fe-ZEE-ma) is a chronic lung disease in which the air sacs of the lungs are overly large. This condition makes the lungs work less efficiently and leads to shortness of breath. About 3.6 million Americans have emphysema, and most of these cases are caused by smoking.
Heart disease A heart attack occurs when the blood supply to part of the heart muscle is decreased or stopped. This situation happens when one of the large blood vessels that bring blood to the heart is blocked, usually by a buildup of fatty deposits inside the vessel. More than 325,000 Americans die each year from a heart attack. Smokers are twice as likely as nonsmokers to have a heart attack, and two to four times as likely to die suddenly of heart problems.
Stroke A stroke occurs when a blood vessel to the brain is blocked or bursts, which can damage the brain. Strokes are the leading cause of serious, long-term disability in the United States. Strokes also kill more than 150,000 people per year. Smoking raises the risk of having a stroke.
Lung cancer Lung cancer kills more people than any other kind of cancer. Each year, more than 174,000 people are diagnosed with lung cancer in the United States, and about 162,000 people die from it. Smoking is the direct cause of almost 90 percent of all lung cancers.
Other cancers Cigarette smoke contains more than 4,000 different chemicals, and more than 60 of these have been shown to cause cancer in humans and animals. Smokers are more likely to get several kinds of cancer, including that of the mouth, larynx* , esophagus* , bladder* , cervix* , pancreas* , and kidney* .
Pregnancy problems Smoking by pregnant women is linked to miscarriage* , stillbirth* , premature birth* , low birth weight* , and infant death. Women who smoke are also more likely to have trouble getting pregnant.
Dental problems Use of smokeless tobacco can lead to gum problems and tooth loss.
Smoking has also been linked to a variety of other health problems, including asthma* , high blood pressure, gum disease* , cataracts* , bone Page 1683 | Top of Articlethinning, pneumonia* , peripheral artery disease (disease of the blood vessels outside the heart, such as those of the legs, hips and kidneys), and peptic ulcers* .
What Are Other Risks of Tobacco Use?
Smoking causes shortness of breath and reduces the amount of oxygen that is available for the muscles and other body tissues to use. These changes can limit people's ability to engage in various activities. In young people, sports performance can suffer as a result. For example, many smokers cannot run as far or as fast as nonsmokers. Tobacco use also makes people less attractive. It stains teeth and causes bad breath, yellowed fingers, and smelly clothes. Research has found that two-thirds of teenagers say that seeing someone smoke turns them off, and more than four-fifths say they would rather date nonsmokers. Over the years, smoking causes skin to wrinkle more than normal aging does among nonsmokers.
Are All Forms of Tobacco Harmful?
No form of tobacco use is safe. In addition to smoking cigarettes, using smokeless tobacco (also called oral, spitting, or chewing tobacco, and snuff), can have deadly results. It can cause bleeding gums, tooth loss, and sores of the mouth that never heal. Eventually, smokeless tobacco can cause cancer of the mouth, larynx, and esophagus. Young people who use smokeless tobacco are also more likely to start using cigarettes.
Pipe and cigar smokers, like cigarette smokers, have higher death rates from heart disease than nonsmokers. They are more likely to get cancer of the mouth, larynx, and esophagus, too. The use of any tobacco product, even ones that are labeled “low tar,” “naturally grown,” or “additive free,”, as well as hand-rolled cigarettes and smoking using a hookah (water pipe), can cause addiction and health problems.
What about Secondhand Smoke?
In addition to harming the health of the smoker, smoking harms nonsmokers. Each year in the United States, about 3,400 nonsmokers die from lung cancer and more than 22,000 nonsmokers die from heart disease caused by exposure to secondhand smoke* . Secondhand smoke also causes infections of the lower airways and lungs in up to 300,000 children and makes asthma worse in as many as 1 million children with asthma each year.
Why Does Tobacco Harm the Body?
Cigarette smoke is a mixture of several thousand chemicals; some are present naturally in the tobacco, and some are added by cigarette manufacturers to enhance the flavor and make smoking more pleasant. Tar, ammonia, carbon monoxide, and nicotine (NIK-o-teen) are some of these chemical compounds. The carbon monoxide in smoke attaches to Page 1684 | Top of Articlecompounds in the blood that normally carry oxygen. As a result, less oxygen is able to reach body tissues. Smoke contains at least 60 chemicals that harm the genetic material inside cells, triggering changes that lead to cancer. Other chemicals in smoke cause inflammation in body tissues, damage the lining of the airways, or harm the body's immune system* . Nicotine damages blood vessels, causing changes that can eventually lead to heart disease and stroke. Cigarettes and tobacco products contain compounds that damage the body in many other ways.
How Do Tobacco Users Become Addicted?
The nicotine in tobacco is the chemical that causes people who smoke to become addicted (hooked). Nicotine is absorbed easily from tobacco smoke in the lungs. Within seconds, nicotine travels through the bloodstream to the brain. There, it signals the brain to release chemicals that make people want to smoke more. The effect is very powerful. Smokers can become addicted to nicotine, which means they can become dependent on it physically and suffer unpleasant symptoms when it is taken away. The ability of nicotine to cause addiction* is as strong as that of heroin or cocaine. Users of smokeless tobacco can also become addicted because nicotine is absorbed through the inner lining of the mouth.
One hallmark of any addiction is tolerance (TAH-le-rans), which means that over time people start to need more and more of a substance to feel its effects. When people first start smoking, one cigarette may make them queasy and dizzy; some first-time smokers even vomit with their first inhalation. Soon these individuals can smoke several cigarettes without any symptoms, however, and most smokers are up to a pack or more each day by age 25.
Another sign of addiction is withdrawal symptoms, which means that people have physical symptoms and feel sick if they stop using the substance to which they are addicted. When people are forced to stop s mokingeven for a short time, they may have unpleasant symptoms. Many rush to light up as soon as they leave a place where smoking is not allowed.
Who Uses Tobacco?
About 45 million adults in the United States smoke cigarettes, including people of all ethnic groups. Among adults in 2005, the highest rates of smoking were among Native American and Native Alaskans (32%), non-Hispanic whites (22%), and African Americans (22%). Hispanics and Asian Americans are less likely to smoke. Although fewer women than men smoke, the gap has been steadily decreasing; in the early 2000s, nearly as many women as men smoke.
Tobacco use during the teenage years is of special concern because nicotine is highly addictive at this age. Four out of five adults who smoke began smoking by age 18. Young people who stay smoke-free through high school have a good chance of never lighting up. The 2004 Page 1685 | Top of ArticleNational Youth Tobacco Survey reported that about 8 percent of middle school students and 22 percent of high school students smoked cigarettes. About 3 percent of middle school students and 6 percent of high school students used smokeless tobacco. Sizeable numbers of students also smoked cigars, kreteks (clove cigarettes), or bidis (small, flavored cigarettes from India). Although the rate of smoking among African-American students nearly doubled in the 1990s, it decreased in the early 2000s, and as of 2008 they were far less likely to smoke than white or Hispanic students.
Young people who start smoking are more likely to get low grades in school than nonsmokers. These students often have low self-esteem, and they may turn to smoking because they think it will make them more attractive or popular. Because such teenagers lack self-confidence, they may have trouble saying no to tobacco.
How Can Tobacco-Related Problems Be Prevented?
The best way to prevent tobacco-related diseases is never to start smoking. For people who already are smokers, there is good news, though. Those who quit, no matter how old they are, live longer than those who keep smoking. Quitting is hard. It usually takes people two or more tries to succeed. However, studies have shown that each time a person tries to quit, he or she learns more about what works and what does not. Eventually, all people can succeed if they really want to stop smoking. Half of all people who have ever smoked have quit.
Quitting the Habit Most smokers say they do not plan to be smoking in five years. But in fact, more than 70 percent of smokers continue to smoke. The main reason it is so tough for them to quit is the discomfort of withdrawal. When smokers suddenly stop or sharply cut back on their tobacco use, a host of distressing symptoms quickly set in. People are tempted to start smoking again to relieve the distress. Common symptoms of tobacco withdrawal include the following:
- Bad mood
- Trouble sleeping
- Short attention span
- Increased appetite
- Weight gain
Three strategies have been shown to best help people quit smoking: using medications, getting support and encouragement, and learning to handle the urge to smoke.
Using medications Research shows that almost all smokers can benefit from temporarily wearing a small nicotine patch or chewing gum that contains nicotine. The nicotine passes through the skin and reduces the craving for this substance. Nicotine patches, gum, and lozenges are available without a prescription, but people should talk to their doctor before using them. A prescription nicotine inhaler and nasal spray are also approved for use in the United States. Bupropion and vereniclineare other prescription drugs approved for use in smoking cessation. Antidepressant medications* , such as nortriptyline, have also been shown to help smokers quit. Using any of these products doubles a person's chances of success.
Getting support and encouragement Personal counseling or a quit-smoking program can help someone learn how to live life as a nonsmoker. Studies have shown that the more counseling people have, the greater their chances of success. A quit-smoking program that offers at least four to seven sessions over a period of at least two weeks and devotes a satisfactory amount of time and attention to the problem. Friends and family members can also give support. In addition, self-help books and telephone hotlines may be helpful.
Learning to handle the urge to smoke People benefit from becoming aware of the situations or problems that make them want to smoke. For example, many people like to smoke when they are around other smokers or are feeling sad or frustrated. It is a good idea to avoid these situations as much as possible when trying to quit. Engaging in physical enjoyable and healthy activities, such as going for a walk or bike ride, can reduce stress. People who want to quit need to keep their minds busy, too, to help control thoughts of smoking.
Avoiding Passive Smoke Choosing not to smoke goes a long ways toward preventing tobacco-related diseases, but it is not enough. Studies have shown that smoke from the cigarettes of others contains carcinogens (car-SIN-o-jenz), cancer-causing chemicals that can affect people who are around smoke often. The secondhand smoke from cigarettes contains more tars and other chemicals than does the smoke exhaled by the smoker. Most cigarettes are filtered and remove at least some of the harmful chemicals. Protecting oneself and others requires taking the following steps:
- Avoiding places wheree people are smoking whenever possible
- Encouraging smokers to quit for their health and the health of others
- Preventing children from regularly being exposed to smoke
- Encouraging restaurants, stores, and other social settings to provide no-smoking areas or to change their policy so the building is smoke free.
Books and Articles
Cowan, David, and Susanna Palomares. Don't Get Hooked: Tobacco Awareness and Prevention Activities. Austin, TX: PRO-ED, 2005.
American Academy of Family Physicians. P.O. Box 11210, Shawnee Mission, KS, 66207-1210. Toll free: 800-274-2237. Web site: http://www.aafp.org .
American Cancer Society. 250 Williams Street NW, Atlanta, GA, 30303. Toll free: 800-ACS-2345. Web site: http://www.cancer.org .
American Heart Association. 7272 Greenville Avenue, Dallas, TX, 75231-4596. Toll free: 800-AHA-USA1. Web site: http://www.americanheart.org .
American Lung Association. 1301 Pennsylvania Ave. NW, Suite 800, Washington, DC, 20004. Toll free: 800-LUNG-USA. Web site: http://www.lungusa.org .
Campaign for Tobacco-Free Kids. 1400 Eye Street NW, Suite 1200, Washington, DC, 20005. Telephone: 202-296-5469. Web site: http://www.tobaccofreekids.org .
Centers for Disease Control and Prevention. 1600 Clifton Road, Atlanta, GA, 30333. Toll free: 800-311-3435. Web site: http://www.cdc.gov/tobacco .
Office of the Surgeon General. 5600 Fishers Lane, Room 18-66, Rockville, MD, 20857. Telephone: 301-443-4000. Web site: http://www.surgeongeneral.gov/tobacco .
QuitNet. Web site: http://www.quitnet.org .
Smoke-Free.gov. Web site: http://www.smokefree.gov .
* stroke is a brain-damaging event usually caused by interference with blood flow to the brain. A stroke may occur when a blood vessel supplying the brain becomes clogged or bursts, depriving brain tissue of oxygen. As a result, nerve cells in the affected area of the brain, and the specific body parts they control, do not properly function.
* cancer is a condition characterized by abnormal overgrowth of certain cells, which may be fatal.
* AIDS or acquired immunodeficiency (ih-myoo-no-dih-FIH-shen-see) syndrome, is an infection that severely weakens the immune system; it is caused by the human immunodeficiency virus (HIV).
* inflammation (in-fla-MAY-shun) is the body's reaction to irritation, infection, or injury that often involves swelling, pain, redness, and warmth.
* mucus (MYOO-kus) is a thick, slippery substance that lines the insides of many body parts.
* chronic (KRAH-nik) lasting a long time or recurring frequently.
* larynx (LAIR-inks) is the voice box (which contains the vocal cords) and is located between the base of the tongue and the top of the windpipe.
* esophagus (eh-SAH-fuh-gus) is the soft tube that, with swallowing, carries food from the throat to the stomach.
* bladder (BLAD-er) is the sac that stores urine produced by the kidneys prior to discharge from the body.
* cervix (SIR-viks) is the lower, narrow end of the uterus that opens into the vagina.
* pancreas (PAN-kree-us) is a large gland located behind the stomach that secretes various hormones and enzymes necessary for digestion and metabolism (me-TAB-o-liz-um), notably insulin.
* kidney is one of the pair of organs that filter blood and remove waste products and excess water from the body in the form of urine.
* miscarriage (MIS-kare-ij) is the end of a pregnancy through the death of the embryo or fetus before birth.
* stillbirth is the birth of a dead fetus.
* premature birth (pre-ma-CHUR) means born too early. In humans, it means being born after a pregnancy term lasting less than 37 weeks.
* low birth weight means born weighing less than normal. In humans, it refers to a full-term (pregnancy lasting 37 weeks or longer) baby weighing less than 5.
* asthma (AZ-mah) is a condition in which the airways of the lungs repeatedly become narrowed and inflamed, causing breathing difficulty.
* gum disease is an infection caused by bacteria that affect the tissues surrounding and supporting the teeth.
* cataracts (KAH-tuh-rakts) are areas of cloudiness of the lens of the eye that can interfere with vision.
* pneumonia (nu-MO-nyah) is inflammation of the lungs.
* ulcer is an open sore on the skin or the lining of a hollow body organ, such as the stomach or intestine. It may or may not be painful.
* secondhand smoke, also called environmental tobacco smoke or passive smoke, is smoke that is inhaled passively or involuntarily by someone who is not smoking. It is a mixture of gases and particles from a burning cigarette, cigar, or pipe and the smoke exhaled by smokers.
* immune system (im-YOON SIS-tem) is the system of the body composed of specialized cells and the substances they produce that helps protect the body against disease-causing germs.
* addiction (a-DIK-shun) is a strong physical or psychological dependence on a physical substance.
* antidepressant medications are used for the treatment and prevention of depression.