Cigarettes and Health Effects

The American Cancer Society (ACS) holds the Great American Smokeout every year to challenge smokers to quit cigarettes for one day, in hopes they will quit forever. Each year, more Americans try to quit smoking on this day than any other day of the year, including New Year’s Day.

In California an average of one in five smokers quit for the day. The event was the creation of Arthur P. Mullaney who in 1971 challenged the citizens of Randolph, Massachusetts to give up cigarettes and donate the money they would have spent on cigarettes for that day to a local high school scholarship fund. By 1976 several communities nationwide were sponsoring similar events. The ACS organized the first Great American Smokeout in 1977. The Great American Smokeout takes place each year on the third Thursday of November.

The Impact of Smoking on Health
The use of and exposure to tobacco smoke has a tremendous impact on the health of an individual. Tobacco use is the most common preventable cause of death in the United States. It is responsible for one in every five deaths. Cigarette smoking is the most lethal form of tobacco use. In the 1960′s, half of all adult men and a third of adult women in the U. S. smoked. By 1993, the number of smokers had declined to 28% of adult men and 23% of adult women; however, the rise in teenagers who smoke is on the rise with 3,000 new smokers a day. On average, Americans begin smoking in early adolescence. The Center for Disease Control (CDC) reports that 50% of adult smokers began smoking by the age 14 and 90% began by the age of 20.

Although cigarette smoking is on the decline in the U.S., worldwide consumption continues to increase by 2% with the highest growth rate in developing countries. The World Health Organization estimates that 10% of the total world population now alive will die of a tobacco related disease. Approximately 400,000 Americans die from tobacco related diseases each year. Annually, that equals 18-20% of all U.S. deaths. Americans who start smoking during adolescence and continue until middle age have a one-in-three risk of dying from a disease caused by tobacco or of developing a serous but non-fatal tobacco-related disease (NIH, 2000).

Coronary artery disease and heart disease is the most common tobacco-related cause of death. Cigarette smoking accelerates the hardening of arteries, increases artery narrowing, and causes reversible vasoconstriction that attributes to high blood pressure. High blood pressure is not more prevalent in smokers but is more difficult to control. Smokers with hypertension need less blood pressure medication when they quit smoking. Heart attacks are five times more common among smokers than non-smokers under the age of 50. The American Medical Association estimates about one-third of all heart attacks and 40% of all stroke related deaths are attributable to tobacco use. Smoking induced peripheral vascular disease also is the most common organic cause of impotence and premature wrinkles.

According to the CDC, tobacco use is responsible for 90% of all lung cancers including those diagnosed in ex-smokers and non-smokers. The risk of dying from lung cancer for the average American smoker is 10%. Smokers who are also exposed to other lung carcinogens such as asbestos or radon have as much as a 50% risk of dying from lung cancer. Many other types of cancers are associated with tobacco use including oral, larynx, esophagus, stomach, pancreas, cervix, kidney, breast, colon and bladder. About 85% of chronic bronchitis and emphysema is attributable to tobacco smoking. Approximately 40% of men over the age of 30 who smoke a pack a day have chronic bronchitis. By age 60, that percentage increases to 80%. It is estimated that 20% of all lifetime smokers develop COPD (chronic obstructive pulmonary disease). Other diseases related to smoking include spontaneous pneumothorax, eosinophilic granuloma, peptic ulcer disease, and osteoporosis.

Health Effects of Second Hand Smoke
Second hand tobacco smoke contains over 4,000 chemicals. The healthcare community now believes that second hand smoke is more dangerous than the smoke inhaled. Some are toxic and some are carcinogenic. Long-term exposure to second hand smoke has been shown to cause lung cancer and coronary heart disease in adults. Family members of a smoker have an increased risk of health effects related to second-hand smoke. Children who live in a home shared by a smoker or who are exposed to second-hand smoke have an increased risk of otitis media, colds, bronchitis, pneumonia, and asthma. Sudden infant death syndrome (SIDS) is more common among infants born to women who smoke or share a home with a smoker. Nicotine and other components of smoke are present in breast milk of nursing mothers who smoke. Infants who ingest these chemicals take smaller volumes with each feeding, gain weight more slowly, and have a higher incidence of vomiting, diarrhea, and restlessness than infants of nonsmoking mothers. The CDC estimates that tobacco accounts for 10% of all infant mortality.

Why Quitting Is So Hard
Quitting cigarette smoking is a very individualized process. Fewer than 5% of smokers are successful on their first attempt at quitting. This should not be considered a failure. On average it takes five to six attempts to quit before achieving permanent abstinence. Most smokers have a “relationship” with cigarettes. For many, smoking is a source of pleasure, comfort and self-esteem. The pleasure is derived from the biochemical effects of nicotine on the brain. Nicotine affects the locus ceruleus, which enhances the feeling of vigilance and arousal and acts on the mesolimbic dopaminergic system that enhances feelings of reward and pleasure. Often a great sense of loss accompanies quitting that leads to relapse.

Nicotine produces a pharmacologic dependence that has withdrawal symptoms during cessation. The severity and frequency of withdrawal symptoms varies between individuals. Withdrawal symptoms can include restlessness, irritability, decreased concentration, headaches, nausea, abdominal discomfort, insomnia and diarrhea. Nicotine patches and medications can assist in reducing withdrawal symptoms. Cigarette cravings can be very intense. The intensity of craving increases more at certain times of the day such as upon waking, after dinner, during social functions and during times of stress.

Experienced smokers have learned to control the dosing of nicotine to produce either a stimulation or relaxation effect. A series of brief, rapid puffs provides the smoker a feeling of enhanced alertness and the ability to focus concentration. Long inhalation, breath holding, and slow exhalation provides the smoker a feeling of calmness. When a person has been relying on a drug such as nicotine to cope with daily stressors, fluctuations of mood and issues of self-control can be quite difficult.

Part of cigarette smoking is habitual behavior. Often a smoker will light a cigarette after a meal, during a coffee break, or while driving and be unaware of smoking until the cigarette is half gone. Chain-smoking is the extreme of habitual behavior. Many smokers enjoy the oral satisfaction of smoking, which is similar to the satisfaction that infants receive with sucking on a bottle or pacifier. It is important to learn to change these habits and set up activities to deal with the cravings. Reducing cigarette consumption over time is more likely to lead to success than quitting “cold turkey” in individuals who experience moderate to severe nicotine withdrawal. It is important to be supportive and recognize the difference between a smoking slip (smoking a few cigarettes) versus a relapse (returning to former smoking patterns). Often smokers become discouraged and give up smoking cessation with the first cigarette, because the person believes that only 100% abstinence is acceptable. Slips during the first 2-4 weeks of cessation are common and can lead to relapse. Slips should be recognized and should also be a way of preventing further slips. As the smoking cessation attempts continue, slips become less frequent and relapse less common.

Smoking Cessation – The Benefits of Quitting
Former smokers live longer and remain healthier than life-long smokers. People who quit by the age of 50 reduce their risk of dying before the age of 65 in half. The risk of sudden death from heart attack or stroke decreases immediately and continues to decline with time after smoking cessation. The risk of lung cancer as well as other cancers begins to decline five to seven years after cessation. COPD, bronchitis, and emphysema may not improve after smoking cessation, but the disease process slows and the illness is less severe. Often cough and sputum production resolves in individuals with chronic bronchitis and is less in persons with obstructive lung disease. After smoking cessation the individual will experience fewer colds, respiratory infections, have an increase of smell and taste, and often-improved lung functioning.

If you have family members or friends who smoke, encourage them to join the Great American Smokeout. Who knows, it could be their first day of a smoke-free life! The ACS and the American Lung Association have several good references and tools to assist with changing smoking habits. But to quit smoking takes more than one day. For some it is easier than others. Get help. Ask your primary health care provider for assistance in quitting. Ask for information about local smoking cessation programs. There are also medication options to help with nicotine withdrawal.

January 14th, 2010 - Posted in Anti Smoking | | Comments Off

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