Smoking and Tobacco Use

Regulations

Health Effects of Smoking

According to the CDC, the health effects of smoking are as follows: Smokers are more likely than nonsmokers to develop heart disease, stroke, and lung cancer.

  • Estimates show smoking increases the risk:
    • For coronary heart disease by 2 to 4 times
    • For stroke by 2 to 4 times
    • Of men developing lung cancer by 25 times
    • Of women developing lung cancer by 25.7 times
  • Smoking causes diminished overall health, increased absenteeism from work, and increased health care utilization and cost.

Smokers are at greater risk for diseases that affect the heart and blood vessels (cardiovascular disease).

  • Smoking causes stroke and coronary heart disease, which are among the leading causes of death in the United States.
  • Even people who smoke fewer than five cigarettes a day can have early signs of cardiovascular disease.
  • Smoking damages blood vessels and can make them thicken and grow narrower. This makes your heart beat faster and your blood pressure go up. Clots can also form.
  • A stroke occurs when:
    • A clot blocks the blood flow to part of your brain;
    • A blood vessel in or around your brain bursts.
  • Blockages caused by smoking can also reduce blood flow to your legs and skin.

Smoking can cause lung disease by damaging your airways and the small air sacs (alveoli) found in your lungs.

  • Lung diseases caused by smoking include COPD, which includes emphysema and chronic bronchitis.
  • Cigarette smoking causes most cases of lung cancer.
  • If you have asthma, tobacco smoke can trigger an attack or make an attack worse.

Smoking can cause cancer almost anywhere in your body:

  • Bladder
  • Blood (acute myeloid leukemia)
  • Cervix
  • Colon and rectum (colorectal)
  • Esophagus
  • Kidney and ureter
  • Larynx
  • Liver
  • Oropharynx (includes parts of the throat, tongue, soft palate, and the tonsils)
  • Pancreas
  • Stomach
  • Trachea, bronchus, and lung

Smoking also increases the risk of dying from cancer and other diseases in cancer patients and survivors.

Smoking can make it harder for a woman to become pregnant. It can also affect her baby’s health before and after birth. Smoking increases risks for:

  • Preterm (early) delivery
  • Stillbirth (death of the baby before birth)
  • Low birth weight
  • Sudden infant death syndrome (known as SIDS or crib death)
  • Ectopic pregnancy
  • Orofacial clefts in infants

Smoking can also affect men’s sperm, which can reduce fertility and also increase risks for birth defects and miscarriage.

Smoking can affect bone health.

  • Women past childbearing years who smoke have weaker bones than women who never smoked. They are also at greater risk for broken bones.

Smoking can have other health effects:

  • Smoking affects the health of your teeth and gums and can cause tooth loss.
  • • Smoking can increase your risk for cataracts (clouding of the eye’s lens that makes it hard for you to see). It can also cause age-related macular degeneration (AMD). AMD is damage to a small spot near the center of the retina, the part of the eye needed for central vision.
  • Smoking is a cause of type 2 diabetes mellitus and can make it harder to control. The risk of developing diabetes is 30–40% higher for active smokers than nonsmokers.
  • Smoking causes general adverse effects on the body, including inflammation and decreased immune function.
  • Smoking is a cause of rheumatoid arthritis.

Health Effects of Second Hand Smoke

Exposure to secondhand smoke has immediate adverse effects on the cardiovascular system and can cause coronary heart disease and stroke.

  • Secondhand smoke causes nearly 34,000 premature deaths from heart disease each year in the United States among nonsmokers.
  • Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of developing heart disease by 25–30%.
  • Secondhand smoke increases the risk for stroke by 20−30%.
  • Secondhand smoke exposure causes more than 8,000 deaths from stroke annually.

Breathing secondhand smoke can have immediate adverse effects on your blood and blood vessels, increasing the risk of having a heart attack.

  • Breathing secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase the risk of having a heart attack.
  • Even brief exposure to secondhand smoke can damage the lining of blood vessels and cause your blood platelets to become stickier. These changes can cause a deadly heart attack.

People who already have heart disease are at especially high risk of suffering adverse effects from breathing secondhand smoke and should take special precautions to avoid even brief exposures.

Secondhand smoke causes lung cancer in adults who have never smoked.

  • Nonsmokers who are exposed to secondhand smoke at home or at work increase their risk of developing lung cancer by 20–30%.
  • Secondhand smoke causes more than 7,300 lung cancer deaths among U.S. nonsmokers each year.
  • Nonsmokers who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers.
  • Even brief secondhand smoke exposure can damage cells in ways that set the cancer process in motion.
  • As with active smoking, the longer the duration and the higher the level of exposure to secondhand smoke, the greater the risk of developing lung cancer.

Sudden Infant Death Syndrome (SIDS) is the sudden, unexplained, unexpected death of an infant in the first year of life. SIDS is the leading cause of death in otherwise healthy infants.6 Secondhand smoke increases the risk for SIDS.

  • Smoking by women during pregnancy increases the risk for SIDS.
  • Infants who are exposed to secondhand smoke after birth are also at greater risk for SIDS.
  • Chemicals in secondhand smoke appear to affect the brain in ways that interfere with its regulation of infants' breathing.
  • Infants who die from SIDS have higher concentrations of nicotine in their lungs and higher levels of cotinine (a biological marker for secondhand smoke exposure) than infants who die from other causes.

Secondhand smoke can cause serious health problems in children.

  • Studies show that older children whose parents smoke get sick more often. Their lungs grow less than children who do not breathe secondhand smoke, and they get more bronchitis and pneumonia.
  • Wheezing and coughing are more common in children who breathe secondhand smoke.
  • Secondhand smoke can trigger an asthma attack in a child. Children with asthma who are around secondhand smoke have more severe and frequent asthma attacks. A severe asthma attack can put a child's life in danger.
  • Children whose parents smoke around them get more ear infections. They also have fluid in their ears more often and have more operations to put in ear tubes for drainage.

Addiction

  • Most smokers become addicted to nicotine, a drug that is found naturally in tobacco.
  • More people in the United States are addicted to nicotine than to any other drug. Research suggests that nicotine may be as addictive as heroin, cocaine, or alcohol.
  • Quitting smoking is hard and may require several attempts. People who stop smoking often start again because of withdrawal symptoms, stress, and weight gain.
  • Nicotine withdrawal symptoms may include:
    • Feeling irritable, angry, or anxious
    • Having trouble thinking
    • Craving tobacco products
    • Feeling hungrier than usual

E-Cigarettes

E-Cigarettes are devices that use a battery to produce a vapor containing flavoring, nicotine (or another drug such as marijuana), and other additives. They are particularly popular among young people, which is a concern because nicotine (and other drugs) hinders brain development and can cause young people to become addicted and form smoking habits later in life. E-cigarettes are often flavored like menthol, alcohol, tobacco, candy, chocolate, or sweets, which is appealing to young people. Additionally, the e-cigarette industry's advertisements are likely to affect young people. During 2011-2012 alone, e-cigarette makers almost tripled their annual advertising expenditures, from $6.4 million to $18.3 million. E-cigarettes are heavily marketed on television, the most commonly viewed media platform, while conventional cigarette advertising has been banned from television since 1971.

Some women choose to smoke e-cigarettes during pregnancy instead of cigarettes. While the aerosol of e-cigarettes has less harmful chemicals, nicotine is a health danger for pregnant women and developing babies and can damage a developing baby’s brain and lungs. Also, some of the flavorings used in e-cigarettes may be harmful to a developing baby.

Some people use e-cigarettes as a way to quit smoking. However, the addictive drug in cigarettes is the same in e-cigarettes, and there is no evidence that

For more information on e-cigarettes: https://e-cigarettes.surgeongeneral.gov/resources.html

Quitting

Quitting smoking has many benefits. It can lower your risk for cancer, heart disease, stroke, and peripheral vascular disorder, reduced coughing, wheezing, and shortness of breath, reduce your risk for lung diseases like COPD, and reduce the risk of infertility in women.

Approximately 68% of smokers reported that they want to quit completely. 45.5% of all high school students who smoke reported that they wanted tried to stop smoking in the past 12 months.

There are many ways to quit, including:

  • Brief help by a doctor (such as when a doctor takes 10 minutes or less to give a patient advice and assistance about quitting)
  • Individual, group, or telephone counseling
  • Behavioral therapies (such as training in problem solving)
  • Treatments with more person-to-person contact and more intensity (such as more or longer counseling sessions)
  • Programs to deliver treatments using mobile phones
  • Nicotine replacement products like over-the-counter (nicotine patch [which is also available by prescription], gum, lozenge), prescription (nicotine patch, inhaler, nasal spray), and prescription non-nicotine medications: bupropion SR (Zyban®), varenicline tartrate (Chantix®)

Counseling and medication are both effective for treating tobacco dependence, and using them together is more effective than using either one alone.