Tobacco

What's the Problem?

Tobacco use is the single most preventable cause of death in our society, causing more than 440,000 deaths in the United States. The death rate from lung cancer is about 23 times higher for male smokers and 13 times higher for female smokers than the rate for those who have never smoked. The costs associated with smoking total more than $150 billion per year ($75.5 billion in excess medical costs and $81.9 billion in productivity losses).

There are more than 4,000 known chemicals in cigarettes-including cyanide, arsenic, and formaldehyde-and more than 250 chemicals in tobacco smoke that are toxic or cause cancer in humans and animals. Smoking is a major cause of cancers of the lung, larynx, mouth, pharynx, esophagus, pancreas, uterus, cervix, kidney, and bladder. It is also a major cause of heart disease, bronchitis, emphysema, and strokes that can leave the victim with permanent disabilities.

Smokeless tobacco and cigars also have deadly consequences, including lung, larynx, esophageal, and mouth cancer. Moreover, novel tobacco products such as bidis and clove cigarettes (kreteks) should not be considered safe alternatives to smoking or using smokeless tobacco.

Who's at Risk?

Persons of all racial/ethnic backgrounds are vulnerable to becoming addicted to nicotine, the drug in tobacco products. Approximately 80% of adult smokers started smoking before the age of 18. More than 6.4 million children living today will die prematurely because of a decision they will make as adolescents – the decision to smoke cigarettes.

People who do not smoke but who are exposed to environmental tobacco smoke are at increased risk of cardiovascular disease and lung cancer. It causes an estimated 35,000 to 62,000 deaths from heart disease in people who were not current smokers. Secondhand smoke can aggravate asthmatic conditions (especially in children), impair blood circulation, and cause bronchitis and pneumonia.

Can It Be Prevented?

People can protect their health by avoiding the use of tobacco products. Smokers who quit will reduce their risk of lung cancer by 30 to 50% ten years after they stop.

The Bottom Line

Tobacco use is associated with a myriad of health problems including death. Cigarette smoke irritates the eyes, nose, throat, and gums. These tissues respond by thickening and by undergoing cellular changes that can eventually lead to mouth, throat, or esophageal cancer. Gum disease and tooth loss are common among smokers.

Tobacco adversely affects reproduction; infertility is more common among men and women who smoke, although it can be reversed if smoking ceases. Tobacco use during pregnancy increases the risk of miscarriage, premature delivery, low birth weight in newborns, stillbirth, and sudden infant death. It is also associated with mental retardation and birth defects such as oral clefts in the children of women who smoked during pregnancy.

Women who smoke reach menopause at a younger age than nonsmokers and may experience more menopausal symptoms. Smoking is associated with osteoporosis in women and spinal-disc disease in both sexes. The calcium that smokers lose from their bones cannot be fully recovered and some bone changes are irreversible. Premature facial wrinkling and graying of the skin occurs after as few as 5 years of smoking.

Case Examples

1. An accomplished singer of stage and movies AND long-time smoker thinks her sore throat will go away. She finally sees a doctor, has tests, and learns that she has cancer of the larynx and may not be able to sing again after surgery and treatment.
2. A couple trying to conceive a child can be counseled to stop smoking to increase their chances of conceiving and delivering a healthy baby.