Even though more and more restaurants and taverns are moving toward non- smoking policies, tobacco abuse continues to be a serious problem in the U.S. and worldwide. Tobacco use is the single greatest cause of preventable deaths globally. The World Health Organization estimates that there were 5.4 million tobacco-related deaths in 2004, and more than 100 million people died from tobacco during the 20th century.
Smoking predominantly affects the heart and lung systems, being the major risk factor for heart attacks, strokes, emphysema and chronic bronchitis. The most common cancers related to tobacco are lung, larynx, oral and pancreatic.
Cigarettes contain multiple substances that act as carcinogens and induce DNA mutations. It is the tar content that increases the risk of disease and it is the nicotine that induces psychological and physical dependency.
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In 2000 smoking was practiced by 1.22 billion people and it is predicted that by 2025 that number will rise to 1.9 billion worldwide. In the US, smoking prevalence is estimated at 17.9% of the population. Smoking is five times more common in males. The rates among men have peaked and started declining, whereas in females they continue to climb. In developing countries, rates are climbing by 3.4% per year since 2002.
Tobacco companies purposefully target adolescents to begin smoking at an age and period in their life when they are most vulnerable. The Center for Disease Control found that 80% of adult smokers began smoking as adolescents. The risk factors for adolescents to start smoking include; one or both parents who smoke, a mother who used cigarettes with alcohol during her pregnancy, low self-esteem, poor academic success, obesity and peer pressure.
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Smoking decreases a person’s life span at least 14 years, triples a person’s risk for premature death by age 60 and kills at least 443,000 people annually. This being the equivalent of three jumbo jets crashing every day with no survivors.
Tobacco use is a significant factor in miscarriages amongst pregnant smokers, premature births and low birth weight babies. It is also associated with sudden infant death syndrome due to the smoking exposed fetal brain not being able to detect a drop in oxygen level in the blood stream increasing the risk of accidental
asphyxiation. The incidence of impotence is 85% higher in males who smoke and a significant factor in erectile dysfunction.
The treatment for tobacco abuse is to support the patient to quit. Non drug therapy includes support groups, meditation, hypnosis or any means that does not involve medication. Over the counter products such as nicotine patches, gum or lozenges can help reduce the withdrawal effects of quitting. Prescription
medication includes Zyban, Clonidine or Chantix. Chantix has received a lot of attention in the media. Although an effective method to stop tobacco use, there have been reported rare incidents of severe depression with suicidal thoughts and aggressive behavior in cases where Chantix was mixed with alcohol.
The cornerstone to treating tobacco use is to prevent the patient from ever starting to smoke. Open and honest communication with teenagers regarding the realistic outcome of long term deleterious effects of smoking can only help in discouraging them from pursuing tobacco use.
If that doesn’t work, take them to a convenience store and show them how much a pack of cigarettes cost. They’ll get the message.
Dr. Ballard is a Board Certified Internist and Geriatrician with a special interest
in Women’s Health. She practices in Enumclaw, 360-825-1389. Dr. Ballard’s
comments are informational only and not to be construed as medical advice. Consult your personal physician for any medical issues.
