Tobacco smoking – The facts

The younger you are when you start smoking, the more likely you are to smoke for longer and to die early from smoking. Many smoking-related deaths are not quick deaths. For example, if you develop COPD you can expect several years of illness and distressing symptoms before you die. Smoking increases the risk of developing a number of other diseases. Many of these may not be fatal, but they can cause years of unpleasant symptoms. The good news is that stopping smoking can make a big difference to your health. It is never too late to stop smoking to greatly benefit your health. For example, if you stop smoking in middle age, before having cancer or some other serious disease, you avoid most of the increased risk of death due to smoking. Help is available if you want to stop smoking but are finding it difficult.

The dangerous chemicals in tobacco smoke

Nicotine -Nicotine is a drug that stimulates the brain. If you are a regular smoker, when the blood level of nicotine falls, you usually develop withdrawal symptoms, such as craving, anxiety, restlessness, headaches, irritability, hunger, difficulty with concentration, or just feeling awful. These symptoms are relieved by the next cigarette.

Tar – this is the collective term for the various particles suspended in tobacco smoke. The particles contain chemicals, including several cancer-causing substances (carcinogens). Tar is sticky and brown, and stains teeth, fingernails and lung tissue.

Carbon monoxide – this odorless gas is fatal in large doses because it takes the place of oxygen in the blood. Each red blood cell contains a protein called hemoglobin that transports oxygen molecules around the body. However, carbon monoxide binds to hemoglobin better than oxygen. This means that less oxygen reaches the brain, heart, muscles and other organs leading to quick fatigability.

Hydrogen cyanide – the lungs contain tiny hairs (cilia) that help to clean the lungs by moving foreign substances out. Hydrogen cyanide stops this lung clearance system from working properly, which means the poisonous chemicals in tobacco smoke can build up inside the lungs. Other chemicals in smoke that damage the lungs include hydrocarbons, nitrous oxides, organic acids, phenols and oxidizing agents 

Free radicals – these highly reactive chemicals can damage the heart muscles and blood vessels. They react with cholesterol, leading to the build-up of fatty material on artery walls. Their actions lead to heart disease, stroke and blood vessel disease

Metals – tobacco smoke contains dangerous metals including arsenic, cadmium and lead. Several of these metals are carcinogenic 

Radioactive compounds – tobacco smoke contains radioactive compounds that are known to be carcinogenic.

Which diseases are caused or made worse by smoking?

Lung cancer. 

Chronic obstructive pulmonary disease (COPD).

Heart disease. 

Other cancers – of the mouth, nose, throat, larynx, gullet (oesophagus), pancreas, bladder, cervix, blood (leukemia), and kidney are all more common in smokers.

Circulation. The chemicals in tobacco can damage the lining of the blood vessels and affect the level of lipids (fats) in the bloodstream. This increases the risk of atheroma forming (sometimes called hardening of the arteries). Atheroma is the main cause of heart disease, strokes, peripheral vascular disease (poor circulation of the legs), and aneurysms (swollen arteries which can burst causing internal bleeding). All of these atheroma-related diseases are more common in smokers.

Sexual problems. Smokers are more likely than non-smokers to become impotent or have difficulty in maintaining an erection in middle life. This is thought to be due to smoking-related damage of the blood vessels to the penis.

Rheumatoid arthritis. Smoking is known to be a risk factor for developing rheumatoid arthritis. One research study estimated that smoking is responsible for about 1 in 5 cases of rheumatoid arthritis.

Ageing. Smokers tend to develop more lines on their face at an earlier age than non-smokers. This often makes smokers look older than they really are.

Fertility is reduced in smokers (both male and female).

Menopause. On average, women who smoke have a menopause nearly two years earlier than non-smokers.

Other conditions where smoking often causes worse symptoms include: asthma, colds, flu, chest infections, tuberculosis, chronic rhinitis, diabetic retinopathy, and hyperthyroidism.

Smoking increases the risk of developing various other conditions including: dementia, cataracts, gum disease, tooth loss etc.

Smoking in pregnancy increases the risk of:

Miscarriage.

Complications of pregnancy, including bleeding during pregnancy, detachment of the placenta, premature birth, and ectopic pregnancy.

Low birth weight. Babies born to women who smoke are on average 200 grams (8 oz) lighter than babies born to comparable non-smoking mothers. Premature and low birth weight babies are more prone to illness and infections.

Congenital defects in the baby – such as cleft palate.

Stillbirth or death within the first week of life – the risk is increased by about one-third.

Poorer growth, development, and health of the child. On average, compared with children born to non-smokers, children born to smokers are smaller, have lower achievements in reading and math, and an increased risk of developing asthma.

Likewise pregnant women being second hand smokers from their husband are at equal risk to the aforementioned complications

Children are also affected:

Children and babies who live in a home where there is a smoker:

Are more prone to asthma and ear, nose and chest infections. 

Have an increased risk of dying from cot death (sudden infant death syndrome).

Are more likely than average to become smokers themselves when older.

On average, do less well at reading and reasoning skills compared with children in smoke-free homes, even at low levels of smoke exposure.

Are at increased risk of developing COPD and cancer as adults.

Passive smoking of adults

You have an increased risk of lung cancer and heart disease if you are exposed to other people smoking for long periods of time. Tobacco smoke is also an irritant, and can make asthma and other conditions worse.

Other problems with smoking

Your breath, clothes, hair, skin, and home smell of stale tobacco. You do not notice the smell if you smoke, but to non-smokers the smell is obvious and unpleasant.

Your sense of taste and smell are dulled. Enjoyment of food may be reduced.

Smoking is expensive.

Life insurance is more expensive.

Finding a job may be more difficult as employers know that smokers are more likely than non-smokers to have sick leave. 

Potential friendships and romances may be at risk. (Smoking is not the attractive thing that cigarette advertisers portray.)

What are the benefits of stopping smoking?

The benefits begin straight away. You reduce your risk of getting serious disease no matter what age you give up. However, the sooner you stop, the greater the reduction in your risk. If you have smoked since being a teenager or young adult and eventually stop smoking before the age of about 35, your life expectancy is only slightly less than people who have never smoked. If you stop smoking before the age of 50, you decrease the risk of dying from smoking-related diseases by 50%. It is never too late to stop smoking to gain health benefits. Even if you already have COPD or heart disease, your outlook (prognosis) is much improved if you stop smoking.

Timeline of health benefits after stopping smoking:

After …

 Health benefit …

 72 hours

 Breathing becomes easier. Bronchial tubes begin to relax and energy levels increase.

 1 month

 Skin appearance improves, owing to improved skin perfusion.

 3-9     months

 Cough, wheezing, and breathing problems improve and lung function increases      by up to 10%.

 1 year

 Risk of a heart attack falls to about half that of a smoker.

 10 years

 Risk of lung cancer falls to about half that of a smoker.

 15 years

 Risk of heart attack falls to the same level that it would be for someone who has never smoked.

 

 Other benefits of stopping smoking include the following:

Chest infections and colds become less frequent.

The smell of stale tobacco goes from your breath, clothes, hair, and face.

Foods and drinks taste and smell much better.

Finances improve. You will save well over D14,000 per year if you have been smoking 20 sticks of Piccadilly a day.

You are likely to feel good about yourself.

 

Tips to quit smoking

No. 1: Know why you want to quit: Quitting smoking is a perfect idea! Get a powerful, motivating reason and do it now! Do it for yourself: to feel better and look younger, and to reduce your chance of getting lung cancer. Do it for your family: protect your loved ones from secondhand smoke.

No. 2: Don’t do cold turkey: It’s not common to successfully quit smoking by stopping immediately. Most people who quit “cold turkey” end up smoking again. Nicotine addiction can require gradual tapering to avoid withdrawal symptoms.

No. 3: Try nicotine-replacement therapy: Nicotine withdrawal can cause restlessness, depression, and can lead to frustration. Cravings can be overwhelming. Nicotine replacement treatments including nicotine gum, patches, and lozenges can help. Do not smoke while using nicotine replacements.

No. 4: Ask about prescription pills: Discuss nicotine replacement with your doctor. There are prescription medications that can reduce the craving for cigarettes and reduce withdrawal symptoms.

No. 5: Don’t do it alone: Friends and family can encourage and support you while you are quitting smoking. Some find support groups and/or counselors helpful. Behavioral therapy is often used with success. When these methods are combined with nicotine replacement therapy, your odds of success in quitting can increase. 

No. 6: Manage stress: Stress reduction techniques are helpful when quitting smoking. Helpful methods can include music, massage, and exercise.

No. 7: Avoid alcohol, other triggers: Alcohol can be a trigger that causes people to return to smoking. Similarly, coffee and meals can cause relapses. Find your triggers, and replace them with other activities. Some find it helpful to brush teeth or chew gum after eating.

No. 8: Clean house: Clear your home of anything that reminds you of smoking. Remove ashtrays and lighters from your home and wash your clothes, upholstery, draperies, and carpets. Air fresheners will also help to eliminate that familiar smell.

No. 9: Try and try again: Relapses are common. If you relapse into smoking, analyze your situation and what might have triggered you to smoke again. Redefine your commitment and set a “quit date” and do it!

No. 10: Get moving: Exercise activity can reduce nicotine cravings and withdrawal symptoms. When you feel like smoking, go move and find an activity you enjoy. This can also help to keep your weight optimal.

No. 11: Eat fruits and veggies: Don’t worry about dieting during the early stages of quitting smoking. Focus on eating healthy foods. Of note, vegetables, fruits, and low-fat dairy products tend to make cigarettes taste poorly, according to a Duke University study.

No. 12: Choose your reward: Another benefit of stopping smoking is financial. Reward yourself by spending your extra money on something that you enjoy or saving for something you really want!

No. 13: Do it for your health: The real reward in stopping smoking is improved health. Stopping smoking lowers your blood pressure, decreases your risk of heart attack and stroke, as well as lung and other forms of cancer.

Cigarette smoking prevention

Prevention can be easy; simply do not start to smoke cigarettes or use any other tobacco products. Unfortunately, quitting is often very difficult. Most smokers begin to smoke as teenagers and nicotine in smoke is addicting for many people. Parents still have the biggest impact on their children’s decision whether to smoke. The best way to prevent a youngster from taking up smoking is to have parents who don’t smoke. Children from smoking households are more likely to begin smoking than children from nonsmoking households. Much attention has been focused in recent years on the influence of Tobacco Company advertising on encouraging young people to smoke. Although cigarette commercials have been banned from advertising their products on the media, tobacco products remain among the most heavily marketed products. 

Studies have shown that youth are particularly susceptible to tobacco marketing campaigns.

In the past, cigarette use by actors in popular films was a means to portray smoking as sophisticated and glamorous.

Although denied by tobacco companies, the use of cartoon animals and the like in advertising campaigns appeals to youngsters.

Counter-advertising by various antismoking advocacy groups may provide some balance, but their advertising budgets pale beside those of tobacco companies.

Schools generally provide education on the use of tobacco, alcohol, and other substances, but their impact is unclear.

Increasing the taxes on cigarettes, and hence their price, has been shown to reduce tobacco consumption, especially among adolescents.

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