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25 Questions About
Smoking and Your Health
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1. Is there a safe way to smoke?
No. All cigarettes can cause damage to the human body and
even a small amount is dangerous. Cigarettes are perhaps the only legal product whose
advertised and intended use is harmful to the body and is a proven cause of cancer.
Although some people try to make their smoking habit safer by
smoking fewer cigarettes, most smokers find that difficult. Some people think that switching
from high tar and nicotine cigarettes to those with low tar and nicotine content makes
smoking safer, but this is not always true. When people switch to lower tar and nicotine
brands, they often smoke more cigarettes or more of each cigarette to get the same nicotine
dose as before. A low-tar cigarette can be just as harmful as a high-tar cigarette when a
person takes deeper puffs, puffs more frequently, or smokes cigarettes to a lower butt
length. Even if smokers who switch to lower tar brands do not make these changes to
compensate, the health benefits are insignificant when compared to the benefits of quitting
completely. If you are a heavy smoker here are
the best e-cigs for heavy smokers.
2. Is cigarette smoking really addictive?
Yes. The nicotine in cigarette smoke is what causes an
addiction to smoking. First, when taken in small amounts, nicotine produces
pleasurable feelings that make the smoker want to smoke more. Second, smokers usually become
dependent on nicotine and suffer both physical and psychological withdrawal symptoms when
they stop smoking. These symptoms include nervousness, headaches, irritability, and
difficulty in sleeping. Third, because nicotine affects the chemistry of the brain and
central nervous system, it can affect the mood and temperament of the smoker.
3. Who is most likely to become addicted?
Anyone who starts smoking is at risk of becoming addicted to
nicotine. Studies show that among addictive behaviours such as the use of alcohol and other
drugs, cigarette smoking is most likely to become an established habit during adolescence.
Therefore, when young people become cigarette smokers they are more likely to become
addicted and more likely to suffer from the variety of health problems caused by cigarette
4. What does nicotine do?
Nicotine is a poison and taken in large doses could kill a
person by paralyzing breathing muscles. Smokers usually take it in small amounts that the
body can quickly break down and get rid of, which is why the nicotine does not kill
instantly. The first dose of nicotine causes a person to feel awake and alert, while later
doses result in a calm, relaxed feeling. Nicotine can make new smokers, and regular smokers
who get too much of it, feel dizzy or nauseous. The resting heart rate for young smokers
increases 2 to 3 beats per minute. It also lowers skin temperature and reduces blood flow in
the legs and feet. Evidence shows that nicotine plays an important role in increasing
smokers' risk of heart disease and stroke.
5. Does smoking cause cancer?
Yes. Tobacco smoke contains at least 43 carcinogenic
(cancer-causing) substances. Smoking causes many kinds of cancer, not just lung cancer.
Tobacco use accounts for 30%, or one in three, of all cancer deaths in the United States.
Smoking is responsible for almost 90% of lung cancers among men and more than 70% among
women, about 83% overall. Cancer of the mouth, larynx, pharynx, esophagus, kidney, bladder,
pancreas, and uterine cervix also have in common cigarette smoking as a major cause.
6. How does cigarette smoke affect the lungs?
Cigarette smoking causes several lung diseases that can be
just as dangerous as lung cancer. Chronic bronchitis - a disease where the airways produce
excess mucus, which forces the smoker to cough frequently - is a common ailment for smokers.
Cigarette smoking is also the major cause of emphysema - a disease that slowly destroys a
person's ability to breathe.
In order for oxygen to reach the blood, it must move across
large surfaces in the lungs. Normally, thousands of tiny sacs make up about 100 square yards
of surface area in the lungs. When emphysema occurs, the walls between the sacs break down
and create larger but fewer sacs, significantly decreasing the amount of oxygen reaching the
blood. Eventually, the lung surface area can become so small that a person with emphysema
has to spend most of the time gasping for breath, with an oxygen bottle near by or with
oxygen tubes inserted into the nasal cavity.
Chronic obstructive pulmonary disease (COPD), which includes
chronic bronchitis and emphysema, kills about 81,000 people each year; cigarette smoking is
responsible for more than 65,000 of these deaths.
7. What in cigarette smoke is harmful?
Cigarette smoke is a complex mixture of organic and inorganic
compounds generated by the combustion (burning) of tobacco and additives. Cigarette smoke
contains tar, which is made up of over 4,000 chemicals, including the 43 known to cause
cancer. Some of these substances cause heart and respiratory diseases, all of which are
disabling and can cause death. You might be surprised to know some of the chemicals found in
cigarette smoke. They include: cyanide, benzene, formaldehyde, methanol (wood alcohol),
acetylene (the fuel used in torches), and ammonia. It also contains the poisonous gases
nitrogen oxide and carbon monoxide. Its main active ingredient is nicotine, an addictive
8. Does cigarette smoking affect the heart?
Yes. Smoking cigarettes increases the risk of heart disease,
which is America's number one killer. Almost 180,000 Americans die each year from
cardiovascular disease caused by smoking. Smoking, high blood pressure, high blood
cholesterol, and lack of exercise are all risk factors for heart disease, but smoking alone
doubles the risk of heart disease. Among those who have previously had a heart attack,
smokers are more likely than non-smokers to have another.
9. How does smoking affect pregnant women and their babies?
Pregnant women who smoke endanger the health and lives of
their unborn babies. Babies of smoking women average 6 ounces less at birth than babies of
non-smoking women. When a pregnant woman smokes, she really is smoking for two because the
nicotine, carbon monoxide, and other dangerous chemicals in smoke enter her bloodstream and
pass directly into the baby's body. Statistics show a direct relation between smoking during
pregnancy and spontaneous abortions, stillbirths, death among newborns, and sudden infant
death syndrome (SIDS). Research shows that the risk of SIDS triples for babies of mothers
who smoke during pregnancy; two-thirds of SIDS deaths among babies of women who smoked
during pregnancy can be attributed to smoking. Mounting evidence in recent years has also
made it clear that children of mothers who smoke have higher than normal risks of developing
asthma, especially if the mother smokes during pregnancy. Exposure to second-hand smoke also
makes a childs asthma more severe than it would be otherwise, and increases the
childs risk of pneumonia, bronchitis, and fluid in the middle ear.
10. What are some of the short- and long-term effects of
Smoking causes cancer, which may not develop for years.
Regardless of how many smokers are lucky enough to escape cancer, the truth is inescapable:
cigarette smokers die younger than non-smokers. In fact, smoking decreases a person's life
expectancy by 10 - 12 years. Smokers between the ages of 35 and 70 have death rates three
times higher than those who have never smoked.
There are many more short-term effects of smoking. A major
consequence of smoking is decreased lung function which is why smokers often suffer from
shortness of breath, nagging coughing, or tiring easily during strenuous physical activity.
Smoking also diminishes the ability to smell and taste and causes premature aging of skin.
11. What are the dangers of environmental tobacco smoke
(ETS), or passive smoking, or second-hand smoke?
Passive smoking occurs when non-smokers inhale the tobacco
smoke created by smokers (environmental tobacco smoke). ETS, also known as second-hand
smoke, includes mainstream smoke, which is smoke drawn through the mouthpiece of a
cigarette, pipe, or cigar that is then exhaled into the air by smokers, and side stream
smoke, the smoke that comes directly from the burning tobacco before it reaches the smoker.
ETS contains the same harmful chemicals as the smoke that smokers inhale. In fact, because
side stream smoke is formed at lower temperatures, it gives off even larger amounts of
cancer-causing substances. At least 43 of the chemicals taken in by those breathing ETS are
known cancer-causing substances, and ETS is now classified by the US Environmental
Protection Agency (EPA) as a Group A carcinogen (known to cause cancer in humans).
ETS causes lung cancer in healthy non-smokers. A non-smoker who
is married to a smoker has a 30% greater risk of developing lung cancer than a non-smoker
living with a non-smoker. Children whose parents smoke are more likely to suffer from
pneumonia or bronchitis in the first two years of life than children who live in smoke-free
households. Several studies have also established a link between parental smoking and the
occurrence of sudden infant death syndrome (SIDS). Children of parents who smoke have a
twofold increased risk of dying of SIDS. Mounting evidence in recent years has also made it
clear that children of mothers who smoke have higher than normal risks of developing asthma,
especially if the mother smokes during pregnancy. It is well known that second-hand smoke
also makes a childs asthma more severe than it would be otherwise, and increases the
childs risk of pneumonia, bronchitis, and fluid in the middle ear.
ETS can also affect non-smokers by causing eye irritation,
headaches, nausea, and dizziness.
12. Is smoking common among young people?
Yes. Tobacco use, including smoking cigarettes, chewing
tobacco, and dipping snuff, remains common among American youth. About 35 percent of high
school students and about 13 percent of middle school students surveyed in 1998 and 1999
reported being users of some form of tobacco, with about 8 percent reporting they smoked
their first cigarette before age 11. About 80 percent of adult smokers started smoking when
they were 17 or younger.
Cigarettes are the most common form of tobacco used by young
people, with 9.2 percent of middle school students and 28.5 percent of high school students
reporting being current cigarette smokers. Among different ethnic groups, whites are more
commonly cigarette smokers or users of smokeless tobacco than blacks or Hispanics in high
school, with less difference among the groups in middle school.
Cigars are the second most common form of tobacco use among
young people, with 6.1 percent of middle school students and 15.3 percent of high school
students reporting current use of cigars (one or more in the 30 days prior to the survey).
Blacks are more likely to smoke cigars in middle school than are whites.
Smokeless tobacco is the third most common tobacco product
used by young people, with 2.7 percent of middle school students and 6.6 percent of high
school students reporting current use. More whites (about 9 percent) use smokeless tobacco
in high school than blacks (2.4 percent) or Hispanics (about 4 percent).
In both middle school and high school, boys were
significantly more likely to smoke cigars or use smokeless tobacco than girls.
The 1998-1999 report shows that many non-smoking young people
are exposed to environmental tobacco smoke from those around them. In the week just before
being surveyed, approximately half the non-smoking students surveyed were in the same room as
someone smoking, and almost one-third rode in a car in which someone was smoking. About 80
percent of all young persons believe smoke from others is harmful to them.
Each day, approximately 6,000 young persons try a cigarette
and approximately 3,000 become daily smokers. In 1997, regular smokers between 12 and 17
smoked over 900 million packs of cigarettes. If current patterns of smoking behaviour
persist, an estimated 5 million American young people 17 and younger in the year 2000 could
die prematurely in future years from smoking-related illnesses. These projected patterns of
smoking and smoking-related deaths could result in an estimated $200 billion (in 1993
dollars) in future health-care costs and approximately 64 million years of potential life
Statistics also show that students who use other drugs, get
in fights, carry weapons, attempt suicide, and engage in high-risk sexual behaviours are more
likely to smoke
13. What are the chances that smoking will kill you?
About four million people die worldwide each year as a result
of smoking. In the United States, tobacco use is responsible for nearly one in five deaths,
killing more than 400,000 Americans each year. This is more than the number of people who
would die every year if three jumbo jets crashed each day with no survivors. Smoking is the
single most preventable cause of death in our society. Statistically, smokers die 10 - 12
years younger than non-smokers.
14. How many people smoke cigarettes?
In 1998, the latest year for which figures are available,
24.1% of adults --about 48 million people-smoked cigarettes. Approximately 26% of men and
22% of women reported being smokers in 1998, reflecting a continuing decline in the
percentage of Americans who smoke. African-Americans smoke about the same as whites, 24% and
25%, respectively. Ethnic groups with the lowest smoking rates are Hispanics (19.1%) and
Asians/Pacific Islanders (13.7%). Education level seems to affect smoking rates as shown by
a consistent decrease in the smoking rate in groups with a higher level of education. About
37% of those with less than a high school education smoke, while only about 11% of those
with a college education or more smoke.
15. Why do people begin to smoke?
Most people begin smoking between the ages of 10 and 18. Peer
pressure and curiosity are the major influences that encourage them to experiment with
smoking. Also, people with parents who smoke are more likely to begin smoking than those who
have non-smoking parents. Those who begin to smoke at a younger age are more likely than late
starters to develop long-term nicotine addiction.
Another prevalent influence in our society is the tobacco
industry's advertisements for its products. The tobacco industry spends nearly $6 billion
annually to develop and market ads that depict smoking as an exciting, glamorous, healthy
16. Can quitting really help a lifelong smoker?
Yes. It is never too late to quit. The sooner smokers quit,
the more they can reduce their chances of getting cancer and other diseases. Within 20
minutes of smoking the last cigarette, the body begins a series of regenerating changes.
After 20 minutes, blood pressure drops to normal. After 8 hours, the carbon monoxide level
in the blood drops to normal. After 24 hours, the chance of heart attack decreases. After
one year, the risk of coronary heart disease is half that of a smoker. In 1 to 9 months,
coughing, sinus congestion, fatigue, and shortness of breath decrease and cilia re-grow in
the lungs. After 10 years, the lung cancer death rate decreases by almost half. After 15
years, the risk of coronary heart disease is that of a non-smoker. It is important to note
that the extent to which these risks fall depends on the total amount the person smoked, the
age the person started smoking, and the amount of inhalation.
17. If you smoke but don't inhale, is there any danger?
Yes. Wherever smoke touches living cells, it does harm. Even
if smokers don't inhale - including pipe and cigar smokers - they are at an increased risk
for lip, mouth, and tongue cancers. Because it is virtually impossible to avoid inhaling
smoke totally, these smokers are also increasing their risk of getting lung cancer.
18. Suppose I smoke for a while and then quit?
Smoking begins to cause damage right away and is highly
addictive. Several studies have found nicotine to be as addictive as heroin, cocaine, or
alcohol; it is the most common form of drug addiction in the United States. Therefore, it is
obviously better never to start smoking cigarettes and become addicted to nicotine than it
is to smoke with the intention of quitting later. And like alcohol, heroin, and cocaine,
nicotine creates a permanent tolerance in the body. When an ex-smoker smokes a cigarette,
even years after quitting, the nicotine reaction may be triggered, quickly hooking the
person on the old habit.
19. How do people successfully quit?
There is no one right way to quit. Successful cessation may
include one or a combination of methods including using step-by-step manuals, attending
self- help classes or counselling, or using a nicotine replacement therapy (nicotine patch or
nicotine gum). Anything that is legal, ethical, and effective is worth trying; this could
include chewing sugarless gum, eating carrot sticks, hiding ashtrays, taking long walks,
asking others not to smoke around you, and spending time in places where smoking is
Each year about 17 million people try to quit for at least a
day during the American Cancer Society's Great American Smoke-out. Of these quitters, more
than 4 million still aren't smoking after three months. About 90% of those who have tried to
quit have done so on their own by either stopping "cold turkey" or using other
methods. Cigarette smoking in adults dropped from 42% in 1965 to 25% in 1995, to 24.1% in
20. What is nicotine replacement therapy?
Nicotine replacement therapies are medications that provide
nicotine without the other harmful components of cigarette smoke. To be most effective,
nicotine replacement therapy should be used with a cessation program that addresses a
person's psychological dependence on smoking. By chewing gum containing nicotine or wearing
a transdermal patch from which the skin absorbs nicotine, a smoker's withdrawal symptoms are
significantly decreased or eliminated.
Not everyone can use nicotine replacement therapy. People
with certain medical conditions and pregnant women should not use it. When using the patch,
it is very important that users do not smoke cigarettes or use tobacco in any form.
21. Why do smokers have "smoker's cough"?
Cigarette smoke contains chemicals that irritate the air
passages and lungs. When a smoker inhales these substances, the body tries to protect itself
by coughing. The well-known "early morning" cough of smokers happens for a
different reason. Normally, cilia (tiny hair-like formations lining the airways) beat outward
and sweep harmful material out of the lungs. Cigarette smoke, however, decreases the
sweeping action, so some of the poisons in the smoke remain in the lungs. When a smoker
sleeps, some cilia recover and begin working again. After waking up, the smoker coughs
because the lungs are trying to clear away the poisons that built up the previous day.
Unfortunately, prolonged exposure to smoke completely destroys the cilia's ability to
function. Then the smoker's lungs are even more exposed and susceptible than before,
especially to bacteria and viruses in the air.
22. Are chewing tobacco and snuff safe alternatives to
No. Smokeless tobacco contains nicotine, the same addictive
drug found in cigarettes. Snuff dippers consume on average more than 10 times the amount of
cancer-causing substances (nitrosamines) than cigarette smokers. In fact, some brands of
smokeless tobacco contain as much as 20,000 times the legal limit of nitrosamines permitted
in certain foods and consumer products, such as beer, bacon, and baby bottle nipples.
The juice from the smokeless tobacco is absorbed directly
through the lining of the mouth. This creates sores and white patches which often lead to
cancer of the mouth. Smokeless tobacco users greatly increase their risk of other cancers
including gum, pharynx, larynx, and esophagus. Other consequences of smokeless tobacco use
include halitosis (chronic bad breath), discoloration of teeth and fillings, gum disease,
and tooth loss.
Since nearly 25% of adult smokeless tobacco users also smoke
cigarettes, their risks of developing cancer is higher.
23. What are the health risks of smoking pipes or cigars?
Smoking cigars or pipes alone is not a healthy alternative to
smoking cigarettes. The risk for lung cancer is higher among smokers who smoke cigarettes
and cigars or pipes, and for smokers who switch to cigars or pipes after years of cigarette
Overall cancer deaths among men who smoke cigars are 34%
higher than among non-smokers. Cigars and pipes also release ETS, which is harmful to anyone
who breathes it.
More information on the health risks of smoking cigars is
available in a separate essay entitled Cigar Smoking and Cancer.
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Updated October 2019