Tobacco , Health and Cessation

Tobacco , Health and Cessation

Tobacco and health

The effects of tobacco on health are significant, depending on the way the tobacco is used (smoked, snuffed or chewed) and the amount. Major health effects of smoking, the most common use of tobacco, include an increased risk in lung cancer and cardiovascular disease. The World Health Organization estimated in 2002[3] that in developed countries, 26% of male deaths and 9% of female deaths were attributable to smoking. Similarly, the United States Centers for Disease Control and Prevention describes tobacco use as "the single most important preventable risk to human health in developed countries and an important cause of premature death worldwide.

Primary risks

Regular smokers are estimated to live to 2.5 to 10 years less than nonsmokers.About one-half of male smokers will die of illness due to smoking.Tobacco related illnesses kill approximately 438,000 USA citizens per year,about 1,205 per day, making it the leading cause of preventable death in the U.S. The World Health Organization has stated that tobacco is set to kill a billion people this century.The main health risks in tobacco pertain to diseases of the cardiovascular system, in particular smoking being a major risk factor for a myocardial infarction (heart attack), diseases of the respiratory tract such as Chronic Obstructive Pulmonary Disease (COPD) and emphysema, and cancer, particularly lung cancer and cancers of the larynx and mouth. It also increases the risk of developing pancreatic cancer by 75%. Prior to World War I, lung cancer was considered to be a rare disease, which most physicians would never see during their career. With the postwar rise in popularity of cigarette smoking came a virtual epidemic of lung cancer.Currently, among people who have ever smoked any kind of tobacco, almost one in ten will develop lung cancer. One in six men who continue to smoke tobacco will develop lung cancer. This compares to only one case of lung cancer in seventy-five lifelong non-smokers.Incidence of impotence is approximately 85 percent higher in male smokers compared to non-smokers, and it is a key cause of erectile dysfunction (ED). Smoking causes impotence because it promotes arterial narrowing.A person's increased risk of contracting disease is directly proportional to the length of time that a person continues to smoke as well as the amount smoked. However, if someone stops smoking, then these chances gradually decrease as the damage to their body is repaired.Diseases linked to smoking tobacco cigarettes include: * Many forms of cancer, particularly lung cancer, cancer of the kidney, cancer of the larynx and head and neck, breast cancer, bladder, esophagus, pancreas,and stomach. There is some evidence suggesting an increased risk of myeloid leukemia, squamous cell sinonasal cancer, liver cancer, cervical cancer, colorectal cancer after an extended latency, childhood cancers and cancers of the gall bladder, adrenal gland and small intestine. * Cardiovascular disease o stroke o peripheral vascular disease * Respiratory ailments o common cold and bronchitis o Chronic obstructive pulmonary disease, emphysema and chronic bronchitis in particular * Birth defects of pregnant smokers' offspring * Buerger's disease (thromboangiitis obliterans) * Cataracts that may cause blindness[citation needed] * Cognitive dysfunction o Increased risk of Alzheimer's disease and decline in cognitive abilities o Reduced memory and cognitive abilities in adolescent smokers o Brain shrinkage (cerebral atrophy) * Impotence0

Cigar and pipe smokers tend to inhale less smoke than cigarette smokers, so their risk of lung cancer is lower but is still several times higher than the risk for nonsmokers[citation needed]. Pipe and cigar smokers are also at risk for cancers of the oral cavity, larynx (voice box), or esophagus, a risk which was widely hypothesized before any link between smoking and cancer was scientifically proved as seen in the news coverage of the tobacco-related cancers of two American presidents; Ulysses S. Grant died in 1885 at age sixty-three after a long and painful public battle with throat cancer which was widely assumed at the time to be the result of his lifelong cigar habit, and Grover Cleveland was diagnosed in 1893 with cancer of the left jaw, which was frequently remarked upon by the press and public as the side where he usually had a cigar clamped. Similarly, cancer of the mouth and jaw is also a risk for chewing tobacco. The benefits of smoking cessation are immediate: blood pressure, heart rate, and temperature return to normal range; heart attack risk decreases; ability to smell and taste is enhanced; circulation improves.

It is generally assumed that the major motivational factor behind smoking is the nicotine it contains. However, the practice of ingesting the smoke from a smoldering leaf generates an enormous number of active chemical compounds, loosely lumped together as 'tar', many of which are biologically reactive and potential health dangers. (Chewing tobacco is also carcinogenic, likely because similar compounds are generated in the practice of curing it; the Nordic snus, which is steam cured and therefore does not generate these compounds, is much less carcinogenic.) There are around 3000 chemicals found in tobacco smoke. Long term exposure to other compounds in the smoke, such as carbon monoxide, cyanide, and other compounds that damage lung and arterial tissue, are believed to be responsible for cardiovascular damage and for loss of elasticity in the alveoli, leading to emphysema and COPD.

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Radioactive components of tobacco

In addition to chemical, nonradioactive carcinogens, tobacco and tobacco smoke contain small amounts of lead-210 (210Pb) and polonium-210 (210Po) both of which are radioactive carcinogens. Lead 210 is a product of the decay of radium-226 and, in turn, its decay product, radon-222; lead 210 then decays to bismuth-210 and then to polonium 210, emitting beta particles in both steps. Tarry particles containing these elements lodge in the smokers' lungs where airflow is disturbed; the concentration found where bronchioles bifurcate is 100 times higher than that in the lungs overall. This gives smokers much more intense exposure than would otherwise be encountered. Polonium 210, for instance, emits high energy alpha particles which, because of their large mass, are considered to be incapable of penetrating the skin more than 40 micrometres deep, but do considerable damage (estimated at 100 times as much chromosome damage as a corresponding amount of other radiation) when a process such as smoking causes them to be emitted within the body, where all their energy is absorbed by surrounding tissue. (Lead 210 also emits gamma rays).The radioactive elements in tobacco are accumulated from the minerals in the soil, as with any plant, but are also captured on the sticky surface of the tobacco leaves in excess of what would be seen with plants not having this property. As might be expected, the radioactivity measured in tobacco varies widely depending on where and how it is grown. One study found that tobacco grown in India averaged only 0.09 pCi per gram of polonium-210, whereas tobacco grown in the United States averaged 0.516 pCi per gram. Another study of Indian tobacco, however, measured an average of 0.4 pCi of polonium 210 per cigarette, which also would be approximately a gram of tobacco. One factor in the difference between India and the United States may be the extensive use of apatite as fertilizer for tobacco in the United States, because it starves the plant for nitrogen, thereby producing more flavorful tobacco; apatite is known to contain radium, lead 210, and polonium 210. This would also account for increased concentration of these elements compared to other crops, which do not use this mineral as fertilizer.The presence of polonium-210 in mainstream cigarette smoke has been experimentally measured at levels of 0.0263 - 0.036 pCi, which is equivalent to about 0.1 pCi per milligram of smoke; or about 0.81 pCi of lead 210 per gram of dry condensed smoke. The amount of polonium 210 inhaled from a pack of 20 cigarettes is therefore about 0.72 pCi. This seems to be independent of any form of filtering or 'low tar' cigarette. This concentration results in a highly significant increase in the body burden of these compounds. Compared to nonsmokers, heavy smokers have four times greater radioisotope density throughout their lungs. The polonium 210 content of blood in smokers averages 1.72 pCi per kilogram, compared to 0.76 pCi per kilogram in nonsmokers. Higher concentrations of polonium 210 are also found in the livers of smokers than nonsmokers. Polonium 210 is also known to be incorporated into bone tissue, where the continued irradiation of bone marrow may be a cause of leukemia, although this has not been proved as yet.Research by NCAR radiochemist Ed Martell determined that radioactive compounds in cigarette smoke are deposited in "hot spots" where bronchial tubes branch. Since tar from cigarette smoke is resistant to dissolving in lung fluid, the radioactive compounds have a great deal of time to undergo radioactive decay before being cleared by natural processes. Indoors, these radioactive compounds linger in secondhand smoke, and therefore greater exposure occurs when these radioactive compounds are inhaled during normal breathing, which is deeper and longer than when inhaling cigarettes. Damage to the protective epithelial tissue from smoking only increases the prolonged retention of insoluble polonium 210 compounds produced from burning tobacco. Martell estimated that a carcinogenic radiation dose of 80-100 rads is delivered the lung tissue of most smokers who die of lung cancer.In other experiments, the alpha particle dosage from polonium 210 received by smokers of two packs a day was measured at 82.5 millirads per day, which would total 752.5 rads per 25 years, 150 times higher than the approximately 5 rem received from natural background radiation over 25 years.[citation needed] Other estimates of the dosage absorbed over 25 years of heavy smoking range from 165 to 1,000 rem, all significantly higher than natural background. In the case of the less radioactive Indian tobacco referred to above, the dosage received from polonium 210 is about 24 millirads a day, totalling 219 rads over 25 years or still about 40 times the natural background radiation exposure. In fact, all these numbers of total body burden are misleadingly low, because the dosage rate in the immediate vicinity of the deposited polonium 210 in the lungs can be from 100 to 10,000 times greater than natural background radiation. Lung cancer is seen in laboratory animals exposed to approximately one fifth of this total dosage of polonium 210.Whether the quantities of these elements are sufficient to cause cancer is still a matter of debate. Most studies of carcinogenicity of tobacco smoke involve painting tar condensed from smoke onto the skin of mice and monitoring for development of tumors of the skin, a relatively simple process. However, the specific properties of polonium 210 and lead 210 and the model for their action, as described above, do not permit such a simple assay and require more difficult studies, requiring dosage of the mice in a manner mimicking smoking behavior of humans and monitoring for lung cancer, more difficult to observe as it is internal to the mouse.Some researchers suggest that the degree of carcinogenicity of these radioactive elements is sufficient to account for most, if not all, cases of lung cancer related to smoking. In support of this hypothetical link between radioactive elements in tobacco and cancer is the observation that bladder cancer incidence is also proportional to the amount of tobacco smoked, even though nonradioactive carcinogens have not been detected in the urine of even heavy smokers; however, urine of smokers contains about six times more polonium 210 than that of nonsmokers, suggesting strongly that the polonium 210 is the cause of the bladder carcinogenicity, and would be expected to act similarly in the lungs and other tissue. Furthermore, many of the lung cancers contracted by cigarette smokers are adenocarcinomas, which are characteristic of the type of damage produced by alpha particle radiation such as that of polonium 210. It has also been suggested that the radioactive and chemical carcinogens in tobacco smoke act synergistically to cause a higher incidence of cancer than each alone.However, the view that polonium 210 is responsible for many cases of cancer in tobacco smokers is disputed by at least one researcher

Other carcinogens

There are over 19 known carcinogens in cigarettes. The following are some of the most potent carcinogens: * Polynuclear aromatic hydrocarbons are produced by pyrolysis in smoldering organic matter and emitted into smoke. Many of them are highly carcinogenic and mutagenic, because they are toxicated to mutagenic epoxides. The first PAH to be identified as a carcinogen in tobacco smoke was benzopyrene, which been shown to toxicate into a diol epoxide and then permanently attach to nuclear DNA, which may either kill the cell or cause a genetic mutation. If the mutation inhibits programmed cell death, the cell can survive to become a cancer cell. Tobacco manufacturers have experimented with combustionless vaporizer technology to allow cigarettes to be consumed without the formation of carcinogenic benzopyrenes. * Nitrosamines are a group of carcinogenic compounds found in cigarette smoke but not in uncured tobacco leaves. Nitrosamines form on flue-cured tobacco leaves during the curing process through a chemical reaction between nicotine and other compounds contained in the uncured leaf and various oxides of nitrogen found in all combustion gases. Switching to indirect-fire curing has been shown to reduce nitrosamine levels to less than 0.1 parts per million. * The carcinogenity of tobacco smoke is not explained by nicotine per se, which is not carcinogenic or mutagenic. It can be a synergistic carcinogen, however.

Nicotine Addiction and Genetic Factors

According to three separate studies commissioned by governments in the US and Europe scientists have identified a genetic link that makes people more likely to become addicted to tobacco. This genetic variation causes individuals to smoke more cigarettes, makes it harder for them to quit and increases their likelihood of developing lung cancer by up to 80%. [

Genetic markers of more than 35,000 people (mostly smokers and ex-smokers) were surveyed by scientists in three separate studies and all three zoned in on the same set of genetic differences. The genetic variations of note encode nicotine receptors on cells and was identified on a region of chromosome 15. Possessing a single copy of the mutation raises an individuals risk of lung cancer by approximately 30%, while possessing two copies can raise that figure to about 80%.

Nicotine and addiction

Because of their nicotine addiction, many smokers find it difficult to cease smoking despite their knowledge of ill health effects.

Because of their nicotine addiction, many smokers find it difficult to cease smoking despite their knowledge of ill health effects.

Nicotine is a stimulant and is one of the main factors leading to continued tobacco smoking. Although the amount of nicotine inhaled with tobacco smoke is quite small (most of the substance is destroyed by the heat) it is still sufficient to cause physical and/or psychological dependence. The amount of nicotine absorbed by the body from smoking depends on many factors, including the type of tobacco, whether the smoke is inhaled, and whether a filter is used. Despite the design of various cigarettes advertised and even tested on machines to deliver less of the toxic tar, studies show that when smoked by humans instead of machines, they deliver the same net amount of smoke. Ingesting a compound by smoking is one of the most rapid and efficient methods of introducing it into the bloodstream, second only to injection, which allows for the rapid feedback which supports the smokers' ability to titrate their dosage. On average it takes about ten seconds for the substance to reach the brain. As a result of the efficiency of this delivery system, many smokers feel as though they are unable to cease. Of those who attempt cessation and last three months without succumbing to nicotine, most are able to remain smoke free for the rest of their lives. There exists a possibility of depression in some who attempt cessation, as with other psychoactive substances. Depression is also common in teenage smokers; teens who smoke are four times as likely to develop depressive symptoms as their nonsmoking peers .

Although nicotine does play a role in acute episodes of some diseases (including stroke, impotence, and heart disease) by its stimulation of adrenaline release, which raises blood pressure, heart rate, and free fatty acids, the most serious longer term effects are more the result of the products of the smouldering combustion process. This has enabled development of various nicotine delivery systems, such as the nicotine patch or nicotine gum, that can satisfy the addictive craving by delivering nicotine without the harmful combustion by-products. This can help the heavily dependent smoker to quit gradually, while discontinuing further damage to health.

Smoking and cardiovascular disease

Smoking also increases the chance of heart disease. Several ingredients of tobacco lead to the narrowing of blood vessels, increasing the likelihood of a blockage, and thus a heart attack or stroke. According to a study by an international team of researchers, people under 40 are five times more likely to have a heart attack if they smoke.

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Oral health

Perhaps the most serious oral condition that can arise from tobacco smoking is that of oral cancer. However, smoking also increases the risk for various other oral diseases, some almost completely exclusive to smokers. Roughly half of periodontitis cases are attributed to current or former smoking. Smokers experience widespread periodontal destruction and have significantly greater loss of bone height. Smokeless tobacco causes gingival recession and white mucosal lesions. Up to 90% of periodontitis patients who are not helped by common modes of treatment are smokers.Smoking has been proven to be an important factor in the staining of teeth. Halitosis is common among tobacco smokers. Other oral diseases that are known to have strong links to smoking are leukoplakia, Snuff Dipper's lesions and smoker's palate. In addition, many smokers report a loss of taste sensation and/or salivary changes.

Tooth loss has been shown to be 2 to 3 times higher in smokers than in non-smokers

Physical and psychological effects on smokers

Smokers report a variety of physical and psychological effects from smoking tobacco. Those new to smoking will experience nausea, dizziness, and rapid heart beat. The unpleasant symptoms will eventually vanish over time, with repeated use, as the body builds a tolerance to the chemicals in the cigarettes, such as nicotine.In many respects, nicotine acts on the nervous system in a similar way to caffeine. Some writings have stated that smoking can also increase mental concentration; one study documents a significantly better IQ on the normed Advanced Raven Progressive Matrices test after smoking. Most smokers say they enjoy smoking, which is part of the reason why many continue to do so even though they are aware of the health risks. Taste, smell, and visual enjoyment are also major contributions to the enjoyment of smoking, in addition to camaraderie with other smokers. Ironically, chronic exposure to tobacco smoke may inhibit one's sense of taste and smell, rendering him or her less able to enjoy these aspects of tobacco smoking.Most smokers, when denied access to nicotine, exhibit symptoms such as irritability, jitteriness, dry mouth, and rapid heart beat. Longer abstinence may lead to insomnia and even mild depression. The onset of these symptoms is very fast, nicotine's half-life being only 1 hour. Withdrawal symptoms can appear even if the smoker's consumption is very limited or irregular, appearing after only 4-5 cigarettes in most adolescents. An ex-smoker's chemical dependence to nicotine will cease after approximately ten to twenty days, although the brain's number of nicotine receptors is permanently altered,[citation needed] and the psychological dependence may linger for months or even many years. Unlike illicit recreational drugs and alcohol, nicotine does not measurably alter a smoker's motor skills, cognition, judgement, or language abilities while under the influence of the drug, but nicotine withdrawal symptoms such as irritability and incapacity to concentrate can have an influence on these aspects. Tobacco withdrawal has been shown to cause clinically significant distress.The majority of these effects are due to nicotine withdrawal, and so smokers who are not addicted to nicotine will not suffer from them.Some studies suggest that a link exists between smoking and mental illness, citing the high incidence of smoking amongst those suffering from schizophrenia and the possibility that smoking may alleviate some of the symptoms of mental illness, but these have not been conclusive.

Tobacco and reproduction

Effects of smoking on sperm cells

There is increasing evidence that the harmful products of tobacco smoking kill sperm cells. Therefore, some governments require manufacturers to put warnings on packets. Smoking tobacco increases intake of cadmium, because the tobacco plant absorbs the metal. Cadmium, being chemically similar to zinc, may replace zinc in the DNA polymerase, which plays a critical role in sperm production. Zinc replaced by cadmium in DNA polymerase can be particularly damaging to the testes.

Spontaneous abortion

A number of studies have shown that tobacco use is a significant factor in spontaneous abortions among pregnant smokers, and that it contributes to a number of other threats to the health of the fetus. Second-hand smoke appears to present an equal danger to the fetus, as one study noted that "heavy paternal smoking increased the risk of early pregnancy loss."

SIDS

Secondhand smoke is connected to Sudden Infant Death Syndrome (SIDS). Infants who die from Sudden Infant Death Syndrome tend to have higher concentrations of nicotine and cotinine (a biological marker for secondhand smoke exposure) in their lungs than those who die from other causes. While smoking during pregnancy increases the risk of Sudden Infant Death Syndrome, infants exposed to secondhand smoke after birth are also at a greater risk of Sudden Infant Death Syndrome whether or not the parent(s) smoked during pregnancy. The nicotine obtained from smoking travels through a women into her breast milk, thus giving nicotine to her child,

Smoking cessation ("Quiting Smoking")

Smoking cessation is the effort to stop smoking tobacco products. With Nicotines addictive substance, many people find it hard to stop smoking without help. Various approaches are available, both psychological and pharmacological, although success rates are relatively low.

The prevalent view is that smoking is not safe for anybody, and that every smoker should be encouraged to stop.

Many of tobacco's health effects can be minimized through smoking cessation. The British doctor study showed that those who stopped smoking before they reached 30 years of age lived almost as long as those who never smoked. It is also possible to help reduce the risks by reducing the frequency of smoking and by proper diet and exercise. Some research has indicated that some of the damage caused by smoking tobacco can be moderated with the use of antioxidants.

Predictive measures of success are a serious commitment to smoking cessation and regular follow-up. After successfully stopping tobacco smoking, quitters are advised to consider ways they should change their lifestyle to improve their chances of not restarting, especially under stressful circumstances.

Smokers wanting to quit (or temporarily abstain from) smoking can use a variety of nicotine-containing tobacco substitutes to temporarily lessen the physical withdrawal symptoms, the most popular being nicotine gum and lozenges. nicotine patches are also used for smoking cessation. Discussing the problem with supportive people can also be helpful. In addition, there are lots of self-help books on the market.

Examples

Methods

* Cold Turkey willpower alone

* Nicotine replacement therapy

* Specific support and counseling

* Self-help books

* Antidepressants

* Hypnosis

* Herbal preparations

* Nutritional nicotine detoxification

* Acupuncture

* Laser therapy

Statistics

No smoking cessation methods have consistently achieved better than a 25% quit rate after six months. About 1.5%–3% of smokers manage to quit each year without support from health services. Enrollment into the placebo arm of medical trial and receiving a minimum level of counseling increases this rate to about 5%–10% after one year, partly reflecting participants' motivation.

Although a significant proportion is successful, many fail several times. A small proportion is unable to quit, even in the face of serious smoking-related disease in themselves or close family members or friends. Nevertheless, incorrigible smokers are encouraged to keep on trying.

2 online Smoking cessation programs.("Quiting smoking ")

These programs vary in method of cessation but with these sites hopefully you can find the method thats right for you.

2 resources to kick the habit.

• 1) Hypnosis To Change Your Life.
  
• 2) EasyQuit System.