Some Programs Can Keep Kids From Smoking

A number of different kinds of family programs can help prevent children from becoming smokers, according to a new review of research on the issue.

Reporting in the current issue of The Cochrane Library, the authors reviewed 14 studies and identified several kinds of successful smoking prevention programs, including one in Iowa that educated parents about substance abuse and encouraged them to set firm family rules about smoking , and another in Norway that emphasized children's freedom to choose.

Some of the successful programs were short interventions, while others were multifaceted approaches that required numerous sessions.

"I'd say that well-tested programs with enthusiastic counselors work" but "these programs are not sure-fire," lead author Dr. Roger Thomas, professor of family medicine at the University of Calgary, in Canada, said in a prepared statement.

Early research on school-based smoking prevention programs suggests that they were not adequate to prevent youngsters from smoking, so experts turned to family-based programs, noted Christine Jackson, a senior research scientist at the Pacific Institute for Research and Evaluation in Chapel Hill, N.C.

She wasn't involved in the review but led research on an effective childhood smoking prevention program in North Carolina that used mail-home activity guides, newsletters for youngsters, and prizes that made it fun for the children.

Smoking prevention programs that reach children well before middle school are most likely to succeed, Jackson said.

"Early onset of smoking is a known predictor of becoming a habitual smoker by late adolescence. That's the problem we are up against. The highest-risk kids are the early starters," she said in a prepared statement.

-- Robert Preidt

Statins Good for Smokers' Lungs

By Ed Edelson
HealthDay Reporter

 

The millions of Americans who take cholesterol-lowering statin drugs may have another reason to cheer: These medications may also help boost the lung health of smokers and former smokers.

And a second study reported at the American College of Chest Physicians annual meeting in New Orleans found that these drugs -- which include Lipitor, Pravachol and Zocor -- may also protect people with severely clogged carotid arteries, the main blood vessels to the brain.

The lung study was conducted by a team led by Dr. Walid G. Younis, a pulmonary fellow at the University of Oklahoma Medical Center. It compared the effect of statins on the lung function of 182 current smokers and 303 former smokers. Just 67 of the study participants had normal lung function.

The researchers measured FEV1 -- the amount of air that a person could expel from the lungs in one second.

According to the researchers, the 238 participants who took statins experienced a decline in FEV1 of 2.5 percent over an average follow-up period of 2.7 years, while those who didn't take the drugs saw their levels fall by an average 12.8 percent over the same time period.

In addition, patients with a serious condition called obstructive lung disease saw their need for respiratory-related emergency room visits and hospitalizations fall significantly after taking a statin medication. The benefits of statin therapy were similar for smokers and former smokers.

This protective effect does not seem to be related to lowered cholesterol levels, Younis said. He noted that, "statins work on [reducing] inflammation as well. It has been shown in rheumatology studies that statins reduce inflammation in the airways."

It's possible that statin therapy could slow the progression of lung disease, he said, but "this is the first study to show that, and we need to confirm it with other studies. Right now, we are in the process of planning other studies to corroborate the finding."

Statin therapy for the lungs is not a panacea, however. "They have no effect on preventing a patient from the major smoking-related killer, which is lung cancer," Younnis said. "Smokers should never lose their incentive to quit smoking."

In the second study, researchers found that statins helped keep carotid arteries clear.

A number of studies have shown that statin treatment is effective in a number of ways against a variety of cardiovascular conditions. For example, researchers reported just last month that early, aggressive treatment with statins was beneficial for people who suffered heart attacks or other acute coronary events.

The new report looked at 449 people with a severe narrowing of one or both carotid arteries.

Only 15 percent of the 298 patients treated with statins experienced strokes or heart attacks or died during an average 26 months of follow-up, compared to 68 percent of the 151 patients who did not get the drugs and who were followed for an average of 21 months.

"Research like this, involving these kinds of incidences in these kinds of patients, has not previously been published," said study author Dr. Gautham Ravipati, a fellow at New York Medical College. He said the findings support the notion that "all patients with carotid artery disease and hypercholesterolemia [high cholesterol] should be treated with statins."

Indeed, "the biggest thing for us in this study is the underuse of statins in patients who had hypercholesterolemia," Ravipati said. "It was the most surprising finding."

Statins might even be underused for patients at high risk of stroke or who have already had one and who have what would ordinarily be considered normal levels of cholesterol, he said. "Their total cholesterol might need to be reduced even further," Ravipati said.

SOURCES: Gautham Ravipati, M.D., fellow, New York Medical College, Valhalla; Walid G. Younis, M.D., pulmonary fellow, University of Oklahoma Medical Center, Oklahoma City; Oct. 23, 2006, American College of Chest Physicians annual meeting, Salt Lake City

Teens Who Smoke, Drink Alone at Higher Risk

By Steven Reinberg
HealthDay Reporter

 

Teens who often engage in unhealthy habits on their own, rather than with peers, may be in bigger trouble, a new study finds.

Researchers at the Rand Corp. found that teens who use alcohol, cigarettes and marijuana when they are alone are less likely to graduate from college, more likely to have substance abuse problems and report poorer physical health by age 23, compared with their peers who only use these substances in groups.

"We found that kids who used these substances while alone were not only at higher risk for problems during adolescences, but 10 years later when they were 23," said study author Joan Tucker, a behavioral scientist at Rand Corp.

"We need to take a closer look at this group of 'solitary users,'" Tucker said. "They are overlooked. When we think about adolescent substance users, we think of those kids who are using substances at parties or when they are hanging out with friends. But we found that there is a significant group that are using these substances by themselves."

Tucker noted that these teens are not loners but are socially active, using alcohol, tobacco or marijuana when they are with friends, but also when they are alone.

Her team's report is published in the December issue of Psychology of Addictive Behaviors.

In the study, Tucker's team collected data on over 6,500 teenagers from California and Oregon who were in a study to evaluate Project ALERT, a drug-prevention program developed by Rand for middle school children. Teens were asked about their substance use and a variety of other issues several times during middle school and high school, and again at age 23.

The researchers found that of the more than 3,300 people who completed the study, 16 percent of eighth graders had smoked cigarettes while alone, 17 percent drank while alone, and 4 percent had used marijuana while alone.

These solitary users admitted to more delinquent behavior, such as stealing and acting out at school, and were less likely to talk to their parents about personal problems than kids who indulged in bad habits more socially. They were also less involved with school, had lower grades and spent less time on homework and school activities.

However, "these are not the loner kids," Tucker said. In fact, most of these high-risk youngsters also spent significantly more time going to parties and dating than other substance-using youth. "They focus less on school and more on activities with their peers," Tucker said.

Moreover, these solitary substance abusers felt that substance use had positive effects on their behavior, helping them relax, have more fun and feel better, Tucker said. Also, they were less likely to think substance use is harmful.

But at 23, more of these solitary users had developed substance abuse problems and were involved in crimes, such as selling drugs and stealing, Tucker said. They also had more physical health problems. "So, across the board, they were faring worse in young adulthood," she said.

One expert believes that a combination of addiction and existing psychological problems account for these behaviors among this subset of youth.

"People who are more likely to be addicted are more likely to use solitarily as well as socially," said Bonnie Halpern-Felsher, an associate professor of pediatrics at the University of California, San Francisco. "In addition, kids who are at risk are more likely to use solitarily."

Halpern-Felsher thinks it is important that health-care providers ask adolescents about their smoking and drug use behaviors -- not only if they use drugs and alcohol but where. "It may be that asking these questions will help identify those teens at risk for other developmental problems," she said.

"It's not just the fact that they are using the substances, but what's going on behind it," Halpern-Felsher said. "Either they are lonely or there is depression or there is something going on at home. It could be that this is a marker for other behavioral and social problems that are going on," she said.

SOURCES: Joan Tucker, Ph.D., behavioral scientist, Rand Corp., Pittsburgh; Bonnie Halpern-Felsher, Ph.D., associate professor, pediatrics, University of California, San Francisco; December 2006 Psychology of Addictive Behaviors

Women Smokers at Greater Risk for Rheumatoid Arthritis

 Smoking nearly doubles the odds of rheumatoid arthritis in women who don't have genetic risk factors for the disease, a U.S. study says.

Researchers compared 115 postmenopausal women with rheumatoid arthritis to 466 women without the disease. The women were participants in the long-term Iowa Women's Health Study tracking participants' lifestyles, such as smoking.

This new study, published in the journal Annals of the Rheumatic Diseases, found that smoking nearly doubled the risk of rheumatoid arthritis in women who did not have the most well established risk factor for the disease -- HLA-DRB1 SE.

However, the researchers from the University of California, San Francisco found no increased risk for the disease among women smokers who did have HLA-DRB1 SE.

The study was limited to older white women, so it's not clear if the same results would be found in other age groups or ethnicities, the researchers noted.

In rheumatoid arthritis, the patient's immune system attacks the joint linings. In these kinds of complex autoimmune diseases, interaction between genes and environmental factors is considered to play an important role.

-- Robert Preidt

What is in the future for smoking?

Health care workers have become extremely active in publicizing the negative effects of smoking. In fact, health care workers have been instrumental in passing various legislation to limit smoking in public. As a result, the proportion of people in the US who smoke has dropped from 40.4% in 1965 to 22.5% in 2002 (data from the US Department of Health).

This reduction in the percent of people who smoke, however, has been significantly less in women than in men. That is, from 1965 to 2002, smoking among men dropped from 50.2% to 25.2% while during the same period, smoking among women dropped from 31.9% to 20.0%. So, in the future, efforts need to be made to understand and eliminate this difference between the genders. Moreover, with the passage of even stricter legislation, the percent of people who smoke should (hopefully) fall to single digits by the year 2010.

One interesting area of the current research on smoking is the study of the population distribution of the genes for smoking (genetic epidemiology). (Genes determine an individual's inherited characteristics.) Only a small fraction of individuals who start smoking as an adolescent will actually become nicotine dependent. So, what determines which individuals will become nicotine-dependent? Investigators have found that smoking initiation (the obligatory first step) and the development of nicotine dependence are both influenced by genetic factors. The genetic factors appear to play a larger role in nicotine dependence than in smoking initiation. The next step will be to identify these genes and learn how they work in order to facilitate the development of effective prevention and treatment strategies for tobacco addiction.

Teen smoking rates remain of concern; in 2003, approximately 22% of high school students were smokers. According to the American Cancer Society, the majority of cigarette use begins before a person reaches 18 years of age. Those who do not begin smoking by age 18 generally do not start to smoke later in life. Education of the at-risk teen population is therefore critical for prevention of tobacco use. Various celebrities and activist groups actively promote campaigns aimed at a teen audience that educate about the consequences of smoking and offer advice on smoking cessation and prevention. While teen smoking rates increased during the 1990s (36% of teens smoked in 1997), prevention and education campaigns have brought about a decrease in teen smoking in recent years.

Smoking and Quitting Smoking At A Glance

• Although smoking is an addiction, people can quit smoking.
• Secondhand smoke is harmful to the health of children, family members, and coworkers
• Quitting smoking cuts the risk of lung cancer, heart disease, stroke, and respiratory diseases The steps in quitting, each of which requires special attention and efforts by the smoker, are getting ready to quit, quitting, and staying quit
• A number of techniques are available to assist people who want to quit, including nicotine replacement therapy (NRT), behavioral modification, and self-help literature
• In nicotine replacement therapy, which is the cornerstone of most smoking cessation programs, another source of nicotine is substituted while the cigarettes are stopped (The idea of nicotine replacement therapy is to eliminate both the smoking habit - although the addiction remains - and the symptoms of withdrawal. Then, the replacement nicotine is gradually stopped.)
• Currently, three forms of nicotine replacement therapy are available over the counter: nicotine patches, nicotine gum, and nicotine lozenges, while two forms are available by prescription, an inhaler and a nasal spray
• Nicotine replacement therapy has about a 25% success rate, which increases to 35 or 40% when nicotine replacement therapy is combined with intensive behavioral counseling
• Nicotine-containing substances have side effects, interactions with other medications, effects on other medical conditions, and limitations in their use
• A prescription drug called bupropion (Zyban, Wellbutrin) has been found to be effective in helping people to stop smoking

What prescription products are available for smoking cessation?

The following products for cessation of smoking are available by prescription only. Nicotine for nicotine replacement therapy is available by prescription as an inhaler or nasal spray (Nicotrol Inhaler and Nicotrol NS). These other forms of delivery of nicotine seem to work as well as the nicotine patches or gum.

Bupropion hydrochloride (Zyban, Wellbutrin) is a medication that is used primarily for treating depression. This drug, however, also has been found to be effective in helping people to quit smoking.

Other agents that have been tried for cessation of smoking include serotonin reuptake antagonists (drugs also used for depression) and the anti-hypertensive drugs clonidine (Catapres) and calcium channel blocker. Although these agents appear to be less effective than nicotine replacement therapy, they may be promising for some patients.

How are nicotine-containing products used safely?

Users of nicotine-containing products should understand that all of these products have side effects as well as effects on other underlying medical conditions such as diabetes mellitus, high blood pressure, asthma, and heart disease. Furthermore, these products can have interactions with other prescribed medications such as pain relievers, blood thinners, and high blood pressure medications. And finally, they do have their limitations. The following guidelines are to help you safely use these products to achieve your goal of quitting smoking.

1. Always read the labels and know the ingredients in the products. Never take more than the recommended dose without checking with your doctor first.
2. If you are pregnant or nursing a baby, seek the advice of a health professional before using any nicotine-containing product.
3. Do not use a nicotine-containing product if you continue to smoke, chew tobacco, use snuff, or other nicotine-containing products.
4. Consult a physician before using nicotine-containing products if you:

• Are under 18 years of age
• Have heart disease, an irregular heartbeat, or have had a recent heart attack (Nicotine can increase your heart rate.)
• Have high blood pressure that is not controlled with medication (Nicotine can increase your blood pressure.)
• Have a history of, or currently have, inflammation of the esophagus (esophagitis) or ulcers of the stomach or duodenum (peptic ulcer disease)
• Take insulin for diabetes.
• Take any prescription medications (Nicotine interacts with some medications, such as aspirin, some medications for the heart, and female hormones to decrease their levels in the blood.)
• Have a skin disorder, such as dermatitis, which may increase the likelihood of skin reactions by the skin to the patch

5. People should stop using nicotine-containing products and see their physician if they have or develop:

• Mouth, tooth, or jaw problems (applies to Nicorette gum)
• Irregular heartbeats or palpitations
• Symptoms of nicotine overdose, such as nausea, vomiting, dizziness, weakness, and rapid heartbeat
• Severe rash, redness, swelling, burning, or itching at the site of the patch

What methods can help a person quit smoking?

Several methods are available to assist those who decide to quit smoking. The three main categories of methods are:

• Changing the behavior that is associated with smoking
• Self-help literature
• Nicotine replacement therapy.

Each method actually offers several different options. Moreover, combinations of the methods usually are necessary, and no one combination will work for everyone. In fact, it may be necessary to try several different methods or combinations of methods before success is achieved.

Behavioral modification and self-help literature

Due to the addictive nature of nicotine, some form of behavioral modification is often necessary for successful cessation of smoking. Educational programs, hypnosis, and aversion therapy (learning how to avoid cigarettes) are a few options. Patients may be counseled to avoid specific triggers or situations that lead to smoking. For example, instead of awakening and grabbing a cigarette at the bedside or smoking immediately after a meal, people may be encouraged to replace the urge to smoke with another activity, such as, taking a walk or reading a book.

Numerous associations and societies, for example, the American Cancer Society, American Heart Association, and the American Lung Association, have developed brochures to help smokers quit smoking. The American Lung Association also has a FREE "Freedom From Smoking®" program.

Nicotine Replacement Therapy

Nicotine replacement therapy (NRT) became available over the counter in the 1990's. The purpose of nicotine replacement therapy is to substitute another source of nicotine while cigarettes are discontinued. By this means, the habit of smoking is eliminated, even though the addiction to nicotine remains intact. But at the same time, nicotine replacement therapy eliminates the symptoms of withdrawal that can trigger more smoking. In addition, behavioral counseling to change smoking-related behavior usually is necessary. Once cigarettes have been replaced during nicotine replacement therapy, the amount of nicotine is then gradually reduced.

Currently, there are three forms of nicotine replacement therapy available over-the-counter; nicotine transdermal systems or patches (Nicoderm CQ and Nicotrol), nicotine polacrilex resin or gum (Nicorette), and nicotine lozenges (Commit). The patch contains nicotine that is stored within a specially designed support or matrix. Once applied, the nicotine transdermal systems steadily release nicotine that is absorbed across the skin and into the blood stream. The gum contains nicotine that is released slowly upon chewing and "parking". Parking refers to the action of shifting the gum to one side of the cheek after chewing in order to speed the absorption of nicotine. Nicotine lozenges contain nicotine within a hard candy that allows for slow release of nicotine as the candy dissolves in the mouth. A program for slowly weaning users from nicotine replacement products is provided by each product's manufacturer.

The nicotine patch, Nicoderm CQ, is available in three strengths; 21, 14, and 7 mg. People are advised to begin with the 21 mg patch if they smoke more than 10 cigarettes per day or the 14 mg patch if they smoke less than 10 cigarettes per day. After six weeks of wearing the initial patch strength, the next lowest patch strength is worn for two weeks. If therapy was started with the 21 mg patch, an additional two weeks is required for the 7mg patch. A maximum of eight or 10 weeks, depending upon the strength of the first patch used, is recommended for a successful quitting program. The Nicoderm CQ patch can be worn for 16 hours (from awakening until bedtime) or 24 hours if the urge to smoke is great upon awakening.

Nicotrol is available as a 15 mg patch, and should be worn no more than 16 hours per day. Nicotrol may be worn for up to six weeks.

The side effects commonly seen with patches are burning, itching, or redness at the site of the patch, headache, insomnia, nervousness, dizziness, cough, rash, joint aches, painful menstruation, and changes in taste. For more, please read the nicotine patch article.

The gum, Nicorette, is available in 2 strengths; 4 and 2 mg. Patients are advised to begin with the 4 mg piece of gum if they smoke more than 25 cigarettes per day or the 2 mg piece if they smoke fewer than 7 cigarettes per day. No more than 20 pieces of the 4 mg strength or 30 pieces of the 2 mg strength should be chewed in one day. Initial weaning from treatment should begin after 2 to 3 months and be completed by 4 to 6 months. The most common side effects with Nicorette are aching jaws or soreness of the gums, changes in taste, abdominal (gastrointestinal) discomfort, hiccups, nausea, vomiting , and belching. For more, please read the nicotine gum article.

Commit nicotine lozenges are available in 2 or 4 mg doses. One dose consists of one lozenge, and no more than 20 doses should be consumed in one day. The manufacturers of Commit recommend choosing the proper dosage based upon when you usually have the first cigarette of your day. According to the manufacturer's instructions, if you smoke within 30 minutes of getting up in the morning, you should use the stronger 4 mg dose. If not, you should use the 2 mg lozenges.

Biting or chewing nicotine lozenges instead of allowing them to dissolve can lead to indigestion or heartburn. You should not eat or drink anything while the lozenge is in your mouth. The lozenges will last for about 20-30 minutes when allowed to dissolve in the mouth. The most commonly reported side effects with nicotine lozenges are indigestion, throat irritation, soreness of the teeth or gums, insomnia, nausea, hiccups, coughing, heartburn, headache, and flatulence.

How effective is nicotine replacement therapy? Approximately 25% of patients successfully stop smoking with nicotine patch therapy. The success rate with nicotine gum is similar. There have not yet been studies to compare the effectiveness of nicotine lozenges to the patch or gum. When intensive behavioral counseling is added, the rate of success for nicotine replacement therapy increases to 35-40%.

Staying Quit

• The expected consequences of quitting are irritability, difficulty concentrating, increased appetite, and of course, urges to smoke. So, if you feel more short-tempered or distracted or sleepier than usual, don't worry because these feelings will pass.
• Try to exercise. For example, take walks or ride a bike.
• Consider the positive things about quitting. For example, think about how much you like yourself as a non-smoker, the health benefits for you and your family, and the example you set for others around you. A positive attitude will help you through the tough times.
• When you feel tense, try to keep busy and think about ways to ease the tenseness. Tell yourself that smoking won't make it any better, and go do something else.
• Eat regular meals because feeling hungry is sometimes mistaken for the desire to smoke.
• Start a money jar with the money you save by not buying cigarettes.
• Let others know that you have quit smoking. You will find that most people will support you. Many of your smoking friends may want to know how you quit. It's good to talk to others about your quitting. In fact, people who stay off smoking for at least one year often have had very strong support from a companion or coworker.
• If you slip and smoke, don't be discouraged. Many former smokers tried to stop several times before they finally succeeded.

On the Day You Quit

Get rid of all your cigarettes. Put away your ashtrays.

Change your morning routine. When you eat breakfast, don't sit in the same place at the kitchen table. Stay busy.

When you get the urge to smoke, do something else instead.

Carry other things to put in your mouth, such as gum, hard candy, or a toothpick.

Reward yourself at the end of the day for not smoking. See a movie or go out and enjoy your favorite meal.

Why should someone quit smoking?

Quitting smoking makes a difference right away in the way you feel. You can taste and smell food better. Your breath smells better. Your cough goes away. These benefits happen for men and women of all ages, even those who are older. They happen for healthy people as well as those who already have a disease or condition caused by smoking.

Even more importantly, in the long run, quitting smoking cuts the risk of lung cancer, many other cancers, heart disease, stroke, and other lung or breathing (respiratory) diseases (e.g., bronchitis , pneumonia, and emphysema). Moreover, ex-smokers have better health than current smokers. For example, ex-smokers have fewer days of illness, fewer health complaints, and less bronchitis and pneumonia than current smokers.

Finally, quitting smoking saves money. A pack-a-day smoker who pays $4.00 per pack can expect to save more than $1,408 per year! What's more, it appears that the price of cigarettes will continue to rise in coming years, as will the financial rewards of quitting.

What are the steps in quitting?

First, one can do certain things to get ready to quit. Then, there are other things to do on the day of quitting. Finally, one can do things to help oneself to remain abstinent. (This is the hardest part.)

Getting Ready to Quit

• Set a date for quitting. If possible, plan to have a friend quit smoking with you.
• Notice when and why you smoke. Try to find the things in your daily life that you often do while smoking (such as drinking your morning cup of coffee or driving a car).
• Change your smoking routines: Keep your cigarettes in a different place. Smoke with your other hand. Don't do anything else when you are smoking. Think about how you feel when you smoke.
• Smoke only in certain places, such as outdoors.
• When you want a cigarette, wait a few minutes. Try to think of something to do instead of smoking. For example, you might chew gum or drink a glass of water.
• Buy one pack of cigarettes at a time. Switch to a brand of cigarettes that you don't like.

What are the signs of cigarette addiction?

The signs of addiction to cigarettes include:

• Smoking more than seven cigarettes per day
• Inhaling deeply and frequently
• Smoking cigarettes containing nicotine levels more than 0.9mg
• Smoking within 30 minutes of awakening in the morning
• Finding it difficult to eliminate the first cigarette in the morning
• Smoking frequently during the morning
• Finding it difficult to avoid smoking in smoking-restricted areas
• Needing to smoke even if sick and in bed

What is addictive disease and why is smoking considered an addictive disease?

The term addictive disease or addiction describes a persistent habit that is harmful to the person. Thus, addiction is a chronic (long duration) disease with reliance on the substance causing the addiction. The addictive substance also causes the accompanying deterioration of a person's physical and psychological health.

Psychologically, an individual's behavior pattern establishes how the addictive substance is used. One type of behavior is compulsive behavior, which is an overwhelming and irresistible interest in use of the substance. For example, the compulsive addict makes sure that the substance is always available. Another type of behavior is habitual behavior, which is using the substance regularly or occasionally for the desirable effects. Physically, continuous use of the substance leads to dependence on the drug by the body. This dependence means that when the drug is discontinued, symptoms of withdrawal or distress occur.

Nicotine is the component of cigarettes that addicts. Almost immediately upon inhalation, the body responds to the nicotine. An individual feels relaxed, calmer, and happier than before the inhalation. These pleasant feelings reflect the physical side of addiction. But then, doing without cigarettes causes craving for more cigarettes, irritability, impatience, anxiety, and other unpleasant symptoms. Indeed, these symptoms are the symptoms of withdrawal from cigarettes. What's more, over time, more and more nicotine is desired to produce the favorable effects and to avoid the symptoms of withdrawal.

What problems are caused by smoking?

By smoking, you can cause health problems not only for yourself but also for those around you.

Hurting Yourself

Smoking is an addiction. Tobacco contains nicotine, a drug that is addictive. The nicotine, therefore, makes it very difficult (although not impossible) to quit. In fact, since the U.S. Surgeon General's 1964 report on the dangers of smoking, millions of Americans have quit. Still, more than 430,000 deaths occur in the U.S. each year from smoking-related illnesses. The reason for these deaths is that smoking greatly increases the risk of getting lung cancer, heart attack, chronic lung disease, stroke, and many other cancers. Moreover, smoking is perhaps the most preventable cause of breathing (respiratory) diseases within the USA.

Hurting Others

Smoking harms not just the smoker, but also family members, coworkers, and others who breathe the smoker's cigarette smoke, called secondhand smoke or passive smoke. Among infants up to 18 months of age, secondhand smoke is associated with as many as 300,000 cases of bronchitis and pneumonia each year. In addition, secondhand smoke from a parent's cigarette increases a child's chances for middle ear problems, causes coughing and wheezing, worsens asthma, and increases an infant's risk of dying from Sudden Infant Death Syndrome (SIDS).

Exposure to passive smoke can also cause cancer. Research has shown that non-smokers who reside with a smoker have a 24% increase in risk for developing lung cancer when compared with other non-smokers. An estimated 3,000 lung cancer deaths occur each year in the U.S. that are attributable to passive smoking. Secondhand smoke also increases the risk of stroke and heart disease. If both parents smoke, a teenager is more than twice as likely to smoke as a teenager whose parents are both nonsmokers. Even in households where only one parent smokes, young people are more likely to start smoking. Pregnant women who smoke are more likely to deliver babies whose weights are too low for the babies' good health. In fact, it has been estimated that if all women quit smoking during pregnancy, about 4,000 new babies would not die each year.