<span class=”paragraphSection”>Tobacco use is a complex polygenic disorder and continues to be the leading cause of preventable death worldwide.<sup><a href=”#CIT0001″ class=”reflinks”>1–3</a></sup> The present issue highlights seven original investigations that address some of the complexities and gaps in the state of the science with innovative methods.</span>
<span class=”paragraphSection”><div class=”boxTitle”>Abstract</div><div class=”boxTitle”>Introduction:</div>Previous studies in adolescents were not adequately powered to accurately disentangle genetic and environmental influences on smoking initiation (SI) across adolescence.<div class=”boxTitle”>Methods:</div>Mega-analysis of pooled genetically informative data on SI was performed, with structural equation modeling, to test equality of prevalence and correlations across cultural backgrounds, and to estimate the significance and effect size of genetic and environmental effects according to the classical twin study, in adolescent male and female twins from same-sex and opposite-sex twin pairs (<span style=”font-style:italic;”>N</span> = 19 313 pairs) between ages 10 and 19, with 76 358 longitudinal assessments between 1983 and 2007, from 11 population-based twin samples from the United States, Europe, and Australia.<div class=”boxTitle”>Results:</div>Although prevalences differed between samples, twin correlations did not, suggesting similar etiology of SI across developed countries. The estimate of additive genetic contributions to liability of SI increased from approximately 15% to 45% from ages 13 to 19. Correspondingly, shared environmental factors accounted for a substantial proportion of variance in liability to SI at age 13 (70%) and gradually less by age 19 (40%).<div class=”boxTitle”>Conclusions:</div>Both additive genetic and shared environmental factors significantly contribute to variance in SI throughout adolescence. The present study, the largest genetic epidemiological study on SI to date, found consistent results across 11 studies for the etiology of SI. Environmental factors, especially those shared by siblings in a family, primarily influence SI variance in early adolescence, while an increasing role of genetic factors is seen at later ages, which has important implications for prevention strategies.<div class=”boxTitle”>Implications:</div>This is the first study to find evidence of genetic factors in liability to SI at ages as young as 12. It also shows the strongest evidence to date for decay of effects of the shared environment from early adolescence to young adulthood. We found remarkable consistency of twin correlations across studies reflecting similar etiology of liability to initiate smoking across different cultures and time periods. Thus familial factors strongly contribute to individual differences in who starts to smoke with a gradual increase in the impact of genetic factors and a corresponding decrease in that of the shared environment.</span>
<span class=”paragraphSection”><div class=”boxTitle”>Abstract</div><div class=”boxTitle”>Introduction:</div>α7 nicotinic acetylcholine receptors (nAChRs) play an important role in vagus nerve-based cholinergic anti-inflammatory effects. This study was designed to assess the role of α7 nAChRs in dextran sodium sulfate (DSS)-induced colitis in male and female mouse. We first compared disease activity and pathogenesis of colitis in α7 knockout and wild-type mice. We then evaluated the effect of several α7 direct and indirect agonists on the severity of disease in the DSS-induced colitis.<div class=”boxTitle”>Methods:</div>Male and female adult mice were administered 2.5% DSS solution freely in the drinking water for 7 consecutive days and the colitis severity (disease activity index) was evaluated as well as colon length, colon histology, and levels of tumor necrosis factor-alpha colonic levels.<div class=”boxTitle”>Results:</div>Male, but not female, α7 knockout mice displayed a significantly increased colitis severity and higher tumor necrosis factor-alpha levels as compared with their littermate wild-type mice. Moreover, pretreatment with selective α7 ligands PHA-543613, choline, and PNU-120596 decreased colitis severity in male but not female mice. The anti-colitis effects of these α7 compounds dissipated when administered at higher doses.<div class=”boxTitle”>Conclusions:</div>Our results suggest the presence of a α7-dependent anti-colitis endogenous tone in male mice. Finally, our results show for the first time that female mice are less sensitive to the anti-colitis activity of α7 agonists. Ovarian hormones may play a key role in the sex difference effect of α7 nAChRs modulation of colitis in the mouse.<div class=”boxTitle”>Implications:</div>Our collective results suggest that targeting α7 nAChRs could represent a viable therapeutic approach for intestinal inflammation diseases such as ulcerative colitis with the consideration of sex differences.</span>
Whether you’re a teen smoker or a lifetime pack-a-day smoker, quitting can be tough. But the more you learn about your options and prepare for quitting, the easier the process will be. With the right game plan tailored to your needs, you can break the addiction, manage your cravings, and join the millions of people who have kicked the habit for good.
Why quitting smoking can seem so hard
Smoking tobacco is both a physical addiction and a psychological habit. The nicotine from cigarettes provides a temporary—and addictive—high. Eliminating that regular fix of nicotine will cause your body to experience physical withdrawal symptoms and cravings. Because of nicotine’s “feel good” effect on the brain, you may also have become accustomed to smoking as a way of coping with stress, depression, anxiety, or even boredom.
At the same time, the act of smoking is ingrained as a daily ritual. It may be an automatic response for you to smoke a cigarette with your morning coffee, while taking a break from work or school, or during your commute home at the end of a long day. Perhaps friends, family members, and colleagues smoke, and it has become part of the way you relate with them.
To successfully quit smoking, you’ll need to address both the addiction and the habits and routines that go along with it.
Your personal stop smoking plan
While some smokers successfully quit by going cold turkey, most people do better with a plan to keep themselves on track. A good plan addresses both the short-term challenge of quitting smoking and the long-term challenge of preventing relapse. It should also be tailored to your specific needs and smoking habits.
Questions to ask yourself
Take the time to think of what kind of smoker you are, which moments of your life call for a cigarette, and why. This will help you to identify which tips, techniques or therapies may be most beneficial for you.
- Do you feel the need to smoke at every meal?
- Are you more of a social smoker?
- Is it a very bad addiction (more than a pack a day)? Or would a simple nicotine patch do the job?
- Do you reach for cigarettes when you’re feeling stressed or down?
- Are there certain activities, places, or people you associate with smoking?
- Is your cigarette smoking linked to other addictions, such as alcohol or gambling?
- Are you open to hypnotherapy and/or acupuncture?
- Are you someone who is open to talking about your addiction with a therapist or counselor?
- Are you interested in getting into a fitness program?
Start your stop smoking plan with START
S = Set a quit date.
Choose a date within the next two weeks, so you have enough time to prepare without losing your motivation to quit. If you mainly smoke at work, quit on the weekend, so you have a few days to adjust to the change.
T = Tell family, friends, and co-workers that you plan to quit.
Let your friends and family in on your plan to quit smoking and tell them you need their support and encouragement to stop. Look for a quit buddy who wants to stop smoking as well. You can help each other get through the rough times.
A = Anticipate and plan for the challenges you’ll face while quitting.
Most people who begin smoking again do so within the first three months. You can help yourself make it through by preparing ahead for common challenges, such as nicotine withdrawal and cigarette cravings.
R = Remove cigarettes and other tobacco products from your home, car, and work.
Throw away all of your cigarettes (no emergency pack!), lighters, ashtrays, and matches. Wash your clothes and freshen up anything that smells like smoke. Shampoo your car, clean your drapes and carpet, and steam your furniture.
T = Talk to your doctor about getting help to quit.
Your doctor can prescribe medication to help with withdrawal and suggest other alternatives. If you can’t see a doctor, you can get many products over the counter at your local pharmacy or grocery store, including the nicotine patch, nicotine lozenges, and nicotine gum.
How to quit smoking: Identify your smoking triggers
One of the best things you can do to help yourself quit is to identify the things that make you want to smoke, including specific situations, activities, feelings, and people.
Keep a craving journal
A craving journal can help you zero in on your patterns and triggers. For a week or so leading up to your quit date, keep a log of your smoking. Note the moments in each day when you crave a cigarette:
- What time was it?
- How intense was the craving (on a scale of 1-10)?
- What were you doing?
- Who were you with?
- How were you feeling?
- How did you feel after smoking?
Do you smoke to relieve unpleasant or overwhelming feelings?
Managing unpleasant feelings such as stress, depression, loneliness, fear, and anxiety are some of the most common reasons why adults smoke. When you have a bad day, it can seem like cigarettes are your only friend. As much comfort as cigarettes provide, though, it’s important to remember that there are healthier (and more effective) ways to keep unpleasant feelings in check. These may include exercising, meditating, using sensory relaxation strategies, and practicing simple breathing exercises.
For many people, an important aspect of quitting smoking is to find alternate ways to handle these difficult feelings without smoking. Even when cigarettes are no longer a part of your life, the painful and unpleasant feelings that may have prompted you to smoke in the past will still remain. So, it’s worth spending some time thinking about the different ways you intend to deal with stressful situations and the daily irritations that would normally have you reaching for a cigarette.
Tips for avoiding common smoking triggers
- Alcohol. Many people have a habit of smoking when they drink. TIP: switch to non-alcoholic drinks or drink only in places where smoking inside is prohibited. Alternatively, try snacking on nuts and chips, or chewing on a straw or cocktail stick.
- Other smokers. When friends, family, and co-workers smoke around you, it is doubly difficult to quit or avoid relapse. TIP: Your social circles need to know that you are changing your habits so talk about your decision to quit. Let them know they won’t be able to smoke when you’re in the car with them or taking a coffee break together. In your workplace, don’t take all your coffee breaks with smokers only, do something else instead, or find non-smokers to have your breaks with.
- End of a meal. For some smokers, ending a meal means lighting up, and the prospect of giving that up may appear daunting. TIP: replace that moment after a meal with something such as a piece of fruit, a (healthy) dessert, a square of chocolate, or a stick of gum.
How to quit smoking: Coping with nicotine withdrawal symptoms
Once you stop smoking, you will experience a number of physical symptoms as your body withdraws from nicotine. Nicotine withdrawal begins quickly, usually starting within thirty minutes to an hour of the last cigarette and peaking about two to three days later. Withdrawal symptoms can last for a few days to several weeks and differ from person to person.
Common nicotine withdrawal symptoms include:
Unpleasant as these withdrawal symptoms may be, they are only temporary. They will get better in a few weeks as the toxins are flushed from your body. In the meantime, let your friends and family know that you won’t be your usual self and ask for their understanding.
Coping with Nicotine Withdrawal Symptoms
|Craving for cigarette||Most intense during first week but can linger for months||Wait out the urge; distract yourself; take a brisk walk.|
|Irritability, impatience||Two to four weeks||Exercise; take hot baths; use relaxation techniques; avoid caffeine.|
|Insomnia||Two to four weeks||Avoid caffeine after 6 p.m.; use relaxation techniques; exercise; plan activities (such as reading) when sleep is difficult.|
|Fatigue||Two to four weeks||Take naps; do not push yourself.|
|Lack of concentration||A few weeks||Reduce workload; avoid stress.|
|Hunger||Several weeks or longer||Drink water or low-calorie drinks; eat low-calorie snacks.|
|Coughing, dry throat, nasal drip||Several weeks||Drink plenty of fluids; use cough drops.|
|Constipation, gas||One to two weeks||Drink plenty of fluids; add fiber to diet; exercise.|
Adapted with permission from Overcoming Addiction: Paths Toward Recovery, a special health report from Harvard Health Publications.
How to quit smoking: Manage cigarette cravings
Avoiding smoking triggers will help reduce the urge to smoke, but you can’t avoid cravings entirely. But cigarette cravings don’t last long, so if you’re tempted to light up, remember that the craving will pass and try to wait it out. It also helps to be prepared in advance. Having a plan to cope with cravings will help keep you from giving in.
- Distract yourself. Do the dishes, turn on the TV, take a shower, or call a friend. The activity doesn’t matter as long as it gets your mind off of smoking.
- Remind yourself why you quit. Focus on your reasons for quitting, including the health benefits, improved appearance, money you’re saving, and enhanced self-esteem.
- Get out of a tempting situation. Where you are or what you’re doing may be triggering the craving. If so, a change of scenery can make all the difference.
- Reward yourself. Reinforce your victories. Whenever you triumph over a craving, give yourself a reward to keep yourself motivated.
Coping with Cigarette Cravings in the Moment
|Find an oral substitute||Keep other things around to pop in your mouth when cravings hit. Good choices include mints, hard candy, carrot or celery sticks, gum, and sunflower seeds.|
|Keep your mind busy||Read a book or magazine, listen to some music you love, do a crossword or Sudoku puzzle, or play an online game.|
|Keep your hands busy||Squeeze balls, pencils, or paper clips are good substitutes to satisfy that need for tactile stimulation.|
|Brush your teeth||The just-brushed, clean feeling can help get rid of cigarette cravings.|
|Drink water||Slowly drink a large, cold glass of water. Not only will it help the craving pass, but staying hydrated helps minimize the symptoms of nicotine withdrawal.|
|Light something else||Instead of lighting a cigarette, light a candle or some incense.|
|Get active||Go for a walk, do some jumping jacks or pushups, try some yoga stretches, or run around the block.|
|Try to relax||Do something that calms you down, such as taking a warm bath, meditating, reading a book, or practicing deep breathing exercises.|
Preventing weight gain after you’ve stopped smoking
Weight gain is a common concern when quitting smoking. Some people even use it as a reason not to quit. While it’s true that many smokers put on weight within six months of stopping smoking, the gain is usually small—about five pounds on average—and that initial gain decreases over time. It’s also important to remember that carrying a few extra pounds for a few months won’t hurt your heart as much as smoking will. Of course, gaining weight is NOT inevitable when you quit smoking.
Smoking acts as an appetite suppressant. It also dampens your sense of smell and taste. So after you quit, your appetite will likely increase and food will seem more appealing. Weight gain can also happen if you replace the oral gratification of smoking with eating, especially if you turn to unhealthy comfort foods. So it’s important to find other, healthy ways to deal with stress and other unpleasant feelings rather than mindless, emotional eating.
- Nurture yourself. Instead of turning to cigarettes or food when you feel stressed, anxious, or depressed, learn new ways to soothe yourself.
- Eat healthy, varied meals. Eat plenty of fruits and vegetables and limit your fat intake. Seek out low-fat options that look appetizing to you and you will actually eat. Avoid alcohol, sugary sodas, and other high-calorie drinks.
- Drink lots of water. Drinking lots of water—at least six to eight 8 oz. glasses—will help you feel full and keep you from eating when you’re not hungry. Water will also help flush toxins from your body.
- Take a walk. Walking is a great form of exercise. Not only will it help you burn calories and keep the weight off, but it will also help alleviate feelings of stress and frustration that accompany smoking withdrawal.
- Snack on low-calorie or calorie-free foods. Good choices include sugar-free gum, carrot and celery sticks, sliced bell peppers or jicama, or sugar-free hard candies.
Medication and therapy to help you quit smoking
There are many different methods that have successfully helped people to quit smoking, including:
- Quitting smoking cold turkey.
- Systematically decreasing the number of cigarettes you smoke.
- Reducing your intake of nicotine gradually over time.
- Using nicotine replacement therapy or non-nicotine medications to reduce withdrawal symptoms.
- Utilizing nicotine support groups.
- Trying hypnosis, acupuncture, or counseling using cognitive behavioral techniques.
You may be successful with the first method you try. More likely, you’ll have to try a number of different methods or a combination of treatments to find the ones that work best for you.
Medications to help you stop smoking
Smoking cessation medications can ease withdrawal symptoms and reduce cravings, and are most effective when used as part of a comprehensive stop smoking program monitored by your physician. Talk to your doctor about your options and whether an anti-smoking medication is right for you. U.S. Food and Drug Administration (FDA) approved options are:
Nicotine replacement therapy. Nicotine replacement therapy involves “replacing” cigarettes with other nicotine substitutes, such as nicotine gum or a nicotine patch. It works by delivering small and steady doses of nicotine into the body to relieve some of the withdrawal symptoms without the tars and poisonous gases found in cigarettes. This type of treatment helps smokers focus on breaking their psychological addiction and makes it easier to concentrate on learning new behaviors and coping skills.
Non-nicotine medication. These medications help you stop smoking by reducing cravings and withdrawal symptoms without the use of nicotine. Medications such as bupropion (Zyban) and varenicline (Chantix) are intended for short-term use only.
Alternative therapies to help you stop smoking
There are several things you can do to stop smoking that don’t involve nicotine replacement therapy or prescription medications: Ask your doctor for a referral or see Resources and References below for help finding qualified professionals in each area.
- Hypnosis – A popular option that has produced good results. Forget anything you may have seen from stage hypnotists, hypnosis works by getting you into a deeply relaxed state where you are open to suggestions that strengthen your resolve to quit smoking and increase your negative feelings toward cigarettes.
- Acupuncture – One of the oldest known medical techniques, acupuncture is believed to work by triggering the release of endorphins (natural pain relievers) that allow the body to relax. As a smoking cessation aid, acupuncture can be helpful in managing smoking withdrawal symptoms.
- Behavioral Therapy – Nicotine addiction is related to the habitual behaviors (the “rituals”) involved in smoking. Behavior therapy focuses on learning new coping skills and breaking those habits.
- Motivational Therapies – Self-help books and websites can provide a number of ways to motivate yourself to quit smoking. One well known example is calculating the monetary savings. Some people have been able to find the motivation to quit just by calculating how much money they will save. It may be enough to pay for a summer vacation.
Smokeless or spit tobacco is NOT a healthy alternative to smoking
Smokeless tobacco, otherwise known as spit tobacco, is not a safe alternative to smoking cigarettes. It contains the same addictive chemical, nicotine, contained in cigarettes. In fact, the amount of nicotine absorbed from smokeless tobacco can be 3 to 4 times the amount delivered by a cigarette.
What to do if you slip or relapse
Most people try to quit smoking several times before they kick the habit for good, so don’t beat yourself up if you start smoking again. Turn the relapse into a rebound by learning from your mistake. Analyze what happened right before you started smoking again, identify the triggers or trouble spots you ran into, and make a new stop-smoking plan that eliminates them.
It’s also important to emphasize the difference between a slip and a relapse. If you slip up and smoke a cigarette, it doesn’t mean that you can’t get back on the wagon. You can choose to learn from the slip and let it motivate you to try harder or you can use it as an excuse to go back to your smoking habit. But the choice is yours. A slip doesn’t have to turn into a full-blown relapse.
I started smoking again, now what?
Having a small setback doesn’t mean you’re a smoker again. Most people try to quit smoking several times before they kick the habit for good. Identify the triggers or trouble spots you ran into and learn from your mistakes.
- You’re not a failure if you slip up. It doesn’t mean you can’t quit for good.
- Don’t let a slip become a mudslide. Throw out the rest of the pack. It’s important to get back on the non-smoking track now.
- Look back at your quit log and feel good about the time you went without smoking.
- Find the trigger. Exactly what was it that made you smoke again? Decide how you will cope with that issue the next time it comes up.
- Learn from your experience. What has been most helpful? What didn’t work?
- Are you using a medicine to help you quit? Call your doctor if you start smoking again. Some medicines cannot be used if you are smoking at the same time.
<span class=”paragraphSection”><div class=”boxTitle”>Abstract</div><div class=”boxTitle”>Introduction:</div>Under-dosing is a recognized problem with current nicotine replacement therapy (NRT). Therefore, a new 6mg nicotine gum has been developed. To compare the nicotine uptake from the 6mg gum versus currently available NRT products, two pharmacokinetic studies were performed.<div class=”boxTitle”>Methods:</div>In one randomized crossover study, 44 healthy adult smokers received single doses of 6, 4, and 2mg nicotine gum, and 4mg nicotine lozenge on separate occasions. In a separate randomized crossover multiple-dose study over 11 hours, 50 healthy adult smokers received one 6mg gum every hour and 90 minutes, respectively, one 4mg gum every hour, and one 4mg lozenge every hour. In both studies, blood samples were collected over 12 hours to determine single-dose and multiple-dose pharmacokinetic variables.<div class=”boxTitle”>Results:</div>In the single-dose study, the amount of nicotine released from the 2, 4, and 6mg gums (1.44, 3.36, and 4.94mg) as well as the resulting maximum concentration and area under the curve (5.9, 10.1, and 13.8ng/mL, and 17.1, 30.7, 46.2ng/mL × h, respectively) increased with dose. The maximum concentration and area under the curve of the 6mg gum were 44% and 30% greater, respectively, than those for 4mg lozenge. Upon hourly administration, the steady-state average plasma nicotine concentration with 6mg gum (37.4ng/mL) was significantly higher than those for 4mg lozenge (28.3ng/mL) and 4mg gum (27.1ng/mL).<div class=”boxTitle”>Conclusions:</div>Nicotine delivery via the 6mg gum results in higher plasma nicotine concentrations after a single dose and at steady state than with currently available oral NRT.<div class=”boxTitle”>Implications:</div>Under-dosing is a recognized problem with current NRT. Therefore, a new 6mg nicotine gum has been developed. Our studies show that upon single-dose and multiple-dose administration, the 6mg gum releases and delivers more nicotine to the systemic circulation than 2mg gum, 4mg gum, and 4mg lozenge. Thus, each 6mg nicotine gum provides a higher degree of nicotine substitution and/or lasts for a longer period of time than currently available nicotine gums and lozenges.</span>
However bad you thought smoking was, it’s even worse.OK
A new study adds at least five diseases and 60,000 deaths a year to the toll taken by tobacco in the United States. Before the study, smoking was already blamed for nearly half a million deaths a year in this country from 21 diseases, including 12 types of cancer.
The new findings are based on health data from nearly a million people who were followed for 10 years. In addition to the well-known hazards of lung cancer, artery disease, heart attacks, chronic lung disease and stroke, the researchers found that smoking was linked to significantly increased risks of infection, kidney disease, intestinal disease caused by inadequate blood flow, and heart and lung ailments not previously attributed to tobacco.
Even though people are already barraged with messages about the dangers of smoking, researchers say it is important to let the public know that there is yet more bad news.
“The smoking epidemic is still ongoing, and there is a need to evaluate how smoking is hurting us as a society, to support clinicians and policy making in public health,” said Brian D. Carter, an epidemiologist at the American Cancer Society and the first author of an article about the study, which appears in The New England Journal of Medicine. “It’s not a done story.”
In an editorial accompanying the article, Dr. Graham A. Colditz, from Washington University School of Medicine in St. Louis, said the new findings showed that officials in the United States had substantially underestimated the effect smoking has on public health. He said smokers, particularly those who depend on Medicaid, had not been receiving enough help to quit.
About 42 million Americans smoke — 15 percent of women and 21 percent of men — according to the Centers for Disease Control and Prevention. Research has shown that their death rates are two to three times higher than those of people who have never smoked, and that on average, they die more than a decade before nonsmokers. Smokers are more than 20 times as likely as nonsmokers to die of lung cancer. Poorpeople and those with less formal education are the most likely to smoke.
Mr. Carter said he had been inspired to dig deeper into the causes of death in smokers after taking an initial look at data from five large health surveys being conducted by other researchers. The participants were 421,378 men and 532,651 women 55 and older, including nearly 89,000 current smokers.
As expected, death rates were higher among the smokers. But diseases known to be caused by tobacco accounted for only 83 percent of the excess deaths in people who smoked.
“I thought, ‘Wow, that’s really low,’ ” Mr. Carter said. “We have this huge cohort. Let’s get into the weeds, cast a wide net and see what is killing smokers that we don’t already know.”
The research was paid for by the American Cancer Society, and Mr. Carter worked with scientists from four universities and the National Cancer Institute.
The study was observational, meaning that it looked at people’s habits, like smoking, and noted statistical correlations between their behavior and their health. Correlation does not prove a cause-and-effect relationship, so this kind of research is not considered as strong as experiments in which participants are assigned at random to treatments or placebos and then compared. But people cannot ethically be instructed to smoke for a study, so a lot of the data on smoking’s effects on people comes from observational studies.
Analyzing deaths among the participants from 2000 to 2011, the researchers found that, compared with people who had never smoked, smokers were about twice as likely to die from infections, kidney disease, respiratory ailments not previously linked to tobacco, andhypertensive heart disease, in which high blood pressure leads to heart failure. Smokers were also six times more likely to die from a rare illness caused by insufficient blood flow to the intestines.
Mr. Carter said he had confidence in the findings because, biologically, it made sense that those conditions were related to tobacco. Smoking can weaken the immune system, increasing the risk of infection, he said. It is also known to cause diabetes, high blood pressure and artery disease, all of which can lead to kidney problems. Artery disease can also choke off the blood supply to the intestines. Lung damage from smoke, combined with increased vulnerability to infection, can lead to multiple respiratory illnesses.
Two other observations supported the findings, he said. One was that the more heavily a person smoked, the greater the added risks. The second was that among former smokers, the risks diminished over time. In general, such effects, known as a dose response, suggest that an observed correlation is more than a coincidence.
The study also found small increases in the risks of breast and prostate cancer among smokers. Mr. Carter said those findings were not as strong as the others, adding that additional research could help determine whether there were biological mechanisms that would support a connection.
A 2014 report by the surgeon general’s office said the evidence for a causal connection between smoking and breast cancer was “suggestive but not sufficient.” The same report found no evidence that smoking caused prostate cancer, but it noted that in men who did have prostate cancer, smoking seemed to worsen the outcome.
The diseases that had previously been established by the surgeon general as caused by smoking were cancers of the esophagus, stomach, colon, liver, pancreas, larynx, lung, bladder, kidney, cervix, lip and oral cavity; acute myeloid leukemia; diabetes; heart disease; stroke;atherosclerosis; aortic aneurysm; other artery diseases; chronic lung disease; pneumonia; influenza; and tuberculosis.
Smoking is responsible for several diseases, such as cancer, long-term (chronic) respiratory diseases, and heart disease, as well as premature death. Over 480,000 people in the USA and 100,000 in the UK die because of smoking each year. According the US CDC (Centers for Disease Control and Prevention), $92 billion are lost each year from lost productivity resulting from smoking-related deaths.
Of the more than 2.4 million deaths in the USA annually, over 480,000 are caused by smoking.1
Smoking is the largest cause of preventable death in the world. Recent studies have found that smokers can undermine the health of non-smokers in some environments.
In an article published online in Medical News Today on 30 May 2013, we presented data demonstrating that, on average, smokers die ten years sooner than non-smokers.
Smoking causes cancer
Lung cancer is one of the most common causes of cancer deaths in the world. According to the American Lung Association, 90% of male lung cancer patients develop their disease because of smoking. In addition, male smokers are 23 times more likely to develop lung cancer than those who have never smoked. Female smokers are 13 times more likely to develop lung cancer than those who have never smoked.2
In addition to lung cancer, smokers also have a significantly higher risk of developing:
Smoking contributes to 80% of lung cancer deaths in women and 90% of lung cancer deaths in men (American Lung Association).
- Bladder cancer
- Kidney cancer
- Cancers of the pharynx and larynx (throat cancer)
- Mouth cancer
- Esophagus cancer
- Cancer of the pancreas
- Stomach cancer
- Some types of leukemia
- Cancer of the nose and sinuses
- Cervical cancer
- Bowel cancer
- Ovarian cancer
- In some cases, also breast cancer
According to Cancer Research UK, one person dies every 15 minutes in Great Britain from lung cancer.
Smoking also raises the risk of cancer recurrences (the cancer coming back).
Why does smoking raise cancer risk?
Scientists say there are over 4,000 compounds in cigarette smoke. A sizeable number of them are toxic – they are bad for us and damage our cells. Some of them cause cancer – they are carcinogenic.
Tobacco smoke consists mainly of:
- Nicotine – this is not carcinogenic. However, it is highly addictive. Smokers find it very hard to quit because they are hooked on the nicotine. Nicotine is an extremely fast-acting drug. It reaches the brain within 15 seconds of being inhaled. If cigarettes and other tobacco products had no nicotine, the number of people who smoke every day would drop drastically. Without nicotine, the tobacco industry would collapse.Nicotine is used as a highly controlled insecticide. Exposure to sufficient amounts can lead to vomiting, seizures, depression of the CNS (central nervous system), and growth retardation. It can also undermine a fetus’ proper development.
- Carbon Monoxide – this is a poisonous gas. It has no smell or taste. The body finds it hard to differentiate carbon monoxide from oxygen and absorbs it into the bloodstream. Faulty boilers emit dangerous carbon monoxide, as do car exhausts.If there is enough carbon monoxide around you and you inhale it, you can go into a coma and die. Carbon monoxide decreases muscle and heart function, it causes fatigue, weakness, and dizziness. It is especially toxic for babies still in the womb, infants and individuals with heart or lung disease.
- Tar – consists of several cancer-causing chemicals. When a smoker inhales cigarette smoke, 70% of the tar remains in the lungs. Try the handkerchief test. Fill the mouth with smoke, don’t inhale, and blow the smoke through the handkerchief. There will be a sticky, brown stain on the cloth. Do this again, but this time inhale and the blow the smoke through the cloth, there will only be a very faint light brown stain.
We have published another article containing a longer list of harmful chemicals found in cigarette smoke and how they can harm you.
Smoking and heart/cardiovascular disease
Smoking causes an accumulation of fatty substances in the arteries, known as atherosclerosis, the main contributor to smoking-related deaths. Smoking is also a significant contributory factor in coronary heart disease risk. People with coronary heart disease are much more likely to have a heart attack.
Tobacco smoke raises the risk of coronary heart disease by itself. When combined with other risk factors, such as hypertension (high blood pressure), obesity, physical inactivity, or diabetes, the risk of serious, chronic illness and death is huge.
Smoking also worsens heart disease risk factors. It raises blood pressure, makes it harder to do exercise, makes the blood clot more easily than it should. People who have undergone bypass surgery and smoke have a higher risk of recurrent coronary heart disease.
According to the American Heart Association:
“Cigarette smoking is the most important risk factor for young men and women. It produces a greater relative risk in persons under age 50 than in those over 50.”
A female smoker who is also on the contraceptive pill has a considerably higher risk of developing coronary heart disease and strokecompared to women using oral contraceptives who don’t smoke.
If you smoke your levels of HDL, also known as good cholesterol will drop.
If you have a history of heart disease and smoke, your risk of having such a disease yourself is extremely high.
A much higher percentage of regular smokers have strokes compared to other non-smokers of the same age. The cerebrovascular system is damaged when we inhale smoke regularly.
Those who smoke run a higher risk of developing aortic aneurysm and arterial disease.
Recent developments on smoking from MNT news
Research has suggested that babies born to mothers who smoke more than a pack of cigarettes a day while pregnant have lower reading scores and a harder time with reading tests, compared with children whose mothers do not smoke.
Researchers estimating the number of deaths from 12 smoking-related cancers have found that 48.5% of the 346,000 deaths in the US in 2011 were attributable to cigarettes.
A meta-analysis published in the journal Lancet Psychiatry reports that people who smoke are more than three times more likely to suffer from psychosis, compared with nonsmokers.
Exposure to secondhand smoke at 4 months of age is associated with an increased risk of tooth decay at age 3 years, concludes a study published in The BMJ.
BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.
When Woodie Guthrie sang, “Let me go here one more time/And one more time,” he was hoping to recapture a past that had faded away. When we ask you to let us revisit, one more time, the subject of e-cigarettes, we’re hoping to help you capture a better future.
Seems every time we turn around, there’s more bad news about these not-exactly-cigarettes. Now it turns out that the heating coil in your e-cig can covert solvents that carry flavorings and nicotine through the device into very toxic vapes. The hotter the device — and the more you use it — the more toxins it produces.
An international group of researchers found propylene glycol, glycerin, nicotine, ethanol, acetol and propylene oxide were in three refill e-liquids they tested. Propylene oxide is a possible carcinogen and respiratory irritant, and the aerosols that the device generates from these ingredients include a previously unidentified carcinogen and many powerful irritants.
This toxic plume is most present in single coil devices. It seems they overheat more than double coils and produce more toxins. In any case, reusing the device without cleaning it also ramps up toxin emissions more than 60 percent!
If you’ve been smoking tobacco for 20 years and you think that moving to an e-cig is going to spare you from exposure to carcinogens, think again. We suggest finding a quit-smoking buddy or a support group online or in your locale, and trying a nicotine patch and an anti-craving pill. And clearly, if you have never smoked, don’t try these vaporizers!
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into “The Dr. Oz Show” or visit www.sharecare.com.
BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.
The Roman scholar Pliny wrote in “Natural History”: “Contact with the monthly flux of women turns new wine sour, makes crops wither, kills grafts, dries seeds in gardens, causes the fruit of trees to fall off, dims the bright surface of mirrors”… and it goes on and on. But while we’re able to dismiss such unscientific hogwash, modern science is discovering that a woman’s menstrual cycle does have a profound influence on her wellbeing and can even be used to help her stop smoking!
A new study published in the Biology of Sex suggests that the reason women have a harder time stopping smoking than men do is because they try to give it up at the wrong time of the month! Researchers found that from day 1 until ovulation, when levels of the hormone progesterone are low, women are apt to have heightened brain activity that stimulates the desire for reward and cigarette cravings increase. That may also be why quitters relapse more often during that time. But in the days after ovulation until the next period, it appears women may be more likely to quit smoking successfully; higher progesterone levels may reduce cravings.
More research needs to be done, but in the meantime, if you’re a woman and you are struggling to quit smoking, this is one more trick to try! And whether it works for you because the findings reflect how YOUR body works, or as a placebo, who cares? The important thing is that you stop smoking. For more tips, check out www.sharecare.com.
Mehmet Oz, M.D. is host of “The Dr. Oz Show,” and Mike Roizen, M.D. is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. To live your healthiest, tune into “The Dr. Oz Show” or visit www.sharecare.com.
<span class=”paragraphSection”><div class=”boxTitle”>Abstract</div><div class=”boxTitle”>Introduction:</div>Numerous studies have characterized impaired cerebral functioning in nicotine-addicted individuals. Whereas nicotine interacts with multiple neurotransmitters in cortical and subcortical circuits, it directly targets the cholinergic system, sourced primarily from the basal nucleus of Meynert (BNM). However, no studies have examined how this cholinergic system is influenced by cigarette smoking. Here, we addressed this gap of research.<div class=”boxTitle”>Methods:</div>Using a dataset from the Functional Connectome Projects, we investigated this issue by contrasting seed-based BNM connectivity of 40 current smokers and 170 age- and gender-matched nonsmokers. We followed our data analytic routines in recent work and examined differences between smokers and nonsmokers in men and women combined as well as separately.<div class=”boxTitle”>Results:</div>Compared to nonsmokers, female but not male smokers demonstrated greater positive BNM connectivity to the supplementary motor area, bilateral anterior insula, and right superior temporal/supramarginal gyri as well as greater negative connectivity to the posterior cingulate cortex and precuneus. Further, BNM connectivity to the supplementary motor area is negatively correlated to the Fagerström Test for Nicotine Dependence score in male but not female smokers.<div class=”boxTitle”>Conclusions:</div>Along with a previous report of upregulated nicotinic acetylcholine receptor in male but not female smokers, these new findings highlight functional changes of the cholinergic systems in cigarette smokers. The results suggest sex-specific differences in cholinergic dysregulation and a need for multiple imaging modalities to capture the neural markers of nicotine addiction.<div class=”boxTitle”>Implications:</div>Nicotine influences cognition via cholinergic projections of the basal forebrain to the cerebral cortex. This study examined changes in resting-state whole-brain functional connectivity of the BNM in cigarette smokers. The new findings elucidate for the first time sex differences in BNM–cerebral connectivity in cigarette smoking.</span>