Xavier Medical
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Cigarette Smoking and Cancer

The 1982 Surgeon General's Report states that "Cigarette smoking is the major single cause of cancer mortality in the United States." This statement is as true today as it was in 1982. Because cigarette smoking and tobacco use is an acquired behavior, one that the individual chooses to do, smoking is the most preventable cause of premature death in our society. Yet, 47 million adults (25 million men and 22 million women) were current smokers in 1999. According to the American Cancer Society's Cancer Prevention Study II, it is estimated that 430,700 US deaths per year (nearly one in five) were attributed to smoking from 1990-1994. Cigarettes kill more Americans than alcohol, car accidents, suicide, AIDS, homicide, and illegal drugs. 
Cigarette smoking is a major cause of cancers of the lung, larynx, oral cavity, pharynx and esophagus and is a contributing cause in the development of cancers of the bladder, pancreas, uterine cervix, kidney, stomach, and some leukemias. About 87% of lung cancer deaths are caused by smoking. Lung cancer is one of the most difficult cancers to treat. It is very difficult to detect when it is in the earliest, most treatable stage. Fortunately, lung cancer is largely a preventable disease. Groups that advocate nonsmoking as part of their religion, such as Mormons and Seventh-day Adventists, have much lower rates of lung cancer and other smoking-related cancers. 

Smoking is a major cause of heart disease, bronchitis, emphysema, and stroke and contributes to the severity of colds and pneumonia. Tobacco has a damaging affect on women's reproductive health and is associated with increased risk of miscarriage, preterm delivery, stillbirth, and infant death, and is a cause of low birth weight in infants. Furthermore, the smoke from cigarettes has a harmful health effect on those around the smoke. (See the American Cancer Society documents "Secondhand Smoke" and "Women and Smoking.") 
Ingredients in tobacco: Cigarettes, cigars, and smokeless and pipe tobacco consist of dried tobacco leaves, as well as ingredients added for flavor and other properties. More than 4,000 individual compounds have been identified in tobacco and tobacco smoke. Among these are about 43 compounds that are carcinogens. 
The effects of burning the additives used in cigarettes are not well understood. Substances that seem harmless or even beneficial when eaten as food can have entirely different effects when burned and breathed as smoke. 
Nicotine addiction: Addiction is characterized by the repeated, compulsive seeking or use of a substance despite harmful consequences. Addiction is often accompanied by adverse physical and psychological dependence on the substance. Nicotine is the addictive drug in tobacco. Regular use of tobacco products leads to addiction in a high proportion of users. 
In 1988, the US Surgeon General concluded the following on nicotine addiction: 
▪   Nicotine is the drug in tobacco that causes addiction.
▪   Cigarettes and other forms of tobacco are addicting.
▪   The pharmacologic and behavioral processes that determine tobacco addiction are similar to those that determine addiction to drugs such as heroin and cocaine.
Nicotine is found in substantial amounts in all forms of tobacco. It is absorbed readily from tobacco smoke in the lungs and from smokeless tobacco in the mouth or nose and rapidly spreads throughout the body. 
Tobacco companies are required by law to report nicotine levels in cigarettes to the Federal Trade Commission (FTC) but are not required to show the amount of nicotine on the cigarette brand labeling. The actual amount of nicotine available to the smoker in a given brand of cigarettes may be different from the level reported to the FTC.

In September 1990, the US Surgeon General outlined the benefits of smoking cessation: 
▪  People who quit, regardless of age, live longer than people who continue to smoke.
▪  Smokers who quit before age 50 have half the risk of dying in the next 15 years compared with                    those who continue to smoke.
▪  Quitting smoking substantially decreases the risk of cancer of the lung, larynx, pharynx,                            esophagus, mouth, pancreas, bladder, and cervix.
▪  Benefits of cessation include risk reduction for other major diseases including coronary heart disease,         lung diseases, and cardiovascular disease.
The risk of having lung cancer and other smoking-related cancers is related to total lifetime exposure to cigarette smoke, as measured by the number of cigarettes smoked each day, the age at which smoking began, and the number of years a person has smoked. 
The risk increases steadily with the number of cigarettes smoked per day. In those who smoke 40 or more cigarettes a day (2 or more packs), the risk of lung cancer is nearly 20 times the risk in nonsmokers. 
The risk of having lung cancer and other cancers can be reduced by quitting. The risk of lung cancer is less in people who quit smoking than in people who continue to smoke the same number of cigarettes per day, and the risk decreases as the number of years since quitting increases. 

Benefits of Smoking Cessation (stopping smoking):