Health Effects Of Cigarette Smoking Research Articles

Health care expenditures attributable to smoking in military veterans.

The health effects of cigarette smoking have been estimated to account for between 6%-8% of U.S. health care expenditures. We estimated Veterans Health Administration (VHA) health care costs attributable to cigarette smoking. VHA survey and administrative data provided the number of Veteran enrollees, current and former smoking prevalence, and the cost of 4 types of care for groups defined by age, gender, and region. Cost and smoking status could not be linked at the enrollee level, so we used smoking attributable fractions estimated in sample of U.S. residents where the linkage could be made. The 7.7 million Veterans enrolled in VHA received $40.2 billion in VHA provided health services in 2010. We estimated that $2.7 billion in VHA costs were attributable to the health effects of smoking. This was 7.6% of the $35.3 billion spent on the types of care for which smoking-attributable fractions could be determined. The fraction of inpatient costs that was attributable to smoking (11.4%) was greater than the fraction of ambulatory care cost attributable to smoking (5.3%). More cost was attributable to current smokers ($1.7 billion) than to former smokers ($983 million). The fraction of VHA costs attributable to smoking is similar to that of other health care systems. Smoking among Veterans is slowly decreasing, but prevalence remains high in Veterans with psychiatric and substance use disorders, and in younger and female Veterans. VHA has adopted a number of smoking cessation programs that have the potential for reducing future smoking-attributable costs.

Tobacco in the 21st century.

1. Karen M. Wilson, MD, MPH* 1. *Children’s Hospital Colorado, University of Colorado School of Medicine and Dentistry, Aurora, CO. * Abbreviations: CEASE: : Clinical Effort Against Secondhand Smoke Exposure FDA: : Food and Drug Administration NRT: : nicotine replacement therapy SHS: : secondhand smoke SIDS: : sudden infant death syndrome Although there is increasing understanding that cigarette smoking and secondhand smoke exposure are significant health risks to children, adolescents continue to start smoking, and children are still exposed to secondhand smoke. To add to this, companies are finding more novel ways to market tobacco products, including electronic cigarettes and dissolvable tobacco products. Pediatricians should understand the consequences of tobacco smoke exposure and the use of emerging products and be able to screen and counsel families about their exposure. After completing this article, readers should be able to: 1. Identify the prevalence of secondhand smoke exposure among children in the United States. 2. Describe the health effects of cigarette smoking. 3. Understand the effects of secondhand smoke on children’s health and behavior. 4. Describe the role of the pediatrician in helping parents quit smoking and how to help parents access pharmacotherapy. 5. Understand the effect and use of noncigarette tobacco products. Eliza is a 5-year-old girl whose mother brings her to the office for wheezing. She has been coughing and having some upper respiratory tract congestion for 3 days, but this morning she developed increased wheezing and shortness of breath. Her mother has been giving her albuterol, which hasn’t seemed to help. She has a diagnosis of asthma and is taking an inhaled corticosteroid, which her mother says she has been using twice a day via a spacer, as directed at her last visit. Eliza was hospitalized at age 8 months with bronchiolitis, and since then she has been to the emergency department 6 times for exacerbations. She had to be hospitalized once but not in the intensive care unit. She has no other medical problems aside from …

Economic cost of smoking in people with mental disorders in the UK

BackgroundSmoking is the largest preventable cause of death in the UK and imposes a huge economic burden on society. Both the prevalence and extent of smoking are significantly higher among...

The costs of smoking and secondhand smoke exposure in Taiwan: a prevalence-based annual cost approach

ObjectivesTo assess the costs of the health effects of cigarette smoking and secondhand smoke (SHS) exposure to society.DesignPrevalence-based, disease-specific cost-of-illness study. We used an epidemiological population-attributable risk method to determine...

The 2014 Surgeon General's Report: Commemorating the 50th Anniversary of the 1964 Report of the Advisory Committee to the US Surgeon General and Updating the Evidence on the Health Consequences of Cigarette Smoking

The question of whether cigarette smoking was associated with lung cancer was central to the expansion of epidemiology into the study of chronic diseases in the 1950s. The culmination of this era was the 1964 report of the Advisory Committee to the Surgeon General, a landmark document that included an objective synthesis of the evidence of the health consequences of smoking according to causal criteria. The report concluded that cigarette smoking was a cause of lung cancer in men and sufficient in scope that "remedial action" was warranted at the societal level. The 2014 Surgeon General's report commemorates the 50th anniversary of the 1964 report. The evidence on the health consequences of smoking has been updated many times in Surgeon General's reports since 1964. These have summarized our increasingly greater understanding of the broad spectrum of the deleterious health effects of exposure to tobacco smoke across most major organ systems. In turn, this evidence has been translated into tobacco control strategies implemented to protect the public's health. The Surgeon General report process is an enduring example of evidence-based public health in practice. Substantial progress has been made, but cigarette smoking remains one of the most pressing global health issues of our time.

The Prevalence of Cigarette Smoking and Knowledge of Its Health Implications among Adolescents in Owerri, South-Eastern Nigeria

Despite the growing problem of global cigarette use, accurate information on the prevalence and pattern in Nigerian adolescents’ remains sparse. The aim of this study was to determine the prevalence of cigarette smoking among in-school male adolescents in Nigerian population and to assess their level of knowledge on the health effects of cigarette smoking. A descriptive cross-sectional study was carried out among 944 randomly selected in-school male adolescents in Owerri, south-east Nigeria, between September and November 2013. Information was obtained using a self-administered questionnaire. The findings indicated a prevalence of 15.3% for ever smoked adolescents and 11.2% for current smokers. The mean age at cigarette smoking initiation was 14 years. Sixty-three percent had good knowledge of health problems associated with cigarette smoking. Lung cancer was the most reported associated health problem. Fifty-two (36.1%) indicated that they were initiated by their friends who offered them their first stick of cigarette. The major reason for smoking cigarette the first time was to be like their friends/role model and out of curiosity. Poor knowledge of health effects of smoking was statistically associated with cigarette smoking (X2 = 26.82, p-value < 0.001). Knowledge of health problems associated with smoking proved to be the major reason for not smoking by never smoked adolescents, which means that awareness creation on health problems associated with cigarette smoking through health education in schools coupled with stiff legislative ban on sale of cigarette to adolescents will, to a reasonable extent, reduce the high prevalence of adolescent cigarette smoking in our society.

The Lived Experience of Smoking in Pregnancy

Smoking in pregnancy is associated with adverse pregnancy outcomes, such as low birth weight, preterm birth, and perinatal death. Despite widespread public awareness of the deleterious health effects of cigarette smoking, up to a quarter of women in developed countries smoke during their pregnancies. In this hermeneutic phenomenological study, the meaning and experience of smoking in pregnancy were explored. Data were collected through interviews with eight pregnant women from the Canadian province of Newfoundland and Labrador. Four main themes were identified in the participants’ stories, namely living in a smoking world, suddenly finding myself on a moral low road, navigating my own way to a high road, and not preparing for postpartum smoking pitfalls. Smoking was perceived to be salubrious and the participants painted a picture of dealing with smoking in pregnancy as a daunting, lonely endeavor that required life-altering solutions. With a better understanding of what smoking means to pregnant women who smoke, nurses can help these women forge a new and lifelong way to health and wellness.

Softening of monthly cigarette use in youth and the need to harden measures in surveillance

ObjectiveTo assess changes in monthly smoking in its relationship to daily smoking and heavier smoking in high school seniors. Public health agencies often report only “current use” of cigarettes among youth as any use in the past 30days, even though additional measures are collected. Monthly use is a crude and changing indicator. MethodsResults from 1975 to 2013 from Monitoring The Future Project were plotted and analyzed by linear regression. ResultsFrom 1975 to 2013, the percentage of monthly smokers who smoked daily decreased by 29% (21.2 percentage points) and monthly smokers who smoked 10+ cigarettes/day dropped by 57% (28 percentage points); the percentage of daily smokers who smoked 10+ cigarettes/day decreased by 40% (26.5 percentage points). ConclusionAdditional measures of frequency and intensity of use of cigarettes and other tobacco/nicotine products need to be more regularly reported. These results indicate softening rather than hardening of “current smoking” and have important implications for tobacco surveillance and for tobacco research because of a) increased likelihood of quitting smoking, b) health effects of cigarette smoking, and c) similar and interacting issues related to measuring the use of all tobacco/nicotine products.

The impact of smoking in adolescence on early adult anxiety symptoms and the relationship between infant vulnerability factors for anxiety and early adult anxiety symptoms: the TOPP Study.

Cigarette smoking is increased in people with trait anxiety and anxiety disorders, however no longitudinal data exist illuminating whether smoking in adolescence can influence the developmental trajectory of anxiety symptoms from early vulnerability in infancy to adult anxiety expression. Using The Tracing Opportunities and Problems in Childhood and Adolescence (TOPP) Study, a community-based cohort of children and adolescents from Norway who were observed from the age of 18months to age 18–19years, we explored the relationship between adolescent smoking, early vulnerability for anxiety in infancy (e.g. shyness, internalizing behaviors, emotional temperaments) and reported early adult anxiety.Structural equation modeling demonstrated that adolescent active smoking was positively associated with increased early adulthood anxiety (β = 0.17, p<0.05), after controlling for maternal education (proxy for socioeconomic status). Adolescent anxiety did not predict early adult smoking. Adolescent active smoking was a significant effect modifier in the relationship between some infant vulnerability factors and later anxiety; smoking during adolescence moderated the relationship between infant internalizing behaviors (total sample: active smokers: β = 0.85,p<0.01, non-active smokers: ns) and highly emotional temperament (total sample: active smokers: β = 0.55,p<0.01,non-active smokers: ns), but not shyness, and anxiety in early adulthood. The results support a model where smoking acts as an exogenous risk factor in the development of anxiety, and smoking may alter the developmental trajectory of anxiety from infant vulnerability to early adult anxiety symptom expression. Although alternative non-mutually exclusive models may explain these findings, the results suggest that adolescent smoking may be a risk factor for adult anxiety, potentially by influencing anxiety developmental trajectories. Given the known adverse health effects of cigarette smoking and significant health burden imposed by anxiety disorders, this study supports the importance of smoking prevention and cessation programs targeting children and adolescence.

Enhancing the Effectiveness of Smoking Cessation Interventions: A Cancer Prevention Imperative

The emergence of the epidemic of tobacco addiction, primarily to cigarette smoking, in the United States and other developed nations in the first half of the 1900s was a global public health tragedy of untoward proportions. After the deleterious health effects of cigarette smoking began to be recognized, a major public health accomplishment was the success of tobacco control efforts in initiating a turnaround in the epidemic. In the United States, the prevalence of current smokers was reduced by 55% (from 42% to 19%) between 1965 and 2010 (1).

Is the cellular response to cigarette smoke predictive of the phenotypic variation of COPD?

The adverse health consequences of cigarette smoking are not limited to the lung but also include effects on multiple other organ systems that are exposed directly or indirectly to the hazardous gaseous and soluble compounds generated by burning tobacco. Cigarette smoking (CS) is a risk factor for many major diseases including chronic obstructive pulmonary disease (COPD), atherosclerosis, cerebral and coronary vascular diseases, hypertension, and many types of cancer. Within the diagnosis category of COPD, it is widely recognized that there is substantial phenotypic heterogeneity with respect to both pulmonary and extrapulmonary manifestations. To understand the variability in responses to CS, it becomes essential to decipher the involved mechanisms at a cellular and molecular level that contribute to cigarette-related pathology. In this issue of the Journal, there are three papers (1, 4, 6) that provide insight regarding the molecular pathogenesis of CS-related COPD that could be related to phenotypic variation, by examining three classes of cell types of lung: endothelial cells, epithelial cells, and immune effector cells.

Review of alternative practices to cigarette smoking and nicotine replacement therapy: how safe are they?

Most adverse health effects of cigarette smoking are attributed to the products of combustion. Efforts to avoid the adverse health effects of cigarette smoking have led to the promotion of alternative products that are perceived to be less harmful. In this paper, we review the available literature for evidence of the effectiveness of the products commonly presented as alternatives to cigarette smoking, and discuss evidence-based information on whether they should be promoted as safe alternatives for long-term use or are effective as cessation aid. Water pipe smoking is becoming prevalent among young people and the electronic cigarette has been recently introduced as smoking alternative in smoke-free areas. Available limited data suggest that while smokers may perceive these alternatives as safer than cigarette smoking, they contain toxic substances and therefore are not harmless alternatives. Data on herbal products are not easily available and where they are, evidence shows that these products are also not effective alternatives. Smokeless tobacco products vary in composition and health effects worldwide. The available literature suggests that these products may be associated with adverse health outcomes and that they cannot be promoted as ‘safe’ alternative tobacco products. Nicotine replacement therapy (NRT) formulations, such as chewing gums and skin patches, have been well studied and evidence suggests that all forms are effective smoking cessation aids, either used alone and in combination with other NRT or cessation medication and behavioural therapy. Primary care physicians should therefore only offer NRT to smokers who are willing to quit in combination with behavioural therapy or other cessation medications approved by the South African Medicines Control Council.

Pilot study of inducing smoking cessation attempts by activating a sense of looming vulnerability

Despite widespread knowledge of the negative health consequences of cigarette smoking, in 2007 a majority (60%) of daily smokers in the USA did not make a quit attempt lasting at least 24 h. Drawing on Riskind's looming cognitive vulnerability model of anxiety, we developed a guided imagery induction intended to increase smokers' perceived susceptibility to the consequences of continued smoking and thereby to increase quit attempts. In a pilot study of this induction, 72 adult daily smokers were randomly assigned to the looming imagery condition or to a control condition exposed to guided imagery that did not concern smoking or its dangers. Those in the looming condition reported significantly higher state anxiety and highly accessible negative outcome expectancies for smoking immediately after the induction, and a significantly lower smoking rate in the month after the experiment. Nonsignificant trends favored the looming condition also for increasing contemplation of quitting, self-efficacy for abstaining from cigarettes, intrinsic motivation to quit as a function of health concerns, and most importantly the likelihood of making a quit attempt in the month following the experiment. Further development and testing of the looming induction as a way to motivate quit attempts is warranted.

Attitudes of Italian dental and dental hygiene students toward tobacco‐use cessation

The aim of this study was to investigate the smoking habits of Italian dental and dental hygiene students and to assess their knowledge on the health effects of cigarette smoking and their attitudes toward tobacco-use cessation (TUC) in dental practice. Data was collected from 220 students attending the Dental and Dental Hygiene Schools (DS and DHS, respectively) at the University of Palermo (Italy). The percentage of smokers amongst DS and DHS students was similar (32.78% vs. 32.5%) with 67.77% of DS students and 77.5% of DHS agreeing that the damages to health caused by smoking were covered in their didactic course work. A high percentage of DS (63.33%) and DHS (67.5%) students reported the relationship between smoking and a number of associated health conditions. Both DS and DHS students showed poor knowledge of TUC interventions. Both DS and DHS students reported to be conscious of their own role as a counsellor, with DHS students feeling more comfortable in approaching counselling in clinical practice. Although DS and DHS students reported a positive attitude toward TUC interventions, almost half of the students had some concerns about the effectiveness of smoking cessation activities. The introduction of a comprehensive tobacco education curriculum in DS and DHS programs could further improve students' perceptions and attitudes and provide knowledge and clinical experience which would lead to the incorporation of TUC into subsequent professional practice.

The Effects of Beliefs About the Health Consequences of Cigarette Smoking on Smoking Onset

Nearly all Americans now recognize that smoking causes lung cancer and other serious diseases; however, cigarette smoking has not yet been eradicated in this country. This might be taken as evidence that beliefs about the health risks of smoking do not influence smoking onset or quitting. In this paper, we report new evidence that perceiving smoking to entail greater health risks reduces the likelihood that a young person will begin to smoke. This evidence suggests that public health campaigns should continue to focus on this theme to bolster resistance to smoking onset among young people.

Cigarette Smoking and Fat Distribution in 21, 828 British Men and Women: A Population‐based Study

To examine the relationship between cigarette smoking habits and fat distribution in a population-based cohort of men and women. We analyzed cross-sectional data from 21,828 men and women who were 45 to 79 years of age, residents in Norfolk, United Kingdom, and were recruited between 1993 and 1997. Cigarette smoking habits and other lifestyle factors were assessed using self-reported questionnaires. Anthropometric measures were obtained during a health examination. Waist-hip ratio was highest among current smokers and least among never smokers after adjusting for age, BMI, alcohol intake, total energy intake, physical activity, and education. Higher waist-hip ratio was directly associated with higher smoking pack-years in current and former smokers and inversely with duration since quitting smoking in former smokers. Adjusting for age, BMI, and other covariates, current smokers had higher waist circumference but lower hip circumference compared with former or never smokers. Cigarette smoking habits seem to influence fat distribution patterns. Although smokers have lower mean BMI compared with nonsmokers, they have a more metabolically adverse fat distribution profile, with higher central adiposity. The explanation for this association may help elucidate the mechanisms underlying the adverse health consequences of cigarette smoking and abdominal obesity.

Adverse effects of cigarette smoking during pregnancy : review article

Extracted from text ... REVIEW Obstetrics & Gynaecology Forum - 12 Adverse effects of cigarette smoking during pregnancy Smoking of cigarettes is a major health problem. This habit is causing the death of about 5 million people per year.1 More than 4000 chemicals, of which at least 60 are known carcinogens, are contained in the smoke from tobacco in cigarettes. The most harmful components are nicotine and carbon monoxide. Nicotine is highly addictive, since it can cause both stimulation and euphoria. 2-4 Outside pregnancy the most common general adverse health effects of cigarette smoking are lung cancer, heart disease, atherosclerotic vascular disease, ..

Predictors of health functioning in two high-risk groups of smokers

The relative and combined health effects of cigarette smoking, heroin use, and depression were examined in 322 clinically depressed smokers and 117 opioid-dependent smokers participating in two studies of the San Francisco Treatment Research Center. Opioid-dependent smokers averaged 16 years (S.D. = 9) of heroin use; 3% of depressed smokers used opiates in the past 6 months. Cigarettes per day ( M = 15, S.D. = 10) and Beck Depression (BDI-II) scores ( M = 21, S.D. = 11) were comparable between the two groups. Health functioning was assessed using the Medical Outcomes Study Short Form ( SF-36). Adjusting for demographic differences, depressed smokers reported better physical but poorer emotional health relative to opioid-dependent smokers. Both groups scored significantly lower than published norms ( p < .05). Within groups, severity of depressive symptoms, tobacco use, and opiate use were independent predictors of lower health functioning ( p < .05). Examining risk-related subgroups based on depression scores (BDI-II ≥ 20), cigarettes per day (≥1 pack), and opiate use, number of risk factors was monotonically related to health functioning in both samples. Individuals with two or more risk factors scored the lowest ( p < .05). Severity of depressive symptoms, tobacco use, and opiate use contributed individually and collectively to lower health functioning. Blended treatments that target multiple risk factors are needed to improve health outcomes.

Harmful health effects of cigarette smoking.

This is a comprehensive review on the harmful health effects of cigarette smoking. Tobacco smoking is a reprehensible habit that has spread all over the world as an epidemic. It reduces the life expectancy among smokers. It increases overall medical costs and contributes to the loss of productivity during the life span. Smoking has been shown to be linked with various neurological, cardiovascular, and pulmonary diseases. Cigarette smoke not only affects the smokers but also contributes to the health problems of the non-smokers. Exposure to environmental tobacco smoke contributes to health problems in children and is a significant risk factor for asthma. Cigarette smoke contains several carcinogens that alter biochemical defense systems leading to lung cancer.

Cigarettes: A Growing Problem for Taiwanese Adolescents

An alarming number of Taiwanese teenagers continue to smoke despite the adverse health consequences of cigarette smoking. This research review describes the prevalence and onset of smoking behavior among Taiwanese adolescents and analyzes the risk factors contributing to smoking initiation. The findings of this review suggest that health educators need to target high-risk groups before they initiate smoking. High-risk groups are those who have poor school achievement, have an external locus of control, have a prosmoking attitude, know others who smoke, and are from low socioeconomic status families. These risk factors support the need for nurses to implement an effective smoking prevention program for adolescents.